哀悼乳房

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1993 / 2月

文‧林靜芸


一九八三年,西西以《像我這樣的一個女子》獲得聯合報副刊短篇小說推薦獎,自此與台灣文壇結緣。此後,她陸續在台灣出版了十餘本著作。

西西的最新著作《哀悼乳房》,敘述她自三年前罹患乳癌,從發現到切除、藥物治療的過程。書中以敘事文、說明文、新詩等不同文體,詳細記錄個人對生命的掙扎和期許。

《哀悼乳房》自出版後受到各方極高評價,榮登國內兩大報系讀書版的去年十大好書;香港報刊並曾製作書評專輯,大力推薦這本既具實用性、又富文學精神的作品。不少評論者都認為這是去年台灣出版界「最突出的文學作品」。我們特別請到整型外科醫師林靜芸作評,並以傳真訪問住在香港的作者西西。


《哀悼乳房》這本書是西西女士的最新著作,一九三八年她生於上海,香港葛量洪學院畢業,曾經擔任過小學老師。

書的一開始,作者以非常鮮明、開朗而柔膩的筆調描寫她多麼地喜歡游泳,喜歡選擇游泳衣,暗示著她是一個喜歡自己身體的健康女性。

切身感受,化為文字

她是在泳場浴室洗澡的時候,摸到胸部有個如花生米大小硬塊,第三天就去找家庭醫師檢查,一星期之後轉到外科作切片手術,證實罹患乳癌。一星期內她接受了乳房根治性切除以及腋下淋巴摘除;由於淋巴結有一個感染,她得繼續作化學治療以及電療。作者在文章中用科學報導的方法,加上文學的筆調,非常詳盡地描述自己的醫療過程。這些報導對於其他的病人,固然是很好的經驗,對於一向「自以為是」的醫療制度,更有一針見血的批評!

醫療人員一天治療無數個病人,很多時候,早已忘記對象是一個生命,當然也沒有時間對一個特定的病人作仔細的術前解說與術後照顧傷口的衛教。也難怪作者乳癌切除之後,在被窩媯o現了與她睡了一晚的引流袋而不知所以。因為在手術後,傷口部分有許多血水,得讓水慢慢地滴出來,但是卻沒有人向她說明那有什麼功用,所以西西替它取了個名字「血滴子」。

上診所拆線之後,醫師用透氣膠布黏貼傷口,作者為著:「一條一條細窄的膏貼,交叉形沿著傷口貼,就像我的傷口是二扉的大門,遭官家抄封,給貼上了封條」。這個在醫療人員看來必要的過程,經由作者有點戲劇味道的手法寫來,改變了外科醫師類似學者的嚴肅面貌,卻也提醒著醫療人員必須體會病人感受。

病人心情誰能體會?

西西哀悼被切掉的乳房,討厭手術的疤痕,因此引經據典,描述自己的苦悶:「紫禁城堛漱蚨妘ㄛO器官欠缺而形成的妖怪,司馬遷是會寫史記的妖怪……我失去了一個乳房,也是器官欠缺而形成的妖怪」;疤痕在前胸無法享受入浴,更無法穿泳衣,西西突發奇想說,外科醫師為什麼不像衣料縫合一般,將衣料摺疊,「留下布邊,在反面疊齊,縫好後反過正面,用熨斗熨平」,就看不見疤了。

得了癌症接受化學治療以及放射治療,她心情轉壞,再加上遍讀世界名著,發現中文的癌字,沒有特別意思,卻是可怕的象形文字:「癌字本身令人畏懼,字心是『品』,聳立在一座『山』上……使人想到山崗上令人心寒的纍纍白骨」。又想到肺癆的病人總是特別惹人疼惜,而且他們的病需要的是陽光與旅行,因此產生許多詩人及文學家;而自己的病卻須忍受如此的折磨,半點都浪漫不起來。治療的時候,她體力不好,因此對人生喪失期望,認為以前的享受都將是遙遙無期了!

她身體情況最糟的時候,想到假如自己不是得癌症,或者醫師診斷錯誤該有多好,甚至形容說外科醫師就像莊子筆下的屠伕庖丁,屠伕也是外科醫師,「在他的眼中,我是一頭全牛,還是一些牛骨頭牛筋和骨肉?」

兼具實用性與文學價值

然而西西總算熬過所有的治療,她形容「電療到了末期,體力越來越差,一到晚上彷彿那些電池將盡的電動玩具,動作慢下來了。又像一個燈泡,由明亮轉為昏暗。這時發現睡眠是治療疲倦最好的方法,只要睡一覺,人就有精神了。晚上覺得什麼地方有點疼痛,一覺醒來全都不痛。動物天生能夠自療,發現自己仍有這種能力,使我很高興。」

作者調侃自己,不能穿泳衣,而是穿上一件永遠不能脫下的奇異新衣,很有普普藝術味道,「大概是達利那樣的畫家設計的,裁縫當然是就外科醫師了」。

書中還整理出她找得到的中國癌症有關資料、營養計算方式、乳房藝術、乳癌知識等等。然而對讀者而言,最好的一個結局應該是,作者又買到了一件適合她的泳衣,而且下過水了。

《哀悼乳房》這本書無法簡單地說它是一個女人如何戰勝乳癌的故事。由書中引用科學數據,加上文字的考究,以及作者詳細的自我心理剖析,在在使我認定它是一本非常難得的佳作。

身為一個女醫師,我發現台灣的婦女,普遍對乳房有強烈的羞赧情結。小病不敢講,罹患乳癌更是只能自己忍受痛苦。我很樂意推薦這本書,因為醫療人員看了,可以進一步了解病人的感受;一般大眾也可以學習如何作一名好病人。而醫病雙方的合作,應該更可以幫助病人度過痛苦的治療過程。

〔圖片說明〕

P.90

作者:西西(原名張彥)

出版者:洪範

定價:220元

頁數:333頁

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近期文章

EN

Mourning My Breast

Lin Ching-yun /tr. by Jonathan Barnard

Hsi Hsi became known to Taiwan literary circles when her story "A Woman Like Me" won the United Daily News short story prize in 1983. She has since published over 10 books here in rapid succession.

Her most recent book, Mourning My Breast, describes her battle with breast cancer three years ago, covering the whole process from discovering the cancer to surgery and treatment. Skipping from narration to explanation to free-verse poetry, she uses a number of different literary forms in the book to describe her personal struggles and hopes for life.

Mourning My Breast was widely praised as soon as it was released and placed on The China Times and United Daily News lists of the best ten books of the year. Hongkong reviews praised the book as both practical and literary. Many critics hailed it as "the most outstanding literary work" published in Taiwan last year. We have specially invited plastic surgeon Lin Ching-yun to write a review, and we have interviewed Hsi Hsi by fax in Hongkong.


Mourning My Breast is Hsi Hsi's latest work. Born in 1938 in Shanghai, she graduated from college in Hongkong and served for a time as an elementary school teacher.

At the beginning, the writer uses a fresh, bright and delicate style to describe how much she loves swimming and choosing her swimming suit, suggesting that she is a healthy woman who likes her own body.

Turning her body's agony into words:

When she is in the showers at the pool, she feels a peanut-sized lump in her breast. Three days later she goes to her family doctor for an examination and a week later has tests carried out on tissue taken from her breasts, tests that prove she has breast cancer. A week later, she has a mastectomy. Because the lymph gland is infected, she goes on to have chemotherapy and electrotherapy. Hsi Hsi structures this section as a scientific report but writes in a literary style, describing in great detail the process of her own medical treatment. The report should be of considerable use as vicarious experience for others who are ill. She also makes some well aimed criticisms of an arrogant medical system.

Medical personnel have to treat numerous patients in a single day, and too often they forget that their patients are also people. And of course they haven't the time to give patients detailed before-operation explanations or after-operation instructions on how best to care for the wounds of surgery. No wonder that after having surgery on her breast, Hsi Hsi found a drainage bag sleeping with her under the quilt, used to collect the blood that drips out after the operation. No one had explained to her its function, and so Hsi Hsi gave it a name--"blood dripper," which is what the Chinese call the flying stars used in martial arts.

After she went to the hospital to have her stitches removed, the doctor put surgical tape on the wound. Hsi Hsi writes, "Strip after strip of thin tape was applied and crossed over on the cut, as if it was a door being sealed for a case of property confiscation." The writer invests a procedure professionals regard as a medical necessity with the flavor of a drama. In so doing, she pulls the expressions of clinical seriousness off of experts like surgeons, reminding medical workers that they must understand people's feelings.

Who can understand the feelings of the sick?

Hsi Hsi mourns over her cut-away breast and resents the scars of her operation. Quoting from the classics, she describes her own hardship and depression: "The Forbidden City's eunuchs are abominations through their lack of an organ. Yet the abomination Ssu-ma Chien wrote Records of the Grand Historian. I am a monster who lacks a breast." With a scar on her chest she can't enjoy a bath, let alone feel comfortable in a swimsuit. She suddenly has a strange idea: "Why can't surgeons sew like tailors, so that all the loose ends are folded to the inside, leaving only the smooth ironed fabric visible with the stitches and scars unseen underneath."

Undergoing radiation and chemotherapy, she finds her moods turning gloomy. From reading the classics, she discovered that the Chinese character for cancer ( 癌 ) has no particular etymology of meaning but rather is just a frightening pictograph. "The character itself terrifies people. Its center is composed of a 品 standing on the top of a mountain (山) . . . it makes one think of white bones on a desolate mountain top. I then thought that people with tuberculosis always especially elicit people's sympathies. What the ailment requires is sunlight and travel, and so it occurs in many poets and literary people. But my own sickness makes me suffer so much--it's not the slightest bit romantic." When undergoing treatment, she had no strength, and so she lost hope in life, believing that all of her former pleasures were being postponed to the indefinite future.

When her physical condition was at its worst, she imagined she wasn't a cancer patient or supposed how wonderful it would be if the doctors had diagnosed wrong, to the point even of comparing the surgeon to the butcher Pao Ting in Chuang Tzu. The butcher is also a surgeon: "In his eyes, what am I but a whole cow, or a bundle of bones, ten-dons and meat?"

Practical and literary:

But Hsi Hsi went through the entire treatment process after all. "At the end of the electrotherapy," she writes, "my energy is nearly used up. I am drained of strength. By nighttime I am like a burned-out light bulb or an electric toy with a depleted battery--I move in slow motion. At times like these, I discover that sleep is the best method for treating exhaustion. As soon as I sleep a bit, I recover my energy. If I feel sore at night, when I wake up all the soreness is gone. Animals can naturally cure themselves. I am elated to discover that I myself have this ability."

The writer mocks herself for not being able to wear a swimsuit and for wearing a strange new set of clothes--with a pop art flavor--that she can't ever take off. "It was probably designed by an artist like Dali, and the dressmaker was, of course, the surgeon."

In the book she also organizes Chinese materials about cancer, methods of calculating nutrition, breasts in art, breast cancer, etc. As far as the readers are concerned, the best possible conclusion would be that the writer buys a suitable swimsuit and takes the plunge.

Mourning My Breast cannot simply be described as the struggle of one woman against cancer. The scientific data introduced along with the elaborate language and detailed analysis of the writer's own feelings all make me feel that it is an uncommonly excellent work.

As a woman doctor in Taiwan, I have found that women here are extremely shy about their breasts. Unwilling even to talk about a small problem, they endure the hardships of breast cancer alone. I happily recommend this book. Through it, medical workers can take another step forward in understanding the feelings of patients, and the general public can study how to be good patients. Better cooperation between medical workers and patients should make it easier for patients to go through the difficult treatment process.

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p.90

Author: Hsi Hsi

Publisher: Hongfan

Price: NT$220

Pages: 333

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