[2022-10-07] 纽约时报 - 被训诫的李文亮如何度过生命最后一程

A New York Times video investigation reveals new details about the death of Dr. Li Wenliang, a national hero who faced censorship after sounding an early alarm on Covid-19.
《纽约时报》的一项视觉调查披露了李文亮之死的新细节。他因在武汉肺炎病毒传播早期发出警报并在面临审查时发声而成为国民英雄。

In early 2020, in the Chinese city of Wuhan, Dr. Li Wenliang lay in a hospital bed with a debilitating fever. He was no ordinary patient, and even then — before Covid had its name — he feared that this was no ordinary ailment.
2020年初，在中国武汉市，因发烧而虚弱的李文亮医生躺在医院病床上。他不是普通的病人，甚至在武汉肺炎尚未被命名之前，他就在担心这也不是普通的疾病。

Dr. Li was widely regarded in China as a heroic truth-teller. He had been punished by the authorities for trying to warn others about the virus, and then, in a terrible turn, had become severely sickened by it. Weeks later, he would become China’s most famous fatality of the emerging pandemic. He was 34.
在很多中国人看来，李文亮是一位英雄般的真相揭露者。他因试图提醒他人小心病毒而受到当局的训诫，事情后来急转直下，他感染武汉肺炎并且症状严重。几周后，他成为这场新出现的流行病大暴发中国内最为人所知的死亡病例。他当时34岁。

His death set off an outpouring of grief and anger on a scale and intensity rarely seen in China. More than two years later, Dr. Li remains a galvanizing figure, a symbol of frustration with the government’s suppression of independent voices. His profile on the Chinese social media site, Weibo, regularly receives hundreds of comments a week, and has become a place where people pay tribute and share their personal stories.
他的去世在中国引发了悲痛和愤怒，其影响力之大和范围之广均属罕见。两年多后，李文亮仍然是一个会触动到公众情绪的人物，象征着对政府压制独立声音的不满。他在微博上的个人页面每周都会收到数百条评论，那里已成为大众向他致敬和倾诉个人故事的空间。

A government investigation into the circumstances around Dr. Li’s death concluded in a report that the Wuhan Central Hospital had spared no effort to try to save him. But a more complete picture of his medical care and his treatment by the authorities has remained elusive.
政府对李文亮死亡情况的调查报告得出结论称，武汉市中心医院不遗余力地挽救他。但是对于他接受的治疗以及领导如何对待他，公众很难获悉更完整的全貌。



The New York Times’s Visual Investigations team has now filled in some of these gaps with an exclusive interview with one of Dr. Li’s colleagues. He provided a firsthand account of Dr. Li’s final hours, describing the resuscitation measures that were used and discussed. We are referring to him only as Dr. B because he is afraid of reprisals from the Chinese government. The Times talked to Dr. B via video, and verified his identity with public information.
《纽约时报》的视觉调查团队通过独家采访李文亮的一位同事，填补了大众认知中的一些空白。这位同事提供了李文亮生命最后几个小时的第一手叙述，描述了使用过和讨论过的抢救措施。由于他担心被中国政府报复，我们仅称他为B医生。时报通过视频与B医生交谈，并通过公开信息验证了他的身份。

The Times also obtained and examined internal memos from Wuhan Central Hospital and Dr. Li’s medical records, some of which backed up Dr. B’s account. The medical records have been verified by experts and contain details that match publicly available information. Eight U.S.-based Chinese medical experts, who have experience treating Covid patients or have practiced in Chinese hospitals, reviewed the medical records for The Times.
时报还获得了武汉市中心医院的部分内部文件和李文亮的病情资料，其中一些证实了B医生的说法。医疗记录经过专家验证，其中的细节与公开信息相符。八位有治疗武汉肺炎患者经验或曾在中国医院执业的美国华人医学专家为时报审阅了这些医疗记录。

We found no evidence his medical care was compromised. But these documents, along with Dr. B’s account and experts’ analysis, reveal important new details about his illness and treatment.
我们没有发现任何证据显示他的治疗质量有受到连累。但这些文件，连同B医生的叙述和专家的分析，揭示了更多有关他的病情和治疗过程的重要细节。

Taken together they show how Dr. Li spent his last 39 days going up against a deadly virus — and navigating government attempts to censor him.
这些信息展示了李文亮在生命的最后39天里如何对抗一种致命的病毒，以及如何应对政府对他的审查。

An Acute Illness
病程凶险

In early 2020, the virus was spreading rapidly in Wuhan, the city in China where the pandemic first took hold. Dr. Li checked into the hospital on Jan. 12 with a fever, a lung infection and other symptoms. According to several of the doctors who reviewed his medical records for The Times, by the third day, Dr. Li was seriously ill and required oxygen support.
2020年初，武汉肺炎病毒在中国武汉市迅速传播，武汉是武汉肺炎大流行最先暴发的城市。1月12日，李文亮因发烧、肺部感染等症状入院。据为时报审阅病历的几位医生说，到第三天，李文亮已告病重，需要给予氧气支持。

“He was infected with an early variant of the virus, so the illness started acutely, its course was life threatening and it developed very fast,” said Dr. Wu Yuanfei, a virologist at UMass Chan Medical School in Worcester, Massachusetts.
马萨诸塞州伍斯特市麻省大学陈氏医学院的病毒学家吴远非说：“他感染的这个病毒非常早，病程非常凶险，发展得非常快。”

The experts said that based on the records, the treatment Dr. Li received, in general, followed the norms of that time for managing the symptoms of coronavirus patients.
专家表示，根据记录，李文亮接受的治疗总体上和当时治疗武汉肺炎患者的常规方法一致。



A little over a week into Dr. Li’s hospital stay, his doctors wrote that he was struggling mentally and diagnosed him as being in a depressive state, a detail that has not been reported. The record did not attribute his emotional condition to any specific factors, but noted that Dr. Li had lost his appetite and couldn’t sleep at night.
李文亮住院一周多后，他的医生写道，病人情绪低落，并诊断出他处于“抑郁状态”，这一细节此前未曾被报道。病例没有将他的情绪状况归咎于任何具体因素，但指出李文亮食欲不振，晚上无法入睡。

He was kept in an isolation ward, allowed to communicate with his family only by video chat. He had just weeks earlier been disciplined by the police for warning friends in a private group on WeChat, a Chinese social media service, about the new virus that was spreading through the city. His employer, Wuhan Central Hospital where he worked as an eye doctor, had made him write a letter of apology, the content of which was obtained by The Times.
他当时住在隔离病房里，只能通过视频聊天与家人交流。诊断出“抑郁状态”的几周前，由于在微信群中提醒朋友有新病毒正在城市中传播，他受到警方的训诫。他在武汉市中心医院当眼科医生，医院领导要求他写一封自我批评。时报获得了这封自我批评的内容。



Despite the official warnings, on Jan. 27, 2020, Dr. Li gave an anonymous interview to a prominent Chinese newspaper, describing how he had been reprimanded for trying to raise the alarm. Eventually, he revealed his identity on social media, and instantly became a folk hero. From his hospital bed, he took more interviews and said he hoped to recover soon to join medical workers fighting the outbreak.
尽管受到官方警告，李文亮仍在2020年1月27日接受了中国一家报纸的匿名采访，描述了他如何因试图发出警报而受到训诫。最终，他在社交媒体上公开了自己的身份，瞬间成为了民间英雄。他在病床上接受了更多采访，并表示希望尽快康复，加入抗击疫情的医务人员队伍。

Deterioration and Attempts at Resuscitation
病情恶化和抢救

But on Feb. 5, Dr. Li’s condition deteriorated severely — his pneumonia grew worse, his breathing became extremely labored.
但在2月5日，李文亮的病情严重恶化，肺炎加重，呼吸非常困难。

That afternoon, Dr. Li’s doctors ordered several tests of his lungs and heart, his medical records show. According to Dr. Yuan Jin, a pulmonary and critical care doctor at Good Samaritan Medical Center in Brockton, Massachusetts, these exams suggest that Li Wenliang’s medical team was responding to a worsened condition.
李文亮的病历显示，当天下午，李文亮的医生对他的肺和心脏功能进行多项检查。据马萨诸塞州布罗克顿好撒马利亚人医院的肺科和重症监护医生袁劲说，这些检查表明李文亮的医疗团队正在对恶化的病情作出反应。

By the morning of Feb. 6, doctors wrote in the progress notes that Dr. Li was at risk of multiple organ failure. Several physicians we spoke to said that Dr. Li’s condition was so serious that his medical team should have at this point, or before it, considered intubating him and placed him on a ventilator — a higher level of oxygen support.
到2月6日上午，医生在病程记录中写道，李文亮有多器官衰竭的风险。时报采访的数位医生说，李文亮的病情已经非常严重，他的医疗团队应该在这时或更早些时候就考虑给他插管并接上呼吸机，提供更高水平的氧气支持。

The records indicate that Dr. Li had earlier been given oxygen through a nasal tube and then an additional oxygen mask. His medical team also tried to use a noninvasive ventilator on Jan. 19, but wrote that “the patient could not tolerate.”
记录显示，李文亮此前通过鼻导管吸氧，后来还增加了氧气面罩。他的医疗团队在1月19日也曾尝试使用无创呼吸机，但写道“病人无法耐受”。

It is unclear why Dr. Li was not intubated. Some doctors are more reluctant to intubate young patients; sometimes the patients themselves refuse it. To this day, there is no consensus on when invasive ventilators should be used on Covid-19 patients.
目前尚不清楚李文亮为何没有插管。有的医生在给年轻的病人插管上会有所保留；有时患者自己会拒绝。时至今日，关于何时应在武汉肺炎患者身上使用有创呼吸机尚未达成共识。

On Feb. 6, Dr. Li went into cardiac arrest at around 7:20 p.m. Though his daily progress note did not explicitly say that his heart stopped, it recorded that the medical team started performing CPR — a procedure that is applied in such an emergency. They intubated him at that point, a common practice during resuscitation. The note said his pupils were not responding to light.
2月6日晚上7点20分左右，李文亮心脏骤停。虽然病程记录没有明确说明他的心脏停止了跳动，但记录显示医疗团队开始对他进行心肺复苏术，这是一种在发生了这个紧急情况时会进行的操作。然后，作为一种抢救过程中的常规操作，医生这时候给李文亮插了管。记录显示他的瞳孔对光反射消失。

According to the medical records, doctors tried to revive Dr. Li for over seven and a half hours, but his heart never restarted.
根据病历，医生对李文亮的抢救持续了七个半小时以上，但他的心脏一直没有重新跳动。









The government investigation said doctors placed Dr. Li on extracorporeal membrane oxygenation. Also known as ECMO, it is a last resort, invasive treatment involving a machine that siphons blood out of the patient, runs it through an oxygenator and pumps it back into the body.
政府调查称，医生给李文亮做了体外膜肺氧合，这种又称人工肺(ECMO)的治疗是作为最后手段使用的一种极具侵入性的操作，通过一种机器将血液从患者体内抽出，通过氧合器将血液泵回体内。

According to Dr. B, who arrived at Dr. Li’s intensive care ward around 9 p.m., about two hours after Dr. Li entered cardiac arrest, the hospital’s leadership pushed the medical team to use ECMO because it wanted to show the public that no effort had been spared.
B医生在晚上9点左右抵达李文亮的重症监护病房，大约是在李文亮心脏骤停两小时后。据B医生说，医院领导层要求医疗团队使用人工肺，因为他们想向公众表明医院进行了不遗余力的抢救。

But several doctors in the room argued that by that point it was too late for it to have been of any use, an assessment that six physicians we talked to agreed with. Dr. B also said putting Dr. Li on ECMO, given its invasive nature, would have been an “insult to his body.”
但在场的几位医生认为，在那个时候上人工肺已经太迟了，无法发挥任何作用。我们采访的六名医生都持相同意见。B医生还说，考虑到人工肺的侵入性，这时候让李医生接受人工肺是“对尸体的一种亵渎”。

Dr. B left the room around midnight. He said ECMO had not been used because an instrument to perform the procedure was not available. It is unclear whether it was ultimately used after he left.
B医生在午夜左右离开了病房。他说他离开之前人工肺没有使用，因为发现少了进行该操作所需的一样重要的东西。他离开之后，人工肺最终是否被使用了，尚不得而知。

There is also no indication in the doctors’ orders from that night that the procedure was ever administered.
当晚的医嘱中也没有任何迹象表明实施过这种操作。

But for some reason, the daily progress notes say ECMO was used. It was the only discrepancy of this kind found in the medical records.
但不知为何，病程记录显示使用了人工肺。这是唯一一次病程记录和医嘱出现不一致。

The Death of Dr. Li
李医生之死

That night, conflicting messages about Dr. Li’s condition — some released by state media outlets, then deleted — generated confusion. At 10:40 p.m., a state-run publication, Life Times, said that he had died at 9:30 p.m.
当晚，有关李文亮病情相互矛盾的信息——有些是由官方媒体发布的，后来又被删除了——引发了混乱。晚上10点40分，官媒《生命时报》称，他于晚上9点30分去世。

It was nearly 4 a.m. the next morning, Feb. 7, when the hospital finally announced Dr. Li’s death. It said he died at 2:58 a.m. The government’s investigation cited an electrocardiography performed at this time that showed he had flatlined.
当医院最终宣布李文亮去世时，已是第二天，也就是2月7日，将近凌晨4点。医院说他死于凌晨2点58分。政府的调查引述了该时刻的心电图“呈直线反应”。

Our investigation found that among the records was an echocardiogram report around 9:10 p.m. the previous evening that showed that his heart had stopped beating.
我们的调查发现，病情资料中有一份前一天晚上9点10分左右的心脏彩超报告，显示他的心脏在那时已经停止跳动。









“I think Dr. Li Wenliang had already died by the time I saw him around 9 p.m. on Feb. 6,” Dr. B said. He added: “The normal process at this point would have been to pronounce him dead.”
“我觉得李文亮医生在2月6号9点钟我见到他的时候，他就已经死掉了，”B医生说。他还说：“按照正常流程的话已经是可以宣告死亡了。”

“They dragged their feet for so long over the announcement. It’s like the hospital really did not treat us as human beings,” he said. For Dr. B, going public with his version of events was an attempt to get his story out and honor Dr. Li’s legacy.
“拖了这么久时间才宣布，医院确实没有把我们当人看，”他说。对B医生来说，向公众讲述原委是为了尊重他所知道的事实，这也正是当初李文亮所做的事。

The Times made multiple attempts to contact Dr. Li’s medical team, but none agreed to answer questions. The press office of Wuhan Central Hospital told The Times that it was not accepting interviews from international media outlets. China’s National Supervisory Commission, the country’s top disciplinary body investigating Dr. Li’s death, did not respond to requests for comment. The Chinese Embassy in Washington, D.C. did not respond to requests for comment.
时报多次试图联系李文亮的医疗团队，但没有人同意回答问题。武汉市中心医院新闻办公室告诉时报，他们不接受国际媒体的采访。负责调查李文亮之死的中国最高监察机关国家监委没有回复记者的置评请求。中国驻华盛顿大使馆没有回应记者的置评请求。

Claire Fu contributed research. Elsie Chen contributed reporting from Seoul. Drew Jordan contributed to production.
Claire Fu 对本文有研究贡献； Elsie Chen 自首尔对本文有报道贡献； Drew Jordan 对视觉制作有贡献。

标红字体均为楼主更改，与原文作者无关。

有一说一，李文亮生前也是个粉红。只不过是他是最早警告武汉肺炎的医务人员之一，所以也被很多人，特别是很多中国人当作一种精神的寄托。话说他如果不是吹哨人，也不过是一个挨捶的粉红而已。

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