Loveable

Part three of the previous series can wait until another time, if ever. I can’t write about it right now. In my own life I can’t seem to move far from fairytale expectations and disappointingly not very grown up ways of thinking about love – ha, the irony.

Healing hearts

I do try to capture a bit of each rotation. As in capture something beyond I-don’t-like-hospital-work sentiments. Earlier this year I was “fixing broken hearts”. Not really. We don’t even have the facilities for PCI (stenting), let alone bypass surgery to fix blocked heart vessels.

Anyway, one story I remember quite well from that rotation happened during the Easter weekend ward round, where an Indigenous lady whose heart had the tendency to go into loooooong pauses insisted that she wanted to leave coronary care to attend the service held that morning by the hospital chaplain. Her English was rather limited but she was also adamant that she didn’t need to consent to a pacemaker insertion. “I want to pray for healing. God will heal me. I won’t need surgery.” she insisted. The consultant was sympathetic and explained whilst it wasn’t safe for her to leave, perhaps the chaplain could come to pray for her at her bedside. I wasn’t sure what to make of it – to commence her for her faith or to convince her that she needed a pacemaker. Maybe I would have done both.

Our best quitter

One hectic day, a few patients from the morning arrived more than half an hour late, just before the clinic closed for lunch. I thought it was a bit ridiculous that they still expected to be seen when they had clearly missed their appointments and the rest of the afternoon was already booked out. So I wasn’t impressed with the teen who sat before me, until I heard about what he came in for.

He had been smoking for a few years and was serious about quitting. On the several occasions that he tried, what stopped him from stopping altogether was not peer pressure from his mates, or a lack of motivation. It was the withdrawal symptoms that he had, including headaches and nicotine cravings. He wondered if patches could help. I don’t know how he did in the end, but this teenage boy was the most self determined quitter I’ve met in all of my smoking cessation discussions – he was clear that he wanted to quit, knew why he wanted to quit, recognised what stopped him from doing so successfully, and forthcoming with asking for help to overcome the barriers. Grown ups certainly have something to learn from him!

Life is a gift

Sometimes you resent patients for simply being complex (which is unfair of course), because you know it will take a long time to dig through their history, see what’s been done so far, get your head around the current problems, and work out a sensible plan. Especially if when there are communication barriers. I had such a patient, who was profoundly deaf even with hearing aids. He had been going in circles between surgical, endocrine, and renal outpatients for essentially the same problems and couldn’t tell me much about it. It took a long time to make sense of the letters that seemed to be bouncing referrals from one specialty to another with no clear conclusions.

Apart from that, there were also some concerns about mild cognitive decline. We got talking about his mood because his family were concerned. Amongst other things I asked about whether he felt that life was not worth living sometimes. He beamed and said, “No! Life is a gift from God.” I smiled back and thought I should take the reminder to heart.

Where’s home?

Working in rural places you meet some interesting staff. T-shirts and shorts seem to be the standard dress code for nurses. Flip flops aren’t uncommon either. Nor are tattoos and multiple piercings. Not that I particularly mind but I just didn’t see much of that in the old school hospital I worked in last year.

I shut off a bit at work and rarely have much emotional attachment to colleagues – but maybe less so in the cosier clinic setting. This time there was a nurse I liked and connected with. Whilst I was thinking about my career goals and applications, she said that she too was thinking about what to do in terms of further training or studies. She had done Masters in midwifery just a few years back but now doesn’t know where she wanted to take that, or do something else. She shared my frustrations in working out where to go, and finding something that was interesting, challenging and fulfilling at the same time. Except, well, she is possibly in her sixties or thereabouts. Now, some of the clinic staff are permanent residents of the region, but many including her are on short contracts from one rural clinic to another, each separated by many thousand kilometres. When we asked her where her permanent home was she said “I really don’t know”, and the other nurse nodded knowingly and said, “ah, so you’re permanently moving around.” I felt I could relate to that oxymoronic description of home. Though, I don’t know what drives people to move from place to place without ever settling. I don’t know if it gets lonely. Yet often I too feel the itch to keep moving. My dad says “you want to go here one day, and move there another. I think you will be more settled when you find someone.” Haha, I guess so.

The loveable couple

He had vulgar language, she had mental health issues, they were previously homelessness and seemed to have drug and alcohol issues in the mix too. At handover I heard about how he had attempted to strangle her over the weekend. Later the same day, she turns up for something unrelated with the same partner. Again, communication was difficult because she was deaf – not only that, she had been deaf since childhood and her speech was also fragmented and difficult to understand. I can’t recall what her issue was with hearing aids. We did some pen and paper talking but he also offered to come in and interpret via sign language. I was wary, but she wanted him to too, so in the end he came in with her. As I mentioned, I resent complexity (medical or otherwise) but I guess they grew on me in the subsequent visit.

This time she was using the external amplifier we had at the clinic. He gleefully told me how she can now pronounce “babe”, as in “bayyyybe” not “bub” with the amplifier on. She was delighted about this too. We got talking about how she came to be deaf. I had assumed it was either congenital or a result of recurrent middle ear infections, given that she was Indigenous and it was so prevalent within Indigenous populations. But it was an unfortunate story of her having sustained significant injuries from being hit or shaken as a baby. He encouraged her to seek help about her other worries and she told me about her abusive father interstate and how she felt unsafe every time she went back home to visit. I sort of asked whether she felt safe where she is now and she replied that she did, because he protected and looked after her. He piped in, “she looks after me too, we look after each other. Love you babe.” They embraced at that point and I thought aww… though I had mixed feelings too, not forgetting the dysfunctional elements of their relationship.

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5 Comments

  1. Hey sister, I feel the stories in this articles are the Quackling tales in real life.

    可爱的人

    之前那个系列的第三部如果可能的话不妨换个时间再写,我目前暂时写不了。在我的生命中,关于爱情,我的想法似乎更趋向于童话故事的幻想而且很不成熟。哈,真讽刺。

    心脏治疗

    因为有时候我不太喜欢医院的工作,因此我需要花努力跟上每个排班表。今年的早些时候,我的任务是“修复受伤的心”。当然,这只是比喻。我们连做PCI(支架)的设施都没有,更别说通过心脏绕道手术区修复病变的心脏血管了。

    不管怎样,在复活节周末工作的时候发生了一件让我记忆犹新的事。有一位土著女人的心脏虽然有长时间停止跳动的危险,但她坚持要离开心脏病监护区去参加由医院的牧师举办的教会崇拜。她的英文不好,但她表示自己不愿意接受心脏起搏器的手术。“我要通过祷告来治疗,神会医治我的,我不需要手术。”她的态度很坚决。会诊医生对她表示同情,并解释这个时候让她离开是很危险的,也许可以让牧师到她身边来祷告。我感到无语,我不知道是要称赞她的信心还是说服她让她接受心脏起搏器。也许两者都需要吧。

    我们最好的戒烟者

    在一个忙碌的上午,有几位早上的病人迟到了半个多小时,在诊所就要关门开始午餐时才姗姗来迟。他们错过了预约时间,并且下午的预约也满了。我觉得在这样的情况下如果他们还怀有见到医生的想法,那就有点荒谬了。因此在一开始这位坐在我面前的年前人让我颇感不快。直到他告诉我他来这里的目的后我才改变了想法。

    原来他抽了几年的烟了并非常想将其戒除。他尝试了几次均没成功。阻止他戒烟的要么是来自同龄朋友的压力,要么就是自己缺少动力。他的断瘾症状包括头痛和对尼古丁上瘾。他想知道皮肤贴片是否会有帮助。我不知道他最后是怎么做的,但这位年轻人是我遇到的戒烟者中目标最明确的一位——他清楚地知道他要戒烟,明白为什么要戒,也认识到阻止他成功戒烟的原因的是什么,并且他进一步寻求帮助以便克服这些障碍。对于已经长大的人一定也可以从这位年轻人身上学到些什么。

    生命是礼物

    有时候仅仅由于病人的情况复杂,你就会因此对他们感到厌烦。因为你有需要花很多时间研究他们的病史,看看目前为止他受过那些治疗,关注现有的问题并制定出一套可行的治疗方案。特别是在有语言障碍时,你会觉得更心烦。曾经我遇到过一个病人,他有着严重的听力障碍,甚至助听器对他也没什么帮助。他因为同样一些重要的问题在外科,内分泌科以及肾门诊部兜圈子,且无法把情况详细告诉我。我花了好长时间才勉强弄懂他的那些信究竟在说什么。这些信给人的感觉就是那些医生在没有明确结论的情况下,将转诊病人从一个部门推到另一个部门。

    除了耳聋,这位病人也有轻度认知功能减退的问题。他的家人为此担忧,因此我们讨论了他的心里的想法。在讨论其他事时,我问他是否有时他会认为会在世上毫无价值。只见他眼睛放出光芒,说道:”不!生命是来自上帝的礼物。”我对他回以微笑,并告诉自己一定要把这句话牢记在心。

    家在何方?

    在乡下工作时你会遇到一些有趣的员工。T恤衫和短裤是护士们的标注服装。这里的护士很多都穿着人字拖,并且有许多纹身和穿孔。我对此不是非常在意,但我去年在学校的医院工作时这种情况并不多见。

    我把主要的精力放在工作上,并没有对同工们有太多感情的依附——同时也难免无法尽情享受诊所舒适的设施。当时我和一位护士走的比较近。当我在考虑我未来的事业和申请时,她说她也在考虑自己未来培训和学习的事。她几年前取得了助产科的硕士学位,当她如今却不知何去何从。她和我一样,在未来发展的问题上都有挫折感。同时,我们也发现了一些有趣,充满挑战且很有成就感的事。唯一不同的是,她已经六十左右了。如今,一些诊所的员工是那个区的永久居民,但是包括那位护士在内的许多人只有不同乡村诊所的短期合同。这些诊所每个地方都相隔好几千千米。当我们问她哪里才是她永久居所时,她回答:“我真的不知道。”而其他的护士则点了点头表示:“啊,所以你永远没有固定的居所。”我觉得这种回答是一种用来描述家的矛盾修饰法。虽然我不知道是什么力量驱使着人们四处搬迁,居无定所。我不知道这样是否会觉得寂寞。但我发现我喜欢搬家的感觉。我的父亲常对我说:“你今天喜欢来这,明天又想去那。我觉得只有当你找到你的另一半后你才会安定下来把。”哈哈,我想是的。

    可爱的夫妇

    他说话粗鲁,她有精神问题。他们之前都是无家可归之人并且同时对毒品和酒精上瘾。在移交处我听说这位丈夫在周末时曾试图勒死他的妻子。在那天的晚些时候,她和同一个伙伴(same partner? his husband?)扯到了一些毫无关联的事。因为她是个聋子,所以我们的沟通再次遇到困难。不仅如此,她从小就耳聋,她讲的话只有一些片段并且非常难理解。我无法知道她的助听器到底出了什么问题。我们进行了一些笔谈,但那个男的也进来并要用手语为她翻译。我很谨慎,没有马上答应。但她坚持要他这么做。因此最终他进来陪着他妻子。正如我提到的,我讨厌复杂(医学或其他方面),但我预感到他们接下来的到访会让我对他们产生好感。

    这一次,她使用了我们诊所的外部扩音器。他高兴地告诉我有了扩音器的帮助,妻子可以将“babe”这个词说成“bayyyybe”而不是“bub”了。她也为此感到高兴。我们讨论了她如何成为聋子的。我先入为主地认为她的耳聋不是先天的就是周期性中耳炎导致的。因为她是个土著人,而这种病在土著居民中很常见。但事实上她之所以失去听力,是因为在她还是个婴孩的时候,她曾被击打成重伤。这真的是个很不幸的故事。他的丈夫鼓励她为自己的其他忧愁求帮助。然后她告诉我在她的父亲是个很粗暴的人,因此每次回家她都觉得不安全。我问她是否已在如今所在的地方找到安全感,她回答找到了。因为她的丈夫会保护她并照顾她。她丈夫听了便插话道:“她也照顾我。我们相互照顾。我爱你亲爱的。”在那时看到他们拥抱在一起,我心道:“哇。。。。。。”当然,我的感觉很复杂,毕竟他们的关系中存在着功能失调的元素。

    Reply

    1. Didn’t know you can translate medical things too haha. I can’t think of a proper equivalent of “partner” (as in, more than boyfriend, maybe living together for a long time but not married) in Chinese.

      Reply

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