看到科学网新闻上有这样一条消息：英国顶尖医学专家理查德•史密斯日前发表专栏文章，呼吁社会各界不要再浪费金钱以试图治愈癌症，因为患癌症而病逝是“最好的死法”。就试着把原文找到翻译了部分自己感兴趣的段落。

   集导演，超现实主义者，道德家，革命者于一身的Luis Buñuel生前对于死亡有过很多的思考。他在1982年，也就是他去世的前一年，写到：“有时候，我认为越快的方式死亡越好，就像我的朋友Max Aub那样，在打牌的过程中突然死亡；但是，大部分的情况下，我更倾向于一个缓慢的死亡过程，在这个过程中，我们可以期待为我们人生的告别进行一次再回首。”

   你将会选择什么样的方式离开这个世界呢？你必须要思考这个问题。

   Buñuel很清楚的明白他不想以什么样的方式离开这个世界。“我不是恐惧死亡，我只是恐惧，在深夜中，当我的包还在打开，我的电影剧本还在书写，我孤独地在宾馆的房间中死去。我必须知道是谁最后把我的眼睛合上”

   “更令我恐慌的是，依靠着现代医学，一个人游走在死亡的悬崖上。以希波克拉底之名，医生们已经创造出了更为痛苦的折磨方式，但却被“生存”二字赋予了神圣的意义”

    Buñuel看见了Franco的死亡过程。Franco死于1975年，死于令人恐怖的医学死亡，一个只有医生可以设计的死亡。器官一个接着一个的衰竭，医生尽力去拯救它们。当我还是大学生时，在大学毕业前的一年时，我在恐惧中看到了类似的一幕。我感觉死亡就像一个笨拙的木匠的表现，锯掉一条桌子腿，然后下一个，最后桌面掉道了地面上。

   Buñuel1983年于墨西哥城去世。在去世前的一个星期前，他依旧和一个耶稣会兄弟就神学进行了讨论。

   Jean-Claude Carrière，Luis的一个认识了好多年的朋友及合伙人这样写道：Luis等待死亡等了很久了。他是一个很好的西班牙人，他已经为死亡做好了准备。他和死神的关系就像他和一个女生的关系那样。他感觉到了爱，恨，温柔，以及长久的离别的讽刺感。他也不想错过最后的偶遇，也就是他们相识的那一刻。他对我说，我想活着离开。最后他实现了。他的遗言是：我要死了。

   你准备好了吗？我准备好了吗？

   我经常问我的听众，你们将会选择什么样的方式去离开，大部分选择了突然离世。我说：“这种方式对于你而言，也许是最好的。但是对于你身边的人确实最为痛苦的事情。特别是，你将会把一段感情留下一个难以磨灭的创伤。如果你想快速的死亡，那么把活着的每一条当做生命的最后一天吧，确保每一段重要的感情都在健康的状态，你所有的事情都仅仅有条，并把你的葬礼说的清晰明白。”

   所以，死于癌症也许是最佳的选择。你可以用时间去告别，去回顾自己的一生，留下最后的消息，或许去一个自己梦寐以求的地方游玩，听一听最喜欢的音乐，读一读爱情的小诗，准备会见你所选择的信仰的祖师爷，或者享受即将到来的那场不再回归的旅行。

   这就是，我所提倡的，一个浪漫的死亡选择，尽管这个选择期间掺杂着爱，吗啡以及白兰地。

附原文

Richard Smith: Dying of cancer is the best death

Luis Buñuel, filmmaker, surrealist, iconoclast, moralist, and revolutionary, thought a lot about death. “Sometimes,” he wrote in 1982, a year before he died at 83, “I think the quicker the better like the death of my friend Max Aub, who died all of a sudden during a card game. But most of the time I prefer a slower death, one that’s expected, that will let me revisit my life for a last goodbye.”

How do you want to die? You must think about it.

Buñuel was clear about how he didn’t want to die. “I’m not afraid of death. I’m afraid of dying alone in a hotel room, with my bags open and a shooting script on the night table. I must know whose fingers will close my eyes.”

“An even more horrible death,” he wrote, “is one that’s kept at bay by the miracles of modern medicine, a death that never ends. In the name of Hippocrates, doctors have invented the most exquisite form of torture ever known to man: survival.”

Buñuel saw how Franco died and found himself pitying a man he hated. Franco’s death in 1975 still stands for the most horrible medical death, a death that only doctors could devise. Organ after organ failed, and the doctors tried to compensate. As a medical student a year before graduation, I watched in horror. I think of the death as an incompetent carpenter trying to get a table level, sawing something of one leg, then the next, and eventually ending with the table on the floor.

Buñuel died of pancreatic cancer in Mexico City in 1983. He spent his last week discussing theology with a Jesuit brother.

His long time friend and collaborator, Jean-Claude Carrière, wrote: “Luis waited for death for a long time, like a good Spaniard, and when he died he was ready. His relationship with death was like that one has with a woman. He felt the love, hate, tenderness, ironical detachment of a long relationship, and he didn’t want to miss the last encounter, the moment of union. ‘I hope I will die alive,’ he told me. At the end it was as he had wished. His last words were ‘I’m dying’.”

Will you be ready? Will I be ready?

There are, as I endlessly repeat, essentially four ways to die: sudden death; the long, slow death of dementia; the up and down death of organ failure, where it’s hard to identify the final going down, tempting doctors to go on treating too long; and death from cancer, where you may bang along for a long time but go down usually in weeks. Suicide, assisted or otherwise, is a fifth, but I’m leaving that on one side for now.

I often ask audiences how they want to die, and most people chose sudden death. “That may be OK for you,” I say, “but it may be very tough on those around you, particularly if you leave an important relationship wounded and unhealed. If you want to die suddenly, live every day as your last, making sure that all important relationships are in good shape, your affairs are in order, and instructions for your funeral neatly typed and in a top draw—or perhaps better on Facebook.”

The long, slow death from dementia may be the most awful as you are slowly erased, but then again when death comes it may be just a light kiss.

Death from organ failure—respiratory, cardiac, or kidney—will have you far too much in hospital and in the hands of doctors.

So death from cancer is the best, the closest to the death that Buñuel wanted and had. You can say goodbye, reflect on your life, leave last messages, perhaps visit special places for a last time, listen to favourite pieces of music, read loved poems, and prepare, according to your beliefs, to meet your maker or enjoy eternal oblivion.

This is, I recognise, a romantic view of dying, but it is achievable with love, morphine, and whisky. But stay away from overambitious oncologists, and let’s stop wasting billions trying to cure cancer, potentially leaving us to die a much more horrible death.

Richard Smith was the editor of The BMJ until 2004. He is now chair of the board of trustees of icddr,b [formerly International Centre for Diarrhoeal Disease Research, Bangladesh], and chair of the board of Patients Know Best. He is also a trustee of C3 Collaborating for Health.

Competing interest: RS will die, perhaps soon: he’s 62.