掙紮在喜怒哀樂之中
(2006-07-28 17:27:53)
下一個
早上很早就進病房了,因為今天是short call,白天會收病人,所以想早早看完自己的病人,就不至於在收病人忙得焦頭爛額的時候還要顧著自己的病人。
大約7點半的時候,聽見有code,一般情況下,我應該趕到code的地點,協助值班醫生搶救病人,但是我想那個時候大多數醫生都開始工作了,補缺我一個,我就繼續作自己的事情,心裏雖然有點不安,但是想結束瑣碎不斷的工作的想法占了上風。
大概過了半個小時,我的住院醫生page我,電話裏,他說,S先生去世了,你過來一下。我愣住了,原來剛才的code,竟然是我自己的病人,而我偷偷躲在醫院的一角忙著寫自己的note.一種失職的自責,惱怒瞬間彌漫了我的整個身體。
住院醫生沉著臉等在病房門口,家屬已經陸續趕來了。這個病人雖然病情挺重的,但是他隻有50歲,而且在好轉,我們都覺得很有希望痊愈的,誰知道發生這樣的不測。住院醫生run 了整個code,包括插管,電擊等搶救,但是沒有成功,我們在告訴妻子和兒子的時候,他們臉上驚愕多過了悲傷,在明白過來以後,二十多歲的兒子用汗衫捂住自己的臉,嗚嗚地開始哭,我的心裏難過極了。
上午上班的時候,大家都問我那個病人怎麽回事情,我覺得很羞愧因為我隻能說,i didn't run to the code, 那種自責和羞愧就一直籠罩著我,雖然我的住院醫生什麽都沒說,但是我知道我的行為一定讓他失望了。
中午我們就開始不停地收病人,我和住院醫生都沒有吃中飯,一個接一個地看病人,分析病情,下醫囑。下午的時候主治醫生過來了,我需要向他present我們收的病人,但是腦子裏亂哄哄的,很多信息拚不到一起,最後assessment and plan的時候,我幾乎說不出什麽了,隻是重複著一兩個可能性。attending睜著灰藍色的大眼睛,靜靜地看著我,一個月的培訓,他耐心的指導,我還是隻能做到這樣,一種失望自暴自棄的感覺不可遏止地控製了我。attending注意到了我的異樣,說are you OK?我點點頭說是的。
新病人不斷地來,我的拷機不斷地響, ICU的,病房的,藥房的,忽然門診電話給我,說門診有病人,我才想起來,今天下午我還有門診。住院醫生讓我先去門診,我拿著筆記本電腦匆匆趕去門診,一個我從來沒看過的,上屆畢業的住院醫生的老病人,已經等了很久了,nurse很不開心,我知道自己沒有借口,just simply forgot。等到我匆匆瀏覽了所有的病人病史,敲開診斷間的門,卻看見一個醫學生已經在看了。我去了門診staff的辦公室,他說因為病人等久了,他們就讓醫學生去看了。staff說,please never forget your patient.我道了謙,跟他說我今天on call,他說我可以先去忙了,今天我隻有一個病人。
提著電腦走回急診室的路上,我的情緒低落到了極點, feels like I can't achieve anything, so cluelss。其他intern好像都很organized,該幹什麽就幹什麽,從容不迫,好像隻有我天天忙來忙去,卻還是紕漏百出。
經過食堂的時候,買了自己一瓶水和最喜歡的m&m巧克力,想了想,又給住院醫生買了一塊pizza。我一邊吃著巧克力,一邊又跟著他開始收新病人,主治醫生也在邊上幫著我們做一些診斷分析。我很喜歡這個team,我的主治和住院都長著娃娃臉,成天嘻嘻哈哈,但是工作起來卻是一絲不苟。主治畢業於美國屈指可數的大醫院,私人從業了很多年,但是決定放棄私人開業,回到醫院裏來教學。收入少了很多,但是他非常敬業。我們現在看的病人,都是medicare, medicaid的病人,不管看多少,他都不會拿一分錢,但是他在他們身上花的時間,是驚人的。我從他身上學到很多東西,難得的是他對下麵住院醫生的體恤和關懷,如果我們受到護士或者其他專科醫生的不平待遇,他都會挺身而出。
最可愛的是,他們都是非常幽默的人,開起玩笑來一個接一個,我常常笑得眼淚直流,必須大聲阻止他們,否則我永遠寫不完病史。在繁重的工作,不愉快的和病人,其他機構打交道的時候,是很容易stress out的,但是他們總是堅強樂觀,自得其樂。今天主治額頭上長了一個青春痘,不停地被我們打趣,我們看完病人出來,在分析心髒體檢,他忽然把聽診器放在青春痘兩邊(好像那個青春痘在聽診),說,我的朋友(那個青春痘)聽見不規則的心律和雜音,我笑得趴在桌上。
主治知道今天我心情低落,所以說了很多笑話,在分析病史的時候也格外耐心,時間飛逝,5點半的時候我們才結束收病人。我明天休息,主治還要來看病人,他起身說再見的時候,我看著他的背影,心中充滿了感激和尊敬。
我想,每個醫生都有這樣的經曆。他們也有著讓他們全力以赴,一刻都不敢掉以輕心的,類似警鍾的回憶。他們可以敏感的看出你的異樣,不是對你失望,他們心裏清楚這是對你的考驗。如果你能在最短的時間重新振作起來,自信起來,更細心,更專業的對待你的病人,這才能真正預示你將會成為一個合格的醫生:)
他們都在注視著你,不是注視著你的失誤,而是注視著你,期待著你勝任作為醫生的心理考驗。期待你明白,這就是醫生這個職業,隻要在崗位上,就不能有一絲的疏漏,畢竟,人命大於天。
我希望你盡快調整好狀態,更相信你一定會勝任醫生的職業:)
加油!
give you a big hug......
Never minded your whining, in fact greatly admire your courage for putting yourself in a fish bowl and self-deprecatingly parsing through your mistakes. Takes a lot of courage to do that, as most of us who make mistakes would never want to mention it to a living soul. Being open, trusting and humble are good virtues to keep, and you have them all.
Before I started, I once said to a secretary that new interns look fine working on the floor. And she said they just look fine but deep inside they are thinking "oh my god, how am I going to survive this job? Did i do everything right?" She's been in program for 15+ years. She told me everyone looks fine when they first start but they all feel horrible.
You will be fine and I have faith in you!!!
tabby, i went to eat after i wrote this, that's why i was not online. i can understand your friend's crying, i am not suprised at all. what most bothers me is the feeling of being the weakest among my intern peer, i could not help comparing myself with them, and get more frustrated and anxious. the only way to correct it is to study more, work more and grow up more quickly. this is so called silly bird flies first? hehe. i just bought some books, including harrison principle and some other books, really need to catch up.
流水浮萍,thank you, i will work hard and stop whinning, i am actually very lucky to have patient resident and attending, all i need to do is to absorb the information as quick as i can.
damao, long time no see! i miss columbus, don't forget to go Yao's kitchen on 10th street, i miss there, also the nice parks.
wuximm, is that you and your kid? hehe. you are right, i should be there during the code, i feel terribly guilty. it won't happen again. i don't think i criticized myself too much, compared to my league, i have a lot to learn. i will try to be patient and stay strong. thank you.
擁抱陽光,i like this name. thank you for reading and leaving the sweet messages here. I harvest a huge amount of encouragement from my blog, maybe we will never meet in real world, but you and other friends are part of my spritual life, you cannot even imagine how important this blog means to me. therefore, no need to thank me for writing, because I gain much more than I give here.
大皇,i hope so, tomorrow i am on call, my last call in my first month, hopefully everything finishes smoothly.
I have been reading your blog for quite a while and I really like your sharing of experience about the way to become a doctor here. Every chinese person here all experience lots of frustrations. I know what a simple encouragement means to me especially when there is nobody to rely on. I can see you're growing up through your writings. Comments by the friends here also encourage me a lot!
I just know that you are already a very good resident. But we always need improvement to achieve our dream. I believe you can do it, so firmly!
我也知道這是個很淺顯的道理,說起來容易做起來難,大家共勉吧。
put your head down,我的理解是專心做事情,不要想太多,一般會說put your head down and get your job done.
stay foolish and stay hungry是蘋果公司老板steve jobs在2005年斯坦福畢業典禮上說的,我的理解是stay foolish so you are eager to learn, stay hungry, so you are eager to eat,說的是一種工作態度。在那個典禮上麵他因為宣揚讀書無用論+說粗口被人趕下台,轟動一時。
我主要是覺得有些東西開始的時候比較容易改,養成習慣就不好了。語言和能力可以慢慢培養。如果冒犯還請多多見諒。
I consider you a very responsible, self disciplined and hard working resident. You criticized yourself way too much. Easy on yourself, you will drastically improve soon. Hug!
得知你一切都好,很高興。
我最近在哥倫布出差,於是想起了你。
祝你一切都好,堅持住!!!
住院醫一開始幾個月stressed out是很正常的事情。我以前的同事剛開始幾個月覺得非常抑鬱,還常常哭(男的),現在已經是留下做主治了。我遇見他時他已經是fellow,不敢相信他當初住院醫開始時如此difficult。(我的第一印象覺得他業務很好)
Talk to your attending, ask for his true opinion and discuss how to improve. You need a better plan and better attitude, just like you said, you need to be organized, otherwise your advantage of strong knowledge would be covered by those "small mistakes" which are not "small" at all.
I can see you are in a bad cycle now, mistakes make you feel bad and stressed, then you lose your motivation, look for short cut and later on make more mistaks.
The only thing which can drag you out of this cycle and relax yourself is to make some progress in your work.
Always feel stressed is not good, it makes you always feel you need relax and be comforted. Forget about stress, don't look for shortcut, do whatever you supposed to do.
Put your head down, stay foolish and stay hungry, this is so true.
老人家說,在困難的時候要看到成績,看到光明。後麵的就不引了,希望它不經常發生。
在職場打拚,不要苛求自己。在美國能做醫生的也個個是人精。能成為他們中間的一員,你應感到自豪。同你一樣,我們每個在美謀生的人都要經曆這樣的低潮(巨牛人除外)。我周一有兩個closing, 從今晚起還有幾十個文件要起草,敲定,恐沒有幾個小時可睡了。對我等禿小子,老伴和客戶可沒有象對你亮妹哪樣耐心的。說這些是想給你鼓鼓氣,沒什莫大不了的。
You can do it! 讓我們共勉。