曾叔叔讲故事之疤痕的故事
Very few people know that if you cut the skin of a baby early enough before birth, amazingly, he/she can often heal without a scar. Wouldn’t you like to have that kind of ability, to heal your wounds without scars! Many other things actually are also very exciting and novel about the baby scars and healing before birth. Two are just shocking.
很少有人知道,如果在婴儿被娩出前足够早的时间割破他/她的皮肤,奇妙的是,他/她通常可以无痕自愈。难道你不希望有那样的无痕而愈的能力吗?实际上,关于类似婴儿在出生前的疤痕和愈合,还有许多其他的事情也非常令人兴奋和新奇。以下就是其中两个简直令人震惊的例子。
First, huge holes in the heart exist normally to facilitate blood flows, for the baby during the fetal period, but they magically close and seal after the baby is born, in the immediate newborn period. Just like scar healing, without scars. Among hundreds of other huge changes in the body, blood flows after birth suddenly become totally different, and dramatically change directions, pressures and volumes: astonishingly, there are then no more holes in the heart. All healed.
第一个,在胎儿时期,心脏上通常会有巨大的洞来促进血液流动;但在婴儿出生后,也就是刚出生的时候,这些洞就神奇地闭合和密封了。就像上面说的伤疤愈合一样,没有疤痕。在数以百计的其他身体上的巨大变化中,出生后的血液流动突然变得完全不同,方向、压力和流量等都发生了巨大的变化。令人惊讶的是,心脏再也没有洞了,都愈合了。
Second, embryonic stem cells, sort of the baby of baby cells, have the super-magical ability to form all kinds of new cells in the body, with totally different functions. They are now touted as a dramatic inspiration for “adult stem cells,” adult cells being made to “revert” to be like these baby cells, in order to use them to heal many diseases, by their creation of specific fresh new tissues to replace diseased ones. Poetically, like healing without scars, without a trace.
第二个,胚胎干细胞,类似婴儿细胞的“婴儿”,它们具有超神奇的能力,可以在体内组合成各种各样的、具有完全不同功能的新细胞。它们现在被吹捧为成体干细胞的重大灵感来源,成体干细胞被制造成类似于这些婴儿细胞的形状,通过创造特定的新组织来取代病变组织,从而用来治疗许多疾病。诗意地说,就像治愈没有伤疤,也无痕迹。
Personally, I have spent my academic life in the events surrounding early life, and I am in awe of the amazing abilities of so-called “immature” organs to totally outperform so-called “mature” organs! Most people call early-life organs as “immature,” but I like to teach my medical students and residents that actually they should be described as “perfect” for the stage of life that they are in, simply developing in different ways at different stages of life.
就我个人而言,我的学术生涯是围绕着新生儿的早期状态中度过的,这让我对那些所谓的未成熟器官的惊人能力感到敬畏。这些能力完全胜过所谓的成熟器官!大多数人认为早期生命器官是不成熟的,但我喜欢告诉我的医科学生和住院医生,实际上它们更应该被描述为完美的生命阶段,只是在生命的不同阶段以不同的方式展开来。
Photos 1, 2 : I like little scars, enough to remind me of the beauty and artistry of healing, but not enough to scar me for life.
图 1, 2:我喜欢小伤疤,这足以让我想起治愈的美丽和艺术,但还不足以让我终生伤痕累累。
Indeed, we all know the amazing ability of young children to pick up fluently all kinds of languages, much, much better than adults, even as we call their brain as “developing immature brain.” Just watch the new immigrant’s young child pick up the local English language fluently in one year, compared to the impossibility of their adult parents to ever speak as fluently. And the child might be able to speak 3 or more languages fluently if the parents and grandparents have other different native languages, and they just talk naturally to the child; it “just happens.”
的确,我们都知道小孩子惊人的语言学习能力,他们能流利地学习各种语言,比成年人强得多。虽然我们仍然称他们的大脑为发育不成熟的大脑。你只需看看新移民的小孩在一年内就能流利地学会当地的英语,而他们的成年父母却不可能说得如此流利。如果父母和祖父母等其他共同生活的人有其他不同的母语,孩子们可能会流利地说3种甚至3种以上的语言,只需要他们的家人自然地和孩子说话,孩子学会这些语言的事实就自然而然地发生了。
To be provocative, I could even legitimately say that many functions and capabilities of our organs actually may go downhill after the fetal, baby or childhood phases! Like the smooth, seamless, painless healing function of a fetal scar, healing completely without a trace, an ability that is seemingly lost later. I like to say the newborn baby skin can be even considered some form of idealized “reference standard,” essentially closer even to “perfection.” For example, wouldn’t it be wonderful if we had all that kind of perfect unscarred skin, all our lives!
为引起注意,我甚至可以合理地说,我们器官的许多功能和能力实际上可能会在胎儿、婴儿或儿童时期之后走下坡路! 就像胎儿疤痕的平滑、无缝、无痛的愈合功能,完全没有任何痕迹地愈合,这种能力后来似乎消失了。我想说,新生婴儿的皮肤甚至可以被认为是某种理想化的参考标准,本质上更接近完美。如果我们的一生都能拥有完美无暇的皮肤,那该多好啊!
In the rest of life, scars can indeed be ugly. We understand instinctively why people always like to cover up their scars, even if they are not wearing bikinis. I have personally had enough scars in my life, from accidents and surgeries. I had a scar above my left eyebrow from a fall in childhood, but I bore that scar proudly as a young man, in a macho kind of way. Boys will be boys, and scars proved it, I figured.
在以后的生活中,疤痕的确可能是丑陋的。我们本能地就可以理解为什么人们总是喜欢掩盖他们的伤疤,即使他们并没有穿比基尼。在我的生活中,事故和手术给我留下了太多的伤疤。我的左眉上方有一块伤疤,那是我小时候摔下来留下的,但我年轻时曾以一种男子汉的气概自豪地承受着这道伤疤。男孩终归是男孩,伤疤就是一种证明,这是我那时的想法。
I had an appendix operation scar however which I did not like, because there were so many ugly needle holes in the rather unsightly scar. However, in both my forehead and my appendix scars, I noticed that, over half a century later, they actually very gradually started fading, and now, at my late age, I can only vaguely see the scars, to my surprise! Then I realized my wife’s surgical scars from her 2 ovarian cancer operations, step-by-step very slowly also fading, an unexpected blessing of long advancing years, I suppose! I don’t remember being taught that scars actually being diminished, given lots of time, but we are quite happy about that.
我还有一个阑尾手术疤痕,但我不喜欢,因为有那么多难看的针洞在这个难看的伤疤上。然而,无论是我前额还是阑尾上的伤疤,我都注意到,半个多世纪后,它们实际上都是在非常缓慢地消退,而现在,在我的晚年,我只能模糊地看到这些伤疤,这让我很惊讶! 然后我注意到我妻子的手术疤痕(她的2次卵巢癌手术留下的),也在逐步地、非常缓慢地褪色。我想这是这漫长岁月中的一个意外的祝福吧!我不记得有人教过我:如果给予足够的时间,伤疤实际上是会消失的。但我们仍然对此非常高兴。
However, I feel sorry for the person who develops keloids, which are the truly unsightly overproduction of scars. The bothersome problem is that surgery to remove the scars can produce worse keloid scars. And sometimes these keloids can really look rather angry.
然而,我为那些长出瘢痕疙瘩的人感到难过,它们是伤疤过度生长导致的非常不雅观的结果。更麻烦的问题是,去除疤痕的手术很可能会产生更严重的疤痕疙瘩。有时这些瘢痕疙瘩看起来真得让人难以接受。
The average doctor actually doesn’t tell you much of what happens to your wounds and scars. You just have to deal with those so-called “minor secondary issues” yourself. My wife had a relatively “simple operation” to place a “port” in her large vein system to give her cancer chemotherapy. It wasn’t explained that the scar would be quite large, could get tangled up with fibrous tissue, and removing the port was not simple, sometimes even requiring a “minor” operation. Indeed, for her, removal was painful, and left a bad puckered scar for years. Scars usually are just not pleasant.
一般的医生实际上不会告诉你你的伤口将会是什么样子的?。你需要自己处理那些所谓的次要问题。我的妻子做了一个相对简单的手术,在她的大静脉系统中放置一个“端口”,来给她做癌症化疗。医生并没有说明这个手术导致的伤疤会很大,还可能会和纤维组织纠缠在一起,将来摘除这个端口也并不简单,甚至需要再做一个小手术。事实上,对她来说,摘除时确实是痛苦的,而且留下了多年皱巴巴的伤疤。伤疤通常都不是太愉快的。
I remember vividly being trained in surgery by very careful surgeons at the eminent Queen Mary Hospital, of the University of Hong Kong School of Medicine, at a time when I was focused on a career in surgery. These “artistic” surgeons liked to close their wounds with very fine thin sutures, basically under the skin, with no skin needle holes needed. There were practically no visible signs of the sutures at all, and the wounds closed themselves gently with minimal scarring.
我清楚地记得,当我专注于外科手术的时候,我曾在香港大学医学院玛丽医院(Queen Mary Hospital)接受过非常细心的外科医生的培训。这些艺术外科医生喜欢用非常细的缝线缝合伤口,基本上是在皮肤下面,不需要皮肤针孔。几乎看不出缝合线的痕迹,伤口慢慢愈合,几乎没有留下疤痕。
These doctors cared not only for the “primary” surgery, the main organs they were treating, but also for the “secondary” appearance and well-being of the patient. I wish all surgeons were trained like that, skins would be a lot more beautiful! Indeed, I have a feeling that scars were meant to heal well, even beautifully, if we just learn to be more delicate and deliberate, and surgeons had more time and patience.
这些医生不仅关心主要问题—-外科手术(他们治疗的主要器官),而且还关心病人的次要问题—-外观和健康。我希望所有的外科医生都受过这样的训练,这样手术后的皮肤会更漂亮! 的确,我有一种感觉,如果我们学会更细致、更深思熟虑,而且外科医生有更多的时间和耐心,那么伤疤本来应该愈合得很好,甚至可以称得上是很漂亮的。
After all, the healing process itself is indeed amazingly complex and artistically beautiful. It is definitely not just stitching up a wound with lots of sutures. Thousands of actions have to take place in a highly organized, even artistic, concert of movements, chemicals, and electrical functions. That these “natural” responses could happen without any human guidance is just another one of those things we take for granted and easily forget about. Without these complex, truly creative, functions that occur “naturally,” frankly there would not be any healing of wounds. Oddly enough, the outward scar is just one small part of the healing, like a visible signature of what is happening invisibly underneath the skin.
毕竟,愈合过程本身确实是出奇的复杂和艺术的美。它绝不仅仅是用大量的缝线缝合伤口。成千上万的动作必须象在进行一个高度组织的,甚至是艺术的音乐会,组合起运动、化学和电子功能等等。这些自然反应可以在没有任何人类引导的情况下发生,这只是我们认为理所当然、容易忘记的事情之一。如果没有这些复杂的、真正有创造性的、自然发生的功能,坦率地说,伤口就不会愈合。奇怪的是,外部的伤疤只是愈合过程的一小部分,就像是皮肤下面正在发生的所有事情的一个可见的标志。
I am immensely touched and impressed by cosmetic surgeons who work on burn patients, so gently and so expertly. Scars related to burns are among the most awful kinds of scars for anyone to face, for patients, family, and even nurses and doctors. We once came to know a child well, from Chongqing, China, who traveled thousands of miles to Cincinnati to be treated at the world-famous Shriners Burns Hospital, and who required ultimately dozens of surgeries in order to treat the extensive burns over nearly all her body. It was amazing to see her grow up as a relatively “normal child,” who did not have to hide herself from society, to basically live a new life in Cincinnati. Her God-loving new family who tenderly cared for her throughout her many operations, and fully adopted her, completed the scar healing process to a remarkable degree. A touching love story for those who were privileged to know them, including many pediatric scholars from China.
我被那些为烧伤病人做整容手术的医生们深深打动了,他们是那么温柔,那么专业。与烧伤有关的伤疤是任何人都要面对的最可怕的伤疤之一,对病人、家人、甚至护士和医生都是如此。我们曾经很熟悉一个来自中国重庆的孩子,她千里迢迢来到辛辛那提,在世界著名的施莱纳斯烧伤医院 (Shriner’s Burns Hospital)接受治疗,为了治疗她几乎全身的大面积烧伤,她最终做了几十次手术。看到她成长为一个相对正常的孩子,不需要躲避社会,基本上在辛辛那提过着新生活,我感到很惊讶。她的新家庭充满了对上帝的爱,在她的许多次手术中,他们都亲切地照顾着她,并完全地接纳她,这使她的疤痕愈合达到了一个非凡的程度。对于那些有幸认识他们的人来说,这是一个感人的爱的故事,其中包括许多来自中国的儿科学者。
Most people are only familiar with plastic surgeons or cosmetic surgeons who make rich people look pretty, but there are also many who are involved in the beautiful work of correcting congenital deformities and disfiguring face and skin conditions. As a baby doctor, I had the chance to see what great creative skills it took, to allow some less fortunate babies to have a chance to look normal and pretty, to avoid a life of misery and discrimination. These are some of the best doctors who try to leave minimal scars, even those related to their own surgery! They truly have to take meticulous pains and care, to make sure each action, each stitch, at the right location is accurately and precisely made, for the best and most beautiful result.
大多数人只熟悉塑形整容等使人(尤其是富人)看起来漂亮的整形外科医生。但也有许多整形外科医生参与纠正先天性畸形和使被毁容的患者的整容工作,他们竭尽全力使患者的面部和皮肤尽量看起来漂亮一些。作为一名新生儿医生,我有机会看到具有创造力的技术,让一些不幸的婴儿有机会看起来正常和漂亮,避免悲惨和受歧视的生活。他们都是最好的医生,他们试图留下最小的疤痕,精益求精地处理手术过程中的所有伤疤!他们真地必须付出千辛万苦和无微不至的关注,以确保每一个动作,每一针,都精准到位,以达到最好的和最美丽的结果。
And, just as physical scars seem to get better after long periods, even emotional scars might sometimes get better, over long periods. I just heard the horrible story of a twin Jewish girl who suffered cruelly in Auschwitz, as an experiment in the evil hands of the notorious Doctor Mengle. To her own surprise, in her very old age she was ultimately able to forgive her tormentors. Corrie Ten Boom, whom I have written about, (see Reggiestales.org), traveled extensively to speak about God’s love, in spite of experiencing hell on earth in Nazi concentration camps. In a dramatic moment of meeting her former camp guard face to face, she suddenly felt God filling her with His love, to forgive even a cruel Nazi tormentor. Deep scars need deep healing.
而且,就像身体上的伤疤在长时间之后似乎会好起来一样,情感上的伤疤有时可能也会在长时间之后得到平复。我刚刚听说了一个可怕的故事,一对双胞胎犹太女孩中的一个在奥斯维辛遭受了残酷的折磨,就在臭名昭著的医生孟可的实验中。令她自己惊讶的是,当她很老了以后, 她最终能够原谅那些曾经折磨她的人。我曾经写过的Corrie Ten Boom (见Reggiestales.org),尽管在纳粹集中营里经历过人间地狱,但她还是四处旅行,宣讲上帝之爱。在一个戏剧性的时刻,她与前集中营看守面对面,她突然觉得上帝用祂的爱充满了她,让她原谅了一个残忍的纳粹折磨者。越深的伤疤需要越深的愈合。
Photos 3, 4: Ahh the baby, whose skin is perfect, unscarred and beautiful. We wish we all had her skin. By permission of Eliana Joy, Ben and Olivia Waters.
图 3, 4: 孩子,皮肤很完美,没有疤痕,很漂亮。我们都希望拥有和她一样的皮肤(图片经伊莱安娜·乔伊,本和奥利维亚·沃特斯许可)。
I suspect most people dream of an idealized place with no scars at all, where everybody looks pretty, where all skin features are smooth, not dimpled, not rough, and certainly without a single scar anywhere. Actually, as we started this story, the newborn baby exhibits many of these dream situations that we would like to have. The skin of a newborn baby is just that beautiful, and if you carefully touch the skin, you will be shocked how soft, smooth, and gentle it feels. Even baby hair has such a great gentle texture to it. That’s a lot to do with why grandparents, unwittingly, fall head over heels in love with their brand-new grandchild!
我猜想大多数人都梦想着一个理想的地方,那里没有任何疤痕,每个人看起来都很漂亮,所有的皮肤特征都很光滑,没有坑洼,没有粗糙,当然在任何地方都没有任何疤痕。事实上,当我们开始这个故事的时候,新生的婴儿就展现了许多我们想要的梦境。新生婴儿的皮肤就是那么美,如果你仔细触摸皮肤,你会惊讶地发现它是多么柔软、光滑和温柔。即使是婴儿的头发也有非常柔顺的质地。这可能就是为什么祖父母会毫无保留地爱上他们新生的孙子/女的原因之一。
As a newborn baby doctor, I can attest full-heartedly that the baby, especially her skin, is indeed such a joy to behold, and I feel, a great hint of what a fully restored human being could be like, in that final land of innocence and no scars! After all, the greatest Teacher even said famously, to enter into the kingdom of heaven, you have to be “like a child,” to have a “new birth.” Words that make a newborn baby specialist beam with pleasure and satisfaction!
作为一名新生儿医生,我可以全心全意地证明,一个新生儿,尤其是她的皮肤,确实令人赏心悦目,我觉得这也是一个巨大的暗示,当我们最终恢复为“完整的人”,将会生活在一片天真无邪、没有疤痕的土地上! 毕竟,最伟大的老师甚至说过一句名言,要进入天国,你必须像个孩子,才会有一个新的生命。这些话会让一个新生儿专家感到非常高兴和满足。
But wait, there is one individual in all of history whose dramatic scars have radically made history, changed history, and impacted the personal history of one third of the world’s population. That person was scarred from beatings, tortures, and a crown of thorns. His wounds and scars are depicted in pictures and paintings over the world, as signature of his supreme love for all. Enabling all to be healed of deep scars, presently and in that place of no scars.
但是等一等,在几千年的历史中,有一个人,他那戏剧性的伤疤彻底地创造了历史,改变了历史,并最少直接影响了世界上三分之一的人。那个人在被殴打、折磨和荆棘冠头之中伤痕累累。他的伤口和疤痕被描绘在世界各地的图画中,作为他对所有人至高的爱的标志。使所有人都能治愈深深的伤疤,就在现在以及那不会有疤痕的地方。
Photo 5: The scars that removed our scars. According to medical journals the nail was likely in the wrist, and not the palm of the hand, to not tear through it.
图 5:消除我们伤疤的伤疤。根据医学杂志,铁钉很可能是在手腕上,而不是在手掌上,这样就不会撕裂手(从谷歌安全搜索,全部使用)。