挣扎在喜怒哀乐之中
(2006-07-28 17:27:53)
下一个
早上很早就进病房了,因为今天是short call,白天会收病人,所以想早早看完自己的病人,就不至于在收病人忙得焦头烂额的时候还要顾着自己的病人。
大约7点半的时候,听见有code,一般情况下,我应该赶到code的地点,协助值班医生抢救病人,但是我想那个时候大多数医生都开始工作了,补缺我一个,我就继续作自己的事情,心里虽然有点不安,但是想结束琐碎不断的工作的想法占了上风。
大概过了半个小时,我的住院医生page我,电话里,他说,S先生去世了,你过来一下。我愣住了,原来刚才的code,竟然是我自己的病人,而我偷偷躲在医院的一角忙着写自己的note.一种失职的自责,恼怒瞬间弥漫了我的整个身体。
住院医生沉着脸等在病房门口,家属已经陆续赶来了。这个病人虽然病情挺重的,但是他只有50岁,而且在好转,我们都觉得很有希望痊愈的,谁知道发生这样的不测。住院医生run 了整个code,包括插管,电击等抢救,但是没有成功,我们在告诉妻子和儿子的时候,他们脸上惊愕多过了悲伤,在明白过来以后,二十多岁的儿子用汗衫捂住自己的脸,呜呜地开始哭,我的心里难过极了。
上午上班的时候,大家都问我那个病人怎么回事情,我觉得很羞愧因为我只能说,i didn't run to the code, 那种自责和羞愧就一直笼罩着我,虽然我的住院医生什么都没说,但是我知道我的行为一定让他失望了。
中午我们就开始不停地收病人,我和住院医生都没有吃中饭,一个接一个地看病人,分析病情,下医嘱。下午的时候主治医生过来了,我需要向他present我们收的病人,但是脑子里乱哄哄的,很多信息拼不到一起,最后assessment and plan的时候,我几乎说不出什么了,只是重复着一两个可能性。attending睁着灰蓝色的大眼睛,静静地看着我,一个月的培训,他耐心的指导,我还是只能做到这样,一种失望自暴自弃的感觉不可遏止地控制了我。attending注意到了我的异样,说are you OK?我点点头说是的。
新病人不断地来,我的拷机不断地响, ICU的,病房的,药房的,忽然门诊电话给我,说门诊有病人,我才想起来,今天下午我还有门诊。住院医生让我先去门诊,我拿着笔记本电脑匆匆赶去门诊,一个我从来没看过的,上届毕业的住院医生的老病人,已经等了很久了,nurse很不开心,我知道自己没有借口,just simply forgot。等到我匆匆浏览了所有的病人病史,敲开诊断间的门,却看见一个医学生已经在看了。我去了门诊staff的办公室,他说因为病人等久了,他们就让医学生去看了。staff说,please never forget your patient.我道了谦,跟他说我今天on call,他说我可以先去忙了,今天我只有一个病人。
提着电脑走回急诊室的路上,我的情绪低落到了极点, feels like I can't achieve anything, so cluelss。其他intern好像都很organized,该干什么就干什么,从容不迫,好像只有我天天忙来忙去,却还是纰漏百出。
经过食堂的时候,买了自己一瓶水和最喜欢的m&m巧克力,想了想,又给住院医生买了一块pizza。我一边吃着巧克力,一边又跟着他开始收新病人,主治医生也在边上帮着我们做一些诊断分析。我很喜欢这个team,我的主治和住院都长着娃娃脸,成天嘻嘻哈哈,但是工作起来却是一丝不苟。主治毕业于美国屈指可数的大医院,私人从业了很多年,但是决定放弃私人开业,回到医院里来教学。收入少了很多,但是他非常敬业。我们现在看的病人,都是medicare, medicaid的病人,不管看多少,他都不会拿一分钱,但是他在他们身上花的时间,是惊人的。我从他身上学到很多东西,难得的是他对下面住院医生的体恤和关怀,如果我们受到护士或者其他专科医生的不平待遇,他都会挺身而出。
最可爱的是,他们都是非常幽默的人,开起玩笑来一个接一个,我常常笑得眼泪直流,必须大声阻止他们,否则我永远写不完病史。在繁重的工作,不愉快的和病人,其他机构打交道的时候,是很容易stress out的,但是他们总是坚强乐观,自得其乐。今天主治额头上长了一个青春痘,不停地被我们打趣,我们看完病人出来,在分析心脏体检,他忽然把听诊器放在青春痘两边(好像那个青春痘在听诊),说,我的朋友(那个青春痘)听见不规则的心律和杂音,我笑得趴在桌上。
主治知道今天我心情低落,所以说了很多笑话,在分析病史的时候也格外耐心,时间飞逝,5点半的时候我们才结束收病人。我明天休息,主治还要来看病人,他起身说再见的时候,我看着他的背影,心中充满了感激和尊敬。
我想,每个医生都有这样的经历。他们也有着让他们全力以赴,一刻都不敢掉以轻心的,类似警钟的回忆。他们可以敏感的看出你的异样,不是对你失望,他们心里清楚这是对你的考验。如果你能在最短的时间重新振作起来,自信起来,更细心,更专业的对待你的病人,这才能真正预示你将会成为一个合格的医生:)
他们都在注视着你,不是注视着你的失误,而是注视着你,期待着你胜任作为医生的心理考验。期待你明白,这就是医生这个职业,只要在岗位上,就不能有一丝的疏漏,毕竟,人命大于天。
我希望你尽快调整好状态,更相信你一定会胜任医生的职业:)
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.
拥抱阳光,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!
我也知道这是个很浅显的道理,说起来容易做起来难,大家共勉吧。
put your head down,我的理解是专心做事情,不要想太多,一般会说put your head down and get your job done.
stay foolish and stay hungry是苹果公司老板steve jobs在2005年斯坦福毕业典礼上说的,我的理解是stay foolish so you are eager to learn, stay hungry, so you are eager to eat,说的是一种工作态度。在那个典礼上面他因为宣扬读书无用论+说粗口被人赶下台,轰动一时。
我主要是觉得有些东西开始的时候比较容易改,养成习惯就不好了。语言和能力可以慢慢培养。如果冒犯还请多多见谅。
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,很高兴。
我最近在哥伦布出差,于是想起了你。
祝你一切都好,坚持住!!!
住院医一开始几个月stressed out是很正常的事情。我以前的同事刚开始几个月觉得非常抑郁,还常常哭(男的),现在已经是留下做主治了。我遇见他时他已经是fellow,不敢相信他当初住院医开始时如此difficult。(我的第一印象觉得他业务很好)
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.
老人家说,在困难的时候要看到成绩,看到光明。后面的就不引了,希望它不经常发生。
在职场打拼,不要苛求自己。在美国能做医生的也个个是人精。能成为他们中间的一员,你应感到自豪。同你一样,我们每个在美谋生的人都要经历这样的低潮(巨牛人除外)。我周一有两个closing, 从今晚起还有几十个文件要起草,敲定,恐没有几个小时可睡了。对我等秃小子,老伴和客户可没有象对你亮妹哪样耐心的。说这些是想给你鼓鼓气,没什莫大不了的。
You can do it! 让我们共勉。