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For my appointment, at 9am sharp one day in early December, I drove to St John's hospital in West Lothian through bands of freezing fog, then made my way from the frosted haze of the car park, following a trail of laminated yellow notices, to the hospital's top floor. Though my core work is daytime general practice, I do shifts a couple of times a month in St John's, for the evening and weekend GP service. The view from the top floor, above the fog, was clear and luminous. The sun was rising, but its orange light was too weak, or the air too cold, for it to clear the air. To the south I could just about make out the pharmaceutical factory in Livingston where a French company, Valneva, has another Covid-19 vaccine in development.
我的预约时间是12月初的一天上午9点整。那天我开车穿过冰冷的雾带，来到西洛锡安的圣约翰医院，然后从雾蒙蒙的停车场出发，沿着一串黄色的层叠布告，来到医院的顶层。虽然我的核心工作是白天的全科医生，但我每个月都会在圣约翰上几次夜班和周末的全科医生服务。从顶楼望去，雾霭之上，景色明朗而明亮。太阳升起来了，但橙色的光太弱，或者空气太冷，无法净化空气。我大概能辨认出南边的利文斯顿的制药厂，那里有一家名为Valneva的法国公司正在研发另一种新冠疫苗。
Though the corridors were quiet, I knew the nearby wards were filling up with Covid patients. West Lothian at that time had a higher prevalence of coronavirus than Edinburgh just a few miles to the east, and was in a higher tier. Over the course of the pandemic I've admitted numerous patients to those same wards – each of them breathless and fevered, many of them panic-stricken.
虽然走廊里很安静，但我知道附近的病房里挤满了新冠肺炎患者。当时西洛锡安的冠状病毒感染率比以东几英里的爱丁堡高，处于更高风险地区。新冠期间我曾在这些病房里接待过很多病人——每个人都呼吸困难、发烧，很多人惊慌失措。
One stands out in my memory: an ordinarily healthy 60-year old man who I'll call Mr Denison. He lived alone, and had been suffering a cough and fever for a week, but – nine months into the pandemic – didn't think to book a Covid test. He had carried on going out, seeing his family, catching up with friends. It's usually seven to 10 days from the onset of fever that, if the lungs are going to be severely affected, they will be. Right on cue, Mr Denison had called for a GP home visit on day nine. His breathlessness became so severe that he was struggling to walk to the toilet.
其中有一个人我记忆深刻：他是一个身体健康的老人，我叫他丹尼森先生。他一个人生活，咳嗽发烧的症状已经有一周了，但新冠爆发9个月的时候他都没有想过预约新冠测试。他依旧外出，看望家人，与朋友叙旧。通常从发烧开始的7到10天，肺部就会受到严重影响。不出所料，丹尼森先生在第9天要求全科医生上门检查。他的呼吸已经变得非常困难，连上厕所都很费劲。
I remembered phoning him from the car to ask him to sit by his front door, then standing on his doorstep to put on an apron, doubled gloves and visor. I nudged open his door to see him sitting on his staircase in a grimy bathrobe. He looked frightened. I stepped in over his threshold, put an oxygen sensor on his finger, and a gloved hand on his shoulder. His breaths were coming quickly, at nearly 30 a minute. Oxygen levels on these monitors should show 97 or 98%, but Mr Denison's was in the low 80s. When he stood up to open his bathrobe for my stethoscope, it fell further still. He needed oxygen, and admission to hospital, so I arranged an ambulance and waited with him until it came.
我记得我在车里给他打电话，让他坐在他家的前门旁边，然后我站在台阶上戴上围裙、双层手套和护目镜。我轻轻推开他家的门，看到他穿着脏兮兮的浴袍坐在楼梯上，看上去吓坏了。我跨过他家的门槛，把氧气传感器戴在他的手指上，把戴着手套的手放在他的肩膀上。他的呼吸很快，接近1分钟30次。监测仪上的血氧浓度应该是97或98%，但丹尼森先生的血氧浓度只有不到80。当他站起来打开浴袍使用听诊器时，血氧浓度又降了一些。他需要氧气，需要送他去医院，所以我安排了一辆救护车并陪着他等到救护车来。
