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乡村医生的一天

冬日清晨五点多,咚咚的敲门声把我从睡梦中吵醒。我在睡眼朦胧中迎来了今天的第一个客人——一个高血压病人来测量血压。

 我是一名乡村医生,我的一天从这里开始。

吓人的意外

 紧接着又来了一老一小。祖孙两人都是发高烧,可家里年轻人都在外打工,夜里没人护送,他们只能苦苦熬到天亮才过来。经过简单检查,我发现小孩是扁桃体肿大、发炎,体温39.5℃;奶奶是慢性支气管炎急性发作。给祖孙俩量体温、做皮试、注射,忙碌完毕,才发现肚子已经咕咕叫了。

 吃完早饭,我本来打算到县城去补点药品。不料,又来了几个感冒病人。等处理好,已经是10点多了。还没来得及歇口气,一个发着高烧的小孩被送了进来。我一边询问病情,一边给他测量体温。突然,小孩全身抽筋,不省人事。时间就是生命,我赶紧进行全力抢救。十几分钟后,小孩总算有所好转,我立即用摩托车将他送到镇中心卫生院进行进一步的诊治。

 值得庆幸的是,这孩子是在我给他用药之前开始抽筋的,如果是用药以后出现这种情况,我就是有一百张嘴也说不清楚了。之后会怎么样,我真是想都不敢想。接下来的一个多小时,我一直被这种情绪困扰着,没有心思做其他事情。

 病人出现意外,是我们乡村医生最害怕发生的事情!

 人家都说医生是个好职业,但乡村医生却恰恰相反。我们村医的收入非常低。现在农村药品市场开放了,大家有个头疼脑热的,去药店买点药就行,相当多的药店本来也在私下非法行医。要是得了大病,就去正规医院。现在很多人参加了新农合,在乡镇医院最多能报销90%的医药费,住院也变得经济实惠多了。这些,对村民当然是件好事,但我们村医夹在中间,生活就艰难了。

 我挣的那点钱,远远不如出外打工的多,而且要承担非常大的风险和压力。村卫生站设备简陋,坦率地说,不少村医的技术和经验也有限。但遇到急症重症疑难病,我们同样得应对。病人一旦出了问题,不管是不是医生的责任,病人一张口就要几十万。网络时代,医疗纠纷容易被闹大。正规医院的医生遇到这种麻烦有单位做后盾,可我们村医势单力薄,所有的麻烦只能一个人扛,稍不留神就有可能弄个倾家荡产。司机高风险,但是他们能上交通强制险,一旦发生事故可以由保险公司分担风险。所以我们村医也特别希望能有商业保险公司为我们分担一些医疗风险,可惜到现在还没有哪家公司注意到我们这个特殊的群体。

头疼的任务

 吃过午饭,我的心情稍稍平静下来。下午,我按原计划给村民进行体检,建立健康档案。这是一件让人非常头疼的事情,因为很多村民不愿意公开自己的既往史和家族史,不愿意谈及个人隐私。可这又是我们乡村医生不得不做的工作。

 今天,我的工作重点是完成精神病人和糖尿病人的随访。我们村一共有7个精神病人,其中一些人是没有症状了,可档案还是要建,所以必须挨家挨户去走访他们或他们的家属,争取他们的配合。结果是百分之八十的人都不愿意提供相关信息,特别是真实的住院时间和医院名称,有的人根本不愿意承认自己曾患有精神病,其中包括一个目前还没有痊愈的病人。结果,跑了一个下午,说得口干舌燥,只有一户人家提供了完整的病人信息。

 糖尿病人的随访也有问题,由于我们卫生站条件限制,目前还没有血糖仪,所以很多数据都无法采集到。我只能祈求老天保佑,保佑上面的督查不要来我们村,不然我就麻烦了。

快乐的时刻

 晚上,处理完几个感冒病人,心想总算可以休息了,又接到电话要求出诊。正规医院的医生再忙,也可以轮班,可乡村卫生站只有我一个人,村民生病又等不得,所以我一天要工作多长时间、能休息多长时间,全看运气。

 急急忙忙赶到病人家,那是个年轻的女性,腹痛难忍,面色苍白,大冷天疼得大汗淋漓,而且吃什么吐什么。我初步诊断她是得了肠梗阻,必须马上住院治疗。幸好我有摩托车,直接把她送到医院。

 等我回来,已经是晚上10点了。前脚踏进卫生站,后脚就来了两个老人和一个孩子,孩子的鼻子里塞了一粒黄豆。孩子的奶奶说,这粒黄豆是孙子自己早上不小心塞进去的。由于卫生站没有专业的设备,无奈之下只好建议家长带孩子到镇中心卫生院进行处理。可是两位老人说孩子的父母都在外务工,家里也没有钱,一再央求我帮帮他们的孙子。

 没办法,我只能用“掏耳勺”这简单又古老的方法试试。好在功夫不负有心人,折腾了半天,还真的把那粒大黄豆挖了出来,已经开始膨胀了。孩子的爷爷奶奶激动地连声道谢……

 这是我们乡村医生最快乐、最欣慰的时刻。人间自有千般苦,唯有行医难,乡村医生归结就是三个字“穷,忙,险”。但是,能够用简单的设备成功地帮助病人解除痛苦,既为他们省下了钱,也省去奔波劳累之苦,再穷再忙再险,我们也都默默地忍受着!        □谢建华


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