Wednesday, June 8, 2016

阿嫲的道别

阿嫲紧紧握着我的手泪如雨下。

阿伯在洗肾时突然心跳停止。接到洗肾室护士通知我飞奔到洗肾室。护士和实习医生已经开始了心肺复苏 (CPR)。心电图仍然是平线。

‘什么状况?’ 我一面穿手套一面准备插管。
“病人70患肾衰竭长期洗肾。这次入院是因为心脏病发作给过了抗凝血劑,  已经好几天了。几天前我们用持續性低效率血液透析(SLEDD) 替阿伯洗肾没有大碍。预计几天后就能出院了。但刚刚洗肾时突然意识昏迷心跳停止。。。”
听完他的汇报呼吸管也已插置完成。确定插管无误,‘继续CPR!’我把管理呼吸的重任交托给护士后急着找病患家属。

阿嫲刚从医院底楼的贩卖部买了面包和包装水准备给阿伯洗肾时充饥。但当她回来时不见阿伯映入眼里的是已被拉上的床帘粉红色帘布背后传来嘈杂的声音还有各种仪器哔哔哔的尖叫声。阿嫲愣了住了手里的塑料袋差点就像电影情节般掉到地上。
我把她扶着带他到一张空椅子让她坐下。
“怎么会这样,我才下去一下。刚才还好好的,怎么会这样?”阿嫲喃喃自语。
‘阿伯刚才洗肾时心跳突然停止了。我们知道阿伯刚患心脏病,所以洗肾风险特别高,因此用必较温和的方式替他洗肾,但可能他还是。。。’ 我安抚着阿嫲的肩膀,‘我们正在为他做CPR, 希望他心跳会恢复。’
阿嫲怔怔望着我。我不得不回到阿伯病床边继续作战。
肾上腺素给过了,在做CPR的战友们都已汗流浃背。心电图随着我们奋力地胸外按压在跳动着。但每两分钟暂停胸外按压,做脉搏检查时,那条绿色的线又毫不给脸,懒洋洋地变回平线。好不容易,CPR进行了二十分钟,阿伯的心脏还是没有动静,瞳孔已经放大。大伙儿对望了一眼,然后都摇了摇头。
我走近坐在洗肾室外椅子上的阿嫲,她十多岁大的孙子在旁静静地陪着她。护士告诉我她的孩子还在途中。“阿嫲,已经二十多分钟了,我们尽力了。”

两行泪水顺着刚才还没干的轨迹划下。我递给她面纸,然后把她带到阿伯床边。
她呆呆地,看着陪她走过半个世纪的老伴,静静地,冷冷地躺着。阿嫲叫了一声“亲爱的”,阿伯闭着双眼没回答。护士把阿嫲带到阿伯身边,让阿嫲在阿伯耳边念祷告文,然后阿嫲轻轻地对阿伯说了最后的几句话。那些本来留着来日方长要细细述说的千言万语,短短的几分钟,又如何说得完呢?
“阿伯已经不在了,阿伯已经不在了。。。”她在椅子坐下后又开始哽咽。像溺水的人抓住一棵救命的稻草,她紧紧地握着我的手。我尝试安抚她,但要安抚一个刚失去了终身伴侣的人谈何容易?
“太突然了,发生得太突然了。没想到。。。我没想到!阿嫲还来不及向阿伯道别,还来不及向他道歉,还来不及。。。”
‘阿嫲,阿伯有听到。刚才你对他说的他都听到。’
“医生你不是说他刚刚已经断气了吗? 阿嫲都还来不及向他告别啊。”
‘不,不。刚刚阿嫲对他说话时他听得见,他那时还没完全离开,他听得见。’
“真的?”泪水还是不断地流下。“真的吗?小弟你不要骗阿嫲。”
‘真的,我没骗你,阿伯听到,阿伯都听得到。’
“你没骗我?”
我奋力地摇了摇头。
阿嫲虽然还是哭泣着,但她的脸突然展现了一丝的宽慰。我不晓得她是不是真的相信了我这善意的谎言。得知与她长相厮守的伴侣,在临走前听到了自己最后的话,最后一次的道别,最后一次的道歉。对我而言,那是举手投足的几句话;但对她来说, 那将会是她余生最珍贵的回忆。


每天在生、老、病、死中穿梭,有时会因为看淡了变得麻木;有时会因为自我保护而保持距离;有时会因为不想受伤害而变得冷漠无情。但这些在白色巨塔不断上演的情节,偶尔还是会冷不防地,像阿嫲抓紧握着我的手般,牢牢地触动我们内心最深处,让冷却的心又炽热过来,让我们在行医的路上坚定地走下去。


p/s:很久沒更新blog了。這是一篇舊文,只是最近才有閒翻譯過來。希望你會喜歡。

Friday, March 1, 2013

Helpless

Soemtimes
i just feel helpless
People around seems don't understand our job...
Unless you are in the practise, or else it is difficult for you to understand what are we been through,
as a doctor....

For most people,
sick is common cold...
The reason they see a doctor are mostly for URTI and AGE....
A lot of healthy people don't realize the diversity of diseases out there...
For them, these maybe only occur in drama or movies...

Well, i will think they are lucky...
Cervical cancer with spinal metastasis causing paralysis...
Ovarian cancer with distant metastases unable to undergo chemo d/t renal impairment
Breast cancer in pregnancy necessitating termination of pregnancy
Invasive mole with massive bleeding requiring massive blood transfusion and chemotherapy
Cervical ca with bilateral obstructive uropathy complicated by urosepsis
These are the few cases i met in my few weeks time in Gynea Onco unit...
Not a cheerful unit...
But i learn a lot...

Healthy people out there has no idea what are we facing...
They also has no idea what cancer patient facing...
It is very difficult to make them understand
but why waste energy and time?

This is the life we choose...
To treat, to help, to care, to comfort....

"Out here in the fields

I fight for my meals
I get my back into my living
I don't need to fight
To prove I'm right
I don't need to be forgiven"
                                         -Baba O'Riley


Tuesday, February 5, 2013

Fix you....


When you try your best, but you don't succeed
When you get what you want, but not what you need......

I got an urgent bilateral antegrade stenting appointment for a cervical ca pt with obstructive uropathy... Hopefully with the stenting she can undergo radio therapy sooner...
After i got the appointment date which is the next day, i tell the pt's husband regarding this...
We sit down, i explained, i draw and illustrated... He hesitated... He wanna try traditional method... He got a few friends with similar problem healed after trying the traditional way....
I say fine... I give time for you to think and decide.... But deep inside my heart i hope they do it.... Traditional way to cure ca? I dont believe it, but i respect what they want....

On the same night the patient husband went to my boss and complain about me...
I dont know what is that about probably i pushed them too hard on the procedure...
Finally they refused for the procedure.....

I cried... I hide myself behind the ward and tear stream down my face and i just cant control them... This is not the first time i cry since i started my life as a doctor for one and half year... Each time for different reason...

"Treating illness is why we became doctors. Treating patients is actually what makes most doctors miserable."  -House MD

It is sometimes true... But I dont agree with this...
I remember few days ago i met a patient of mine during Ortho...
He has a fall and sustained Rt intertrochanteric fracture...
Planned for op initally however cancelled as we found his right lung is totally white from pre-op CXR...
We then go for conservative mx...
He is leaving in a nursing home... He is single and have no child....
At least he can sit on a wheelchair when he discharged from ward, after few weeks of skeletal traction....
I met him outside ED... He came for some followup...
He smiled, he actually laugh when he saw me... We shake hands...
I have to run for some urgent stuff and we didnt chat much...
That reunion really make my day...

There are a lot of other forms of reward in life of a doctor...
If the only motivation of work is your salary, then i suggest you to quit and get a office job....


I just need a small break...
I will pick myself up...
I will carry on.....

Thursday, July 26, 2012

那被extend的一个礼拜

四个月了
离被extend 的一个礼拜
在surgical posting

回眸看这一个星期
当时被冲晕头的沮丧不见了
取而代之的是很正面的立场

谢谢那一个礼拜
我更了解我自己
我看到了我的倔强
如果我对自己姑息
如果我对自己说谎
即使别人原谅我也不能原谅

谢谢那一个礼拜
我更珍惜我身边的人
主人
朋友
同事
还有两个最好的partner

谢谢那一个礼拜
我们还跑去看hernia OT
跑去看minor OT 做subcutaneous skin closure

谢谢那一个礼拜
我剩下的假期都被取消
待我留着以后用

谢谢那一个礼拜
我明白了Batman Begins 里的名句
Why do we fall?

谢谢那一个礼拜
我体会到了<那些年>里的
“人生就是不停的奋斗"


谢谢那一个礼拜
谢谢他的冷言冷语
我能大声地说
Throw your sticks and stones
Throw your bombs and your blows
But you're not gonna break my soul
This is the part of me that you're never gonna ever take away from me


今天完成了Paeds 最后一个assessment
回头看
真的要感谢那被extend 的一个礼拜

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