譯/王麗娟 My patient and I both knew he was dying.
Not the long kind of dying that stretches on for months or years. He would die today. Maybe tomorrow. And if not tomorrow, the next day. Was there someone I should call? Someone he wanted to see?
我的病人和我都知道死神已離他不遠。
它不是會拖上數月或數年的那種死法。他可能今天就死。或許明天。若不是明天，也會是後天。我該打電話給誰？他有想見的人嗎？
Not a one, he told me. No immediate family. No close friends. He had a niece down South, maybe, but they hadn't spoken in years.
For me, the sadness of his death was surpassed only by the sadness of his solitude.
沒半個，他告訴我。他沒有近親。沒有密友。有個姪女在南部，或許，但已多年沒有說過話了。
對我來說，比他大限將至的傷感更深的，只有他的孤獨帶來的傷感。
Every day I see variations at both the beginning and end of life: a young man abandoned by friends as he struggles with opioid addiction; an older woman getting by on tea and toast, no longer able to clean her cluttered apartment. In these moments, it seems the only thing worse than suffering a serious illness is suffering it alone.
Social isolation is a growing epidemic — one that's increasingly recognized as having dire physical, mental and emotional consequences. Since the 1980s, the percentage of American adults who say they're lonely has doubled from 20 percent to 40 percent.
我每天在生命的起點和終點看到各種變奏：一個年輕人在和類鴉片癮搏鬥時，朋友棄而他去；一個靠茶和土司度日的老太太，已不再有能力清理她凌亂的公寓。在這些時刻，看起來比生重病更慘的，是孤單一個人承受這些苦痛。
社交孤立是一種越來普遍的流行病─人們越來越認識到它對身體、精神和情緒產生的可怕後果。從1980年代至今，表示自己感到孤寂的美國成人，從20%倍增到40％。
About one-third of Americans older than 65 live alone; half of those over 85 do. People in poor health — especially those with mood disorders like anxiety and depression — are likelier to feel lonely. Those without a college education are the least likely to have someone they can talk to about important personal matters.
A wave of new research suggests social separation is bad for us. People with less social connection have disrupted sleep patterns, altered immune systems, more inflammation and higher levels of stress hormones. One recent study found that isolation increases the risk of heart disease by 29 percent and stroke by 32 percent.
65歲以上的美國人約有三分之一獨居，85歲以上者更有半數獨居。健康狀況較差的人，特別是有焦慮和憂鬱等情緒障礙的人，更容易感到孤寂。沒受大學教育者是最不可能找到人討論重大私事的一群人。
一波新的研究結果顯示社會隔離對我們有害。較少社交連結的人睡眠模式可能變得紊亂，免疫系統可能出現變化，也會出現更多的發炎症狀和較高濃度的壓力荷爾蒙。最近的一項研究發現，孤立會使罹患心臟病風險提高29%，中風風險提高32％。
Another analysis that pooled data from 70 studies and 3.4 million people found that socially isolated individuals had a 30 percent higher risk of dying in the next seven years, an effect largest in middle age.
Loneliness can accelerate cognitive decline in older adults, and isolated individuals are twice as likely to die prematurely as those with more robust social interactions. These effects start early: Socially isolated children have significantly poorer health 20 years later, even after controlling for other factors. All told, loneliness is as important a risk factor for early death as obesity and smoking.
另一個根據70項研究，涵蓋340萬個研究對象的資料完成的分析指出，社交孤立的個人其後7年內死亡的機率升高30%，且這種效應在中年人身上最為明顯。
孤寂會使老年人認知功能加速衰退，孤立的人早死的機率是社交互動活躍者的兩倍。這些影響很早即會開始：社交孤立的兒童20年後健康明顯較差，即使在控制了其他因素後仍是如此。總而言之，孤獨和肥胖、吸菸一樣，是導致早死的重大危險因素。
Loneliness is especially tricky because accepting and declaring our loneliness carries profound stigma. Admitting we're lonely can feel as if we're admitting we've failed in life's most fundamental domains: belonging, love, attachment. It attacks our basic instincts to save face, and makes it hard to ask for help.
孤寂是特別棘手的一個問題，因為接受和宣告我們的孤寂往往成為深刻的烙印。
承認孤寂宛如承認我們在生活最基本的領域打了敗仗，沒有歸屬感，缺少愛，也沒有依賴感。它會攻擊我們想要保住面子的基本本能，使我們很難開口請求幫助。
