[转]insani英文网站上面关于Narcissu的文章

4.1 Setsumi's illness
• Setsumi's illness is a mystery; not enough information is given to firmly influence the reader to one diagnosis or another, but a few of the more likely diagnoses -- congenital cardiac anomaly, hematogenous malignancy of childhood, cystic fibrosis, systemic lupus erythematosus -- are given above.
• The fact that she has hair that long would tend to speak against someone with a malignancy; the fact that she has large postsurgical scars that are fairly new in origin (surgery for the repair of a congenital cardiac anomaly would happen very early in life) would tend to speak against a congenital cardiac anomaly; the fact that she looks thin and frail would tend to speak against systemic lupus erythematosus. Therefore, among the differential diagnoses mentioned above, it is probable that Setsumi suffers from an intractable cystic fibrosis, had lung transplantation fairly early on, and did better than anyone could have expected with it.
• Even so, this is a fairly shaky diagnosis, even on the best of days.

4.2 The protagonist's illness
• No argument here -- the protagonist suffers from a relentless non-small-cell lung carcinoma. He is status post partial pneumonectomy (which as done with the intention to cure the cancer), but his cancer has metastasized. He was put on Iressa, but it did not do very much good for him. And now here he is, devoid of any other treatment options.
• There is only one very concerning thing here, and that is the fact that this young man is 20 years old. It is vanishingly rare that someone of this age would have any kind of cancer at all, let alone a non-small-cell lung carcinoma. However, as noted above, such cases do happen -- they just happen to be about as common as hens' teeth.

4.3 The portrayal of Hospice
• Whether intentionally or unintentionally, Tomo Kataoka paints Hospice in a very negative light in this piece.
• First of all, the doctors flat out lie to the protagonist about its purpose -- they tell him at one point that it is a place where unique therapies are tried in order to cure the patient, which could not be further from the truth -- in fact, it is better said that a Hospice ward would be the only place in a hospital where therapies with the intent to cure the patient of a disease were not being instituted.
• Second of all, the Hospice ward is portrayed as a cold, empty place with no one in it, patients left to fend for themselves in terms of interests and activities, nothing to do except to watch TV. This could not be further from the truth -- in the Hospice setting the patient is encouraged to engage in as many activities as he or she would like, and is constantly being dragged by nurses and other personnel to these activities.
• Finally, the patients on 7F are portrayed as being prisoners of a sort. Again, this is very strange, given that patients on Hospice care are generally allowed to wander anywhere they wish, within limits.
• That said, it is quite possible that these attitudes toward Hospice are colored by the narrator's own viewpoint toward the healthcare system. It is entirely possible that he is not reporting accurately on these matters -- and does not care to -- such is his antipathy toward both what is happening to him and the system that has taken over his life.

4.4 Medication regimens
• At one point in the piece, the protagonist narrates that he was told that he could go at most two days without his medications -- after that, he would be in trouble. While usually, this kind of statement is very sketchy from a medical standpoint, it might be entirely reasonable given the circumstances Setsumi and the protagonist find themselves in.
• In the protagonist's case, the medications he must keep taking are probably various pain medications; without them, he would be in so much pain that he could not function at all. This kind of situation is not uncommon at all among advanced-stage cancer patients.
• In Setsumi's case, if she has some kind of autoimmune disease or a disorder like cystic fibrosis, a few days without her anti-inflammatory medications could serve as the trigger for a violent flare of the disease process, which could very well prove fatal if she did not get help in time.
• What is somewhat problematic is the way the drugs are dispensed in a certain scene in the work. Any pharmacist would ask to see the prescriptions first; he would not bring medications to the counter first. Also, the kinds of medications that both Setsumi and the protagonist need are generally only found in the pharmacy departments that exist within hospitals, not even in pharmacies that are affiliated with hospitals.

4.5 Strength and its loss
• Believe it or not, even a week spent lying in a hospital bed can leave a patient far physically weaker than he was before. This is a mixture of muscle atrophy, emotional imbalance, and lack of sleep.
• That said, the very rapid deterioration of strength seen throughout the course of this work are most likely more a result of fatigue than they are due to acceleration of any disease process. After all, it is an exertion to drive around all day, and the diets that Setsumi and the protagonist choose to maintain aren't exactly the most nourishing in the world.

4.6 Nourishment
• While it is possible for a patient with end-stage lung carcinoma to survive on a few riceballs and a few sports drinks a day, it is difficult to believe that he could even muster the energy to drive a car for one day without falling asleep on this kind of diet -- let alone for a week straight.

4.7 Final words
• When all is said and done, and all the medical inconsistencies present in Narcissu are tallied up, one must remember a few things:
  • Tomo Kataoka is not a trained member of any of the medical professions
  • That said, he made a valiant effort to at least not get the medical details wrong
  • One of the translators who worked on this localization is a 4th-year medical student
  • Many of the things that he took issue with are details that anyone without appropriate medical training would not notice
• Therefore, I say to you: accept this piece the way it is, medical inconsistencies and all. The spirit of the work is not damaged in the places where it got medical details wrong, and it would be petty to criticize the author for not knowing some of the things that I knew when I translated the piece. So go forth; read Narcissu again with a somewhat more broad understanding of the medical issues involved; but do not raise your voices in criticism against Tomo Kataoka. The only thing he deserves out of you is your wholehearted thanks and praise for having brought this wonderful piece to you.

18 August 2005
Seung Park
4th-year medical student, University of Michigan Medical School