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。

Call them boomerang retirees: people who exit gracefully after their career at a company, then return shortly afterward to work there part time.

More and more companies are establishing formal programs to facilitate this, for reasons that benefit the employer and the retiree. Leaving a satisfying job cold-turkey for a life of leisure can be an abrupt jolt to people accustomed to feeling purposeful, earning money and enjoying their colleagues. From the corporate perspective, it is useful to have experienced hands who can train younger people, pass along institutional wisdom and work with fewer strings attached.

凡在一家公司結束職涯優雅退休，不久後又回去做部分工時工作者，我們稱為回力鏢退休人士。

愈來愈多公司正設置正式計畫來推動這項工作，因為這對雇主和退休者兩利。就此辭別一份令人滿意的工作去過悠哉的生活，對於習慣於有目的感，能賺錢，以及享受同事情誼的人來說，可能是個突然的震撼。而從企業角度來看，讓有經驗的老手訓練年輕人、傳承制度智慧及以較少的工作附帶條件是很有用處的。

“People in the U.S. define themselves by their work, and they like their co-workers,” said Roselyn Feinsod, senior partner in the retirement practice at the human resources firm Aon Hewitt, the human resources consultancy. Thus, unlike many retirees from past generations, people from the blue-collar and white-collar sectors are more eager to retain ties to the familiar working world that they enjoyed (and sometimes loathed).

Mark Keefe, who spent his career as a human resources manager at Overlook Medical Center in Summit, New Jersey, retired in 2014, when he was 66. Since his wife still worked, he took on household chores and cooked evening meals. “It was really a time to relax,” he said.

怡安翰威特人力資源顧問公司的退休業務資深合夥人羅絲琳•費恩薩德說：「美國人透過自身工作來定義自己，而且喜歡他們的同事。」因此，跟許多過去世代退休人士不同的是，藍領與白領階層的人更渴望與他們所喜歡（有時也厭惡）的孰悉工作世界保持聯繫。

馬克•基夫職涯中一直擔任紐澤西州薩米特市照護醫學中心的人力資源經理，2014年退休，當時他66歲。由於妻子仍在工作，他承擔了家務與做晚飯的工作。他說：「這真是個可以放鬆的時光。」

But the company that owns Overlook, Atlantic Health Systems of Morristown, New Jersey, is among the growing ranks of employers that sponsor a formal program to invite retirees back into the workforce, for no more than 1,000 hours per year. The company’s Alumni Club — formerly known as the 1,000 Hour Club — was established in 2006, and about 300 Atlantic Health retirees are on the company’s payroll in various capacities. “They’re engaged employees; they’re productive,” said Lesley Meyer, Atlantic Systems’ manager of corporate human resources. “They’re a stable talent pool.”

不過，該醫學中心的母公司，紐澤西州摩瑞斯郡的大西洋醫療系統，則是不斷擴大的一個雇主行列的一員，這些雇主正式推出邀請退休員工重返岡位，每年工作不超過1000小時的計畫。該公司的校友俱樂部（前稱1000小時俱樂部）成立於2006年，目前約有300名大西洋醫療退休員工在不同職務上支領該公司薪水。大西洋系統的公司人力資源經理雷思麗•梅爾說：「他們是很投入的員工；他們具有生產力。他們是個穩定的人才庫。」

Starting in March 2015, Keefe began putting on a suit and tie and returning to work every Wednesday. He taps his human resources experience to counsel employees who are nearing retirement about benefit packages.

The soon-to-be-retired always have plenty of questions, and Keefe enjoys offering them information and guidance, including insights gleaned from his own experience. “I look at it this way: I have a six-day weekend,” he said. “I love it.”

自2015年3月開始，基夫每周三穿西裝打領帶回去工作。他以他的人力資源經驗向即將退休的員工提供有關各種福利方案的諮詢。

即將退休的人總是有很多問題，而基夫喜歡向他們提供資訊和指引，包括汲取自親身經驗的深刻見解。他說：「我是這麼看待它，我有長達六天的周末，我很喜歡。」