肯亞所見系列 (7)

Friday, January 27, 2006

Bittersweet Symphony (悲喜參半的交響樂曲)

But that’s life... So little time has passed since the last post yet so much has happened. I returned to Siaya in the moving mountains bus with the gang. The drive was about 7 hours in total and we left around 4:30am in the morning. We arrived in Siaya Hospital for 2 hard days of work and commenced almost immediately.

I quickly checked on our patients including George who had the bone traction inserted. He was doing quite well and the bones were well aligned in the AP plane and the bones had good separation. The man who was stabbed in the abdomen had passed away due to what they think was electrolyte disturbance. I was gutted. Changa Man had neglected him for days supposedly and he passed away. He was only 24. The 10 year boy who had multiple fractures and was smashed in the face by a mutatu had gotten up and walked out of the hospital. It was amazing. Even Dr Ochieng couldn't believe how resilient the boy was. The afternoon was spent stitching up these security workers who had been cleavered by a gang of thugs and robbed at gunpoint. They had some pretty nasty wounds on their head including a boy who had a large V about 15 cm in size cut out on the parietal bone.

We spent the evening back in Kisumu and I went to King Kong again (fantastic movie !). Naomi Watts rocked. Had no idea she was 38 years of age. The other teachers in Wagai (Becky, Kate, Ciaran and Jon) all came along as well and it was tremendous fun. We spent the night in Kisumu and returned early next morning (6am) back to Siaya for my last day of work.

My final day at Siaya was a tremendous strain. Besides having 7 operations continuous, there was also mass burial happening at the morgue as they were trying to reduce the bodycount. The smell was unbearable and some of the bodies were so decayed I thought i was going to vomit. We spent the night in Siaya having dinner with all the doctors and the teachers and the atmosphere was amazing if not a little sad. It was such a draining day and I spent the evening sleeping back in Wagai for one last time.

It was excellent hanging out with Ciaran and Becky. They were so passionate about teaching. Jon is a history student here to teach who is keen to do postgraduate med and even came along to Siaya to check out the scene. Kate had just finished school and was keen to be a chef here in Africa. Such diversity was refreshing and it was such an inspiration to meet people who were so eager to help and who possessed so much passion.

The next morning we took off back to Nairobi and eventually returned back around 6pm at night. A building had collapsed in Nairobi while we were away. They cut many corners and the builders were trapped under the rubble. Overall about 20 people died although they had not uncovered all the bodies yet. IT was chaos driving around as roads were closed but eventually we returned back to Serena for a peaceful night and a good sleep.

This morning Noel rang and he had arrived long last in Nairobi. We met up and spent the day touring around Nairobi seeing the sights and sorting out administrative tasks. I could not believe it was my last day. We all went to Carnivore for dinner which is the most famous restaurant in Kenya. There is no menu and they serve only meat. You sit and they bring giants amount of meat on long skewers and you were served continuously until you felt full after which you would take the flag down from the table. I tried to struggle as long as I could but it was very difficult. Bob, one of the moving mountains workers who was here to help with the accounting was also around and we thought we'd splash on a cigar at the end of the evening. It was very serene and i felt tremendous sadness that I was about to leave all these people. They had all looked after me in various ways and welcomed me like I was family.

Tomorrow I hop on a plane at night. I will return to the cheetahs and giraffes to get better photos and show Noel as well.

I was contemplating staying one more night but I feel like it might be detrimental overall. It is hard leaving this place and the people have been simply amazing. I hope my parents and friends all come back here one day to travel as there is so much to see and experience.Boston awaits and I have been e-mailed all the details. Noel is giving me a hard time about leaving and I wish I was staying longer. We listened to the Christmas album we recorded this year and had some laughs. It will truly be hard to leave it all behind.... (# posted by Phil Huang @ 11:18 AM )

雖說是悲喜參半, 但這就是人生. 離我上次寫完 blog “部落格” 文章, 雖然是沒多久; 只有短短的幾天而已; 可是這中間卻發生了很多事. 我和一些人, 坐著慈善團體 Moving Mountains 的巴士, 又回到了 Siaya 希阿亞.. 我們在早上 [註: 應是當地 23/Jan] 約 4:30左右就從奈羅比出發, 車程總共加起來大概有 7 個小時. 我是打算要在希阿亞區域醫院再待上兩個工作天, 而由於時間短暫而且緊湊的關係, 因此我 11 點多一抵達醫院以後, 幾乎是馬上就直接投入在工作裡面. 很快的, 我先去巡視之前看過的病人; 包括我曾替他植入骨骼牽引器的 George [註: 29/Dec 那天所排的最後一刀, 為了把鋼釘鑿進病患骨頭內以致他一直待在手術房內直到晚上 10 點, 雙手的手掌也起了好幾個大水泡的那個病例. 詳情請看 “肯亞所見 (3) - Saturday, December 31, 2005, The Strangest thing... (最奇怪的事….)” 那篇文章]. 他復原得很好. 他的骨骼現在已經和 AP plane 前後水平形成一條直線, 也彼此之間沒有再相疊. 那位腹部被刺的病患 [註: 1/Jan 那天早上, 臨時被叫進手術房幫忙一整天, 其中一個花了 4 個小時做器官檢查剖腹開刀, 最後總算發現是腹部被刺時有傷及小腸以致兩處穿孔; 卻因有長期酗酒問題的醫生的疏忽而先前小腸穿孔未被處理就縫合傷口, 導致腸液流出造成急性腹部疼痛的病例. 詳情請看 “肯亞所見 (4) - Sunday, January 08, 2006, The Breaking Point (轉折點)” 那篇文章], 則已經不幸過世了; 院裡的醫生認為可能是由於 electrolyte disturbance, 開刀後因體內電解值失衡而致死. 我的一顆心簡直是沉到谷底裡去; 這應該又是那位有長期酗酒問題醫生的多日沒有巡房之疏失, 以致加添另外一位病患不幸過世的結果. 這位病患只有 24 歲, 他的生命卻這樣的被浪費掉了. 至於那位 10 歲被一輛迷你小巴給撞傷的小男孩 [註: 6/Jan 在離開這間醫院打算要去攀登肯亞山時所照顧的最後一個病人. 病患有多處的嚴重骨折, 其中一處還包括了在頭蓋骨的底部. 詳情請看 “肯亞所見 (4) - Sunday, January 08, 2006, The Breaking Point (轉折點)” 那篇文章], 他當初入院時不僅全身多處骨折, 臉部還被小巴嚴重撞傷; 現在不但是可以自行站立起來, 而且也已經出院回家休養去了. 這真是一件令人驚喜的事情. 甚至 Dr. Ochieng 也無法相信這位小男孩快速復原的神奇彈力. 這天下午, 我在手術房內幫好幾位安全警衛縫合傷口. 他們是在槍口下, 被一群搶匪拿著切肉刀往他們的身上一陣亂砍. 有些人他們的頭部傷口很深很糟糕; 其中還包括有一位受傷男孩在他的parietal bone 顱頂骨側, 有一處長達 15 公分的大 V 字型傷口.

當晚, 我回到Kisumu [註: 肯亞第三大城市, 離 Siaya 約一個小時的車程] 找了家旅館住, 也跑去又看了一次 “King Kong (金剛)” (很棒的一部電影!). 女主角 Naomi Watts 演得真是憾動人心, 我之前都不知道她居然年齡已經是 38 了. 替代我住在 Wagai 宿舍裡的那幾位老師們 (Becky, Kate, Ciaran 和 John) 也跑來 Kisumu 找我聊天, 我們聊得非常熱鬧有趣. 我隔天早上 (清晨 6 點鐘) [註: 應是當地 24/Jan] 就回到希阿亞區域醫院, 做我在肯亞的最後一天實習工作.

我在希阿亞的最後一天, 過得真是非常緊湊. 除了連續在手術房我上了 7 刀以外, 醫院裡還有把很多個屍體掩埋下葬的情形發生, 這是因為院裡的太平間終於要把停放在裡面的遺體清點, 並且把遺體的數目要想辦法減少一下了 [註: 停屍間只能存放 15 具屍體, 可是他們卻置放了 57 具屍體. 詳情請看 “肯亞所見 (3) - Saturday, December 31, 2005, The Strangest thing... (最奇怪的事….)” 那篇文章]. 由於有些遺體已經腐爛多年, 太平間裡的味道非常難聞令人無法忍受; 我差一點以為我會當場就在那裡開始嘔吐起來了. 這個晚上, 我和院裡所有的醫師們與那幾位老師一起到希阿亞一家餐廳裡吃晚餐. 餐中的氣氛, 如果不是讓我覺得有一點感傷以外, 其實一切都是很棒的. 這一天, 我把自己過得是如此的緊繃, 因此這個晚上我決定要回到 Wagai, 再睡它最後的一次.

和 Ciaran 與 Becky 在 Wagai 宿舍裡的聊天相處, 真的是很棒. 他們對教書是如此的滿懷熱情. Jon 是一位歷史系的學生, 到這裡來教書是因為他想要繼續唸學士後醫學系, 所以他先跑來希阿亞探看情形是怎麼一回事. Kate 剛畢業, 想在非洲當一位廚師. 能夠和這些背景新鮮多元擁有如此多熱情的人們相遇認識, 看到他們都是如此急於想用自己所知道的方式來幫助別人, 對我來說, 這實在是很啟人深思的一種鼓勵.

隔天早上 [註: 應是當地 25/Jan], 我開始從 Wagai 出發要回到奈羅比,, 可是卻在晚上 6 點鐘左右才又住進了 Nairobi Serena 旅館. 這是由於在我離開奈羅比的這兩三天裡, 有一棟興建中的大樓工地倒坍; 救難人員為了方便到處挖掘牆角搶救依然深陷廢墟中的建築工人, 因此有很多道路都被封鎖或需要改道; 市區裡的交通, 開起車來是到處一片混亂. 雖然還沒有尋獲到所有失蹤的人員, 不過他們在當晚已經挖掘到 20 具的屍體. 住進旅館後, 因為實在是太累了, 我馬上倒床就睡, 也睡了一夜安寧的好覺.

一覺醒來 [註: 應是當地 26/Jan], 班上同學 Noel 就來電, 說他昨晚終於已經抵達奈羅比. 我們碰面後, 我就帶他整天在奈羅比市區內觀光, 也去辦了他報到前的一些行政上的手續 [註: Noel 即將要在肯亞展開為期 3 個月的校外實習]. 我真不敢相信這將是我留在肯亞的最後一天. 晚上我們到肯亞最有名的 Carnivore 食肉者餐廳裡去用餐. 這家餐廳沒有菜單, 而且也只提供各種肉類食物讓顧客吃到飽. 你找到座位坐下來以後, 他們就不斷的拿著好幾根烤肉鐵長條上很多數量的各種烤好的肉類食物給你吃; 直到你覺得吃飽了, 你就把桌上的那面白旗拿下來, 這時他們才不會再繼續拿肉給你. 我是盡可能的撐到最後一刻, 可是天知道這有多難, 它的量實在是太多了.

慈善團體 Moving Mountains 裡的職員 Bob, 因為要跟我清帳的關係, 這晚他也和我們在一起. 所以在用餐結束後, 我們決定到另一個房間裡來抽根雪茄. 在雪茄煙霧中, 大家都不發一語; 周遭的一切事物也顯得是更加的寧靜. 在過去幾個禮拜以來, 我停留在這個國家裡, 有很多人都是以各種不同的方式在照顧著我, 像對待自己家中成員一般的歡迎著我. 對於即將要離開這些人們一事, 我感到一股特別的濃濃哀傷.

明天晚上 [註: 應是當地 27/Jan], 我即將搭機前往下一個旅程. 但是, 在搭機前, 我會帶 Noel 再回去 Nairobi Animal Sanctuaries 奈羅比動物庇護園裡, 去看看那些長頸鹿和 Cheetah印度豹, 和牠們好好地照幾張照片. 我很想在奈羅比多待一個晚上 [註: Philip 預訂 27/Jan 晚上搭機離開奈羅比, 28/Jan 抵達波士頓; 但哈佛醫學院是要他 30/Jan 早上才報到, 因此他中間還有一兩天的空檔可以做調節], 但我知道, 此舉對我整個行程的安排將會是很不好的. 這裡的人們對我是這麼的好, 要我就這麼的說走就走, 實在是很難的一件事情. 我很希望在將來的有一天, 我的父母和朋友們也都能回到這裡來旅行, 只因為這裡有很多的東西他們可以觀看, 也有好多的事情他們可以體驗. 波士頓正在等著我; 過去的幾天裡, 他們已經 e-mail 了所有詳細的相關資料給我. 看到Noel 的到來, 一想到我必須要走, 而他卻可以在接下來的 3 個月裡都待在這裡, 讓我更是難過. 我真希望我可以再留久一點.

我和 Noel 一起聆聽今年 [註: 意指 2005 年] 我為系上同學特別錄製的我和他一起表演聖誕節歌曲的專輯, .兩人不禁因回想起當時的趣事而互相大笑. 要把我在這個國家裡所經歷過的這麼多歡笑和親身體驗, 就這麼地拋諸於腦後, 將會是真的好難, 好難…….. (posted by Phil Huang @ 11:18 AM )

Sunday, January 29, 2006

A City of Excess (一個什麼事都是超過的城市)

The final day in Nairobi was tremendously sad. Me and Noel woke up a little late but packed in some breakfast as quick we could (even though the previous night's meat was still fresh in our stomach. We made our way quickly around Nairobi once again and went to the giraffe and cheetah sanctuary again. We also made our way to the elephant and rhino orphanage which was equally amazing.

Dr OChieng was in Nairobi and all of us sat down to a late lunch. The team made me an excellent shirt as well with Japanese Muzungu written on the front and my usual menu of mutumbo, sukuma and ugali on the back. The drive to the airport was a solemn one and there was next to no conversation in the car.

The next few hours were a bit blurry as I made my way through checkout after an emotional farewell. I was so envious of Noel and the adventure he was about to have. I know the team will look after him. Leaving Nairobi was so difficult but I knew that further adventures awaited in Boston. I could not believe how quickly time had passed. It was almost coming to an end.

The flight from Kenya to Dubai was uneventful. I had slept and awoken without any disturbance and hopped off one flight straight onto another towards New York. There was no time in between the two flights at all. The plane from Dubai to New York was amazing in comfort. Airbus had out did themselves. Seats did not recline backwards at all. Each seat was a unique Hub that had carved out its own space already. The seat merely reclined within this space. This meant seats reclined back within a already defined space which did not intrude on the passenger behind. The entertainment system was also amazing and I watched Hitchhikers and Wonka. I have forgotten how much I love movies.

14 hours passed quickly and I arrived in New York around 7am. The flight to Boston was at 11 and I had a few hours to relax in the terminal. The first thing you notice about the US is the security. I was probed, searched and all my luggages were swabbed for explosives. It was a real sight. Another thing I immediately noticed was the advertising here in the states. They were selling defibrillators in magazines on the plane for home use and the napkins on the plane were sponsored by Diet Coke. I feel more unsafe in the states than i ever did in Nairobi. The news are filled with stories of fear.

Eventually late in the afternoon I arrived in my apartment in Appleton St on the South Side of Boston (Copley Square). It was beautiful. The apartment was a beautiful studio on the 2nd floor which had a Murphys Bed and a sofa bed. It was very cozy and I fell in love with it immediately. After unpacking and setting up the internet (wireless available for free in the room) I realised how different this city was going to be. I ordered some lunch/dinner on the internet and it arrived within 15 minutes. The dangers and excesses of this city immediate became apparent and I realised this was going to be a different world... (# posted by Phil Huang @ 1:03 PM)

在奈羅比的最後幾個小時, 是超級的令我感到離愁難捨. Noel 和我起床時有一點兒晚 [註: 應是當地 27/Jan], 所以我們盡快地梳洗完畢. 雖然昨晚的肉類食物在我們的胃裡仍然算是 “新鮮” , 我們還是匆忙的抓了一些早餐往外就跑. 我們坐著觀光巴士, 快速的在奈羅比的市區裡繞了一圈, 然後抵達了Nairobi Animal Sanctuaries 奈羅比動物庇護園裡的長頸鹿和 Cheetah 印度豹園區. 我們也去參觀了大象和犀牛的孤兒園區. 這個園區裡的動物, 也是一樣很棒.

Dr. Ochieng 也在奈羅比, 所以我們就相約, 一起吃了個時間比較晚的午餐. 他把醫院裡的醫師們要送給我的一件超酷襯衫上衣帶來給我. 上衣的前方印有日文 “Muzungu (白種人)” 的字樣; 後方則是印著平常我經常點吃的 Mutumbo (腸子) , Sukuma (肯亞蔬菜) , 和 Ugali (玉米麵團) 的圖樣. 我坐在開往機場的車子中, 一路無語眼眶泛紅. 我幾乎都沒有開口和任何人交談.

在機場裡, 和來送我機的每個人一一的激動道別後, 我大步地邁向海關的過關安檢關口. 迎面不斷流下的淚水, 讓我在接下來的幾個小時中, 景象幾乎是一片模糊. 我是多麼的羨慕Noel 與妒忌他接下來的 3 個月裡所能擁有的一切經歷啊!

我知道慈善團體 Moving Mountain 的這些人, 將會妥善地把他照顧好. 要我這樣的說離開就離開奈羅比, 是何等困難的一件事情; 但是我也知道, 在波士頓將有更多的經歷在等著我. 我無法相信, 時間居然會過得這麼快. 我在肯亞的日子, 幾乎已告一個段落, 就此結束了.

從奈羅比飛到杜拜的途中, 一路順利, 沒有什麼特別的事情發生. 我在沒有受到空中小姐任何打擾的情形下, 睡了又醒; 然後跳上另一架飛機直接飛往紐約. 這中間, 根本就沒有可以到轉機室稍作休息的時間. 在從杜拜飛到紐約的班機上, 一切的設備裝置, 是說不出來的超舒適. 空中巴士的裝備, 真是沒話說; 比以前更棒了. 它的座椅根本就不會向後倚斜傾靠, 而是每張座椅都已事先規劃好乘客自己的活動空間, 張張座椅都像是乘客自己擁有個人獨特的活動中心似的; 任何倚斜傾靠都只會在這個活動中心裡的空間內發生, 而不會去影響或侵犯到坐在他後面的那位乘客的空間. 機上所提供的娛樂設備也很新很棒. 我在飛機上看了 Hitchhikers 和 Wonka 這兩部電影. 我幾乎都快要忘掉, 我是這麼的喜歡觀看電影了.

14 個小時的飛行時間, 一下子就過去了. 我是在早上 7:00 左右抵達紐約的 [註: 應是當地 28/Jan 農曆年除夕, 當時室外氣溫是攝氏零下1°]. 從紐約到波士頓的班機要到早上 11 點鐘才起飛, 因此我還有好幾個小時, 可以輕鬆的在各個不同的機場大廈之間閒逛. 一踏上美國的領土, 你會注意到的第一件事, 就是它在各機場大廈裡的安全檢查設施. 我被金屬探測; 搜身; 所有的行李也都被逐件的觸摸是否夾帶有爆炸物. 它安檢的嚴密程度, 真是叫人嘆為觀止. 另外一件事讓我馬上注意到的, 就是在美國這裡的廣告促銷方式. 在飛機上的雜誌, 我看到他們居然賣醫學上用的 defibrillators 電擊器是給家用的. 而機上盥洗室裡給嬰兒用的免費紙尿布, 它的贊助廠商竟然是 Diet Coke 健怡低糖可樂. 電視和報紙上的報導, 到處都是對各種事物充滿著恐懼的新聞故事. 我身在美國, 覺得還不如留在奈羅比來得安全些.

最後, 我終於在傍晚的時刻, 抵達了位在波士頓南區 (Copley Square 科波利廣場附近) 的 Appleton Street 艾波頓街上的短期租處. 這間租處好漂亮. 它是在二樓的一間一房小套房, 附有一張 Murphy’s Bed 和一張沙發床. 房間裡面的佈置很舒適, 我第一眼看到它的時候, 就立刻愛上了它.

將行李解開找地方放好, 並架設好網路上網的準備工作之後 (房間內可以免費無線上網), 我突然意識到, 波士頓這裡, 將會是與我之前實習的地方大為不同的一個城市. 我上網點叫的一些午/晚餐, 15 分鐘以後, 已經熱騰騰的送達到我手中. 個人的身家安全問題和這個城市裡什麼事都是超過的, 馬上很明顯地都浮現出來. 這也讓我在心底不禁深深的體會到, 和非洲大陸的肯亞相比起來, 這裡將會是一個全然不同的世界……….
(Posted by Phil Huang @ 1:03 PM)

[後記]

當 Philip 在28/Jan農曆年的除夕夜, 於美國波士頓的一間小套房內, 細嚼適應一個全然不同的世界時; 在台灣的我是正好和他爸爸趁著 29/Jan 大年初一高速公路上清晨 4:00 的時候不會有返鄉過年車潮的情形發生, 一路順暢地開了 3 個小時的車回到台南老家過年. 女兒 Alice 於 21/Jan 從澳洲墨爾本飛回台灣和我們先過了一個早年. 她爸爸 28/Jan 晚上送她到機場回澳, 看到她在 20:30 進入機場海關關口後回到家, 正想可以喘口氣在開車回鄉前先閉目養神一下; 23:10 左右我們卻接到 Alice 打來的電話告知說, 因為飛機上的零件故障, 以致搭乘的華航班機, 不能如期地在原訂的 22:10 起飛. 她自 21:50 開始就被關在機艙裡不能下機. 而根據機長 5 分鐘前對旅客的報告, 這班班機應可在 23:30 左右就可以把零件修復準備起飛. 至於她要在這班班機的降落點布里斯本市轉接國內線班機繼續飛回墨爾本; 抵家換衣趕赴醫院上晚班一事, 恐怕將會因而有所延誤, 但請我們不要為她擔憂, 她會自己想辦法來解決. 懂事孝順的女兒, 因為不願看到她在台灣的兩老, 雖有一對兒女, 農曆過年時卻是無子女在身旁來相陪, 所以她排除萬難, 特地在百忙中, 抽空回台一週. 現在她卻因為華航定期維修部門員工的人為疏失, 導致零件故障延誤起飛, 以致無法如期轉機, 這讓我原本認為華航是服務品質每況愈下的印象更為惡化. 如果說是因為天候的因素, 以致班機延誤起飛的話, 這我可以諒解, 沒話說. 但是從台北到布里斯本的班機, 因零件故障以致延誤起飛的情形已經是不止一次的發生, 這實在是讓人憤怒失望, 不禁訥悶: 華航的班機, 那兒來的有這麼的零件可以發生故障呢?

女兒 Alice 總算在最後的一刻, 趕上了在墨爾本皇家婦女醫院上產房晚班的上班時間. 2 天以後, 她 Fax 了墨爾本當地大報 Herald Sun 上面 25/Jan 的一則聲明啟事給我們做參考:

這個案例我曾經在 Alice 回台時聽她提起過. Kim 是她在要回台前所接生的最後一個產婦. 產前幾個小時, 當 Kim 看到 Alice 長得一付娃娃臉的時候, 已經是大吃一驚; 要推入產房時, 又聽到她同事故意開她玩笑說 Kim 是 Alice 負責接生的第一位產婦 (實際上是她已接生過不下 300 位嬰兒), 她是滿臉驚恐的努力催生. 不料催生過程不順, 嬰兒須緊急剖腹取出. 嬰兒出生後, 局部麻醉中的 Kim 卻在短短幾分鐘內大量失血 1,000 多 c.c.. 所幸在 Alice 的急救下, 母子皆平安. 但 Alice 隨後就登機返台, 不能在事後巡視這位產婦和嬰兒的情況, 一直是 Alice 在台期間最掛意的事情.

沒想到她一返澳後, 她的同事馬上就把這份報紙上的聲明啟事拿給她看, 讓她直嚷有虧職守愧對產婦.

雖說這已經不是第一次產婦寫感謝函或登報致謝給 Alice, 但我們還是引Alice 以為傲. 一位醫生的養成不易; 要成為一位好的醫生更是不簡單. 平常我們所看到的一位名醫光環罩頂的背後, 總有他 (她) 們不為人所知的長時辛勞付出, 如果不是帶著一顆熱情的心隨時想幫助周遭的人, 這個職業真不是可以做得來的. Alice 是如此, Philip 也是如此, 所有成千上萬的其他醫生們更是如此! 在此, 我謹向這些懸壺濟世的無名華陀致敬!!