波士頓所見系列 (2)

Tuesday, February 07, 2006

Trauma, Part I (外傷, 上半部份)

And indeed I am traumatised. Not because of the surgery but because of my brief romp through e-bay. After the success of the 4 Sydney guys who sold themselves for a good time and beers etc on ebay for about a grand, hundreds of similar auctions have appeared from people selling themselves to become your friend for a weekend. Some sell invites to their birthday party, most just promise time spent with them in their company.

It makes me sick to the bone to think about this. There was even an auction on ebay for a girl who wants to get breast implants and promises the winning bidder a before and after photo. Such is the insane world we live in and sometimes I wish I could curb my curiosity. It reminds me of the time I went and downloaded the hostage beheadings in IRAQ because the news said they were available. I was never the same since that day. Issues aside, I hope it all passes. Most of them are getting no bids which is always a positive sign.

The most noticeable one is a group of 4 girls from the Gold Coast who are offering their company for a weekend (etc etc) and the starting bid is $10,000. There were no bids at the time of writing this. Anthony had made it up for the weekend and we had an excellent time around Boston. I picked up a few more workshirts for hospital as I underestimated how many I would actually need. We had a nice meal at Uno Chicago Grill (thickest pizza I've ever had) and then he headed back to New York. It was so surreal once again meeting people here overseas. I think I will help set up a database next year of where everyone is going for elective and that way people can catch up with one another. It was a great weekend.From the point of the hospital, it has been a fantastic week. IT started relatively early at 6:30am although I had to be there much earlier as the week progressed to see the patients before rounds commenced. I was able to scrub into every single surgery and Jeff and Neal (mentioned previously) were brilliant in their teachings and giving me hand on. Neal would pass me instruments here and there and get me to cut or drill or stitch. IT was a real difference from the surgical registrars at home who often found students to be more of a chore and hinderance. I promised myself that I would never become like that and would attempt to emulate myself after them. I also met Josh the anaesthetic resident who is a pretty cool guy who’s been out to Oz previously. It was an excellent day in theatre as we repaired a difficult medial tibial plateau fracture, Hip hemiarthroplasty and debridements. The residents here have a great relationships with the consultants. Dr Harris, the trauma consultant was an exceptionally humorous man and had a great relationship with the residents. He treated them like colleagues. I've also noticed that students and residents are not put on the spot as much as they are at home and I am definitely less on edge as a result.

On Tuesday, it began like any other at around 5am as we checked out all the post op patients from the day before. Ward round came and passed and we were in theatre at 7am. After repairing a distal radius, the next patient was wheeled in. IT was very difficult intubating this patient but eventually we got it. Suddenly, a nurse ran in and told us that the next room had flooded.

Construction workers had hit a mains water pipe and water was flooding into the theatre next door at an alarming rate. IT was like a ride from Universal studios. For the next 45 minutes there was chaos in the entire theatre as all operations were cancelled except one. The one that remained was a spine operation which was in the flooded room. They had made the incision into his neck when the water came in and had to move the patient down 3 rooms and continue the operation as fast as possible. It was an insane sight to see everybody running around with towels and moving instruments to prevent the flood from spreading. I have video of it but its a little rough (had to edit quickly). http://www.philiphuang.com/bwh/bwhflood.wmv

Neal and Jeff finished their trauma term today but Neal will be heading to joints where I'll be in the last week.. I also found out that Neal's family was from Taiwan but he had only been back there once. Ben(close up) starts tomorrow as the replacement and seems like a good bloke. Should be an interesting transition nonetheless. Hopefully theatre will be open by then. (# posted by Phil Huang @ 1:20 PM)

是的,這個禮拜我是人在外傷部門, 可是我的心靈上也受到了創傷; 而這創傷並不是因為所從事的外傷手術工作所引起, 反而是由於我偶然之間簡短地上了 eBay 搜尋的結果. 在 4 位雪梨的年輕人 於eBay上 把與他們共飲啤酒之類的歡度美好時光, 用 AS$ 1,000 成功地拍賣掉以後, 好幾百個想把自己在週末賣給陌生人當朋友的類似拍賣案例, 突然一下子都在澳洲的 eBay上跑出來了. 有些人甚至於是在拍賣他們生日派對的參加權. 絕大部份的人, 則是在拍賣他們自己的與人作伴相陪的時間. 我一想到這些人, 連與人相處的快樂時光, 都可以用 “刻意製造” 想要來賺取金錢上的利益, 這件事, 實在是令我心寒到骨子裡去. 在 eBay 的網頁上, 甚至於, 有一位女孩子為了想要籌措隆乳的手術, 她居然說, 她保證將來等她隆乳完成後, 成功的得標者就可以得到她的隆乳前和隆乳後的照片. 我們現在真是活在一個多麼瘋狂的世界裡啊! 什麼樣千奇百怪的事, 都有人會去做! 我真希望我的好奇心可以收歛一點, 那我也不會這麼受不了了. 這讓我也想起之前因為新聞報導說可以去網上下載來看, 結果我真的就去下載在當年伊拉克被擄人質遭砍頭的影片來觀看這件事. 從那以後, 我想我對這個世界的看法是整個就被改變了. 因為如果人們可以對一位毫不相識的陌生人, 為了自己的信仰理念, 無視被害人質的哀號求饒; 完全不留情地在鏡頭前, 用長刃一刀一刀的把另外一個人的頸部, 割到斷了為止, 那這個世界裡的人們一定是瘋了! 把這個岔開的話題擺在一旁不要再提, 我只希望像這類一窩蜂地上網拍賣自己的時間這種現象, 可以很快的就退流行了. 從大部份像這類的拍賣者最後都流標了的角度來看, 這個世界裡的人, 應該還有很多人是保持清醒的. 至少, 像這樣流標了的結果, 是正面的. 最近很被討論注意到的, 就是有一群住在昆士蘭省黃金海岸 (Gold Coast) 這個城市裡的 4 位女孩子, 她們在 eBay網上拍賣與她們共度週末的 “歡樂” (或類似性質等等) 時光, 起跳標價是 AS$ 10,000 [註: 約合 NT$ 240,000] 這個案例. 至少在我寫這篇文章時, 還沒有任何一位出價者 [註: 對此案例有興趣者, 可到: http://cgi.ebay.com.au/A-weekend-guided-tour-of-Brisbane-by-4-Hot-Girls_W0QQitemZ5663361958QQcategoryZ324QQssPageNameZWDVWQQrdZ1QQcmdZViewItem].

Anthony 週末時, 終於和我見到面了 [註: 應是當地 5/Feb], 我們也很高興地在波士頓裡好好的把這個城市逛了一下. 由於我低估了在醫院裡上班時實際上所須要穿著襯衫的數量, 因此我也挑選購買了幾件正式的襯衫. 我們在 Uno Chicago Grill (他們的披薩 pizza, 是我所見到吃過中最厚的) 餐廳裡大飽一頓之後, 他就又坐巴士返回紐約去了. 在他鄉能夠遇到故知, 我又再一次地感受到, 這一切彷彿是在作夢般的不真實. 我想我回到澳洲以後, 今年一定要找個時間, 把系上將要到海外做校外實習同學的資料好好地整理一下. 這樣一來, 將來這些人在海外的時候, 就可以彼此取得聯繫, 多多連絡一下了 [註: Philip 是系上學生代聯會的會長]. 上個週末, 我是真的過得很棒, 很過癮!

至於在醫院方面, 這個禮拜, 我過得也很棒. 通常巡房都是一早在清晨 6 點半鐘的時候就開始, 不過我這個禮拜裡的每天早上, 都是在比那個時間更早很多的時候就抵達了醫院; 因為我總要花些時間, 一一地先訪視過病人的資料, 這樣我才可以在跟著巡房時有所準備, 不會被問倒或是完全在狀況之外. 每個手術, 我都有刷到手跟到刀 [註: 應是當地 6/Feb], 而 Jeff 和 Neal (我之前曾提及過的骨關節駐院醫生) 很棒, 也很聰明. 不但很有耐心的帶領著我, 他們還毫不自私的隨手就把手術工具交到我的手上, 讓我能夠有機會動手上刀.

尤其是 Neal [註: Philip 曾在上週協助他處理過一個女病人因撞車車禍, 以致她的手和手腕有多處骨折的病例], 他總會在這裡或那裡的把手術工具轉交給我, 讓我有機會可以為病人劃刀, 鑿骨, 甚至是縫合傷口. 這和我在雪梨時和那些在手術房裡的總醫師們一起工作時的情形, 有很大的不同. 在雪梨的那些總醫師們總是覺得我們這些醫學院的學生, 好像是在幫他們打零工做他們不想做的小件雜事, 或是只會在他們身旁礙手礙腳似的. 我曾對自己許下諾言說, 有朝一日我若爬升到像他們位置的時候, 自己絕對不要像他們這樣的對待底下的人, 而且我將來一定要在工作上表現得比他們還要傑出. 我同時也認識了麻醉駐院醫師 Josh. 這個人不錯, 最近還去過澳洲玩. 總之, 我這一天在手術房裡的收穫很多. 除了修復一個很困難的中間脛骨高原骨折 (medial tivial plateau fracture) 病例以外, 我還幫忙做了臀部半髖關節成形術 (Hip Hemiarthroplasty) 和清除壞死組織術 (Debridements). 這裡的駐院醫師們和他們科裡的主治醫生們, 彼此之間的相處都很不錯. 就以我們骨科外傷部門裡的主治醫生 Dr. Harris 為例來說好了, 他為人是非常的幽默, 講話也很風趣. 他和駐院醫師們的關係就很好. 他對這些駐院醫師們, 就好像是對待和他等級相當的其他主治醫生同事一樣. 他講話絕對不會盛氣凌人, 或是指名道姓的大聲罵人. 我也注意到, 這裡的醫學院學生或駐院醫師們在跟刀或在旁協助時, 並不會像我們在雪梨般的, 當場上級主治醫師馬上就一面動刀一面問我們問題, 要我們作答. 因此, 像這裡這樣的由主治醫師一面動刀一面只要我們在旁觀摩的方式, 我覺得比較不緊張.

在星期二 [註: 應是當地 7/Feb] 清晨 5 點鐘的時候, 我和前一天般的訪視昨天剛作完手術後的病人資料. 然後, 我們就開始巡房, 過後在 7 點鐘的時候, 就進了手術房. 在修復完一個手腕的腕關節末梢輻射骨骨折 (distal radius) 病例後, 接下來的病人也被推進了手術房裡. 花了好一會兒的工夫, 當我們很不容易地才幫這位病人插好管 (intubating) 之後沒多久, 突然有一位護士跑進房來通知我們說, 隔壁間的手術房裡淹水了. 由於建築工人不小心挖斷了一根主要的大水管, 因此隔壁間的手術房裡正以驚人的速度在淹水中. 接下來的景象, 就彷彿像是我在環球製片廠 (Universal Studios) 裡觀光時所乘坐的飛車一樣. 一聽到這件事之後的 45 分鐘裡, 整個手術房樓層的裡外上下, 大家是一陣地慌亂; 所有的手術都被迫緊急取消, 除了有一件病例之外.. 那個病例是因為那位病患當時正躺在淹水中的手術房裡的檯上接受脊椎手術. 淹水時, 由於醫生已經在他的頸部切口, 因此只好緊急把他移送到隔 3 間房以外的另外一間手術房裡去, 儘快地繼續替他完成這個手術. 所有的事情都發生得很快, 只見到每一個人都好像瘋了似的, 緊張地在搬開手術工具, 或是到處跑來跑去地拿著毛巾舖在地上吸水,以免淹水繼續擴散漫延開來. 我把其中的一些淹水景象, 有一點粗糙簡短地把它們給錄製下來 (因為我必須儘快的剪輯, 然後趕緊去幫忙). http://www.philiphuang.com/bwh/bwhflood.wmv [註: 很精彩, 大家應該要上此網址去看一看]

Neal 和 Jeff, 今天剛好結束了他們兩人在外傷的輪調. Neal 接下來是會輪調到骨關節部門那裡去, 那裡也是我最後一個禮拜實習時, 被安排要去的部門. 我同時發現到, Neal 的父母親也是台灣人. 他是在美國本土裡出生長大的, 可是這輩子到目前為止, 他竟然只到過台灣一次而已. Ben (特寫近照的那位) 從明天 [註: 應是當地 8/Feb] 開始就會取代他在外傷部門的工作, 他看起來, 好像是人還不錯的樣子. 不論如何, 這個禮拜的中間, 有發生換人來帶我的情形, 應該是一件有趣的事情. 但願, 明天的手術房樓層, 到時候, 是可以再度的開放了. (posted by Phil Huang @ 1:20 PM)

Thursday, February 09, 2006

Trauma Part II (外傷, 下半部份)

The rest of the week seemed to fizzle out after the flood. Not too sure what happened there. Perhaps it was the switch of chief residents, or maybe because it was relatively quiet. Either way, there seemed to be nothing much happening at hospital. I also met Dr Vrahas briefly who is other half of the trauma team. I didn't really get to interact with him at all this week unfortunately but he seemed nice. Trauma started out so strongly for me this week (in part thanks to Neal and Jeff) but I am a bit lost now that the week is over. I have not really had any interaction with the new residents whatsoever and have been mainly working with the interns who are really only 1 year ahead of me and unfortunately are so busy with the ward work. Kevin (the intern) has been feeling bad all week for me and has been so run off his feet that all he could teach me was writing notes. Its been a real disappointment overall really... Part of what is shitty being a medical student is that fact that we have to stick to residents like glue. Feeling uncomfortable and lingering around on the wards without purpose like we don't exist is almost daily living. Some would even say it is initiation. Yet what alters our experience and changes our perceptions of medicine are the registrars and residents who approach us and makes us feel at ease. What made Hands and Trauma Part 1 so fulfilling was the fact that the teams made me feel comfortable immediately. They understood and remembered what it was like to be a student and never made me feel conscious about following them.

They would introduce me to everybody and allow me to participate and scrub in on surgery. All of this was of course lacking in the last half (3 days really) of the week. The new residents seemed really nice but we barely exchanged 3 words. Jordan, the 2nd year resident who I was supposed to be paired up with was so busy that I didn't even see him once this week. I felt like a lost orphan again on the wards, scraping the trash looking for food and hoping I can find a parent who can teach and guide me. Alas it was not to be. I started going to hospital later and later and today got there about 7am. Ward rounds was just beginning and ended about 15 minutes later. Then there was stillness. Nothing was happening. dead calm.

The operation for a C6-C7 discectomy wasn't until 1:30pm. I just sat in the common room and did nothing. Occasionally Kevin would tell me that he was off to do some boring paper work and that it wasn't worth me going but really that was just a cop out. I hated it when they said that. True that paperwork wasn’t exciting but it sure beats sitting around doing shit all. And that’s the main lesson I hope I never forget when I finish. Something, no matter how trivial or tedious will always be superior to nothing. To have followed Kevin around would have certainly been superior to sitting in the room watching the finals of the African Cup of Nations live on the computer. When a resident or intern tells me that I wouldn't be interested in doing "this or that" he isn't really looking out for me or being considerate. He has only his own interest at heart. He would rather get the job done and not have to deal with a student following him around. Reading over the above passage it would appear as if I am bitter. But that is untrue. Just waking up and going to the hospital has been an immense experience in itself. And the last week and a half has equally been brilliant. Dr Harris was also on brilliant form today and it was hilarious to be in theatre in the afternoon. It hasn't been all negative. Part of this venting is to remind myself that even at brilliant institutions, things remain the same.. I want to never forget what its like to be on the receiving end of negligence. To be transparent. I want to make sure that i never treat another in the same way again. I walked down the changing rooms filled with lockers at the end of the day and felt completely drained.On the plus side, I spoke with Catherine today who was the Spine Resident. She was very helpful and gave me a detailed outline for the ensuing week. It gave me hope once again but we'll have to wait and see.

I also met up with Sparks this week whose roommate Johanna(from NZ who is working on a PhD about neuropsychimmuno which is all about emotional factors affecting post op etc etc) and she was interested in doing med. So we all went out for a meal and discussed the various routes one can enter medicine in Oz. It was a relaxing evening and we went to a local pub after dinner and had a few drinks.

Josh the anaesthetic resident also invited us to his house tonight for some drinks and candlestick bowling.He was pleasantly surprised by his photo (supposedly he has HUGE ears and a tiny nose but the photo shows otherwise). We arrived at Josh's house fashionable late in greenline and we drank some Australian wine. Josh was a Southern Baptist from Texas and was not as conservative as typical Christians. They understood the meaning of grace in Christianity. It was excellent hanging out with him and his wife. We met some of the anesthetic team and had some drinks (cherry beer, kriek) with fantastic conversations. We made out way to the milky way lounge and waited for about 30 minutes for a lane to play some candlepin bowling.

The pins are cylindrical like dildos and we used a coconut (4 pounds) to bowl. It was surprisingly fun even though I sucked. IT was a great way to end an otherwise uneventful week and we were surrounded by good company.. (# posted by Phil Huang @ 6:26 AM)

淹水之後的這個禮拜下半段, 一切情形, 就好像是像泡沫般地消失在半空中一樣, 我也不太清楚到底是發生了什麼事. 或許是因為在這個禮拜的中間, 我必須換去跟著另外一位總醫師, 也或許是這個禮拜的下半段很靜, 沒有什麼病例吧! 不管是因為什麼原因, 這個禮拜的下半段, 我在醫院裡, 看起來就好像是在浪費時間一樣, 並沒有多少的事情有發生. 我也短暫地和 Dr. Vrahas 打過照面了, 他是我們外傷團隊裡的另一位主治醫師.. 雖然我沒有任何機會可以和他有所互動, 但他看起來, 像是人還不錯的樣子. 外傷的這個禮拜, 對我來說, 開始時一切是那麼的棒 (這應該是要感謝 Neal 和 Jeff 他們兩人的肯帶領著我), 可是現在這個禮拜已告一個段落時, 我卻覺得若有所失. 我不但是毫無機會有和新來的兩位總醫師們有任何的互動之外, 我變成整天跟著那些只比我高一個年級的剛畢業的實習醫師們, 而這些實習醫師們卻因為整天有做不完的病房工作, 根本就沒空來帶我. 只有其中的一位實習醫師 Kevin, 多少他還有注意到我的存在, 會替我感到難過.

可是忙不完的病房工作, 讓他整天是到處的跑來跑去, 他抽得出時間來教我的唯一一件事, 就是要如何寫日誌筆記. 總之, 這個禮拜的下半段, 我是真的感到很失望. 身為一個醫學院的學生, 最糟糕的一件事, 就是你一定要像黏膠般的黏住駐院醫師們, 他們不教你什麼, 也不讓你動手做什麼, 你自己就會變得像是個孤魂野鬼似的. 我覺得, 我這個禮拜的下半段每天過的生活, 就是整天很不自在地在病房裡幌來幌去, 既不知道到底自己在那裡的目的是為了什麼, 也像是自己根本就不存在似的在那裡面到處走動著; 或許有些人會說, 那一個醫生不是從像這樣子的情形開始的呢? 可是我一定要這樣說, 如果想要增加我們將來行醫時的經驗和領悟力的話, 那麼主治醫生和駐院醫師們, 在對待像我們這些醫學院的學生時, 就應該要多和我們接近, 或是可以讓我們覺得更自在一些. 像在第一個禮拜的手部門和第二個禮拜的外傷部門前半段時候, 為什麼我會認為自己是過得很充實很滿足, 那是因為團隊讓我馬上就覺得和他們接觸和互動是很自在的緣故. 那些人不但能夠了解, 同時也還記得他們過去身為一個醫學院學生時的心底感受, 是什麼樣的滋味和情景. 他們也從來都不會讓我自己覺得像是在 “跟” 著他們在團團轉的跟屁蟲似的. 反而, 他們總是會把我介紹給每一個人認識, 也會讓我刷到手跟到刀. 當然了, 在這個禮拜的下半段 (實際上是有 3 天的時間裡), 像這樣的事情是什麼都沒有發生. 新來的駐院醫師們, 看起來人是很好; 但是他們和我的交談, 卻是不到 3 個字. 就以Jordan 來說, 他是第二年工作的駐院醫師, 也是應該要帶我的人, 卻因為他工作實在是太忙了, 忙到我這個禮拜連見也沒有見到他的面一下. 我深感自己在病房裡, 很像是位孤兒一樣的, 整天在垃圾堆裡搜找食物, 也非常希望能夠找到可以教導和帶領著我的一位大人. 唉! 事情不應該是會演變成像這樣情形的呀!

我變得一天比一天晚到醫院裡去, 今天早上 [註: 應是當地 10/Feb], 甚至到醫院裡時, 都已經是快要 7 點鐘了 [註: 這個禮拜的前 2 天, 他都是在清早 4:30 或 5:00 時, 就已經抵達到醫院裡去]. 當時是巡房剛開始, 然後 15 分鐘之後巡房就結束了. 之後的情景, 就像是一切都靜止似的, 什麼事都沒有發生在我身上般地一片沉靜. 有一刀 c 6 -c 7 discectomy [註: 頸椎第 6 到第 7 椎間盤的切除術], 是排在下午 1:30 時才會舉行. 在那之前, 我沒有事做, 只好跑到醫師休息室裡去呆坐著. 偶而, Kevin 會告訴我一聲說, 他正要離開病房必須去做一些文書報告的填寫工作; 由於這些填寫是很枯燥的工作, 因此我就不須要再跟著他去了. 這話其實講得是正好相反, 一點都不正確, 我很討厭聽到人們是如此的告訴我. 因為雖然文書報告的填寫確實是很枯燥, 但它卻是比一個人獨自在呆坐找不到事做的情況好多了. 而這, 也是我希望在我這次的實習課程結束後, 將永遠都不會忘記的一個教訓, 那就是: 無論事情是多麼地細小或是多麼地沉悶, 有事做, 將會永遠比沒事做還來得好. 換句話也就是說: 能夠跟著 Kevin 到處跑, 當然是遠比我自己一個人坐在那裡, 透過自己的膝上型電腦獨自觀賞著非洲國家盃的足球比賽, 實在是好太多了. 我認為, 當一位駐院或實習醫師告訴我說, 我將不會有興趣去 “做這個或做那個” 事情的時候, 在說這句話的背後, 他並不是在關心或是體諒我, 而是他心底只有想到他自己的需要而已. 也就是說, 他只想到說他需要趕快把自己的工作給做好; 而不是需要去和一位跟在他後面跑的醫學院學生打交道而已.

從以上的文章,, 唸到這裡也許你會認為說, 我現在是很怨恨, 自己覺得一切好像都是很辛酸, 滿腹苦水似的. 其實不然. 我只是覺得, 每天自己都能夠很早就起床然後趕到醫院裡去, 這件事本身對我來說, 就是一件無比快樂的事. 而之前的一個半禮拜, 就讓我覺得每天過得都是很棒. Dr. Harris [註: 外傷部門的主治醫生] 也在今天下午的手術房內表現得很優異, 我在房內也很高興有學到一些事情.

並不是所有的事情都是負面讓我失望的. 我之所以拉拉雜雜的會傾倒這麼多的心底感想, 是因為我想提醒自己說, 縱使是在一間像這樣棒地哈佛醫學院的教學醫院裡, 事情還是和在其它的醫院裡並沒有兩樣. 我要自己永遠都不會忘記, 身為被忽略掉的接收者那端的人, 他們的感受到底會是像什麼. 一句話, 他們的感受, 就是自己像是位隱形透明人似的. 我要確定自己, 無論如何, 將來絕對都不會用像他們如此對我的這般方式, 再去對待另外一個人. 在結束今天的工作, 走向空無一人到處都是儲衣櫃的換衣間時, 我突然覺得全身的精力, 都已經被耗盡了.

另外, 有一件至少還算是正面的事, 那就是, 我今天有和下禮拜要去實習的脊椎部門的駐院醫師 Catherine 講到話. 她很幫我, 也把我下個禮拜應該要做些什麼, 都跟我詳細地講解了一下概要. 這讓我的內心中, 又再度地燃起了希望. 但是, 我們到時候, 再看看好了.

這個禮拜, 我也和 James Sparks [註: Philip 的多年好友, 前曾為 Stephen Hawking 的學生, 現則為哈佛大學數學系的助教], 和他的室友 Johanna (她是從紐西蘭來的, 現在正在攻讀 Neuropsychimmuno 科系的博士學位; 這個系是專門研究人的情緒因素, 將會如何地影響到手術後病人的復癒等等問題) 在我的住處裡, 又再度地碰面了. Johanna 想要以後當一位醫生, 因此我們 3 個人就到外頭去找了家餐廳, 一面用餐, 我一面告訴她在澳洲要念學士後醫學系的話, 到底是有那些不同的途徑可以去試一試. 這個晚上, 我過得很輕鬆. 飯後, 我們接著就到餐廳附近的一家 pub 裡, 喝了幾杯小酌一下.

醫院裡的麻醉駐院醫師 Josh [註: 最近曾去過澳洲玩的那位], 今晚 [註: 應是當地 10/Feb] 邀請了我和一些人到他的家裡先去喝點酒, 大家再一起出去打保齡球 (Candlestick Bowling). 當他看到我幫他照的幾張相片以後, 既高興也很驚奇 (因為他自認自己的耳朵是特大且鼻子太小, 沒想到相片照出來以後, 情形卻是相反). 我們是像時下所流行的一樣, 在故意遲到但又不會太遲的情況下, 才抵達 Josh 的家中, 並且在那裡也喝了一些澳洲酒. Josh 是從德州 Texas 來的一位南方浸信會教會 (Southern Baptist) 的信徒, 因此他並不像一般基督徒那樣的保守. 這些信徒們對基督教義裡面的感恩禱告 (grace), 也非常瞭解. 今晚我能夠有這個機會和他與他的老婆相處, 實在是很棒! 我也和醫院裡的其他幾位麻醉醫師團隊裡的成員互相打招呼. 大家一起聊天交談, 話題很愉快, 還喝了些飲料 (像比利時用櫻桃來發酵的啤酒 Kriek之類的). 之後, 我們就到一家 Milky Way Lounge 裡. 排隊排了 30 分鐘後, 才租到一條球道. 大家就開始玩幾局 10柱細長瓶棒的Candlepin 保齡球起來了.

這些細長瓶棒的形狀, 長得就像是圓柱形的性愛按摩器 (Cylindrical Dildos) 一樣. 而用來要擲向這些瓶棒的, 就是一顆椰子 (4 磅重). 雖然我打得並不好, 可是這種保齡球遊戲玩起來, 其實還算是出人意料之外的很好玩. 用這樣的方式來結束我毫無事件發生的這個禮拜, 也是很不錯; 更何況, 我身邊還有一些很好相處的人來陪著呢! (posted by Phil Huang @ 6:26 AM)

[附記]

1)

所謂新英格蘭州區域所謂的 Candlepin Bowling 燭管保齡球, 是一種由我們所常見的 10-pin 保齡球所衍生出來的另外一種運動. 它是在 1880 年,
由美國麻薩諸塞州 (Massachusetts) 的 Worcester 市裡一位保齡球館老闆 Justin White 所推廣發展的, 至今廣泛流行於美國的所謂新英格蘭州區域 (New England States) [註: 這個區域是在美國本土地圖的東北角, 它涵蓋有: Connecticut 康乃狄克州, Maine 緬因州, Massachusetts 麻薩諸塞州, New Hampshire 新罕普仕夏州, Rhode Island 羅德島, 和 Vermont 維爾曼州. 波士頓是這個區域的商業與文化中心, 也是人口最多的城市, 60 萬人] 一帶; 在Maine 緬因州, Massachusetts 麻薩諸塞州, 和 New Hampshire 新罕普仕夏州的很多地方城市, 到處都可以看得到這種運動. 在其它地方, 例如在 Cincinnati, Ohio 俄亥俄州的辛辛那提市, 和在美國與加拿大邊界的 New Brunswick 區域, 也有這種運動的保齡球館.

這種保齡球運動的瓶棒, 每根高達 40cm, 很像是燭管, 中間部份的直徑約為 7.6cm (3 英吋). 遊戲規則是: 玩者把手中的球體擲向木製地板球道的另一端, 將那些瓶棒打倒越多根越好. 但是, 它和我們一般所常見的 10-pin保齡球打法不同的地方, 是在它所要擲出的球體上. 燭管保齡球的球體比較小也輕很多, 中間也沒有洞; 玩者可直接將它握在手掌中. 每一個 “得分格”可以丟擲 3 次球體, 每丟一次球體, 倒下來的瓶棒並不會由瓶棒清理機器把它們收走, 而是繼續把 3 顆球體都擲完或瓶棒全倒為止, 才換成下一位玩者. 它記分的方式與 10-pin不盡相同; 得分的機會也較難. 1958 ~ 1996 年間, 很多麻薩諸塞州的電視台每週都有這種燭管保齡球職業比賽的轉播, 例如: 波士頓市的 WHDH-TV/WCVB (第五頻道). 由於瓶棒細長而且球體輕小, 因此要瓶棒全倒的話, 並不容易; 截至目前為止, 在一局比賽的最高分正式記錄, 是 300 分裡面得到 245 分.

2) 美國東北暴風雪 大雪橫掃14州

根據媒體報導:

60年以來的最大暴風雪，12/Feb/2006 肆虐美國東北部十四個州，上千個班次飛機停飛，20萬戶停電，密西根州公路上更發生一起連環車禍，將近80輛車子撞在一起，所幸沒有造成太大傷亡。民眾鏟雪鏟到手軟，停在路旁的車子被厚厚的雪覆蓋住這一場60年以來的大雪，橫掃美國東北部將近14個州，從緬因到賓州被一片白茫茫的大雪蓋住，更造成空陸交通大亂。 因為地面結冰，駕駛們在道路上行駛，特地把速度放慢，卻還是造成車禍發生.

美國東北地區十二日也遭到有史以來最大風雪侵襲，紐約市降雪量創下歷史最高紀錄，同時出現罕見的雪天閃電奇觀，兩千多飛機航班被迫取消，不少旅客被困在機場.

十多萬戶家庭電力供應中斷，多數學校周一停課，遊民收容所人數暴增，上班族通勤嚴重受阻。入冬以來，紐約地區降雪量極低，媒體不久前還稱暖冬之時，超級大風雪卻於情人節夕的周末襲擊美國東北，紐約中央公園積雪量高廿六點九英寸 (60cm)，創下一百卅七年以來最高紀錄。氣象局說，這是自一八六九年有氣象記錄以來，紐約地區最大的一次降雪。

根據 Philip 在台北時間 12/Feb (禮拜天) 早上於電話中所告訴我們的, 波士頓自 11/Feb 開始也是風雪交加, 出門處處不便.

[後記]

從上個禮拜的波士頓所見系列 (1) 一文中, 最後的一句話: “外傷部門, 我來了!”, 到這個禮拜的: “我痛恨被當作是一位隱形透明人”, 這中間還夾雜著在手術房裡的淹水事件; 沒想到, Philip原先對外傷的熱情與興奮, 竟然在短短地幾天裡面, 就給澆熄了. 骨科裡的外傷部門, 一向就是 Philip 的最愛; 也難怪他會在期待有一個精彩禮拜的希望落空之後, 反應是如此的強烈了.

在 “白色巨塔”中坐 “冷板凳”, 或是遭到同事的排擠怨妒, 這些都是每個做醫生的人, 所必須要走過來的路. 在塔中劇烈的彼此競爭中, 要站穩腳步一層一層地往上爬; 這其中所流下的淚水和汗水, 早就可以淹滿好幾間的手術房了. 當年, 我站在女兒 Alice 的身旁, 心疼地拿著水桶, 到處承接她所流下的水滴. 現在, 我則是又一次心疼地默默承接 Philip 他所吐出的苦水. 這 2 個孩子的個性不同, 他 (她) 要自己跳出這片水澤之地的處理方式, 當然也不會相同. 身為他 (她) 媽的我, 唯一能夠做的就是當他 (她) 的 “垃圾處理機”, 試著給他 (她) 加油打氣, 早日遠離濕地, 繼續往那 “白色巨塔”的塔頂前進; 因為在那裡, 有他們的最終目的地, 也可以看得更遠更廣. 而最重要的是, 當初他們也是為了理想和興趣, 自己決定要一腳踏進這塔裡面來的.

Philip 離開肯亞以後, 我原來以為他在波士頓的生活, 應該是可以不會再有那麼多讓我的一顆心, 隨著他那些林林總總意料外之事而起伏不定的事情發生了. 從這篇文章中看來, 我是錯了. 看來, 我是應該要這麼說: Philip 所到之處, 總有讓我們 surprise 的事圍繞著他! 他還剩下有 2 個禮拜的時間, 須要留在波士頓這個城市裡. 從他居然在他的 blog 部落格網頁中, 破天荒地加入 Charlie Brown 的 3 幅漫畫一事中看來, 此刻他的心情應該還是覺得很嘔, 也很悶; 正在想辦法要來調適自己的心情. 但願 Philip 能夠早日跳脫這讓他遍體鱗傷的 “外傷” 之中, 恢復往日的鬥志, 繼續揮刀衝向脊椎部門裡去. 也讓我們大家拭目以待, 看他這台 “雲霄飛車”, 接下來, 到底是要 show 給我們看什麼樣的景色吧!

When a train goes through a tunnel and it gets dark, you don't throw away the ticket and jump off. (Corrie Ten Boom, 1892 – 1987)

I am not afraid of storms, for I am learning how to sail my ship.

Far away in the sunshine are my highest inspirations. I may not reach them, but I can look up and see the beauty, believe in them and try to follow where they lead. (Louisa May Alcott, 1832 - 1888 )

The wheel goes round and round, some are up and some are on the down, and still the wheel goes round. (Josephine Pollard, 1843-1892, American poet)



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1) 分享孩子的成長, 也感受身為人母的喜悅與欣慰. 依然的我要說, 妳曾有過的付出才有孩子今天的成就. 我為你驕傲, 那是妳該得的尊榮.