医学生日记2016年3月7日-选择

医学生日记2016年3月7日-选择
阿山 （庞静译）二零一六年三月七日

今天我实践妇科麻醉。我的朋友们都知道我对儿科非常有兴趣，经过婴儿时，我根本无法不硬扭着我那转动有限的脖子去多看那个婴儿几眼。但是今天我的注意力必须集中在母亲们身上。这一天过得很慢，没有几个新生儿。我只见了几个病人。有一个病人着实引起了我的注意，让我绞着脑汁想了一阵子。

她只有二十一岁，刚生完第三个孩子。我在此不想详述那些关于医疗保障、教育、妇女生育权力、伦理标准、等々一系列矛盾的论辩。以前，很多人都很专业性地讲过这些。这里我只想说々我怎么看待她的想法。

我跟她接触非常有限，仅々摸了一下她脊背上麻药注射点的标记，她的输卵管结扎手术完成之后，我又帮助她下了手术台。为什么她让我这么着迷？她比我年轻三岁。就在这里，她居然做了今后不再生育的决定。

如今有很多避孕方法可取，粗翻了一下她的医疗档案，我推断，直到她怀孕，她都几乎没有机会了解那些避孕方法。她为什么要做这个决定？最直接了当的回答是：三个孩子已经足够了，她不需要也不想再多要了。

在她做结扎手术时，我无法不多看々她的脸。一条蓝色单子把她的脸和她的身体隔开了。她的眼睛看上去那么遥远，就如同她将来再也不能生育一般虚幻。如果她的决定并不单纯，三个孩子并不意味着足够，结果会怎么样呢？

她在怀孕期间经历过什么样的痛苦？她为她自己和她的三个孩子展望着什么样的未来？她经历这些时，她的家在哪？无论这些问题的答案是什么，我觉得结扎输卵管是一个挺好的决定。

我终于想明白了什么对我震动最大。我可以自信地说，用特权来衡量，我们的背景十分不同。我总是有很多机会和很多途径去做我想做的事情，而且从来不用顾及后果。最近，我开始懂得感恩这个事实：也就是我有很多机会，我可以非常自由地抓住这些机会，学习、成长、进步。而她，什么样的生活和经历可以使她在这么年轻的年纪就自愿放弃自己的选择呢？

我看着她抱着自己的婴儿坐在轮椅上被推出了医院，没有鲜花，没有气球。我以前在密西根儿童医院把这些都看习惯了。我突然明白过来我已经失去了和她说话的机会，无法再了解她的角度和立场了。老师教我们可以从接触的病患那里学习。就在今天，她挑战了我考虑问题的方法。我指望我可以学更多。比起她所放弃的，无论一切显得多么微不足道，我还是失去了一次机会。

March 7, 2016 – No better option

Today, I had the chance to rotate with obstetric anesthesia. Those who know me know that I am very interested in pediatrics, and I can’t walk past a baby without testing my neck’s range of motion. But today, my focus was on the mothers. It was a slow day, not many babies were being born. I got to meet only a few patients, but there was one that has overwhelmingly entangled my imagination.

She was only 21 had just given birth to her third baby. I’m not here to expound upon the cases and arguments about contraception, health care access and education, women’s reproductive rights, moral standards, yada yada yada the topics that many with much more expertise have presented before me. I’m simply here to reflect on my thoughts about her thoughts.

Why did she fascinate me so much? I had extremely limited interaction with her: I only palpated her spinal landmarks for her spinal anesthesia injection and helped her off the operating table… after her elective bilateral tubal ligation. Here she was, 3 years younger than me, when I still feel very much like a child, yet she was already the mother of 3. And here she was, making the decision to end all possibility of another baby in the future.

Why was she making this decision? There are so many contraceptive methods available nowadays, and scouring through her medical record, I can reasonably make the deduction that she had very little exposure and education about those methods until her pregnancies. The simple answer would have been: 3 babies are enough, she doesn’t need or want more.

I couldn’t resist looking at her face and into here eyes during her tubal ligation. A blue drape separated her face from the rest of her body. The look in her eyes was just as distant and disconnected as she was physically with her reproductive future. I wondered, what if the answer wasn’t simply: 3 babies are enough?

What type of fear or emotional anguish did she experience during her pregnancies? What type of future did she envision for her 3 children and herself? Where was her family through all of this? No matter what the answer was to these questions, I realized the tubal ligation would have still felt like a good decision to pursue.

I figured out what had struck me most. I can confidently say we come from vastly different backgrounds in terms of privilege. I’ve always had abundant opportunity, had the means to pursue any choice I made, and felt confident I would be okay no matter the consequence. Mostly and recently, I’ve gained great appreciation for the fact that I have available options, and I’m mostly free to pursue them as I learn and grow and change. What type of life and experiences would somebody have had to gone through to willingly give up this option at such an early age?

I watched her get wheeled out of the hospital with her new baby, without the flowers and balloons that I had become so accustomed to seeing at Michigan. And I realized I lost the opportunity to talk to her, to maybe get to learn her perspective. We were told that we could learn something from every patient we encounter. Even in this brief day, she’s challenged me to think differently. I just wish I had learned more. And so I also lost an opportunity, despite being ridiculously miniscule compared to what she gave up.