THINGS THAT NEED DOING, THE(ISBN=9780307463241) 英文原版 pdf snb 115盘 kindle 在线 下载 pmlz mobi

　　“You keep fighting, okay?” I whispered. “We’re in this

together. You and me. You’re not alone. You hear me? You are not

alone.”

5:38 p.m. It was the precise moment Sean Manning was born and the

time each year that his mother wished him happy birthday. But just

before he turned twenty-seven, their tradition collapsed. A heart

attack landed his mom in the hospital and uprooted Manning from his

life in New York. What followed was a testament to a family’s

indestructible bond—a life-changing odyssey that broke a boy and

made a man—captured here in Manning’s indelible memoir.

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　　SEAN MANNING is the editor of the nonfiction

anthologies Rock and Roll CageMatch, The Show I’ll Never

Forget, Top of the Order, and Bound to Last. He lives

inNew York. 

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　　C H A P T E R  O N E

　　I.

　　I probably should’ve left early. She even told me to go. The

procedure was scheduled for ten the next morning. I’d have to be

back first thing. But I wanted to say it right at midnight—or,

rather, since by then I knew better than to trust the unit’s

clocks, at the moment Home Improvement ended and The Fresh Prince

began.

　　I got up from the high-backed chair and went to the side of the

bed. A full-on hug was out of the question; jostling the ventilator

hose even the slightest bit was liable to set her off on one of

those awful coughing fits. Instead, I delicately slipped my left

hand behind her neck, steadied myself against the air mattress with

my right, leaned down so that our noses practically touched, and

smiled.

　　“Happy birthday.”

　　She smiled herself, mouthed her thanks, and ran a hand trembling

from medication and ner vous ness about the procedure through my

hair. Reaching past my temples, it was the longest I’d worn it

since freshman year of college—like my love for basketball, an old

proclivity renewed in the eight months since the heart attack and

my return home.

　　I leaned closer still and was kissing her forehead when her nurse

came in with the Ambien. (I forget who—being a Wednesday,

officially Thursday, most likely Nick, maybe Night Christina.)

Before I could step aside and gather my things to go, she clutched

my arm.

　　However shaky, her grasp was still plenty strong. She’d quit

smiling.

　　“Don’t say anything,” she mouthed.

　　I understood perfectly—she’d be bummed enough spending her

birthday in the hospital without the nurses and aides and other

wellwishers among the staff popping in every five minutes to remind

her of the fact—and so, before finally leaving to go home and grab

a little sleep, promised her I wouldn’t blab.

　　Except someone already had. Aunt Claire probably, or maybe it’d

been deduced from her chart or wristband. For when I walked back

into the room in the morning, there was tied to the nightstand a

helium balloon and HAPPY BIRTHDAY! written on the dry-erase

assignment board.

　　Both were Wendy’s doing. Of the ten or so respiratory therapists

within the Cleveland Clinic’s Respiratory Special Care Unit

(reSCU), she was the one I knew least. Unlike most of the RTs,

whose schedules varied—a morning here, an evening there, and, with

no limit on overtime, often both—Wendy worked strictly first shift,

from eight to four, leaving about a half hour before I usually

arrived. Still, our paths crossed enough to make an

impression.

　　She was around Mom’s age, ruddy complected, glasses set low on

her nose, heap of blond hair styled in big bangs and a ponytail. As

immense as that hair was, her personality was even more so. A

world-class talker—five minutes and you’d know the names, ages, and

dietary restrictions of her entire family, pets and all—she would

have driven Mom batty in better health. As it was, she enjoyed

Wendy’s monologues. It took her mind off weaning from the vent,

and, panicked as that torture justifiably made her, she always felt

relieved in the presence of an RT, regardless of whom.

　　That morning, weaning was of no concern. It hadn’t been for a few

days now, ever since she’d been placed back on full support—the

reason we were finally going ahead with the G- and J-tubes.

　　*

　　Precisely what it sounds like, gastroparesis is the partial or

complete paralysis of the stomach. Symptoms range from minor

(feeling full quicker) to major (chronic nausea and vomiting).

Mom’s were major. A gastric emptying test—in which she drank a

gray-colored, chalkytasting barium milkshake, its progress tracked

by X-ray—concluded that what would take most people two to three

hours to digest took her eight to nine. She was nauseated around

the clock and every six to eight hours received medication to

help—Compazine or Reglan or Zofran or Phenergan. Less reliable and

easy to assuage was the vomiting. She could go three days without,

then suddenly throw up every ten minutes for a whole week. Then,

just as suddenly, it’d stop. There was no telling why. Suctioning

(a thin, vacuuming catheter slid deep into the airway to extract

secretions the lungs aren’t strong enough to expel and thereby

prevent pneumonia) often triggered it, but not always. Three of

four different brands of tube feed were tried, but none was better

tolerated than the other. The tube feed’s delivery rate didn’t

matter. Twenty cc’s an hour—equivalent to four tablespoons—was

thought to be safe, but sometimes even that tiny bit would come

back up. Whenever it did, whenever any did, the

　　pump would be turned off for a few hours, but that was still no

guarantee. The buildup of bile was enough to get her going.

　　What caused the gastroparesis was no less puzzling. It could’ve

been any number of things—a reaction to medication, something viral

perhaps. The rest of the family and I felt sure the bypass had

something to do with it, since the

　　nausea and vomiting started shortly after, but the doctors

rejected the connection. Their best guess was that the initial

intubation following the heart attack or the extubation two weeks

later had damaged the vagus nerve, which runs from the brain down

the back of the throat and esophagus to the colon and is

responsible for initializing digestion.

　　Pinpointing the cause would’ve done little good anyway.

Gastroparesis can’t be cured. Online I’d found a few recent cases

in which a newly developed stomach pacemaker had been tried with

some success. But the consulting

　　gastrointestinal doctors claimed it was still too untested.

Besides, Mom was in no state to endure such drastic surgery. Were

the nausea and vomiting to be alleviated, the only viable option

was a G-tube.

　　Short for percutaneous endoscopic gastronomy tube (also known as

a PEG), a G-tube is a roughly inch-in-diameter, foot-long piece of

pliant rubber sutured to the stomach. Typically used for feeding—a

more permanent, more comfortable alternative to the Corpak in the

nose—Mom’s was to serve the opposite purpose, draining any

backed-up tube feed and bile.

　　*

　　That was another issue long in need of resolving: feeding.

Because of the extent of the gastroparesis, eating was worthless.

The only way she could get any nutrition was from the Corpak

advanced through the stomach on into the jejunum, the middle

portion of the small intestine.

　　Some Corpaks can go a couple months before beginning to clog.

Hers was lucky to last half that long, on account of how much

medication passed through the pinhead-wide tube over the course of

a given day and how thick and sticky most of it was. (The nurses

were supposed to flush the Corpak with water after every medication

and finished bag of tube feed, but they didn’t always remember.) At

first, the clogs were small and could be broken up with ginger ale

and a little back-and-forth on the syringe. For more temperamental

clogs, the Corpak was connected to a gravity bag that was filled

with ginger ale, hung from the IV pole, and left to work for an

hour or so before the nurses tried the syringe again. Before long

the clogs would worsen and could only be undone by Clog Zapper, an

industrial-strength solution that looked like spackling and came in

a single-use packet with its own miniature syringe. When this

failed, the Corpak would need replacing.

　　For Corpaks that terminate in the stomach, this can be done at

the bedside; because Mom’s needed to be advanced farther and into

such an exact spot, she had to travel from reSCU, located on the

eighth floor of the Clinic’s G Building, down to the basement,

where the X-ray department was located. Occasionally only a few

days would elapse between trips, such as the time about a month

before her birthday. The Corpak had just been replaced the day

before. Mom was using a tissue to get a hair out of her mouth, a

loose corner of tape snagged the tissue, and, when she took it

away, it tugged the Corpak about a foot out of place. (Total, it

was about a foot and a half long and stayed put via crosswise

strips of cloth tape wound about the tube and the bridge of her

nose. Because of how oily her face would get from not being able to

wash, the tape would need replacing every two or three days. A

bridle looped through the nostrils had been tried but was too

painful.)

　　By then—April 27, Claire’s journal has it—there had already been

talk of the G-tube; following this incident, the prospect of a

J-tube was introduced as well.

　　No different from a G-tube—same dimensions, just positioned six

inches or so lower on the surface of the belly—a J-tube is used

solely for feeding, directly into the jejunum (hence its name).

When the Corpak clogs, it’s simply

　　detached and a fresh one is connected to the J-tube. Though the

J-tube itself might clog, because of how short it is, it usually

flushes without trouble.

　　While not without potential complications—namely infection—the

two procedures were done endoscopically and so were relatively

low-risk. The whole thing would take less than an hour. Yet

standard as it all was and as much as it’d help Mom, I still had

misgivings.

　　I hated the thought of putting in not just one but two more

lines. Already there was the trach, the urine foley, the fecal

tube, the peripheral IV in her hand. (Just which hand changed

daily, sometimes twice a day, and sometimes it wasn’t even her

hands but her feet, so routinely did the IVs infiltrate, so shot

were her veins—the reason the Corpak had to be so relied on for her

meds.) For a long time now, with little control over anything

except what channel to keep

　　the TV on—and not even that when it came to Everybody Loves

Raymond—she’...

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媒体评论

　　Sean Manning brings a delicate touch to the heaviest details

of loss and grief: the late-night drives, the waiting-room

magazines, the loneliness, the community. His story of his mother's

life and death manages to be both honest and inspirational--not to

mention incredibly moving.

　　-Rob Sheffield, author of Love is a Mix Tape

　　"The Things That Need Doing is a marvelous and heartbreaking

book. Manning leads us through the minefield of his mother's

illness with grace and tenderness. This is a stunning portrait not

just of his brave and loving mother but of the current American

system of sickness and death. This odyssey will engross and enchant

you and ultimately leave you in tears."

　　—Anthony Swofford, author of Jarhead and Exit A

　　“At once a son’s cry of grief and an ode to the power of familial

love, told in the kind

　　of detail that carries the reader into the story, into the

hospital room, and into the

　　heart of this brave and beautiful book.”—Dani Shapiro, author of

Devotion

　　“A beautiful portrait of hope and perseverance and the final

mercy that even death

　　can sometimes be. Tender and funny and will move the most cynical

of souls.”

　　—H. G. “Buzz” Bissinger, author of Friday Night Lights

书籍介绍

“You keep fighting, okay?” I whispered. “We’re in this together. You and me. You’re not alone. You hear me? You are not alone. ”

5:38 p.m. It was the precise moment Sean Manning was born and the time each year that his mother wished him happy birthday. But just before he turned twenty-seven, their tradition collapsed. A heart attack landed his mom in the hospital and uprooted Manning from his life in New York. What followed was a testament to a family’s indestructible bond—a life-changing odyssey that broke a boy and made a man—captured here in Manning’s indelible memoir.