醫學生日記2016年3月8日-她可能是我的母親

醫學生日記2016年3月8日-她可能是我的母親
阿山 （龐靜譯）二零一六年三月八日

胰腺囊腫和胰腺癌 — 時間的不同，生和死的區別。

我和弟弟曾經陪伴著媽媽經曆了診斷，治療、和康複。那是一個很小的良性囊腫，早期發現，監視了很多年之後徹底切除，完全康複。

今天我的病人比我媽媽當年老了三十歲，這段時間足夠了，一個良性胰腺囊腫一定能發展成胰腺癌 。

很小的事情都可以把你和臨床聯上。她坐在輪椅上，從住院區被推到這裏。我期待的是一個重病垂危的老患者。她看上去不太一樣，非常瘦（久病的結果），骨架很小，和我們常見的超肥重的病患形成了鮮明的對比。她的身材和她的診斷使我馬上就在腦子裏比較了她和我自己的母親。

她的兩個成年的兒子都來了。他們放下了手頭所有的事情來陪伴她。當年媽媽住院的時候，弟弟和我放下了所有學校的功課。他們相差18個月，我和弟弟也相差18個月。哥哥看上去很外向開朗，跟我一樣，進行了全部與醫護人員的溝通。而那個弟弟很安靜，在他母親身邊寸步不離，像我弟弟一樣，隻字不漏地聽著周圍人的交談。她真的就可能是我的母親。

但是這裏有一個很大的區別：我媽媽的是良性胰腺囊腫，可以完全治愈，沒有什麽凶險；而她已經知道時日不多了，沒必要再施行切除癌灶的大型手術，現在隻是采取一點小措施，使她活得舒服一點。

昨天的事情讓我學乖了。我知道我為她做不了什麽，但是我有時間，當她等待小手術時，我可以站在她旁邊和她聊天。她的兒子們努力讓她的臉上一直布滿了笑容，她的身邊一直充滿了笑聲。她對我說：

“我天天都在感謝上帝給了我八十年的健康，讓我有兩個兒子，他們非常愛我，一直為了讓我得到一個幸福的結局而努力。”

她說這話時眼睛裏有淚水。她那個很健談的大兒子這時候也是非常安靜地低頭看著地麵。

當她小手術之後醒來時，跟所有手術之後從麻醉中蘇醒過來的病人一樣，她很難受。這時候我也沒辦法。我隻能握著她的手，確定毯子能給她保溫。

時間的區別，她不可能是我的媽媽。

March 8, 2016 – She could have been my mom

Pancreatic cyst and pancreatic adenocarcinoma – a difference of time, a difference of life and death.

My brother and I were the ones that were beside my mother for her diagnosis, treatment, and recovery process. It was a small benign cyst, detected early, monitored for many years, completely removed, and allowed for a full recovery.

My patient today was about 30 years older than my mother, plenty of time for a benign pancreatic cyst to make the cancerous transition into pancreatic adenocarcinoma.

The smallest things allow you to make a connection in the clinical setting. When she was wheeled down from the inpatient unit, I was expecting another old sick patient. But she was only slightly different, being very thin (in part due to her long illness) and of a slight frame, a notable contrast to the majority of overweight patients we see. Her size and her diagnosis were what first made me make the comparison of her to my mom in my head.

Then, came her two adult sons. They had dropped everything to come be with her, my brother and I both neglected quite some schoolwork during my mom’s hospitalization. They were separated in age by 18 months, same as me and my brother. There was a sociable and friendly older brother that did all the talking with the medical staff, like me. There was quiet younger brother that did not leave his mother’s side and despite his quietness, paid attention to every word being said, like my younger brother. This woman definitely could have been my mother.

But there was one major difference. My mom had a benign cyst and was expected to make a full recovery with relatively low risk. This woman knew she did not have long to live, forgoing the large extensive operation to remove the cancer, and instead electing for short surgeries to just make her more comfortable.

I learned my lesson from yesterday. I knew I wouldn’t be able to do much for her, but I had the time, so I just stood next to her and talked to her while she was waiting for her procedure to get started. Her sons did their best to keep her smiling and laughing the entire time. In one moment, she told me:

“I thank God every day for giving me 80 years of a healthy life, and for letting me have 2 sons that love me so much to work so hard to make sure I’m happy at the end”

There were tears in her eyes. Even the talkative son was quiet and looking down at the ground.

When she was waking up from her procedure, she was in quite a bit of discomfort, like anybody that is waking up from surgery and anesthesia. At this stage, I still couldn’t do much. I just held her hand and made sure the blanket was keeping her warm.

The difference of time, she could’ve been my mom.