Shiao Chu said to me excitedly, “Ting-ting is back!” And I exclaimed, “Really?!”
It had been almost a year and Ting-ting was back to complete her pediatrics training.
Back then, a group of female doctors, including me in general surgery, Shiao Chu in gynaecology and obstetrics, and Ting-ting in pediatrics, took a place respectively, in three out of the four major specialties that was facing imminent depletion of talents. With Shiao Mei in orthopedics, we were in the same batch, running PGY together, which was a complete waste of time, and therefore we also get together quite a lot.
Nevertheless, the returned Ting-ting from a break was totally different.
She was still polite towards family members of her patients and thorough with them when it came to attaining information. However, she said, “Pediatrics is, after all, a specialty that takes care of family members.” Now, somehow her attitude was “pacifying family members is enough”. She said that while looking coldly at a young child passing by. I was curious and asked, “What do you mean?” She said, “Have you come across clinics with reputation that is both extremely good and bad at the same time, but zealous and trusting parents are visiting them faithfully anyway?” I said yes.
Having work in a medical centre for an extended period of time, I was actually quite detached from “the practice”. Some methodologies that came to my knowledge are indeed shocking, which include abusing of antibiotics, as well as mixing of vitamin B complex electrolyte with diluted anti-inflammatory medicine, making a big fancy bottle of golden pills; or marketing “IV antibiotics/total parenteral nutrition/large”. After injection, patients would feel energized, exclaiming, “Swell!”
More unethical doctors would inject steroids. The effect is immediate with what seems to be without any symptom whatsoever (of course, being the elixir from the US). Consequently, patients’ white blood cell count would drop to 3000 (whereas the normal level is approximately 10,000)
As for delivering warnings for indexes dropping below or exceeding reference ranges, Ting-ting shook her head and shrugged, then said to me, “What to do? Those practitioners talk a good medical care, leaving family members ignorant with the fact that their children’s low white blood cell count was indeed, a result of their own actions.”
One other condition is where a practitioner with high authority wouldn’t allow family members asking questions during consultation. This is fine, after all, nine times out of ten, advice given is correct. Nonetheless, it is difficult to tell what is strange about the advice for the first time.
“Kids need to build up their own immune system because turning to medicine time and again is simply surrendering to viruses! It is crucial that we take care of our bodies so that we can fight off sickness on our own,” Ting-ting related her views to me.
I said, “This makes sense -- avoid steroid; no antibiotics unless it’s absolutely necessary. This is the general pediatrician principle.”
Ting-ting explained, “But the doctors would criticize previous approach, the medicine prescribed by other clinics are wrong.”
I said, “More often than not, kids fall ill due to virus infection.”
Ting-ting continued, “Then some family members would even say, ‘I deserve to be scolded because I made a mistake. I don’t want to be a presumptuous parent. Learning this for the sake of my kids, I think it’s great. I accept the reprimanding with no complaint whatsoever’”
I was dubious, “Seriously?”
Ting-ting said, “Finally, the doctors would impose some medical check-ups, give advice on torticollis, sleeping posture and family members would accept with much gratitude.” I laughed in disbelief and said, “How often is torticollis anyway?”
After consulting with these practitioners, patients seems like they have received a higher calling. They have been reprimanded so hard that they stop thinking altogether, degrading from lacking of consideration to believing doctors with complete faith. But, medical care is never about authority and who gets to play god.
Establishing the correct health education takes time and effort. Doctors do encourage patients to look for second opinion. Nevertheless, when doctors only explaining medical reports during consultation, patients find that “no prescription, why pay?” This has become a pervasive principle held by the intractable, moulded mainly by the health care policy. Who would spend the time to —explain? “Taking care of family members is all that matters,” Ting-ting said dryly.
Shiao Chu whispered to me, “Do you think Ting-ting…” “Yes”, I said. We could all tell that Ting-ting had changed. Ting-ting, the once loving-all-baby gardener, who quietly and consistently sowing the little garden of tiny human beings, was badly hurt.
Medical care is not the usual service industry. Hospitals are not hotels, nurses are not waiters. The pain “life” brings upon everybody was given by Him impartially. Nobody would want to get admitted to a hospital, no medical care professional would want to aggravate the patients’ pain. “Medical care professional”, how much have these three simple words driven us to devote our lives studying, training, practicing, and gaining experience? And then, when facing the pain of our patients, we have to have empathy. But at the same time, we are required to overcome the emotional barrier that is useless to our work, and “deal with the problems professionally”. But no one respect professionalism, even our superiors take it for granted. So how worthy is it to have empathy? This was exactly what happened to Ting-ting.
We have no solution to offer. Ting-ting said, “You know how I took the car seat sticker down with tears at my back glass? I can’t possibly care for all other kids anymore. I would think of … I know that an embryo’s heart stop beating after 5 weeks is medically called “missed abortion”. I also know that it‘s a problem of chromosome binding. But when I faced life and death, I not only know the content of the textbooks, more importantly, I am also a just a normal person, a normal mother.” She sobbed, and continued, “I am not better at my work. I am just a normal person and I can’t meddle in other people’s business anymore. I just can’t. Right now, all I can think of is finish my training, get my specialist qualification and then leave immediately.”
When it comes to life, she, liked all others are hurting and struggling. The once flaring torch was now diminishing.
The cup of coffee I bought her was turning cold in her hands.
The once lush towering trees were withering away, unable to escape their fate in the winter.
Tonight, Shiao Chu, Ting-ting and I were all happened to be on call together.
In Shiao Chu’s delivery room, a woman gave birth to a 6-month premature baby. Due to family problems, she decided not to keep the baby. Shiao Chu was upset because “the baby is already wiggling his fingers and toes…” Stories like this repeat itself time and again. But tonight, it was different.
Normally, in the case of a premature baby, there will be a pediatrician standing by during delivery. After taking over from the obstetrician, the pediatrician must suck out the baby’s oral liquid, even intubate and put the baby in an incubator. The emergency treatments on these angels with tiny hands are beyond imagination. Doctors have to use 2 fingers to perform cardiac massage, because babies are so delicate and fragile…
Tonight, the pediatrician on duty to take over the premature baby happened to be Ting-ting. She said she would “respect the will of family members”. So baby was not provided with any incubation and cleaning, but was left in a deserted delivery room waiting for him to stop displaying any “vital sign”. Deep down, I was screaming like Munch’s painting but this was very common in the gynecological and pediatrics department.
We continued our duty, awaiting the long night to be over. I walked with Ting-ting and we chatted. But she was constantly checking her cellphone for duty call… We both knew what was to come but carefully avoided the elephant in the room.
Three hours later, Shiao Chu called to tell us, “The baby is still moving, and looks pinkish. I’ve never seen anything like this before.” But the mother already let us know not to give her further notifications.
Having a medical system that emphasizes mutual respect and puts the wishes of family members before everything, patients may not blame the doctors but family members might. What good does it do when I am anxious? Am I simply bringing problems upon myself? Every doctor is contemplating thousands of issues and yet there is nothing one can do…
Four hours later, Shiao Chu shakily told us, “The baby is crying… I can’t take it any more…”
Ting-ting slammed the table and stood up abruptly! She roared, “Which bed is the mother at?”
Shiao Chu said, “Eighth floor, Bed twenty third. What are you trying to do?”
Before she could finish, Ting-ting already dashed out, leaving me with my jaw dropped…
Five minutes later, something shocking happened. Ting-ting called Shiao Chu breathlessly and told her, “The mother gave order to save her baby!” Shiao Chu was at the on-call room by the delivery room then. Everyone, or should I say, every medical personnel in the whole delivery room jumped! Shiao Chu said, “Okay, where are you?” She continued to talk on the phone while wearing her shoes and dashed out. Ting-ting said, “I am at the eighth floor. I will come right down!”
Delivery room and the operating room where I worked were linked. I was at the hallway when Ting-ting who was carrying a medical box rushed by. I didn’t have time to ask for details.
“The mother ordered save the baby!”
I was absolutely shocked while Ting-ting’s ponytail disappeared at the end of the corridor. Then, it was as if The Verve’s “Bittersweet Symphony” was ringing at my ears. The melody that captured the beating heart was as if echoing at the hallway.
Shiao Chu and Ting-ting together treated and saved Little Fourth Prince (a nickname deriving from enduring four long hours), then put him in an incubator.
At Neonatal Intensive Care Unit (NICU), I asked her, “Do you know you were a hot head?”
Ting-ting smiled and replied, “Erm… I do know that.”
I asked her again, “He was left there for so long, four long hours. If you save him but he suffered any physical deformation in the future, what were you going to do if the parents blame it on you?”
But no further explanation was necessary. We looked at each other, and then at the Little Fourth Prince who was sound asleep in the incubator. His mother was right by his side and he held her finger with his tiny hand…
Finally, I asked her, “What exactly did you tell the mother?”
Ting-ting said, “I just said, ‘It’s been four hours and the baby is still kicking. Do you want to save him?’”
I asked, “What did the mother say?”
Ting-ting replied, “The mother burst into tears and asked me, ‘It’s been so long. Is it still possible to save him?’ I said, ‘If you are sure, pleading with all you heart and soul, then I would save him!’”
She paused for a bit and then continued, “’Once, I failed to save the baby I wanted to save most. But right now, I promise you, if you are absolutely sure, begging for mercy with all you heart and soul, then I would save him with all my might.’”
Ting-ting turned to me and smiled.
Flowers were blooming once again.