Patient Treated by Doctors with Love

人球與求人

簡守信(Sou-Hsin Chien) ； 賴勝權

《慈濟醫學雜誌》 17卷3期 (2005/06) Pp. 195-197

https://doi.org/10.6440/TZUCMJ.200506.0195

摘要

星期六的下午急診室來了一位五十多歲的中年男子，他來的時候，狀況很不好。年紀不大，可是他的腳整個都爛掉了，很臭。因為他有糖尿病，血糖控制的不好。他還不只是有糖尿病，還有痛風、腎臟功能不好，抵抗力也很不好，也已經有敗血症的跡象。裹在腳上厚厚的紗布下流出黃色的膿汁，空氣中傳來陣陣的惡臭。在糖尿病併發足部壞疽及敗血症的診斷下，病人迅速的被送到加護病房治療休克及不穩定的生命徵象。在抗生素投予，體液補充及血糖控制下，總算暫時回穩。
整形外科醫師苦口婆心的勸病人接受截肢手術。住院醫師勸了近半個小時，病人仍無動於衷。主治醫師也加入游說的行列，告訴病人傷口癒合後穿上義肢仍然可以走路，而現在腳部的傷口只靠清創引流是沒有辦法解決問題的。如果不趕緊手術，細菌會大量入侵，病況可能會無法控制，不但會造成自己痛苦，家屬也會留下許多的遺憾。這位病人的女兒也是醫護人員，她也苦口婆心地勸爸爸要接受截肢手術。病人似乎有些軟化，醫師們很高興的進開刀房準備手術。可是，沒多久加護病房的護理人員又傳來病人拒簽手術同意書的消息。此時在加護病房照顧其他病人的另一位主治醫師知道了這樣的情形後也主動加入勸說，並且以自己的親人做例子讓病人安心。因為這位醫師的爸爸以前也有同樣的情況，截肢之後，保住了生命，又裝上義肢，坐著輪椅，還是可以活動。所以他就苦口婆心地勸那位同仁的爸爸。只是這一勸竟然花了近一小時。我們等那一張手術同意書，真的是等的心焦如焚。後來終於等到了，手術室中的整形外科醫師們聽到這個好消息後，大家才放下心裡的一顆石頭。
當天我們就趕快將病人送到開刀房做截肢手術，手術完之後，送回加護病房。第二天，因抵抗力很不好，病人引發肺部感染。由於病人的感染情況不好控制，我們就趕快作氣管內插管，使用呼吸器，加上強力抗生素，在好幾科的醫師共同努力照顧之下，他的狀況一天比一天進步。看到病人的病情改善，那分高興實在是難以形容。
我想，醫師應該就是這樣，雖然不是他的病人，當他知道有這樣的狀況，還是非常熱心的規勸病人接受治療。在病榻旁，大家一起集思廣益，想想有什麼辦法來讓病人的病況轉好。這一種共同一起的力量，在這個過程中，大家求病人同意開刀，也許病人在那個時候不能理解，但是我相信，病癒後，他一定能了解眾人對他的愛心。這對他將來在復健的過程中，也是幫助非常的大。我們在每一次的醫療過程中都感受得到這樣愛的力量。以前念書的時候，念到「眾志成城」，沒有那樣直接的感受。但是，現在就感受得到這麼多人的愛心凝聚。眾人的愛心凝聚能夠完成一個充滿愛心的希望工程，這就是愛的工程。
在“人球”事件發生的同時，大林慈濟醫院發生了這樣的故事。這不是什麼特例，而是幾乎天天上演的故事。許多人也許因為“人球”事件而對台灣的醫病關係和醫療系統有許多悲觀的想法，但在探討“人球”事件的同時，是不是也應多報導台灣醫界這種”求人”（為病人好、懇求病人接受治療）的平凡事。

並列摘要

A middle-aged man was sent to the emergency room at Dalin Tzu Chi Hospital on a Saturday afternoon. The condition of the man, a diabetic in his 50's, was quite bad as his feet had become putrefied, giving off a foul smell. His blood sugar was not under proper control. Besides diabetes, he had gout. His kidneys were not functioning well and his immunity against illness was poor. He was also beginning to show symptoms of septicemia. Yellow pus was oozing out of the thick gauze on his feet, producing an unpleasant stench.
After he was diagnosed as having diabetes-induced foot putrefaction and septicemia, the patient was rushed to ICU for emergency treatment due to shock and a diminishing sign of life. His condition became stable after doctors gave him antibiotics and other medication to increase his body fluid and control his blood sugar levels.
Surgeons earnestly advised the patient to have his foot amputated. He refused, despite the caring doctor trying to persuade him for nearly half an hour. The attending doctor also offered encouragement, telling him that he could walk again with artificial limbs. He explained to the patient that treatment of the wound alone could not resolve the problem and warned that the wound might produce massive bacteria if the operation was not conducted immediately. In that case, the condition might become uncontrollable, prolonging the pain of the patient and also bringing emotional pain to his family.
The patient's daughter happens to work at the surgical bedroom ward. She also asked her father to undergo the operation. The patient appeared to have softened his attitude, and the doctors began making preparations for the operation. But not long after that, the nurses said that the patient had changed his mind and refused to sign the consent form for the operation.
Having heard about the situation, Dr. Lee Wei-Che, another attending doctor at ICU who was not the patient's doctor, took the initiative to see if he could persuade the patient, telling the man that his father had a similar case and could move again on a wheelchair after undergoing amputation operation. It took almost one hour before the patient finally agreed to sign the letter of agreement. Our surgeons, who were waiting anxiously in the operation room, felt relieved after hearing the good news.
After the amputation operation, the patient returned to ICU. On the following days, he had a lung infection because his immune system was down. Because the infection was not easy to control, the doctors performed a tracheostomy and put him on a respirator. Through the joint care of physicians from various departments, the patient's condition improved day by day. The joy that all of us on the medical team felt as we watched the progress of this patient is truly hard to describe.
In this case, many doctors, when they came to know of the situation, helped to persuade the patient to undergo the operation despite the fact that the man was not their patient. I think all doctors must do so. They must put their heads together at the bedside to consider the best cure for the patient.
When the doctors made their efforts to persuade the patient to receive the operation, the patient might not have been able to understand their good intentions at the time. But I believe he certainly felt the love rendered to him while he was recovering. This will also be very helpful to the patient during the process of rehabilitation. We have felt the power of such love during the process of treatment every time.
When I was a medical student, I had no direct feeling about the power of joint efforts. But now I can feel the power of love emanating from the hearts of so many people. The joined power of love is able to accomplish a project of hope that is filled with love.
This case occurred at Dalin Tzu Chi Hospital at the same time the ”human ball” incident occurred in Taipei. (In the ”human ball” incident, a four-year-old girl died after she was turned away by several Taipei hospitals. She suffered from severe head injuries inflicted by her drunken father. The girl was accepted later by a Taichung hospital and was eventually pronounced brain death on Jan. 23, 2005).
After hearing of the ”human ball” incident, many people may become pessimistic about the relationship between doctors and patients as well as the whole medical system in Taiwan. But at a this ”human ball” incident comes to light, there is also a need to report more on the cases about doctors' kind moves to persuade the patients to receive better treatment. Such cases can be found at our hospital almost everyday.