Dr. Breit comes in Sunday morning and tells him, "Harold, you're looking A?1. Ray does beautiful work. They say around the OR, `He could tickle1 a tapeworm under the chin with that catheter."' Breit looks up through his furry2 eyelashes for the expected laugh, doesn't get it, and perches3 on the edge of the bed for extra intimacy4. "I've been reviewing our own films plus the stuff the jerks down at Deleon Community finally got around to sending us. Your lumen in the LAD has gone up from fifteen per cent of normal to sixty. But I can't say I'm crazy about your RCA, the right coronary artery5; it shows I'd put it at about eightyper?cent blockage6, which is fine and dandy as long as the welldeveloped collateral7 is supplying the right ventricle from the circumflex. But a lesion is developing at the bifurcation of the circumflex and the LAD, and a lesion at a bifurcation is tougher to treat with angioplasty. Same thing ? I assume you're interested in this ? if the lesion is too long, or in a hyperkinetic AV groove8, or in a situation where in the middle of the procedure you might get stranded9 without enough collateral circulation. In those kinds of cases, it can get hairy."
His legs are a little short for sitting on the bed comfortably; he bounces his ham a little closer to Harry10's legs, and Harry feels the blood inside his supine body sway. Breit smiles and his voice grows confidential11, like when he was murmuring over Dr. Raymond's shoulders. "The fact is, Harold, PTCA is a pretty Mickey Mouse treatment, and what I want you to seriously consider as you lie here these few days, even though as I say this procedure appears to have produced good results for the time being, is, now that you've tested the waters, going ahead with a CABG. Not right away. We're talking four, six months down the road before we go in again. We'd bypass both the RCA and the CFX, and the LAD depending on the restenosis, and you'll be a new man, with damn close to a brand?new heart. While we're in there we might want to look at that leaky aortic12 valve and think about a pacemaker. Frankly13, we may have had a little postoperative MI; your electrocardiogram shows some new Q waves and there's been an elevation14 of the CPK isoenzyme, with positive MB bands."
"You mean," Harry says, not totally snowed, "I've been having a heart attack just lying here?"
Dr. Breit shrugs15 daintily. All his gestures have a daintiness that goes with his milky16?pink skin. His voice is a bit squeaky, piped through his blistered17?looking lips. He says, "PTCA is an invasive procedure, nobody said it wasn't. A little trauma18 is to be expected. Your heart shows myocardial scarring from way back. All a heart attack is is some heart muscle dying. A little can die without your noticing. It happens to all of us, just as everybody over a certain age has some emphysema. It's called the aging process and there's no escaping it. Not in this life."
Harry wonders about the next life, but decides not to ask. He doubts that Breit knows more than The National Enquirer19. "You're telling me I've come into this hospital for I don't know how many thousands of dollars for a Mickey Mouse operation?"
"Rome wasn't built in a day, Harold, and your heart isn't going to be rebuilt in a week. Angioplasty does some good, at least for a while, in about eighty per cent of the cases. But bypass is up to around ninety?nine per cent initial success. Look. It's the difference between scrubbing out your toilet bowl with a long brush and actually replacing the pipes. There are places you can't reach with a brush, and deposits that have become chemically bonded20. A man your age, in generally good health, shouldn't be thinking twice about it. You owe it not only to yourself but to your wife and son. And those cunning little grandchildren I've heard about."
The faster Breit talks, the more constricted21 Harry's chest feels. He gets out, "Let me see if I understand it. They rip veins22 out of your legs and sew them to your heart like jug24 handles?"
A frown clouds the young doctor's face. He is overrunning the allotted25 time for his visit, Rabbit supposes. With visible patience he licks his sore?looking lips and explains, "They take a superficial vein23 from your leg and in some cases the mammary chest artery, because arteries26 hold up better under arterial pressure than veins. But you don't have to worry about any of that. You're not the surgeon, it's our bailiwick. This operation is done tens of thousands of times in the United States every year ? believe me, Harold, it's a piece of cake."
"You'd do it here?"
Breit's eyes behind his flesh?colored glasses are strange furry slits27, with puffy pink lids. "The facilities don't exist yet in this physical plant," he admits. "You'd have to go to Philadelphia, I doubt we could slot you into Lancaster, they're booked solid for months."
"Then it can't be such a very little deal, if you need all these facilities." Since childhood, Rabbit has had a prejudice against Philadelphia. Dirtiest city in the world: they live on poisoned water. And Lancaster is worse ? Amish farmers, overwork their animals to death, inbred so much half are humpbacks and dwarfs28. He saw them in the movie Witness being very quaint29, Kelly McGillis wiping her bare tits with a sponge and everybody chipping in to build that barn, but it didn't fool him. "Maybe Florida would be the place," he offers Dr. Breit. Florida always seems unreal to him when he's up here and having the operation there might be the same as not having it at all.
Dr. Breit's sore?looking mouth gets stern; his upper lip has sweat on it. Why is he selling this so hard? Does he have a monthly quota30, like state cops with speeding tickets? "I haven't been that impressed by our dealings with Deleon," he says. "But you think about it, Harold. If I were in your shoes, it's what I'd have done ? without any hesitation31. You're just toying with your life otherwise."
Yeah, Rabbit thinks when the doctor is gone from the room, but you're not in my shoes. And what's life for but to toy with?
收听单词发音 |
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tickle
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| v.搔痒，胳肢；使高兴；发痒；n.搔痒，发痒 | |
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furry
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| adj.毛皮的；似毛皮的；毛皮制的 | |
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perches
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| 栖息处( perch的名词复数 )； 栖枝； 高处； 鲈鱼 | |
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intimacy
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| n.熟悉，亲密，密切关系，亲昵的言行 | |
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artery
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| n.干线，要道；动脉 | |
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blockage
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| n.障碍物；封锁 | |
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collateral
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| adj.平行的；旁系的；n.担保品 | |
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groove
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| n.沟，槽；凹线，（刻出的）线条，习惯 | |
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stranded
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| a.搁浅的，进退两难的 | |
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harry
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| vt.掠夺，蹂躏，使苦恼 | |
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confidential
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| adj.秘（机）密的，表示信任的，担任机密工作的 | |
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aortic
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| adj.大动脉的 | |
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frankly
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| adv.坦白地，直率地；坦率地说 | |
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elevation
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| n.高度；海拔；高地；上升；提高 | |
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shrugs
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| n.耸肩（以表示冷淡，怀疑等）( shrug的名词复数 ) | |
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milky
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| adj.牛奶的，多奶的；乳白色的 | |
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blistered
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| adj.水疮状的，泡状的v.（使）起水泡( blister的过去式和过去分词 )；（使表皮等）涨破，爆裂 | |
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trauma
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| n.外伤，精神创伤 | |
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enquirer
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| 寻问者，追究者 | |
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bonded
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| n.有担保的，保税的，粘合的 | |
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constricted
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| adj.抑制的，约束的 | |
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veins
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| n.纹理；矿脉( vein的名词复数 )；静脉；叶脉；纹理 | |
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vein
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| n.血管，静脉；叶脉，纹理；情绪；vt.使成脉络 | |
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jug
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| n.(有柄，小口，可盛水等的)大壶，罐，盂 | |
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allotted
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| 分配，拨给，摊派( allot的过去式和过去分词 ) | |
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arteries
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| n.动脉( artery的名词复数 )；干线，要道 | |
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slits
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| n.狭长的口子，裂缝( slit的名词复数 )v.切开，撕开( slit的第三人称单数 )；在…上开狭长口子 | |
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dwarfs
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| n.侏儒，矮子（dwarf的复数形式）vt.（使）显得矮小（dwarf的第三人称单数形式） | |
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quaint
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| adj.古雅的，离奇有趣的，奇怪的 | |
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quota
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| n.（生产、进出口等的）配额，（移民的）限额 | |
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hesitation
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| n.犹豫，踌躇 | |
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