跑病房會診的時候影響最大了，有的代訓真的很認真的要做好，我很感謝他們，但有的真的很不願意花時間在那邊陪大家和時間競賽，在病房遞針盤和取針。我完全可以理解，也不好意思指揮學長姐跑腿。所以那時候搭檔是誰就是看運氣。
The biggest hit came when I was managing consultation cases of hospitalized patients. Some of the trainees were really serious about doing a good job, and I was very grateful to them, but some of them were really unwilling to spend their time doing those things. I can totally understand that, and I feel embarrassed to order senior doctors to run errands. So at that time, it was all a matter of luck who your work partner was.
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那時候我都覺得，無論如何，這是我們內部的問題，病人來到這裡就是要接受那個規格的醫療和服務，再怎麼樣都要想辦法做到，如果同組的人不行，我也要把他那份一起做好，才不會影響到病人。
At that time, I felt that no matter what, this was our intrinsic issue. Patients came here to receive medical care and services of that quality, and we had to find a way to deliver it. If the people in my group couldn’t manage it, I would do their part, because there’s no reason to pose risks to the patient.
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西醫在會診其他科別都會尊重對方醫師的專業，如果會診醫師覺得不是他們科可以處理的，可以回覆意見，另找途徑解決，但會診我們中醫就是一律要接，我好像沒有看到VS拒絕過。絕大多數西醫發會診單給中醫，也不會像發給其他科時寫得那麼清楚，例如，血液腫瘤科給中醫的會診單會寫：for chemotherapy。所以是要中醫過去病房幫忙打化療嗎？
Western medicine doctors usually do respect the expertise of other doctors when consulting with other departments. If the doctor consider it’s not something they can handle, he/she can reply with a suggestion. However, we Chinese medicine doctors accept all cases. I don't think I have seen any VS refuse to do acupuncture. Most Western medicine doctors give an order for Chinese medicine consultation without clear information. For example, we often got a consultation note from the haematology and oncology department written: “for chemotherapy.” So does that mean a Chinese medicine doctor needs to come over to the ward and give chemotherapy to the patient?
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到底會診中醫是要做什麼？很多就是家屬要求、還是看護建議、隔壁床看護建議，所以不得不發會診單給中醫自己來評估處理。有的就是想「會會看」，而西醫沒有反對，就會了。
What exactly is a Chinese medicine consultation for? Many of them are requests from family members, suggestions from the caregivers, or suggestions from caregivers of the neighbour patient. Instead of saying “no, I don’t think so” to them, they sent us a consultation note. Some people just want to “try” Chinese medicine, and if Western medicine doctor doesn’t reject it, they can have it.
每接一個會診，你就要自己想辦法查病歷、去看病人，了解病史和西醫治療進度，想好中醫治療計畫，幫VS排好會診路線，一切都要在很短時間內完成，而且還不只一個病人。
Every time you take on a consultation case, you have to find a way —-check the medical records, go check the patient directly…… to understand the patient’s medical history and the Western medicine treatment plan and progress, think what you are going to do using Chinese medicine, and arrange the consultation route for VS (have to see all the patients in one or two round). Everything must be completed in a very short time, and there are many patients on the list.
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有的西醫對中醫很友善，雖然不太清楚中醫會對他的病人做什麼，但還是相信會有幫助。有的西醫會固定會診某位中醫VS，但常常忘記跟病人和家屬講。我們R跑去接會診、簽治療同意書時，很常遇到被當成奇怪的推銷員（雖然穿著白袍，胸前別著醫師執照），我往往需要解釋很久自己是誰，中醫要對他們做什麼，然後一邊緊張能不能在VS來會診之前簽好同意書。
Some Western doctors are friendly to Chinese medicine. Although they are not sure what Chinese medicine doctors will do for their patients, they still believe that it will be helpful. Some Western doctors have regular consultations with a Chinese medicine VS, but they forget to tell the patient or their family members. When we residents go to the patient and ask them to sign the consent form for treatment, we are often treated as creepy salesmen (even though we are wearing white robes with license in front of chest). It always took me quite some time to explain who I was, and what Chinese medicine doctor was going to do to them, and at the same time so nervous about running out of time, wondering whether I could get the patient’s signed consent form before VS come and apply treatment.
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去病房針灸就是夾縫中求生存，我覺得中醫在醫院病房很像霍格華茲的小精靈，要在不影響所有人的情況下完成治療（而且不能掉針）。因為住院病人可能安排了一系列的檢查，不能帶著VS去到那邊，病人已經推去CT了人根本不在。有的病人同時有物理治療、語言治療、職能治療。我常常不知道他們是不是認真想會診針灸，病人復健回來很累不想針，肚子餓不想針，剛吃飽不想針，中醫VS門診空檔也有限，我們開醫囑、開藥囑讓藥局備藥和處理醫令計價的時間就那麼一點點，一定要當天完成。然後又有新會要趕快接。
Going to the ward to do acupuncture treatment is like trying to survive in the cracks. I think Chinese medicine doctors in hospital wards are a lot like the elves in Hogwarts. They have to complete their job without interrupting anyone else’s (and they can’t drop the needles). Because hospitalized patients may have a series of examinations scheduled, we can’t let Chinese medicine VS go there just to find out the patient has already gone to a CT scan and is not there. Some patients have scheduled physical therapy, speech therapy, and occupational therapy. I often wonder if they are serious about getting acupuncture treatment. Patients are tired after rehabilitation and don’t want acupuncture. They also don’t want acupuncture when they are hungry or just full. The available time between outpatient clinics is also limited. We had to give medical orders and also prescriptions so the pharmacy could prepare it. There is only a short time to do all these and also the billing, must be completed on the same day. Then the phone rings, popping messages, new consultation cases.
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我們也會遇到針一半西醫過來查房，一陣尷尬。但我也可以理解，有的西醫有受過中醫的氣，例如針灸過程掉針、針扎事件、吃了中藥病情產生變化等等，如果是不好處理的病情，或是外科術後，好不容易穩定了，不希望多一個變數。
We also run into Western medicine doctors. It's when the attending doctor came to check on the patient, while we were halfway through an acupuncture treatment, which was quite awkward. But I can also understand that some Western doctors have had bad experiences with Chinese medicine, such as needles falling off during acupuncture, needlestick injuries, condition changes after taking Chinese medicine, etc. If the patient has a complicated issue, or just went through a surgery, the doctor would want no additional factors that would possibly trigger a change in the patient.
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我記得我有把這些事問過當時的主任，關於究竟哪些可以做，哪些不能做，我們難道不能判斷後拒絕嗎？我永遠記得他說，我們就要像百貨公司，病人走進來，要什麼就有什麼。
I remember asking our department director about these things, about what can be done and what cannot be done, can't we judge and then say no? I always remember him saying that we should be like a department store where patients can walk in and get whatever they want.
百貨公司？
A department store?
我以為我這是在盡力幫助人，盡力保護病人。我覺得我應該只做必要的或是對病人有幫助的處置，但主任回答我，針了又不會怎樣，而且他們要針，那你就針。
I thought I was trying my best to help people and protect them. I thought I should just do what was necessary or beneficial for them, but the director replied that it wouldn't hurt to get them an acupuncture session, and if they want it, then just do it.
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工作移到地方診所之後，我多了很多休息時間，終於有餘裕可以思考了。也少了龐雜的行政工作，也沒有發SCI paper的壓力了。取而代之的是地方民眾的看診習慣帶來的文化衝擊。
After moving my work to a local clinic, I had more time to rest and finally had enough time to think. There is also less paperwork, and no pressure to publish SCI papers. But instead, it was the cultural shock brought by the local people's habit of seeing a doctor.
↞ Chapter 3/4 ↠
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