医学生日记2016年3月31日 - 天使和老巫婆的画像
医学生日记2016年3月31日 - 天使和老巫婆的画像
阿山 （庞静译）
有些天我们遇到的糟心事连我自己都难想象，而且真的让我觉得非常绝望，希望自己一定不要经历自己的病人所经历的。最可恨的是这种情形并不少见。
今天我们在门诊看了一个十几岁的女孩。她已经十分不幸了，出生所带的少见的基因条件造成她轻度痴呆，身体畸形，心脏缺陷，以及尿道问题。她十分不幸地被一个吸毒的母亲所生，还十分不幸地被她的父亲性虐待。所幸，她被从她的生父母那里救了出来。但不幸的是她得依赖这个社会从一个机构转到另一个机构，从一个家庭转到另一个家庭，因此一直得不到她需要的照顾。她的这些经历又使她十分不幸地患上了PTSD(Post Traumatic Stress Disorder 创伤后压力症侯群)，现在她心中反复地经历她以前的悲惨经历。
她被虐待的故事和她不公平的命运根本讲不完。我并不想讲这些。因为听到希望，所以许多人才来接受治疗。我要讲的是这个女孩生命中的烛光。
通过家庭领养机构，几个月前一个老女人领养了这个女孩。今天，这个老女人带她来看病。我承认，我对这个老女人产生了一个很不公正的第一印象。相衬于她的满头白发，她穿的衬衫太短了，她的嗓音就像卡通片里的巫婆，掺杂急速喘息的笑声令人联想她长期吸烟的历史和卑劣的灵魂。她很快就开始抱怨这些忙碌了一天的医生们护士们如何地忽视她。她抱怨照顾这个女孩多么烦琐。简单地说，她就是那种人，你第一次见，一定不喜欢。
但是，老师们反复教我们不要评判别人。所以，我坐下来，听她诉说。我听她说她如何从政府机构领养这个女孩，当时女孩卷缩成一团，身上沾满了稀屎。我听她说当这个女孩经历一次致命的感染时，她如何和女孩在医院呆了一个星期。我听她说她每天夜里十一点早晨三点半起来给女孩插尿管，帮女孩排光膀胱里的尿。她带来了每天的记录，详细记录了过去几个月每次她帮女孩排尿的尿量，她怎么做的，尿的清浊和颜色。每天早晨五点半她要起来帮助女孩做好上学的准备。今天她开了五个小时的车，带着病人来看她认为是全州最好的医生。
我坐在诊室里，为自己那么快地判断这个女人而惭愧。就是在诊所，她也在量她给这个女孩喝了多少水。这个女孩经历了无数的创伤，她却在教女孩仪态有多么重要。她讲笑话，引得女孩发笑。这些事仅仅凭读病历是无法知道的。我们的病人居然直接和我们说话，告诉我们她在学校怎么样，问我们有什么办法可以帮她解决尿和拉肚子的问题。
这件事让我知道了人类的关爱是无穷无尽的。我们还看到了，无论现状多糟，人试图快乐的能力和恢复的能力。我懂了：一定不能根据第一印象对人家的人格做判断。
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.