决定了,拔管让她走吧!(含着泪也要看完)

2017-09-24 田红 医学界急诊与重症频道

作为一名ICU主任,面对此情此景,我不知道眼泪往哪放?

那个夏天,出奇的热,地面蒸发的气体有让人窒息的感觉。

早上交完班,医生就告诉我,2床家属早早在门外等候了,想见我,我心里一怔,知道他们要见我的原因,有些沉重。

见家属前,我必须再见一下2床病人,这或许是我们最后一次见面了。

这是一位一周前入院的女性病人,我清晰地记得她姓蒋,退休前是一家企业的书记,来看望她的同事都叫她蒋书记,57岁。

她已经是第二次住我们重症监护病房了。病人去年夏天被确诊为肺癌,并做了手术化疗等相关治疗,3个月前因为呼吸衰竭,全身多处转移第一次住进ICU,还上了呼吸机,虽然最后治疗好转出院了,但我们都清楚病人很快还会回来的,因为她的时间不多了。

她这次来,我第一眼都没有认出她。她消瘦了许多,双侧面颊已经明显凹陷,四肢只有皮肤和骨头,病人本身个子不高,现在看起来更虚弱了。我静静地看着她,可能心有灵犀吧。

她的右手轻轻挪动了一下,冰冷、无力地握住了我伸向她的手,双眼用力睁开一条线,望着我——眼神里是乞求?依赖?还是绝望?告别?

我的眼睛有些湿润了,被她那么信赖的主任也救不了她了。

人类不是很强大吗?为什么还有那么多人战胜不了渺小到我们自己都看不到的癌细胞呢?我不忍心再继续面对这样一个全身插满管子,奄奄一息的生命,我想离开她,也许我们将永远离开了她。

我还要去面对她的那些健康活着,却比她更受煎熬的亲人们。

我是医生,虽然我真的还不能完全体会到一个生命被癌症判了死刑后,断绝杂念,积极治疗依然无法治愈的孤独与绝望。但是,我却可以体会到一个重症医生每天面对不同生命走向死亡的内心煎熬与残酷磨练。

我走进家属接待室,病人的丈夫和子女已经坐在了接待室的椅子上,这一家人留给我印象很深,也很好。丈夫姓王,是老伴一个企业的退休工人,女儿是老大,叫小娟,已结婚成家,儿子叫小军,还在读书,好像是医学专业研究生。

病人第一次住院时,我记得她丈夫拿了一个厚厚的,写得密密麻麻却清晰了然的笔记本,详细记录了病人得病以来的所有治疗过程,包括每天服药的剂量、反应、还有饮食起居情况以及所有贴得整整齐齐的各种检查报告单,医生护士们闲聊时也常说这家病人丈夫、子女特别好,每天精心做好可口的饮食送到病房,一家人都很有礼貌和素质等等,一看就是一个幸福和谐的家庭。

现在,这一家人以不同的状态在我面前。老王坐在我对面,小娟和小军分别坐在爸爸两旁,三个人都低着头,老王头耷拉着,小娟两手环抱着爸爸胳膊靠在爸爸肩上,小军直直地坐着,眼睛看着放在两膝上的手。

三个人一言不语,我知道他们要对我说什么,但是因为这个决定太残酷了,即使他们心里已经下了一万次决心。但真的要在某一刻,用语言、文字表述出来,也是非常艰难的,放弃无用的治疗,向先进理念学习,让病人有尊严地死去。这在目前的中国,在老百姓心里,还需要接受的时间与空间。

我理解他们,人毕竟是有感情,有信念的,此时,门里的亲人还活着,至少还活着,但是一旦我们放弃了,门里门外也许在瞬间就阴阳相隔,永远分离。

接待室的空气沉闷极了,能听到每个人的心跳,咚哒咚哒,像时光在一点一点流逝,又像是生命在做最后的告别。

我实在闷得受不了,轻轻地问了句:“你们想好了?”

小娟、小军蓄积很久的眼泪迸发出来,放声大哭,老王双手掩着脸,头低低地埋在双膝里,本来就瘦小的身体卷曲成一团,随着抽泣声一起一伏,小娟把手里的纸巾塞给爸爸,爸爸接过来,擦了擦眼泪,做了个手势,两个孩子相互搀扶着离开了接待室。

老王又擦了下眼泪,慢慢抬起头,开始和我交流,我看着这张脸,两天没见,在他脸上时光像走过了20年,头发几乎全白了,眼睛红肿,带着血丝,眼袋很深,面色苍黄,干裂的嘴唇起了很多小泡。

他穿着的一件浅灰色长袖衬衫,可以见到有汗水浸透过又干了的痕迹,我无法想象这两天,这个男人度过了怎样的煎熬。他的声音有些沙哑,我给他倒了一杯水,说,“我们坐沙发上说话吧。”因为这样,他和我都会轻松些。

“田主任,我们想好了,尊重老伴意见,让她安静地走吧”,老王说着,停顿了几秒,擦了擦眼睛,继续诉说着。

我不想打断他或者安慰他,其实很多人在这种时候,心里早已有了决定,只是需要有人倾听他们内心真实的声音。老王一边说着,一边从衣服口袋里拿出一个用手绢包着的东西,一层层打开,是一张叠得不是太整齐的白纸。

他说这是两天前下午探视时老伴给他写的,然后用颤抖的双手递给了我,自己不停地擦着眼泪,我仔细看了前几行。

“老王,我要走了,这次我可能不能和你一起回家了,这一年,你们已经尽力了,谢谢你。我也尽力了,但是我真的很难受,我受不了了,也拖累了你们,就让我走吧,我在另一个世界等着你,我爱你们,小娟小军都是好孩子,会照顾你的----”

后面的字迹,我已经看不清了,我竭力控制着自己眼泪,不要在病人家属面前流下来,我把白纸还给老王。

他一直拿着,一会儿抬起头没有目的的看看,一会儿低着头盯着那张纸看,然后自言自语着。

“让她走吧,让她走吧,她上次回去就没有睡过一个安稳觉,24小时就那么坐着,偶尔趴在胸前的被子上打个盹,也吃不下什么东西,只能喝点稀的,好好的一个人变成这样,我看着难受啊,她自己也经常悄悄流泪,以前她那么好强,爱干净,爱唱歌,照顾单位,照顾家里,风风火火的,现在变成这样,身上插那么多管子,也不能说话了,就让她走吧。”

老王不断地重复着:让她走吧。我看了心里真的很心酸。

接下来就是机械性的流程,无论多么残酷,病情告知、放弃签字都是医生必须要做的。我走出家属接待室回到了办公室,再没有正面接触这一家人,我实在没有勇气看到他们最后和亲人告别的场面,我更害怕看到病人最后因为缺氧一步步走向死亡的挣扎,就像一个人掉入深渊,拼命地想向上攀爬,最后力气一点点耗尽,坠落到深底的绝望。我今天是怎么了。

监护大厅传来撕心裂肺的哭声,是小娟和小军的,他们在和妈妈告别,还有老王在和老伴说的我一句也没有听清的话语,最后他们是在医生和护士的搀扶下离开了监护大厅。

后面听护士说,太感人了,在家属最后快要看不到病人时,两个孩子突然跪下,朝妈妈方向磕了三个头,老王给老伴深深鞠了一个躬,我知道这些行为里:有愧疚,有感谢,有不舍,有祝福。

这就永别了,也许另一个世界没有疾病的折磨,会快乐很多。

十几分钟以后,病人就永远离开了这个世界。

一周左右时间,小娟陪着爸爸来办理一些病历手续,他们憔悴了很多,也平静了很多,生活就是这样,生老病死,分分合合,我们谁也没有办法把握自己会如何离开这个世界。

但是,我们可以把握在有限的生命里珍爱健康,珍惜友情亲情,一旦真的面对无法抗拒的死亡,选择坚强和理性也是我们可以把握的。

他们就是这样一家人。

看着老王和女儿离开的背影,我的心里一阵酸楚,眼睛有些湿润,祝愿这个家庭今后的生活圆满幸福,祝愿天堂之人一路平安。

两年后的某一天,我在街上见到了小娟,和一个很帅的小伙推着一个婴儿车,一看就是一家三口,小娟向他丈夫介绍我是给她妈妈看病的医生,听小娟说小军已经从医学院毕业了,在附院做了一名医生,爸爸也很好,就是时常想起妈妈还是会流泪。

记得三毛说过:

在这世界上,没有人能单独地消失,除非记得他的人,全部一同死去。不然,那人不会就这么不存在了。在我们有生之年,即使失去了心爱的人,如果我们一日不死,那人就在我们记忆中永远共存。直到我们又走了,又会有其他爱我们的人,把我们保持在怀念中。

爱,是人类唯一的救赎,他的力量,超越死亡。

生活依然要继续前行,爱激励着我们。

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    2017-09-28 changjiu

    学习一下.谢谢

    0

  2. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Mon Sep 25 07:05:18 CST 2017, time=2017-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=247484, encodeId=98d024e4841f, content=唉.一声叹息, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Mon Sep 25 07:04:00 CST 2017, time=2017-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=247463, encodeId=bdf724e4635c, content=学习.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhb9xDeHojCicsdRdyC3XXdGk2ib9yLypZuHN06WeW4HO8WN0GGrgEfvnTX8gsckof05GHOU5OM4Mvx/0, createdBy=9cee1982656, createdName=执着追梦, createdTime=Mon Sep 25 06:49:52 CST 2017, time=2017-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=247442, encodeId=1f2824e44239, content=感动.真实的人生, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo61WAV0ROeLAoicPxPKoKaogwLWLL8STv86qplbdOibN2YR4KxkJicqNectCXGR8gPJhGLc7yYLSdnpx4kaVXndTfu/0, createdBy=a6962042337, createdName=1391e9f2a7m, createdTime=Mon Sep 25 06:12:50 CST 2017, time=2017-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=247438, encodeId=a83424e43863, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Mon Sep 25 06:11:02 CST 2017, time=2017-09-25, status=1, ipAttribution=)]
    2017-09-26 steven_u4
  3. 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    2017-09-25 Julie W

    在这世界上.没有人能单独地消失.除非记得他的人.全部一同死去.不然.那人不会就这么不存在了.在我们有生之年.即使失去了心爱的人.如果我们一日不死.那人就在我们记忆中永远共存.直到我们又走了.又会有其他爱我们的人.把我们保持在怀念中.

    0

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createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhb9xDeHojCicsdRdyC3XXdGk2ib9yLypZuHN06WeW4HO8WN0GGrgEfvnTX8gsckof05GHOU5OM4Mvx/0, createdBy=9cee1982656, createdName=执着追梦, createdTime=Mon Sep 25 06:49:52 CST 2017, time=2017-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=247442, encodeId=1f2824e44239, content=感动.真实的人生, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo61WAV0ROeLAoicPxPKoKaogwLWLL8STv86qplbdOibN2YR4KxkJicqNectCXGR8gPJhGLc7yYLSdnpx4kaVXndTfu/0, createdBy=a6962042337, createdName=1391e9f2a7m, createdTime=Mon Sep 25 06:12:50 CST 2017, time=2017-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=247438, encodeId=a83424e43863, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Mon Sep 25 06:11:02 CST 2017, time=2017-09-25, status=1, ipAttribution=)]
    2017-09-25 戒馋,懒,贪

    谢谢分享

    0

  5. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Mon Sep 25 06:11:02 CST 2017, time=2017-09-25, status=1, ipAttribution=)]
    2017-09-25 午后阳光

    感人的文章!

    0

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createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhb9xDeHojCicsdRdyC3XXdGk2ib9yLypZuHN06WeW4HO8WN0GGrgEfvnTX8gsckof05GHOU5OM4Mvx/0, createdBy=9cee1982656, createdName=执着追梦, createdTime=Mon Sep 25 06:49:52 CST 2017, time=2017-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=247442, encodeId=1f2824e44239, content=感动.真实的人生, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo61WAV0ROeLAoicPxPKoKaogwLWLL8STv86qplbdOibN2YR4KxkJicqNectCXGR8gPJhGLc7yYLSdnpx4kaVXndTfu/0, createdBy=a6962042337, createdName=1391e9f2a7m, createdTime=Mon Sep 25 06:12:50 CST 2017, time=2017-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=247438, encodeId=a83424e43863, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Mon Sep 25 06:11:02 CST 2017, time=2017-09-25, status=1, ipAttribution=)]
    2017-09-25 sunfeifeiyang

    临终关怀

    0

  7. 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    2017-09-25 yfjms

    唉.一声叹息

    0

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    2017-09-25 执着追梦

    学习.谢谢分享

    0

  9. 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    2017-09-25 1391e9f2a7m

    感动.真实的人生

    0

  10. 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    2017-09-25 changjiu

    学习了.谢谢

    0

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