醫護人員的無奈 The Helplessness of Medical Staff

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去年我看無線電視劇《天與地》的時候,看到飾演劉俊雄一角的林保怡,我馬上就想起他早前拍的港劇《妙手仁心》。猶記得當年的《妙手仁心》吸引了不少觀眾,據說還激勵了一些年輕人發奮圖強考上醫學系當醫生,或者其他跟醫療行業相關的大學科系,例如藥劑系、護理系,以便畢業後可以享受一下劇中醫護人員的生活方式。

我印象比較深刻的《妙手仁心》演員包括林保怡、吳啟華和蒙嘉慧。在這部長達三輯電視劇裏,一群年輕的醫護人員常常在下班之後到高級餐廳、酒吧食飯飲兩杯,或者忙著與情人談情說愛。若然觀眾對醫護人員的真實生活一無所知,還真的誤以爲從事醫療行業的人都是如此享受著生活:家住高級公寓,出入有名車代步,還有閒暇光顧城中知名餐廳享用美食,飯後與情人十指緊扣漫步在維多利亞港吹著綿綿海風,對著讓人如癡如醉的香港夜景說著甜蜜情話…一句講完,就是生活無憂,非常清閒輕鬆,意即廣東話說的「佗佻」(粵語發音:taa4 tiu4)。

但問題是港劇最爲人詬病的問題就是絕大部分的港劇跟香港市民的生活實況相差太遠,如果我們對港劇所呈現的畫面都信以爲真的話,我們還真的會以爲在香港,每個人都住得起私人樓宇、一個人工作賺錢就一定開得起 Nissan Murano 或 Land Rover ,甚至以爲每個醫護人員下班之後都過著《妙手仁心》劇情裏的那種悠閒生活。

其實,醫護人員的工作從來都不是輕鬆的,更不可能清閒(除非那家醫院或診所要倒閉了)。試著從這個角度想,閣下一整個晚上不睡覺的感覺如何?睡過一小時之後再起身工作十二個小時是什麼感覺?你/妳幻想一下自己完全沒睡覺持續工作三十六個小時—今天早上七點工作到晚上七點,晚上七點到第二天清晨五六點值個小夜班、大夜班,清晨五點多閉上眼睛拼命忍著不要睡死,然後六點半起身準備從早上七點開始工作到晚上七點。醫生更可憐,除了超過二十四小時不停工作無時間食飯嘆茶、陪家人和情人,甚至親生父母臨終之前都沒有時間趕回家鄉見最後一面(這絕對不是開玩笑),他們還要研讀很多paper寫論文、跟進全球最新的醫學知識與發展。如果沒跟上最新知識而造成醫療疏忽,一旦被病人告上法院隨時會傾家蕩產,因爲在法律上這個叫做「應注意、能注意而未注意的細節,結果造成醫療疏忽」。

醫生不是常告誡我們生活作息要正常,早睡早起身體好,閒來無事常跑跑,然後還耳提面命叫我們千萬不要熬夜不睡覺嗎?這些道理大家都知道,那醫生自己又做得到嗎?不好意思,醫生沒有這種美國時間去享受我們一般大眾所享受的睡覺和運動習慣。醫生和醫護人員明明知道他們如此日以繼夜工作是最傷身的,但他們都沒有選擇,他們不能因爲疲累所以跟緊急病房和加護病房的病人說「非常抱歉,我們很累,今天請假一天,車禍手腳斷掉請到隔壁醫院就醫」,更不可能跟人家說因爲工作了三十六個小時眼皮太沈重所以昨天開錯藥、手術開刀造成疏忽…

醫生的光環底下隱藏著許許多多我們一般人都不曾體驗過的辛勞,但我們往往不瞭解,以爲醫生是最賺錢的工作,以爲醫生都是最聰明的人所以我們可以期待他們不會犯錯,以爲醫生常常不睡覺拼命照顧病人就是叫做「懸壺濟世」。

其實,縱使頂著社會上最耀眼的光環,醫生比你我都更需要正常的工作時間、正常的作息。祇可惜那光環遮蔽了社會的眼睛,我們不大願意聆聽他們的心聲,結果他們也祇好默默承受,繼續埋頭苦幹。

醫生、醫護人員,您們還好嗎?需不需要請假回家睡一睡?

When I saw Bowie Lam acting as Lau Chun Hong in the TVB drama When Heaven Burns last year, I thought of his another Hong Kong drama in earlier years—Healing Hands. I still remember that the drama attracted quite a large fan base back then. It was also said to have inspired some young boys and girls to study hard to get into medical school or other degree programmes which are related to the medical industry, such as pharmacy and nursing, in the hope that when they graduate, they can enjoy the lifestyle of the medical staff in the drama.

In the drama Healing Hands, I was more impressed with Bowie Lam, Lawrence Ng and YoYo Mung. In this three-series long drama, the young medical staff enjoyed their dinner and drinks at luxurious restaurants and pubs or busy spending time with their lovers after working. If the audiences have no clue of the real life of medical staff, they would have thought that all medical staff are enjoying life this way—living in sophisticated condominium, driving luxurious cars, and they have time to enjoy good food at the famous restaurants in town, after dinner they would enjoy the night breeze with their lovers at Victoria Harbour, sweet-talking with their lovers while viewing the fascinating Hong Kong night scenery. In conclusion, they have no worries in life and they are very free and relaxed, just like what the Cantonese term aptly describes as taa4 tiu4 (Cantonese pronunciation).

But the problem is that HK dramas are notorious for being way too unrealistically different from the real life of most Hong Kongers. If we are to take everything appears in HK dramas seriously, we would have thought that in Hong Kong, everybody affords a private apartment, a working class person affords to drive Nissan Murano or Land Rover, or we would even believe that every medical staff enjoys life relaxingly like the roles of the Healing Hands story did.

In fact, the work of medical staff has never been relaxing, let alone free (unless the hospital or clinic is on the verge of closing down). Try to think from this perspective—how do you feel for staying awake all night? How do you feel when you have to work for twelve hours after sleeping for only an hour? Try to imagine that you work for 36 hours without sleeping—from 7am to 7pm today, night shift from 7pm to 5am or 6am tomorrow, you close your eyes after 5am but forcing yourself to avoid a sound sleep, and you wake up at 6:30am and work another full shift from 7am to 7pm. Doctors are even worse; they don’t have time for their family and lovers because they need to work for 24 hours without rest, even when their parents are saying goodbye they don’t have time to rush home to see them for the last time (this is no kidding). And they need to read many research papers and write theses to keep themselves abreast of the latest medical knowledge and development. If they fail to keep themselves updated of the latest knowledge and make medical mistakes, they risk bankruptcy if they are sued by their patients, for according to law, this is called ‘the details which should have been paid attention to but being ignored, and it caused medical malpractice’.

Haven’t doctors been advising us to have healthy lifestyle, sleep and rise early, go for a jog when we’re free, and do not stay awake all night? We know all these dos and don’ts, but do doctors practise it themselves? Sorry to say that doctors do not have the American time (Taiwanese colloquial, literally means free time) to enjoy the sleep and exercise that the public enjoys. Doctors and medical staff are very clear that working round the clock harms their health, but they have no choice. Even if they are really exhausted, it is impossible for them to tell the patients in the emergency rooms and intensive-care units ‘we’re terribly sorry, we’re dead beat tired and we need one day off, if you have your hands and legs broken in a car accident, please visit the hospital next door’. It is even more impossible for them to tell the patients they prescribed the wrong medicine or made mistakes during a surgery because they have heavy eyelids due to their 36-hour work shift.

The toiling inexperienced by most ordinary people is kept unseen behind the pride of doctors. But we don’t understand that, so we thought doctors earn the highest income, they are the smartest people so we don’t expect them to make mistakes, they work without sleep to take care of the patients and this is called practising medicine to help the people.

In fact, despite being honoured by the society, doctors need normal working hours and more rest than we do. Unfortunately, the honour and pride blind the society’s eyes, we are not really willing to listen to them, and they have no choice but to accept silently and continue to work industriously.

Doctors and medical staff, are you guys still alright? Do you need to take a leave and go home for a sleep?

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