A HOT SPOT OF HEALING

治癒的熱點

At first glance, Issam Nemeh’s exam room looked like any other. A bit antiseptic, with a paper sheet over the exam bed, medical equipment hanging on the walls, a sink, and a rolling doctor’s stool. But little differences stood out, such as the shelves lined with personal mementos from patients who experienced dramatic turnarounds under his care.

乍一看，Issam Nemeh 的檢查室看起來和其他任何房間都一樣。有點防腐，檢查床上有一張紙，牆上掛著醫療設備，有一個水槽和一個滾動的醫生凳子。但幾乎沒有什麼不同，比如書架上擺滿了在他的照顧下經歷了巨大轉變的患者的個人紀念品。

In his exam room, Nemeh described what he generally did with patients. Most of it is connection: he talks with them, he listens. He prays over them, or over a specific body part that bothers them. Appointment lengths are variable. Sometimes people are in and out quickly; other times he’ll spend two, even three hours with someone if that’s how long it takes. People sit in his waiting room for hours, patiently waiting their turn. He works late into the night, then gets up in the morning and starts again.

在他的檢查室里，Nemeh 描述了他通常對患者所做的工作。其中大部分是聯繫：他與他們交談，他傾聽。他為他們祈禱，或者為困擾他們的特定身體部位祈禱。預約時長是可變的。有時人們進進出出很快;其他時候，他會花兩個甚至三個小時和某人在一起，如果這需要多長時間的話。人們在他的候診室里坐了幾個小時，耐心地等待輪到他們。他工作到深夜，然後早上起床，重新開始。

At one point, he looked at me sitting in my chair, taking notes, and said, “You’ve got a back problem.”

有一次，他看著坐在椅子上做筆記的我說，“你的背部有問題。

I did have a back problem. As a kid, I worked hard on my parents’ farm, carrying heavy hay bales and five-gallon water buckets. When very young, I had to hold them up high so they wouldn’t drag. I’d always assumed my back pain was from that physical labor, that I’d permanently damaged my back through overwork from a young age. I barely thought about it anymore; I’d gotten used to it, accepted it as simply part of life. It came and went but flared up especially badly when I was under stress.

我確實有背部問題。小時候，我在父母的農場辛勤工作，背著沉重的乾草包和五加侖的水桶。在很小的時候，我必須把它們高高舉起，這樣它們就不會拖拽。我一直認為我的背痛是體力勞動造成的，我從小就因過度勞累而永久性地損害了我的背部。我幾乎不再想這件事;我已經習慣了它，接受了它只是生活的一部分。它來來去去，但當我處於壓力下時，它發作得特別嚴重。

Nemeh looked at my back. Something was out of alignment, he told me. He prayed, a low murmur. It was brief. When he placed his hands on my back, it suddenly felt very warm and pliable as rubber. He moved something into place—or it felt like he did—and the pain was gone.

Nemeh 看著我的背影。他告訴我，有些事情不對勁。他祈禱著，低沉的喃喃自語。它很簡短。當他把手放在我的背上時，突然感覺非常溫暖和柔韌，就像橡膠一樣。他把什麼東西移到了原位——或者感覺像是他這樣做了——然後疼痛就消失了。

For the rest of the day, I kept expecting it to return, but it never did. Years later, it still hasn’t.

在那天剩下的時間里，我一直期待著它會回來，但它從未回來。多年後，它仍然沒有。

The next day, I began interviews with Dr. Nemeh’s patients. In a small conference room at the hotel, I moved some chairs into position and showed the cameraman where he should set up his tripod. He was a volunteer, sent to help out by Issam Nemeh and his wife. I’d asked them to send me patients willing to speak to me about their recoveries. I was explicit about the criteria: I needed people who’d had an incurable medical illness, as well as indisputable evidence of both accurate diagnosis and recovery. I was hoping they’d have at least a few people who met those requirements. Kathy Nemeh, a fiery, outgoing spark plug of a woman and the hyperorganized engine behind Nemeh’s practice, sent me twenty-five. And there were always more if I needed them, she promised.

第二天，我開始採訪Nemeh醫生的病人。在酒店的一個小會議室里，我把一些椅子挪到適當的位置，並向攝影師展示他應該把三腳架放在哪裡。他是一名志願者，由Issam Nemeh 和他的妻子派來幫忙。我要求他們給我送來願意和我談談他們康復情況的病人。我明確了標準：我需要患有不治之症的人，以及準確診斷和康復的無可爭辯的證據。我希望他們至少有幾個人滿足這些要求。Kathy Nemeh，一個火熱、外向的女人火花塞，也是 Nemeh 實踐背後的高度組織化的引擎，給我發了 25 個。如果我需要它們，總會有更多，她保證。

People cycled through the conference room over the course of two days as sharp snow fell outside the hotel windows. It was a whirlwind, with hours and hours of interviews, one stacking onto the next as I took rapid notes and tried to think on my feet to ask the necessary follow-up questions whenever an interview took a surprise twist. Back in my hotel room at the end of each day, I went over the evidence. It was tough. They were all fairly strong cases. But some weren’t quite as clear-cut as others. With some, I couldn’t be completely sure that the person had fully recovered and wasn’t simply in a temporary remission that’s typical for that particular disease. Lymphoma and leukemia, for instance, are extraordinarily complex illnesses. There are some forms of these diseases that are quickly fatal, but others wax and wane for long stretches of time. In other instances, the diagnoses and recoveries were well documented and real, but the disease in question was obscure and rare. When a disease is peripheral and rarely seen, we don’t have a lot of research or data on it, and we can’t be sure how it behaves and what’s possible. A sudden remission may be in the realm of possibility for the normal course of this disease—we just don’t know.

在兩天的時間里，人們騎車穿過會議室，酒店窗外下起了大雪。這是一場旋風，有幾個小時的採訪，一個接一個，我快速做筆記，並試圖獨立思考，每當採訪出現意外轉折時，都會提出必要的後續問題。每天下班后回到酒店房間，我都會仔細檢查證據。這很艱難。它們都是相當有力的案例。但有些並不像其他人那樣明確。對於一些疾病，我無法完全確定這個人是否已經完全康復，而不僅僅是處於該特定疾病典型的暫時緩解狀態。例如，淋巴瘤和白血病是極其複雜的疾病。這些疾病的某些形式會迅速致命，但其他形式的疾病會在很長一段時間內起伏不定。在其他情況下，診斷和康復是有據可查的和真實的，但所討論的疾病是模糊和罕見的。當一種疾病是週邊的並且很少見時，我們沒有大量的研究或數據，我們無法確定它的表現如何以及可能發生什麼。這種疾病的正常病程可能有可能突然緩解——我們只是不知道。

But others leaped out, startling examples of what’s possible in human healing. There was Guy, who suffered from severe rheumatoid arthritis, an incurable autoimmune disease that attacks the joints and is progressively painful and debilitating. Under Dr. Nemeh’s care, he went from a complete inability to function to leading a normal life. He attributed his healing to Dr. Nemeh but also to forgiveness. He felt that forgiving a close family member who had hurt him deeply decades earlier had “removed a toxin” from his body. And indeed, the way he described it, the process of forgiveness had seemed to literally loosen his joints.

但其他人跳出來，令人震驚地說明了人類治癒的可能性。蓋伊患有嚴重的類風濕性關節炎，這是一種無法治癒的自身免疫性疾病，會攻擊關節，並逐漸疼痛和虛弱。在 Nemeh 醫生的照顧下，他從完全無法正常工作到過上正常的生活。他將自己的治癒歸功於 Nemeh 醫生，但也歸功於寬恕。他覺得原諒幾十年前深深傷害過他的親密家庭成員已經從他的身體中“去除了毒素”。事實上，正如他所描述的那樣，寬恕的過程似乎真的讓他的關節鬆動了。

His story was almost unbelievable, but I knew there was also some degree of scientific basis for his claims; I’d seen multiple studies on the health benefits associated with the process of forgiveness. Researchers theorized that it could dislodge entrenched patterns of stress and anxiety, lessening and rebalancing the stress hormones in the body. Forgiveness has been associated with lower blood pressure and lower risk of heart attack; people who are more hardwired to forgive others seem to have stronger, more robust immune responses. Unforgiveness, on the other hand, because of the complex mix of hormones and chemicals released by constant negative feelings, can dampen the immune system and make it worse at fighting off viruses and bacteria.² Listening to Guy’s story, it made me wonder if the science on forgiveness was just the tip of the iceberg. If such strong correlations had been found in controlled scientific studies, perhaps, in certain situations, even more is possible.

他的故事幾乎令人難以置信，但我知道他的說法也有一定程度的科學依據;我看過很多關於寬恕過程對健康益處的研究。研究人員推測，它可以消除根深蒂固的壓力和焦慮模式，減輕和重新平衡體內的壓力荷爾蒙。寬恕與降低血壓和降低心臟病發作的風險有關;更天生就善於原諒他人的人似乎具有更強、更強的免疫反應。另一方面，由於持續的負面情緒釋放的激素和化學物質的複雜混合物，不寬恕會抑制免疫系統，使其在抵抗病毒和細菌方面變得更糟。²聽了蓋伊的故事，我想知道關於寬恕的科學是否只是冰山一角。如果在受控科學研究中發現了如此強的相關性，也許在某些情況下，甚至有可能更多。

And then there was Karen.³ She and her twin sister had both been born with cerebral palsy, a serious disorder that affects the brain and muscles and can be quite debilitating. Cerebral palsy is a permanent, irreversible condition. And yet Karen had recovered. Before she began seeing Issam Nemeh, Karen had frequently used a wheelchair. At school, she tried to get along without it, pulling herself up the stair railings, but walking was always difficult. Now she could not only walk on her own, she could run. She felt stronger than she’d ever felt in her life.

然後是 Karen。³她和她的雙胞胎姐姐都患有腦癱，這是一種影響大腦和肌肉的嚴重疾病，可能會使人非常虛弱。腦癱是一種永久性的、不可逆的疾病。然而，凱倫已經康復了。在開始見到 Issam Nemeh 之前，Karen 經常使用輪椅。在學校里，她試圖在沒有它的情況下相處，把自己拉上樓梯欄杆，但走路總是很困難。現在她不僅可以自己走路，還可以跑步。她感覺自己比這輩子任何時候都更強大。

Startled, I wondered if this could possibly be true, pressing her for more details—and then I remembered my own session with Nemeh, how my back had suddenly felt strange and pliable.

我嚇了一跳，想知道這是否可能是真的，追問她更多細節——然後我想起了我自己和Nemeh的談話，我的背是如何突然感到奇怪和柔韌的。

So what did I think about prayer and healing? I still wasn’t sure. I could see how the act of praying, in the way that it connects you to others, could launch a praying person into what Barbara Fredrickson called the “upward spiral” of the heart. Feeling connected to others, a sense of community and belonging—those kinds of positive feelings can mitigate stress and activate the parasympathetic. But was there more to prayer? What did the research show? I needed to dig into it. And I still needed to talk to Dr. Kaine, one of those whose story had propelled me out to Ohio in the first place.

那麼，我對祈禱和醫治有什麼看法呢？我仍然不確定。我可以看到祈禱的行為，以它將你與他人聯繫起來的方式，如何使一個祈禱的人進入芭芭拉·弗雷德里克森（Barbara Fredrickson）所說的心的 “螺旋上升”。感覺與他人有聯繫、社區感和歸屬感——這些積極的情緒可以減輕壓力並激活副交感神經。但是，祈禱還有更多嗎？研究表明了什麼？我需要深入研究它。我仍然需要與 Kaine 博士交談，他的故事最初將我推向俄亥俄州。

“I’LL PRAY FOR YOU”

“我會為你祈禱”

Dr. Nemeh’s patients believed their healings came from God and that Dr. Nemeh was a conduit. He tends to describe himself as an “energy healer” and believes that prayer is, in fact, a form of energy. But the research on prayer and healing, when I dug into it, was a morass of contradictions and controversy. There’s not a lot of hard research to look at—it’s difficult to get funding to study prayer—and the research I did find was a mess. A meta-analysis of all major studies done on prayer concluded that less tightly controlled studies obtained positive responses, whereas the tighter, more rigorous studies found no particular correlation between prayer and healing. But they were difficult to evaluate. Overall, there was a pretty even split between studies that found prayer had a positive impact on healing and those that didn’t. I wondered about the methodologies, though. In applying the scientific method as it is commonly used, with the classic double-blind, placebo-controlled study design, were we washing away everything that made prayer potentially powerful?

Nemeh 醫生的病人相信他們的醫治來自上帝，而 Nemeh 醫生是一個管道。他傾向於將自己描述為“能量治療師”，並認為祈禱實際上是一種能量。但是，當我深入研究祈禱和醫治時，它卻是一個充滿矛盾和爭議的泥潭。沒有很多艱苦的研究需要看——很難獲得資金來研究祈禱——我發現的研究一團糟。對所有關於祈禱的主要研究進行的薈萃分析得出的結論是，控制較嚴格的研究獲得了積極的回應，而更嚴格、更嚴格的研究發現祈禱和治癒之間沒有特別的相關性。但他們很難評估。總的來說，發現祈禱對康復有積極影響的研究和沒有的研究之間存在相當均勻的分歧。不過，我想知道這些方法。在應用常用的科學方法時，通過經典的雙盲、安慰劑對照研究設計，我們是否洗掉了所有使祈禱可能強大的東西？

In 2006, Herbert Benson, ever interested in the mind-body connection after his work on meditation and the relaxation response, received a million-dollar grant to run the largest study on prayer ever completed. The study was to look at intercessory prayer and surgical outcomes. Intercessory prayer refers to prayer on behalf of others. So the question was, could somebody praying in Oklahoma have an impact on the outcome for someone in Ohio who was being wheeled into surgery?

2006年，赫伯特·本森 （Herbert Benson） 在從事冥想和放鬆反應的工作后一直對身心聯繫感興趣，他獲得了一百萬美元的資助，用於開展有史以來最大的祈禱研究。這項研究是為了觀察代禱和手術結果。代禱是指為他人祈禱。所以問題是，在奧克拉荷馬州祈禱的人會對俄亥俄州被推入手術的人的結果產生影響嗎？

Benson’s study was the most rigorously designed study in the history of prayer research. It was randomized, double-blind, placebo-controlled—by official standards, it was watertight. Here’s what they did: They took 1,500 people from six hospitals across the United States who were all getting the same surgery, a coronary artery bypass graft. Benson likely chose this particular surgery because he was trained as a cardiologist and because a lot of previous studies on prayer had been done with heart patients. Plus, heart disease is one of the leading causes of death in this country and across the Western world, and this particular surgery is a common one—the year this study was done, more than 350,000 Americans, and over 800,000 people worldwide, received this surgery. That made it easy to get a good sample size.

本森的研究是祈禱研究史上設計最嚴格的研究。它是隨機的、雙盲的、安慰劑對照的——按照官方標準，它是無懈可擊的。他們是這樣做的：他們從美國各地的6家醫院接收了1,500人，他們都在接受相同的手術，即冠狀動脈旁路移植術。本森選擇這種特殊的手術可能是因為他接受過心臟病專家的培訓，而且之前很多關於祈禱的研究都是對心臟病患者進行的。此外，心臟病是這個國家和整個西方世界的主要死亡原因之一，這種特殊的手術很常見——在這項研究完成的那一年，超過 350,000 名美國人和全球超過 800,000 人接受了這種手術。這使得獲得良好的樣本量變得容易。

Patients who agreed to participate were randomly assigned to one of three groups. The first group was told that they may or may not receive prayers during their surgery, and then they did receive them. The second group was told the same thing, but then didn’t receive prayer. The final group was told that they would definitely receive prayer, and they did. Typically, about 50 percent of all patients receiving this particular heart surgery are expected to have at least one complication. This was the measure Benson used going into the study to determine whether or not intercessory prayer could have an impact on the success of a surgery—whether or not this number dropped when people were prayed for.

同意參加的患者被隨機分配到三組中的一組。第一組被告知，他們在手術期間可能會也可能不會接受祈禱，然後他們確實接受了祈禱。第二組被告知同樣的事情，但後來沒有得到禱告。最後一組被告知他們肯定會接受祈禱，他們做到了。通常，接受這種特定心臟手術的所有患者中約有 50% 預計至少會出現一種併發症。這是本森在研究中用來確定代禱是否會對手術成功產生影響的措施——無論當人們被祈禱時，這個數位是否下降。

Benson found three prayer groups that agreed to participate for the entire length of the study, which was quite a commitment: the study would run for three years. For the duration of the study, Benson’s team faxed each group a list of names the night before those patients’ surgeries. Catholic prayer group participants at St. Paul’s Monastery in Minnesota and the community of Theresian Carmelites in Worcester, Massachusetts, and one prayer group called Silent Unity in Lee’s Summit, Missouri, who knew nothing about the people they were praying for except their first name and last initial—Matthew L., Sarah G.—repeated the same scripted prayer each time for each name on the list: For a successful surgery with a quick, healing recovery and no complications.

本森找到三個禱告小組，他們同意在整個研究期間參與，這是一個相當大的承諾：這項研究將持續三年。在研究期間，Benson 的團隊在這些患者手術的前一天晚上向每組發送了一份姓名清單。明尼蘇達州聖保羅修道院和馬薩諸塞州伍斯特市特蕾西安加爾默羅會社區的天主教祈禱小組參與者，以及密蘇里州李峰會一個名為“沉默的團結”的祈禱小組，他們對他們所祈禱的人一無所知，除了他們的名字和姓氏首字母——馬修 L.、莎拉 G.——每次都為名單上的每個名字重複相同的腳本祈禱： 手術成功，恢復迅速，癒合良好，無併發症。

The results of the study were distinctly not what many had hoped for. The first two groups—those who were unsure as to whether they’d be receiving prayer—had almost identical rates of complications post-surgery, at 52 percent and 51 percent, respectively. This was just a percentage point or two away from the usual rate of complications with this surgery—statistically insignificant. So when people were unsure of whether they’d be prayed for, the prayers they received—or didn’t—seemed to have no impact. However, those who knew they’d receive prayer, and did, had a markedly higher rate of complications: 59 percent.

這項研究的結果顯然不是許多人所希望的。前兩組——那些不確定自己是否會接受祈禱的人——術后併發症的發生率幾乎相同，分別為 52% 和 51%。這與這種手術的通常併發症發生率僅相差一兩個百分點——在統計學上微不足道。因此，當人們不確定他們是否會得到禱告時，他們收到的禱告——或沒有——似乎沒有產生任何影響。然而，那些知道自己會接受祈禱並且確實接受了祈禱的人，併發症的發生率明顯更高：59%。

What happened there? Why on earth would the prayed-for people have a higher rate of complications? Could prayer hurt instead of help somehow?

那裡發生了什麼？為什麼祈禱的人併發症的發生率會更高呢？祈禱會不會以某種方式造成傷害而不是説明？

Benson had a couple of theories. One was that it was a fluke—a 9 percent increase in the rate of complications within a study group could simply be the normal fluctuation of results. It wasn’t too far outside the range, and the normal rate of 50 percent is of course an average, compiled from hundreds of thousands of surgeries each year. His other theory was that the study results were complicated by other prayers. Study participants were told not to alter their usual plans surrounding their surgeries, to simply continue on as if they weren’t being prayed for by strangers in Minnesota, Missouri, and Massachusetts. And many of those people already had friends and family praying for them. Many prayed for themselves. To ask people not to do this, or to forbid friends and family from praying for them, would have been “unethical and impractical.”

本森有幾個理論。一個是這是僥倖——研究組內的併發症發生率增加9%可能只是結果的正常波動。這並沒有超出範圍太遠，50% 的正常比率當然是每年數十萬例手術的平均值。他的另一個理論是，研究結果因其他祈禱而複雜化。研究參與者被告知不要改變他們通常的手術計劃，簡單地繼續進行，就好像他們沒有被明尼蘇達州、密蘇里州和馬薩諸塞州的陌生人祈禱一樣。這些人中的許多人已經有朋友和家人為他們祈禱。許多人為自己祈禱。要求人們不要這樣做，或禁止朋友和家人為他們祈禱，將是“不道德和不切實際的”。

“Thus,” Benson wrote, “our study subjects may have been exposed to a large amount of non–study prayer, and this could have made it more difficult to detect the effects of prayer provided by the intercessors.”

“因此，”本森寫道，“我們的研究物件可能已經接觸到了大量非研究性的祈禱，這可能使我們更難察覺代禱者提供的祈禱的效果。

It fascinated me that those who knew they were being prayed for had a higher rate of complications. Benson’s hypotheses about why that happened were certainly valid. But I wondered if there were more to it. Perhaps some people viewed prayer, and God, as something external, something outside of themselves—and so in this case, prayer became a sort of silver bullet. There could be danger in that just as there was danger in viewing medications as a silver bullet. In these instances, nothing in you needs to change—not your attitude or your perspective; you just wait to be healed. Being prayed for, perhaps, is too passive an activity to have an impact on healing. And Dr. Nemeh spoke of prayer as an energy, something that can have different levels of quality—but the quality of prayer was a dimension wholly unexamined in this study.

令我著迷的是，那些知道自己被禱告的人併發症的發生率更高。本森關於為什麼會發生這種情況的假設當然是有效的。但我想知道是否還有更多。也許有些人把禱告和神看作是外在的，是他們之外的東西——所以在這種情況下，禱告變成了一種靈丹妙藥。這可能存在危險，就像將藥物視為靈丹妙藥一樣。在這些情況下，你內心的一切都不需要改變——你的態度或觀點也不需要改變;你只是等待被治癒。也許，被祈禱是一種太被動的活動，不會對醫治產生影響。尼梅博士說祈禱是一種能量，可以具有不同程度的品質——但祈禱的品質是本研究完全沒有考察過的一個維度。

Ultimately, I found that I couldn’t take this study—rigorous as it was—as a final statement on prayer. Perhaps it was more of a statement on the design of the study and how studies are run in general. Our studies are rooted in a traditional understanding of science and the scientific method and are designed to measure only things “outside of us,” things known through our five senses. Looking at something like prayer, which is infused with mental, emotional, and spiritual factors, is almost impossible for our current conception of the scientific method, which by design washes the individual, with all their uniqueness, their exceptionality, their deeper qualities, out of the equation. With a study like this, we have no idea about the intensity of the prayers and no idea about the level of spiritual development involved.

最終，我發現我不能把這個研究——儘管它很嚴格——作為關於禱告的最終陳述。也許它更像是關於研究的設計以及研究的一般運作方式的聲明。我們的研究植根於對科學和科學方法的傳統理解，旨在只測量“我們之外”的事物，即通過我們的五種感官所知道的事物。看著像祈禱這樣注入了心理、情感和精神因素的東西，對於我們目前的科學方法概念來說幾乎是不可能的，它通過設計將個人的所有獨特性、特殊性、更深層次的品質從等式中洗脫出來。通過這樣的研究，我們不知道祈禱的強度，也不知道所涉及的靈性發展水準。

It was the same way I was trained as a doctor. In medical school, they taught us to block out the context, the individual story, and focus on the disease, the symptoms. We weren’t supposed to take into account the patient’s feelings, backstory, intensity, or desires. We were trained to cut that out, create a tight circle around their symptoms, and place that small, tight circle on the microscope deck for evaluation. We miss a lot by taking this approach. And so did the studies on prayer. How you pray could be an important factor. And what about how deeply people believe in the power of prayer, or if it’s more of a social function or tradition for them? Are there ascending qualities of prayer, just like there are levels of capacity between different athletes?

這與我接受醫生培訓的方式相同。在醫學院，他們教我們遮罩背景、個人故事，專注於疾病和癥狀。我們不應該考慮患者的感受、背景故事、強度或願望。我們接受過培訓，將其剪掉，在他們的癥狀周圍創建一個緊密的圓圈，然後將那個小而緊密的圓圈放在顯微鏡平臺上進行評估。採用這種方法，我們錯過了很多。關於祈禱的研究也是如此。你如何祈禱可能是一個重要因素。人們對祈禱的力量有多深的信仰，或者它對他們來說是否更像是一種社交功能或傳統呢？祈禱的品質是否不斷上升，就像不同運動員之間的能力水平一樣？

So many of these studies, including Benson’s, guaranteed that people were performing prayer but didn’t examine anything beyond that. I thought of the way that studies on the healing effects of meditation and yoga asked participants to perform these rituals and how we are just beginning to think about how to measure the depth to which people were investing themselves in these activities—or not. There is a difference, it turns out, between meditation studies with untrained college students and advanced meditators. Why wouldn’t this also be true for prayer?

這些研究中的許多，包括本森的研究，都保證了人們在祈禱，但沒有檢查除此之外的任何事情。我想到了關於冥想和瑜伽的治療效果的研究要求參與者進行這些儀式的方式，以及我們如何開始考慮如何衡量人們在這些活動中投入的深度——或不投入這些活動。事實證明，未經訓練的大學生和高級冥想者的冥想研究是有區別的。為什麼禱告不也是這樣呢？

Benson’s prayer study was rigorously designed from the perspective of scientific medical research. His methods were unimpeachable; nobody could have accused him of being sloppy or unscientific. But to me, the study didn’t actually tell us whether there was power in prayer when it came to healing. That question had to come down to what the praying person thought, felt, and experienced. Prayer is not yet quantifiable the way a medication is; it can’t be evaluated in the same way. You can’t say for certain what it’s “made of” or what the “dose” is. Perhaps prayer could be transformative, or it could be utterly powerless—depending on what you believed.

本森的祈禱研究是從科學醫學研究的角度嚴格設計的。他的方法無可挑剔;沒有人可以指責他草率或不科學。但對我來說，這項研究實際上並沒有告訴我們，在治癒方面，祈禱是否有力量。這個問題必須歸結為禱告者的想法、感受和經歷。祈禱還不能像藥物那樣量化;它不能以相同的方式進行評估。你不能確定它 「由 」組成 「或 」劑量 「是什麼。也許祈禱可能是變革性的，也可能是完全無能為力的——這取決於你的信仰。

The same is true for faith. We use the phrase faith healer reflexively to describe people like Issam Nemeh, but what do we really mean when we say faith? It’s a simple word with an enormous amount of weight hanging on it. Faith has been defined as “the assurance of things hoped for, the evidence of things not seen.” To “have faith” is to be able to hold on to your beliefs, even in the face of adversity or suffering. But just like prayer, faith means different things to different people. And if it means holding on to your beliefs no matter what, then doesn’t it matter what, exactly, you believe in?

信仰也是如此。我們條件反射地使用信仰治療師這個詞來描述像 Issam Nemeh 這樣的人，但當我們說信仰時，我們真正的意思是什麼？這是一個簡單的詞，上面有很大的分量。信心被定義為 「所望之事的確據，未見之事的證據」。“有信心”就是即使面對逆境或苦難，也能堅持自己的信念。但就像祈禱一樣，信仰對不同的人意味著不同的事情。如果這意味著無論如何都要堅持你的信仰，那麼你到底相信什麼不重要嗎？

Ultimately, both prayer and faith are expressions of belief. When we try to dissect whether prayer can heal, or whether faith can heal, what we really need to look at are the belief systems underpinning it all—how we see the world, how we make sense of our lives, what we believe is possible or impossible. In cases of spontaneous healing, was there evidence that what you believe can affect how and if you heal? If so, to what degree? How much is wishful thinking or a psychological solace, but ultimately nothing more than that: something that soothes your suffering but has little impact on disease trajectory? Can what you believe actually affect the biology of your physical body?

歸根結底，祈禱和信仰都是信仰的表達。當我們試圖剖析祈禱是否能治癒，或者信仰是否能治癒時，我們真正需要關注的是支撐這一切的信仰體系——我們如何看待世界，我們如何理解我們的生活，我們相信什麼是可能的或不可能的。在自發癒合的情況下，是否有證據表明您的信仰會影響您的癒合方式和是否癒合？如果是這樣，程度如何？有多少是一廂情願或心理上的安慰，但最終只不過是：可以緩解你的痛苦，但對疾病軌跡幾乎沒有影響的東西？你相信的東西真的會影響你身體的生物學嗎？

On The Dr. Oz Show, Patricia Kaine attributed her healing to prayer and to Dr. Nemeh. He’d been a conduit to God, she said. Prayer healed her. But when she went into that conference room months later for the follow-up interview, it turned out that there was so much more to the story.

在 The Dr. Oz Show 上，Patricia Kaine 將她的治癒歸功於祈禱和 Nemeh 博士。她說，他一直是通往上帝的管道。祈禱治癒了她。但幾個月後，當她走進那個會議室進行後續採訪時，事實證明，這個故事還有很多。

“MIRACLES ARE REAL”

“奇跡是真實的”

Patricia Kaine took off her winter coat, sat down, and folded her hands in her lap. She was exactly how I’d remembered her from the soundstage on The Dr. Oz Show: cool and composed, no-nonsense, yet with a warm and friendly demeanor. I asked her to tell her story in her own words, in her own way. She paused and took a deep breath.

派特里夏·凱恩 （Patricia Kaine） 脫下冬衣，坐下，雙手交叉放在膝蓋上。她正是我在 The Dr. Oz Show 的攝影棚里記得的她：冷靜沉著，嚴肅，但舉止熱情友好。我請她用自己的話、自己的方式講述她的故事。她停頓了一下，深吸了一口氣。

“How much time do we have?” she said, practical as always.

“我們有多少時間？”

“As long as it takes,” I said, flipping to a fresh page in my notebook.

“只要需要，”我說，翻到筆記本上的新一頁。

“You mean you want the whole story?” she said. “Nobody’s ever asked for that before.”

“你是說你想要整個故事？”“以前從來沒有人要求過。”

Patricia’s sister contracted polio when they were both very young, right before the vaccine came out. The hospital that treated her told the family that it was the worst case of polio they’d ever had where the patient had survived. They were told to expect a lifetime of disability; she would never walk without a brace.

Patricia 的姐姐在他們都很小的時候就感染了小兒麻痹症，就在疫苗問世之前。治療她的醫院告訴家人，這是他們患過的最嚴重的脊髓灰質炎病例，患者倖存下來。他們被告知，他們預計會終生殘疾;她永遠不會在沒有支架的情況下走路。

Patricia remembered her sister coming home from the hospital, weak and incapacitated. Her mother would do exercises with her sister every day, trying to strengthen her wasted limbs, even though the doctors had told her there was no point. Patricia’s aunt even traveled to Lourdes, the famed healing waters in France, and brought back a vial. Patricia’s mother used it to bless her sister’s limbs, hoping it would help.

派特裡夏記得她的姐姐從醫院回家，身體虛弱，行動不便。她的母親每天都會和姐姐一起做運動，試圖加強她消瘦的四肢，儘管醫生告訴她沒有意義。派特裡夏的姨媽甚至去了法國著名的療癒之水盧爾德，帶回了一個小瓶。派特裡夏的母親用它來祝福她姐姐的四肢，希望它能有所説明。

“With my mother’s dedication to the exercises, and the Lourdes water, too, she got better,” Patricia says. “She walked. She became a nurse. She works as an RN now. But the real importance of this story is that I grew up knowing that miracles are real.”

“由於我母親對鍛煉的奉獻精神，以及盧爾德河的水，她變得更好了，”派特裡夏說。她走路了。她成為了一名護士。她現在是一名註冊護士。但這個故事的真正重要之處在於，我從小就知道奇迹是真實的。

Patricia married young, at twenty. When her husband switched jobs, they moved to rural Appalachia, the area where southeast Ohio meets West Virginia and Kentucky. It was a scrappy, insular, and downtrodden area, beautiful in its own way, with silvery, weathered wooden buildings that stood before a backdrop of forested, sunset-colored mountains. People often lived in those buildings without running water or electricity.

派特裡夏 20 歲就嫁了。當她的丈夫換工作時，他們搬到了阿巴拉契亞農村，即俄亥俄州東南部與西弗吉尼亞州和肯塔基州的交界處。這是一個雜亂無章、與世隔絕、受壓迫的地區，以自己的方式美麗，銀色、風化的木製建築矗立在森林覆蓋、日落色的山脈前。人們經常住在那些沒有自來水或電的建築物中。

Pregnant with their fourth child, Patricia paid monthly visits to her doctor. She noticed how difficult it was to get care, how wildly the demand for health care outpaced the supply. Her appointment was always the last one of the day. The doctor was obviously exhausted. She’d often be the fiftieth patient he’d seen that day, and yet he still had to muster up the energy, the attention and focus, to review her chart, to listen to her baby’s heartbeat, to tell her in a weary voice what she needed to know about prenatal vitamins and the upcoming birth. She felt for him, and she felt for the community, especially the people who didn’t even try to visit the doctor because they couldn’t pay. There weren’t enough doctors to go around.

懷著他們的第四個孩子，派翠夏每個月都會去看醫生。她注意到獲得護理是多麼困難，對醫療保健的需求是多麼的嚴重超過供應。她的約會總是一天中的最後一個。醫生顯然已經筋疲力盡了。她通常是他那天看到的第 50 個病人，但他仍然必須鼓起精力、注意力和注意力，查看她的圖表，傾聽她孩子的心跳，用疲憊的聲音告訴她需要瞭解的有關產前維生素和即將到來的分娩的資訊。她同情他，她同情社區，尤其是那些因為付不起錢而甚至不去看醫生的人。沒有足夠的醫生來四處走動。

She realized that this was her calling. She knew she had the intellectual ability to be a doctor. In school, she’d had perfect grades. But she’d set all that aside to become a wife and mother, which was what was expected of girls at that time in her community. When Patricia applied to medical school in the 1970s, only 3 percent of students entering med school were women. She was turned down from school after school, where admissions officers felt that because she was a mother, she couldn’t be a doctor. Only two schools allowed her to even fill out an application. Only one gave her an interview. When she walked into the room, all eyes went to her belly; she was six months pregnant with her fifth child. She counted on her fingers right in front of the interviewer and said, “Look, by the time school starts, I won’t be pregnant anymore.”

她意識到這就是她的使命。她知道自己具有成為一名醫生的智力。在學校里，她的成績很完美。但她把這一切放在一邊，成為了一位妻子和母親，這是當時她所在社區對女孩的期望。當派翠夏在 1970 年代申請醫學院時，進入醫學院的學生中只有 3% 是女性。她一次又一次地被學校拒絕，招生官覺得因為她是母親，所以她不能成為一名醫生。只有兩所學校甚至允許她填寫申請表。只有一個人接受了她的採訪。當她走進房間時，所有人的目光都集中在她的肚子上;她懷有第五個孩子六個月。她在面試官面前用手指數著說：“你看，等開學時，我不會再懷孕了。

She started at Wright State University School of Medicine six weeks after giving birth. She was still bleeding heavily; something was wrong, but she hadn’t been able to see the doctor. Her husband was out of work, they had five little kids, and she was now a full-time student, waiting for the loans she’d applied for to come through. She was sitting in the exam room with an infection in her uterus, bleeding into a pad, “stuck in that tiny piece of paper that’s supposed to be a gown,” when the billing person came in and told her she’d need to pay in full before she could see the doctor. She had to put her clothes back on and leave without getting help. The experience showed her that this was the state of medicine in the United States. This was the reality for so many struggling families.

她在分娩六周后開始在萊特州立大學醫學院學習。她還在流血;出了點問題，但她沒能去看醫生。她的丈夫失業了，他們有五個小孩，她現在是一名全日制學生，等待她申請的貸款通過。她坐在檢查室里，子宮感染，血流到墊子裡，“卡在那張本應是長袍的小紙上”，這時計費人員進來告訴她，她需要先付清全部費用，然後才能去看醫生。她不得不重新穿上衣服，在沒有得到幫助的情況下離開了。這次經歷告訴她，這就是美國的醫學狀況。這就是許多苦苦掙扎的家庭的現實。

“I understand what happens to underserved people when they can’t get medical care,” she said. “I’ve lived it.”

“我理解當服務不足的人無法獲得醫療服務時會發生什麼，”她說。“我經歷過。”

After her first year in medical school, she had only a C average. Technically, that was fine; it wouldn’t keep her from graduating or becoming a doctor. But she didn’t feel comfortable with her performance or knowledge base. She asked to repeat the year.

在醫學院的第一年之後，她的平均成績只有 C。從技術上講，這很好;這不會阻止她畢業或成為一名醫生。但她對自己的表現或知識基礎感到不舒服。她要求重讀一年。

“It wouldn’t be fair to patients,” she said, “to not get the best training.”

“不對患者公平，”她說，“沒有得到最好的培訓。

Wow, I thought. Now this is the kind of doctor I’d want for myself.

哇，我想。現在，這就是我自己想要的那種醫生。

She graduated after five years with a quarter million dollars in debt, five children, and an out-of-work spouse. She and her husband eventually divorced. After her residency, she returned to Appalachia—the place that had called her to medicine. The vast majority of her patients were on Medicaid or some other form of relief, as she once had been. Some didn’t have running water. They’d take their baths in the creek before coming to see her. But from the time the creek froze over until it thawed, there was no bathing. The first year she practiced, she made barely enough to survive and make the monthly loan payments. It was a constant struggle. But every time a patient came in who couldn’t pay, she remembered when she’d been in that same position—sitting there, bleeding and sick, in a tiny paper gown, with no money in the bank to pay the bill.

五年後，她畢業時負債二十五萬美元，有五個孩子和一個失業的配偶。她和丈夫最終離婚了。住院醫師培訓結束后，她回到了阿巴拉契亞——那個召喚她從醫的地方。她的絕大多數病人都像以前一樣，正在接受醫療補助或其他形式的救濟。有些人沒有自來水。他們會在小溪裡洗澡，然後再來看她。但從小溪結冰到解凍，就沒有洗澡了。她練習的第一年，她賺的錢勉強夠維持生計和支付每月的貸款。這是一場持續的鬥爭。但每次有病人進來時付不起錢，她都會想起自己當時的處境——坐在那兒，流血不止，生病了，穿著一件小紙袍，銀行里沒有錢付帳單。

“Looking back, it was all preparation for what I’d go through with my illness later on,” she said. “It’s not that this one has privilege and deserves care and this one does not. We are all equal in the eyes of God.”

“回想起來，這一切都是為我以後的疾病做準備，”她說。“這並不是說這個有特權，值得照顧，而這個沒有。在上帝的眼中，我們都是平等的。

After four years of practicing in Appalachia, the government changed their payment structure. Even as she increased the number of patients she was seeing, her income dropped by a quarter. She was sinking. With kids in college and no child support, she couldn’t make enough money to pay her loans and support her family. So she took a salaried position in Bellevue, Ohio, up north near Lake Erie. It was right on the highway corridor between Toledo and Cleveland. More people, more patients, better insurance, more money. She could make a living there. Sadly, though, it meant putting her goal of helping the underserved on hold.

在阿巴拉契亞執業四年後，政府改變了他們的支付結構。即使她增加了看病的病人數量，她的收入也下降了四分之一。她正在下沉。由於孩子在上大學，沒有子女撫養費，她賺不到足夠的錢來支付貸款和養家糊口。因此，她在俄亥俄州貝爾維尤（Bellevue， Ohio）的伊利湖（Lake Erie）北部找到了一份帶薪職位。它就在托萊多和克利夫蘭之間的高速公路走廊上。更多的人、更多的病人、更好的保險、更多的錢。她可以在那裡謀生。然而，遺憾的是，這意味著她幫助服務不足者的目標被擱置了。

And then, in 1995, the first sign of trouble: she was tired, achy. It’s nothing, she thought, I’m just fighting something off. But it didn’t go away.

然後，在 1995 年，麻煩的第一個跡象：她又累又痛。這沒什麼，她想，我只是在和什麼東西作鬥爭。但它並沒有消失。

For months, she saw specialist after specialist. But she wasn’t getting better. At the time, not much was known about idiopathic pulmonary fibrosis; it wasn’t really on anybody’s radar, not even Patricia’s, a dedicated family doctor. Finally, she decided to see an infectious disease specialist she’d worked with and admired during her residency, who ordered a chest x-ray. It turned up an immediate red flag.

幾個月來，她看了一個又一個專家。但她並沒有好轉。當時，人們對特發性肺纖維化知之甚少;它並沒有真正引起任何人的關注，甚至沒有引起 Patricia 的注意，她是一位敬業的家庭醫生。最後，她決定去看一位她在住院期間共事過並欽佩的傳染病專家，他要求進行胸部 X 光檢查。它立即出現了一個危險信號。

In a typical chest x-ray, the two symmetrical shields of the lungs should show up black, while the hard bone of the ribs and spine are white. Patricia’s lungs, instead, were fuzzy, almost crystalline, like looking through a shattered car windshield. The terminology in medicine is ground glass appearance.

在典型的胸部 X 光片中，肺部的兩個對稱盾牌應顯示為黑色，而肋骨和脊柱的硬骨應顯示為白色。相反，派翠夏的肺是模糊的，幾乎是晶瑩剔透的，就像透過破碎的汽車擋風玻璃看東西一樣。醫學術語是毛玻璃外觀。

A quick follow-up CT scan showed fibrous tissue in both lungs—the soft and spongy lung tissue was turning to tough, striated scars. A nuclear scan was consistent with this. And then the biopsy confirmed it. Four out of four tests showed only one possible diagnosis: idiopathic pulmonary fibrosis.

快速的後續 CT 掃描顯示雙肺纖維組織——柔軟海綿狀的肺組織正在變成堅韌的條紋疤痕。核掃描與此一致。然後活檢證實了這一點。四項測試中有四項顯示只有一種可能的診斷：特發性肺纖維化。

Dr. Kaine was already familiar with the disease. In Bellevue, a very small community, another family doctor she knew had also been diagnosed with idiopathic pulmonary fibrosis that very year. And he’d died from it.

凱恩醫生已經熟悉這種疾病。在貝爾維尤，一個非常小的社區，她認識的另一位家庭醫生也在那一年被診斷出患有特發性肺纖維化。他就這樣死了。

Lung fibrosis starts with a tightening along the walls of the lungs as scarring begins. As the disease progresses, the wall of scar tissue becomes harder and tighter, wrapping the lungs like a plaster casing. The lungs become less and less flexible and expansive, and it becomes impossible to take a deep breath. The body cannot get enough oxygen. Patients report extreme fatigue and weakness. Sometimes, caregivers report people passing peacefully in their sleep. Other times, there is chest pain and overwhelming fear as one struggles with oxygen starvation, unable to inflate the lungs and pull in air. But it always ends in death; there is no cure for idiopathic pulmonary fibrosis.

肺纖維化始於隨著瘢痕形成的開始，沿肺壁收緊。隨著疾病的進展，疤痕組織壁變得更硬、更緊，像石膏一樣包裹著肺部。肺部變得越來越不靈活和擴張，無法深呼吸。身體無法獲得足夠的氧氣。患者報告極度疲勞和虛弱。有時，照護者報告患者在睡夢中平靜地去世。其他時候，當一個人與缺氧作鬥爭時，會出現胸痛和壓倒性的恐懼，無法給肺部充氣和吸入空氣。但它總是以死亡告終;特發性肺纖維化無法治癒。

The word idiopathic means “of unknown cause.” Patricia was diagnosed in 1995; today, doctors still don’t know what causes it. In some cases, it could be genetic, although Patricia didn’t have a family history of fibrosis. It could be autoimmune—the body turning against itself, the immune system confused. In fact, I found a study from 2015 showing that patients in the acute stages of IPF temporarily responded to autoimmune therapies, suggesting that the root of the disease is in fact an immune system gone haywire. However, regardless of the trigger, it’s still known to be incurable, progressive, and eventually fatal. And as I researched the disease, I found it was more common than I’d realized; today, it affects over one hundred thousand people in the United States alone, and five million worldwide.

特發性這個詞的意思是 「原因不明」。派特裡夏於 1995 年被診斷出;今天，醫生仍然不知道是什麼原因引起的。在某些情況下，這可能是遺傳的，儘管 Patricia 沒有纖維化家族史。它可能是自身免疫的——身體開始反抗自己，免疫系統感到困惑。事實上，我發現 2015 年的一項研究表明，處於 IPF 急性期的患者對自身免疫療法暫時有反應，這表明疾病的根源實際上是免疫系統失控。然而，無論觸發因素如何，它仍然是無法治癒的、進行性的，並最終致命的。當我研究這種疾病時，我發現它比我意識到的更常見;今天，僅在美國就有超過10萬人受到影響，全世界有500萬人受到影響。

Five years is what the specialists told Dr. Kaine. That’s how much time she had, at the very most. And even that was a generous prognosis. The median survival rate for IPF was three years. Less than 20 percent of patients survived beyond five. Patricia wanted to make it into that 20 percent and stretch her time as far as she could. She had grandkids now; there was so much she wanted to do and see. If she was going to die of IPF, so be it, but this was too fast.

五年是專家告訴 Kaine 博士的。那是她最多有多少時間。即便如此，這也是一個慷慨的預測。IPF 的中位生存率為 3 年。只有不到 20% 的患者存活超過 5 歲。Patricia 想進入那 20% 並盡可能延長她的時間。她現在有孫子孫女了;她想做和看的東西太多了。如果她要死於IPF，那就這樣吧，但這太快了。

Over the next few years, she steadily declined. She got weaker, tireder. She had to go on disability and then on oxygen, carry a CPAP machine around with her wherever she went to help force the oxygen through her ever-more scarred lungs. She was sleeping eighteen hours a day, constantly tired because her body had insufficient oxygen. She tried going to a specialist in Toledo, but she was so wiped out after the drive there and back that she slept for a full twenty-four hours.

在接下來的幾年裡，她穩步下降。她變得更虛弱，更累了。她不得不殘疾，然後吸氧，無論走到哪裡都隨身攜帶 CPAP 機器，以説明迫使氧氣通過她越來越傷痕纍纍的肺部。她每天睡 18 個小時，因為身體氧氣不足，所以一直很累。她試圖去看托萊多的專家，但在開車來回后她已經筋疲力盡了，以至於她睡了整整 24 小時。

When her niece suggested Dr. Nemeh, she shrugged. “Why not?” she said. She’d tried everything else.

當她的侄女推薦 Nemeh 醫生時，她聳了聳肩。“為什麼不呢？”她已經嘗試了其他所有方法。

Fast-forward a year and a half. Patricia was stronger, more alert, more energetic. She was back to sleeping a regular schedule of eight to ten hours a day. And she was continuing to improve. She went off disability and got back on track with what she’d always felt was her mission in life: to help those who needed it. She went back to work, making home visits to people living in the inner city who had trouble getting to doctors. And she found herself using the CPAP less and less. Eventually, she stopped using it completely. It had become unnecessary.

快進一年半。派特裡夏更強壯、更警覺、更有活力。她又回到了每天 8 到 10 小時的規律睡眠時程表。她還在繼續進步。她擺脫了殘疾，回到了她一直認為的人生使命的正軌上：説明那些需要説明的人。她回到工作崗位，對住在內城區看病有困難的人進行家訪。她發現自己越來越少地使用 CPAP。最終，她完全停止使用它。這已經變得沒有必要了。

It was a stunning reversal of a progressive, incurable, and fatal disease. Patricia Kaine shouldn’t have been getting better; she should have been getting worse. What sort of sudden magic had Dr. Nemeh performed?

這是一種進行性、無法治癒和致命的疾病的驚人逆轉。派特里夏·凱恩 （Patricia Kaine） 不應該變得更好;她應該越來越糟。Nemeh 博士施展了什麼樣的突然魔法？

First of all, Patricia said, nothing happened overnight. It happened incrementally, in small steps, over the course of a year and half while she was seeing Nemeh once every two months or so. She would drive out to Cleveland for the visits, where Dr. Nemeh would start with “electro acupuncture,” a type of acupuncture he developed that incorporated vibrations and magnetism to target areas of the body in need of attention. He used the machine, and prayer, in every session. It was just Dr. Nemeh and Dr. Kaine in the room. She felt that she was the complete focus. When he prayed over her sick body, it felt to her like energy was flowing from him to her. The sessions could run anywhere from forty-five minutes to two hours—they were scheduled for an hour, but ended up lasting, according to Dr. Kaine, “as long as God wants them to.”

首先，派翠夏說，沒有什麼是一夜之間發生的。在一年半的時間里，它以小步驟逐漸發生，而她每兩個月左右就會見一次 Nemeh。她會開車去克利夫蘭就診，Nemeh 醫生會從“電針”開始，這是他開發的一種針灸，結合振動和磁力來針對需要關注的身體部位。他在每一次會議中使用機器和祈禱。房間里只有 Nemeh 博士和 Kaine 博士。她覺得自己就是全神貫注的焦點。當他為她生病的身體祈禱時，她感覺就像能量從他流向她。這些會議可以持續 45 分鐘到 2 小時不等——它們原定為一個小時，但根據 Kaine 博士的說法，“只要上帝願意，”最終都會持續“。

“You lose complete track of time when you’re in there,” she said. “It’s like time doesn’t exist.”

“當你在裡面時，你會完全忘記時間，”她說。“就像時間不存在一樣。”

After the sessions, she didn’t feel depleted like she had after traveling to see other specialists. She felt calm and energized. She rebounded more quickly. Each of the dozen or so times she saw Dr. Nemeh felt like a leap forward.

會議結束后，她並沒有像去看其他專家後那樣感到筋疲力盡。她感到平靜和充滿活力。她的反彈速度更快。她看到 Nemeh 醫生的十幾次，每一次都感覺像是向前飛躍。

“Why do you think that was?” I asked her, scribbling notes.

“你覺得這是為什麼？”我問她，潦草地做筆記。

She thought for a long time. “Every time I would see him,” she finally said, “I would leave knowing that I was closer to God.”

她想了很久。“每次我看到他，”她最後說，“我都會離開，因為我知道我離上帝更近了。

Finally, a chest x-ray came back with impossible news. Her lungs, those two shield shapes on the light board that had once come up blurry, crisscrossed with scar tissue like a shattered windshield, instead showed clean black. Clear. No evidence of scar tissue.

最後，胸部 X 光片回來了，帶來了不可能的消息。她的肺，燈板上的那兩個盾牌形狀，曾經變得模糊不清，像破碎的擋風玻璃一樣與疤痕組織縱橫交錯，反而呈現出乾淨的黑色。清楚。沒有疤痕組織的證據。

Even after all the years of hearing these stories, I was still astounded. And Patricia’s story was absolutely staggering. How do you make sense of it? She was diagnosed by biopsy—the gold standard. She was given three to five years to live, with no possibility of cure. And yet here she was, almost a decade later, sitting in front of me, breathing easy, vibrant and healthy. But scar tissue in the lungs does not just disappear.

即使聽到這些故事這麼多年，我仍然感到震驚。派特裡夏的故事絕對令人震驚。你怎麼理解它？她是通過活檢診斷出來的，這是金標準。她只能活 3 到 5 年，而且沒有治癒的可能。然而，將近十年後，她就在這裡，坐在我面前，呼吸輕鬆、充滿活力和健康。但肺部的瘢痕組織不會就這樣消失。

The case raised some big questions. Patricia hadn’t made many diet or lifestyle changes as so many others had, and so I couldn’t attribute her stunning recovery to those kinds of radical life shifts. I had come so far in my study of spontaneous healing; I’d felt that I was so close to getting the big picture. But perhaps each of the previous factors I’d isolated—diet, inflammation, immune function, stress, and even love and connection—all hinged on something bigger, something deeper, something more fundamental. Each of these principles had been an important stepping-stone on the road to understanding, but I was beginning to see that the most pivotal factors were unmeasurables—things that had been left to the side by science because they simply could not be quantified in a controlled experiment the way nutrition, inflammation, stress hormones, and even thought patterns could be.

這個案子引發了一些大問題。派特裡夏沒有像許多其他人那樣改變很多飲食或生活方式，所以我不能將她驚人的康復歸因於那些激進的生活轉變。我在研究自發治癒方面已經走了這麼遠;我覺得我離瞭解大局是如此之近。但也許我之前分離的每一個因素——飲食、炎症、免疫功能、壓力，甚至愛和聯繫——都取決於更大、更深、更根本的東西。這些原則中的每一個都是理解道路上的重要墊腳石，但我開始看到最關鍵的因素是不可測量的——這些因素被科學擱置一旁，因為它們根本無法像營養、炎症、壓力荷爾蒙甚至思維模式那樣在受控實驗中量化。

When I asked Patricia Kaine to try to explain what Nemeh could do, and why, she thought for a while.

當我讓 Patricia Kaine 試著解釋 Nemeh 能做什麼，以及為什麼時，她想了一會兒。

“My way of describing it is to think about water,” she said. “If you have to walk ten miles to a well carrying a bucket, you can bring water back to a community, but it limits how much you can bring. If you build a conduit, a pipe or an aqueduct, you can bring much more—unlimited amounts. That’s how Dr. Nemeh is, but instead of water, it’s love. And he’s the conduit.”

“我描述它的方式是考慮水，”她說。“如果你必須提著水桶走 10 英里到一口井，你可以把水帶回社區，但這限制了你能帶多少水。如果您建造管道、管道或渡槽，您可以帶來更多 – 數量不受限制。這就是 Nemeh 博士的樣子，但不是水，而是愛。而他就是管道。

A lot of people conceptualize their remarkable healings in this way: as something separate or external that is poured into them like a healing drink. They view it as a gift from God, with the healer working as a kind of conduit. And perhaps there’s something to that hypothesis; there is so much we don’t know about this vast and mysterious universe we inhabit. But as we just discussed, is it the prayer itself that heals, or the act of praying? Is it that healers like Nemeh are truly conduits for some kind of healing energy, or is it that people believe with their whole hearts that they are? How much could what you believe truly affect your biology?

很多人以這種方式將他們非凡的治療概念化：作為獨立或外在的東西，像治療飲料一樣注入他們體內。他們將其視為上帝的禮物，治療師作為一種管道。也許這個假設是有道理的;關於我們所居住的這個廣闊而神秘的宇宙，我們有很多不瞭解的地方。但正如我們剛才討論的，是祈禱本身治癒了，還是祈禱的行為？是像 Nemeh 這樣的治療師真的是某種治癒能量的管道，還是人們全心全意地相信他們是？你相信的東西能真正影響你的生物學有多大影響？

I was going to have to dig deeper into one of the more controversial and hotly debated topics in medicine: the placebo effect.

我將不得不更深入地研究醫學中最具爭議和激烈爭論的話題之一：安慰劑效應。