醫學生日記2016年3月31日 - 天使和老巫婆的畫像

醫學生日記2016年3月31日 - 天使和老巫婆的畫像

阿山 （龐靜譯）

 

有些天我們遇到的糟心事連我自己都難想象，而且真的讓我覺得非常絕望，希望自己一定不要經曆自己的病人所經曆的。最可恨的是這種情形並不少見。

 

今天我們在門診看了一個十幾歲的女孩。她已經十分不幸了，出生所帶的少見的基因條件造成她輕度癡呆，身體畸形，心髒缺陷，以及尿道問題。她十分不幸地被一個吸毒的母親所生，還十分不幸地被她的父親性虐待。所幸，她被從她的生父母那裏救了出來。但不幸的是她得依賴這個社會從一個機構轉到另一個機構，從一個家庭轉到另一個家庭，因此一直得不到她需要的照顧。她的這些經曆又使她十分不幸地患上了PTSD(Post Traumatic Stress Disorder 創傷後壓力症侯群)，現在她心中反複地經曆她以前的悲慘經曆。

 

她被虐待的故事和她不公平的命運根本講不完。我並不想講這些。因為聽到希望，所以許多人才來接受治療。我要講的是這個女孩生命中的燭光。

 

通過家庭領養機構，幾個月前一個老女人領養了這個女孩。今天，這個老女人帶她來看病。我承認，我對這個老女人產生了一個很不公正的第一印象。相襯於她的滿頭白發，她穿的襯衫太短了，她的嗓音就像卡通片裏的巫婆，摻雜急速喘息的笑聲令人聯想她長期吸煙的曆史和卑劣的靈魂。她很快就開始抱怨這些忙碌了一天的醫生們護士們如何地忽視她。她抱怨照顧這個女孩多麽煩瑣。簡單地說，她就是那種人，你第一次見，一定不喜歡。

 

但是，老師們反複教我們不要評判別人。所以，我坐下來，聽她訴說。我聽她說她如何從政府機構領養這個女孩，當時女孩卷縮成一團，身上沾滿了稀屎。我聽她說當這個女孩經曆一次致命的感染時，她如何和女孩在醫院呆了一個星期。我聽她說她每天夜裏十一點早晨三點半起來給女孩插尿管，幫女孩排光膀胱裏的尿。她帶來了每天的記錄，詳細記錄了過去幾個月每次她幫女孩排尿的尿量，她怎麽做的，尿的清濁和顏色。每天早晨五點半她要起來幫助女孩做好上學的準備。今天她開了五個小時的車，帶著病人來看她認為是全州最好的醫生。

 

我坐在診室裏，為自己那麽快地判斷這個女人而慚愧。就是在診所，她也在量她給這個女孩喝了多少水。這個女孩經曆了無數的創傷，她卻在教女孩儀態有多麽重要。她講笑話，引得女孩發笑。這些事僅僅憑讀病曆是無法知道的。我們的病人居然直接和我們說話，告訴我們她在學校怎麽樣，問我們有什麽辦法可以幫她解決尿和拉肚子的問題。

 

這件事讓我知道了人類的關愛是無窮無盡的。我們還看到了，無論現狀多糟，人試圖快樂的能力和恢複的能力。我懂了：一定不能根據第一印象對人家的人格做判斷。

 

原文

March 31, 2016 – Portrait of an Angel as an Old Witch

 

 There are days where we see monstrosity that I’m barely even capable of imagining, that make you truly contemplate how extreme despair can be and hope you will never experience what your patient has. The most revolting thing about all this is that it is not that uncommon to see.

 

 Today, we saw a teenage girl in clinic. She was already unlucky enough to be born with a rare genetic condition, resulting in her mild mental retardation, physical deformities, heart defects, and urinary tract problems. She was unlucky enough to be born to a drug addict mother. She was unlucky to be sexually abused by her father. She was lucky to be taken away from her parents, but unlucky to need to rely on a system that bounces her from institution to institution and home to home, never receiving the care she needs. She was unlucky enough to be left with Post Traumatic Stress Disorder (PTSD) from all she’s been through, and now constantly re-experiences in her mind.

 

 The stories about her abuse and how unfair fate can be would be endless. But I don’t want to focus on all of that. What keeps many people going in medicine is hearing stories of hope, and I want to focus on the glimmer of light in this girl’s life.

 

 Our patient was adopted from an institution into foster care by an old woman several months ago. Today, it was this old woman that brought her to clinic. I will admit, I, very unfairly, formed a negative first impression of this old lady. She wore a shirt cut much too low for the full head of white hair, had the voice of a witch kid’s see on cartoons, and a cackling wheezy laugh that was suggestive of a long smoking history and mean spirit. She was quick to complain, making negative remarks about how the doctors and nurses who had been scrambling all day were ignoring her. She complained about how taxing caring for this girl on her. She was simply one of those people you meet for the first time and just cannot like.

 

 However, medicine constantly teaches us not to judge people, so I sat down, and I listened. I listened to her talk about how when she picked up this girl at the government institution, she was all curled in a ball and covered in her own diarrhea. I listened to her talk about how she stayed with our patient in the hospital for a week when she had a life threatening infection. I listened how she woke up every night at 11pm and 3:30am to catheterize the patient and manually empty her bladder. She brought with her a journal, documenting how over the last several months, every time she drained the urine from our patient and exactly how much did she drain, adding notes about if it was clear, cloudy, or colored. She also woke up at 5:30am every day to get our patient ready for school. Today she drove 5 hours by herself to get this patient to who she believed were the best doctors in the state.

 

 I sat there in clinic feeling ashamed of how quickly I had negatively judged this woman. Even in clinic, she was measuring how much water to give our patient. She was lecturing this girl, who had been through countless trauma, on the importance of manners. She made jokes and our patient was laughing and smiling, something that would have been incomprehensible from solely reading about her history. Our patient even talked directly to us, telling us about what she was doing in school, and asking us about how we were going to solve her urination and diarrhea problems.

 

 This encounter showed me just how immense humanity’s reservoir for caring and kindness was. We also saw the resilience, the ability of people to try to be happy despite the most desperate of situations. And never form a lasting judgment about person’s character by a physical first impression.