这是一篇由丁香园战友ginnyran翻译的文章，写的是一位美国护士，第一次遇到Condition A....后写的感受。

这是原文：
                 Perhaps Death Is Proud; More Reason to Savor Life
By THERESA BROWN
Published: September 8, 2008

At my job, people die.
That’s hardly our intention, but they die nonetheless.

Usually it’s at the end of a long struggle — we have done everything modern medicine can do and then some, but we can’t save them. Some part of their body, usually their lungs or their heart or their liver, has become too frail to function. These are the “good deaths,” the ones where the family is present and knows what to expect. Like all deaths, these deaths are difficult, but they are controlled, unsurprising, anticipated.

And then there are the other deaths: quick and rare, where life leaves a body in minutes. In my hospital these deaths are “Condition A’s.” The “A” stands for arrest, as in cardiac arrest, as in this patient’s heart has all of a sudden stopped beating and we need to try to restart it.

I am a new nurse, and recently I had my first Condition A. My patient, a particularly nice older woman with lung cancer, had been, as we say, “fine,” with no complaints but a low-grade fever she’d had off and on for a couple of days. She had come in because she was coughing up blood, a problem we had resolved, and she was set for discharge that afternoon.

After a routine assessment in the morning, I left her in the care of a nursing student and moved on to other patients, thinking I was going to have a relatively calm day. About half an hour later an aide called me: “Theresa, they need you in 1022.”

I stopped what I was doing and walked over to her room. The nurse leaving the room said, “She’s spitting up blood,” and went to the nurses’ station to call her doctor.

Inside the room I found my patient with blood spilling uncontrollably from her mouth and nose. I remembered to put on gloves, and the aide handed me a face shield. I moved closer; I put my hand on her shoulder. “Are you in any pain?” I asked, as I recall, thinking that an intestinal bleed would be more fixable than whatever this was. She shook her head no.

I looked in her eyes and saw ... what? Panic? Fear? The abandonment of hope? Or sheer desperation? Her own blood was gurgling in her throat and I yelled to the student for a suction tool to clear it out.

The patient tried to stand up so the blood would flow into a nearby trash can, and I told her, “No, don’t stand up.” She sat back down, started shaking and then collapsed backward on the bed.

“Is it condition time?” asked the other nurse.

“Call the code!” I yelled. “Call the code!”

The next few moments I can only describe as surreal. I felt for a pulse and there wasn’t one. I started doing CPR. On the overhead loudspeaker, a voice called out, “Condition A.”

The other nurses from my floor came in with the crash cart, and I got the board. Doing CPR on a soft surface, like a bed, doesn’t accomplish much; you need a hard surface to really compress the patient’s chest, so every crash cart has a two-by-three-foot slab of hard fiberboard for just this purpose. I told one of the doctors to help pick her up so I could put the board under her: she was now dead weight, and heavy.

I kept doing CPR until the condition team arrived, which seemed to happen faster than I could have imagined: the intensivists — the doctors who specialize in intensive care — the I.C.U. nurses, the respiratory therapists and I’m not sure who else, maybe a pulmonologist, maybe a doctor from anesthesia.

Respiratory took over the CPR and I stood back against the wall, bloody and disbelieving. My co-workers did all the grunt work for the condition: put extra channels on her IV pump, recorded what was happening, and every now and again called out, “Patient is in asystole again,” meaning she had no heartbeat.

They worked on her for half an hour. They tried to put a tube down her throat to get her some oxygen, but there was so much blood they couldn’t see. Eventually they “trached” her, put a breathing hole through her neck right into her trachea, but that filled up with blood as well.

They gave her fluids and squeezed bags of epinephrine into her veins to try to get her heart to start moving. They may even have given her adenosine, a dangerous and terrifying drug that can reverse abnormal heart rhythms after briefly stopping the patient’s heart.

The sad truth about a true cardiac arrest is that drugs cannot help because there is no cardiac rhythm for them to stimulate. The doctors tried anyway. They went through so many drugs that the crash cart was emptied out and runners came and went from pharmacy bringing extras.

When George Clooney and Juliana Margulies went through these routines on “E.R.,” it seemed exciting and glamorous. In real life the experience is profoundly sad. In the lay vernacular of Hollywood, asystole is known as “flatlining.” But my patient never had the easy narrative of the normal heartbeat that suddenly turns straight and horizontal. Her heartbeat line was wobbly and unformed, occasionally spiked in a brief run of unsynchronized beats, and at times looked regular, because chest compressions from CPR can create what looks like a real cardiac rhythm even though the patient is dead.

And my patient was dead. She had been dead when she fell back on the bed and she stayed dead through all the effort to save her, while blood and tissue bubbled out of her and the suction clogged with particles spilling from her lungs. Everyone did what she knew how to do to save her. She could not be saved.

The reigning theory was that part of her tumor had broken off and either ruptured her pulmonary artery or created a huge blockage in her heart. Apparently this can happen without warning in lung cancer patients. Only an autopsy could tell for sure, and in terms of the role I played in all this, it doesn’t matter. I did the only thing I could do — all of us did — and you can’t say much more than that.

I am 43. I came to nursing circuitously, following a brief career as an English professor. Often at work in the hospital I hear John Donne in my head:

Death be not proud, though some have called thee

Mighty and dreadful, for thou art not so.

But after my Condition A I find his words empty. My patient died looking like one of the flesh-eating zombies from “28 Weeks Later,” and indeed in real life, even in the world of the hospital, a death like this is unsettling.

What can one do? Go home, love your children, try not to bicker, eat well, walk in the rain, feel the sun on your face and laugh loud and often, as much as possible, and especially at yourself. Because the only antidote to death is not poetry, or drama, or miracle drugs, or a roomful of technical expertise and good intentions. The antidote to death is life.

Theresa Brown is a staff nurse at a hospital in Pennsylvania.
以下是译文：

    我的工作总是与死亡有关。尽管我们并不想如此，但我们无法阻止死亡。

    死亡通常要经历漫长的过程－我们用尽所有的现代医疗手段，但依然救不了他们。他们身体的某些部分（通常是肺、心或肝脏）逐渐衰竭。这些都是“没有遗憾的死亡”，这些患者的家人都在身边，知道会发生什么。跟所有的死亡一样，这类死亡也难以让人接受，不过它们是可控的、意料之中的、有思想准备的。

    但还有其他一些死亡：仓促而罕见，几分钟之内生命就消失不见。在我所在的那家医院，我们把这种死亡称为“A级情况”。“A”表示停止，就像心跳骤停，患者的心脏突然停搏，我们需要尽力恢复其心跳。

    我是一名新护士，最近我遇到了我的首次A级情况。我的患者是一位非常和蔼的老太太，患有肺癌，状况“良好”（像我们通常所说），除了几天来断断续续的低烧外没有其他不适症状。她入院是因为咳血，我们解决了这个问题，她正准备当天下午出院。

    进行完上午的常规检查，我把她交给一位实习护理，然后去检查其他患者，想着我将渡过相对平静的一天。大约半小时后，一位助手呼叫我：“特蕾莎，1022室需要你。”

    我停下手头上的工作，赶去她的房间。护士离开房间的时候说，“她一直吐血，”然后她去了护士站呼叫主治医生。

    在房间里，我发现病人的口鼻不停地流血。我记得戴上了手套，助手递给我一个面罩。我靠近病人；用手扶助她的肩膀。“你觉得哪儿疼吗？”我问她，因为我记得肠道出血比目前这种情况容易处理。她摇摇头表示不。

    我望着她的眼睛，看到了…什么？恐慌？害怕？放弃希望？或者完全的绝望？她的血从喉咙里汩汩的冒出来，我大声叫实习生拿吸引器清除血液。

    病人试图站起来，好使血液可以流进附近一个垃圾桶里，我告诉她，“不，不要站起来。”她坐回去，开始抖动，然后向后倒在床上。

 “ 出现A级情况了吗？”另一位护士问。
 “进行呼叫!”我喊道。“进行呼叫!”

   接下来的时间里，我感觉像做梦。我感觉到她的脉搏，而事实上并没有。我开始实施CPR。头顶上方的扩音器，一个声音叫道，“ A级紧急情况”。

    该楼层的其他护士推着急救车拥进来，因此我获得一块硬板。在软地方（比如说床）做CPR，效果很差；你需要一个硬面才能真正按压病人的胸腔，所以每个急救车都有一个2*3英尺的硬纤维板做此用途。我请一位医生帮忙将病人抬起来，这样我好将木板放在她身下：现在她没有感觉，很重。

    急救小组到来之前我一直在进行CPR，急救小组的行动速度比我想象的要快：重症护理人员（擅长重症护理的医生）、重症监护室护士、呼吸专家及其他我叫不上来的人员，可能是肺科医生，也可能是麻醉医生。

    呼吸机接替了心肺复苏，我靠在墙上，满身血污，难以置信。我的同事全权处理了急救过程的所有琐碎事情：在病人的静脉输液泵上另开一个液路、记录病人状况、时不时的喊道，“心脏再次停搏，”意味着她心跳停止。

    他们抢救了半个小时。试图进行气管插管供给氧气，但由于到处是血，急救人员无法找准位置。最终他们成功切开气管，在病人颈部正对气管部位开了一个呼吸孔，但是那儿也涌满了血液。

    他们通过静脉为病人补充体液，把一盒盒的肾上腺素挤进静脉，试图使她恢复心跳。他们甚至给予腺苷（一种危险的强效药物，通过暂时性阻断病人心跳，来逆转不正常心律）。

    但是对于真正的心跳停搏，事实上无药可救，因为完全没有可用以刺激的心跳节律。医生试了所有办法。他们用了很多药，以致急救车都被清空了，有人从药房跑进跑出拿来其他的药。

    在《急诊室的故事》里，当乔治·克鲁尼和茱莉安娜·玛格丽丝进行这些急救程序时，似乎很令人振奋并很吸引人。但是在现实生活中，这样的经历是非常糟糕的。在好莱坞的电影台词中，把心脏停搏称为“flatlining”（心电图成直线）。但是我的病人从来没有出现过这种简单描述的情况：正常的心电图突然变成了水平直线。病人的心电图不稳、毫无规则，偶尔变成一连串非同步搏动，有时看上去很正常，因为CPR的胸腔按压可以产生类似于真正心律的心电图，即使病人已经死亡。

    我的病人死了。当她倒在床上的时候就已经死了，在整个抢救过程中她已经死了，与此同时血液和组织不断的从她身体里冒出来，吸引器被肺部流出的一些小块赌塞。每个人都竭尽全力的挽救她，但她已无法挽救。

    对于此次病人情况的分析主要观点认为病人肿瘤部分破裂，因此导致肺部动脉破裂或在心脏部位产生巨大栓塞。显然，对于肺癌患者，这种情况可能毫无预兆。只有尸体解剖才能说清楚，鉴于我在整个事件中所处的角色，这对我已不重要。我做了我唯一可以做的事（每个人都会这么做），除此之外你还能说什么。

    我43岁了。在做了一段时间的英语教师后，我几经辗转才成为护士。在医院工作的时候，我的脑子里经常想起约翰-多恩的诗：

死亡你莫骄傲，尽管有人说你，
如何强大，如何可怕，你并非如此。

    但是在我经历了这次A级事件后，我发现他的话很空洞。我的病人就这样死了，看上去就像来自“惊变28周”（恐怖片）里的一个食人僵尸，而事实上在现实生活中，即使在医院里，这类死亡也是令人害怕的。

   我们该怎么办呢？

    回家，爱你的孩子，尽量不要争吵，注意饮食，在雨中漫步，感觉阳光拂上面颊，时常大笑，尽可能大笑，特别是对自己大笑。

    因为能对抗死亡不是诗歌、戏剧、灵丹妙药、满屋子的技术专家及良好意愿，唯有生活可以对抗死亡。
                     （特蕾莎布朗是宾夕法尼亚州一家医院的护士。）
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    看完这篇译文，我深有感触。虽然工作很多年了，记得实习第一次见到病人死亡哭的稀里哗啦，到现在虽说没有那种震撼的感觉但我还是会心情沉痛，因为受不了亲人离别那种场面，感受到生命的短暂和脆弱，人啊，没法和死亡去抗衡，所以要珍惜每一分每一秒，享受生活，要学会感恩，每天早晨醒来，笑着对自己说，活着真好！ 
   特别喜欢这句： Go home, love your children, try not to bicker, eat well, walk in the rain, feel the sun on your face and laugh loud and often, as much as possible, and especially at yourself. Because the only antidote to death is not poetry, or drama, or miracle drugs, or a roomful of technical expertise and good intentions. The antidote to death is life.
很有道理。要好好珍惜生活，对活着的可以关心的人好一点，也要善待自己，才能更好去帮助他人！The antidote to death is life.　每个人都应该这样。