现在继续讲述曾经的故事。

   

        07年11月的那次COGI会议还有一件印象极其深刻的事情——美国医生G. Granai的餐前演讲。内容绝对震撼，感受绝对深遂，回味绝对绵长（不是百龄潭威士忌的广告）。我花了4个晚上听写下来，一个字一个字，因为它太能反应这么多年来我一直在思考的部分问题，虽然答案不是绝对的，但感受却是每一位同仁能够领悟的。今天先把原版放上，过几天再放个翻译版。

Perceived for birds

 

What is the deep part of medicine? That’s also what we want to know about us today: who we are and what our roll is.

To perceive it a little further, I turn elsewhere. I turn to an artificial survey on older doctors, because older doctors have a perspective of time. Let’s see it in logical. So I want them to be asked: During the course of your careers, what brought you here and what be most taken by? Specifically I asked this: Which is more important, science or art? What they said is “it all depends”. Oh, I didn’t know what the answer is, but I believe it absolutely the truth. Do you believe in absolute truth? Do you? Do I hear “No”? Well, first of all if you believe in absolute truth, fine, we do. But if you don’t believe in absolute truth and you say “No, I don’t”, then, you know she did? you know the absolute truth. So therefore, you prove an absolute truth exists and absolute truth does exist, there must be an answer other than “It all depends”. That’s the wish you want and she is to answer, so we want the absolute truth.

So I went back and I thought the second opinion, and I said which is more important, science or art? You know what they said—“It all depends”. Wow, that’s frustrating. “You have to pick one over the other”. And they said, “If you force me to pick, science.” They said, “Think about it, when a patient comes to you with a strep throat, when they need to deliver a baby and have a cesarean section, when they underwent a seizure and you literally relieving for them by a machine, your doing surgery in all fashion-way like Dr. Moore dose with his hands, or your doing it like Dr. Nezhat does with a robot… Those are things you need, you need the technology, you need the science, you count on those doctors, and you know what they are doing, and they count you for that, right? This is wonderful knowledge; this is science; these are P values; it's evidence-based medicine; it’s what’s society counts on you for; it’s a balanced world and you are part of that.” In fact, if you did not, if we as a profession did not have an on-going analyst commitment to the best of science, what would we be? We would be fraud. Because that’s what they count on us for, they count on you for the science. You can get Lord in San-Francisco, but you can’t get the science and medicine just in any odd place. The only place you can get that science----this is the science of medicine, is from you. That’s what you do, and you do it well, and it’s great! That’s what brought you here, right? The science and the surveying through that science (humanity, of course, that’s part of it), that’s what really brought you here.

Why are doctors demoralized? Theoretically, what is demoralization? You know what I think it is? It’s this gut-visceral feeling that draggles you down. Most of us are demoralized but we even don’t know it. We count on walking through life. How do you get there? How do you lose it? It’s probably our own shades and graves. When you start you are going this way, while slowly you are moving this way near the end of here, but you even don’t realize that. How does that happen? In the process you loose your passion, your creativity and your energy… Err? Things like yesterday because it’s like all the same. You know what I think the causes of that? We slowly, slowly come off the track with our values, with what brought us in the first place. We don’t even recognize it. Surely we have to make compromises, we have to live in a real world, but those compromises bring us so far from what at the beginning we wanted to be that we become demoralized and we don’t even know it, and we lose the energy to do what we really wanted to do, and we also lose the energy of our own lives.

The question is how do we help when become demoralized? We don’t want to become that, how do we do that? Well, we need to stay on track and our values. So, how can we do that? Two ways come to mine. One is our own internal compass. You can look at your own heart, right now, a challenge. You can see it here inside in my doing the right thing from what I am supposed to be doing at this point in my life. Those are your introspective moments, your compass will tell you the answer. The other thing that I think we depend on more and more in real time----we can’t live there everyday, we can’t guess everything we do, but you know one of the things that help us to stay on track are true friends. These are the people care us enough about and tell us, “You know what? I think you’re having a bad day, you’re a little off-track…” They know when they say that to you, you can be angry with them, but they love you enough, they care enough about you and they will tell you that anyway. Who are your true friends? Are they sitting beside you right now, some of them? And that they are! We all depend on them professionally and personally.

Coming back to the question on medicine, in doing medicine, in the highest possible way for the circumstances, we have to stay on track with our values, which brings us back to the question: What brought us here in the first place? Logic, science and prose…Yeah, we were interested in science, but mostly other things brought us here, I suspect. What, for example, is the P value for sadness? What’s the P value for intimate moments? You know, in our program we have this problem called “hard to say”. If you permit me, our periphrasis is the last phrase. We are honored by those who allow us near or at those intimate moments; we are proud that despite of our own great fears, we don’t shy away, because in the end we believe in the good of what we do. How lucky for all of us to be able to believe in intrinsic goodness of the worth that we do. Most people don’t have that opportunity to truly believe what they do is good. What you do is good, you deserve that pride, and how privileged that we would be invited into people’s intimate moments. They actually ask us to come into their lives at those intimate times. How can that be? Look at us, who are we? You are asking us and come into their lives. Those are scary, though. I can tell you that we all have those fears, and I have the fears, but I want to tell you about two intimate moments in my life. In the luck it occurred on my behalf to get me out of them. How about you? Have you ever been lucky like this?

One day I was walking through the hospital’s lobby at the women & infancy, and this man I knew, whose wife just had a baby. In the United States, I suspected around the world, it’s not politically correct any more but everyone there was talking about with cigars when their wives have babies. So when I walked into the lobby, “Hey, Doc! My wife, she’s had a baby!” He tossed me a cigar. I actually got it. I got it, I put it into my pocket and walked up forth. I went to the elevator and went to the fourth floor where there are my patients----cancer patients. I walked into the first room, in it there was a woman dying of ovarian cancer. We kept her infusion, she was in pain, she was not happy. I walked into the room, she was angry with me. I didn’t say anything. “Where you’ve been, Dr. Granai? You’ve kept me waiting. I’m in pain, I’m tired. Nurses are terrible and every thing is terrible! ” Well, she didn’t have to be happy about that after all. She sat down, “You know, what are you doing? You're not taking care of me!” Then I was just kind alike nervous, I was a nervous kind guy. Having my hands in my pockets like this, and I was figging around. I didn’t know what to say, so I did like this, and I brought about. By random chance, I touched the cigar the guy had given me down stairs about one minute before. She saw the cigar in my hand and she said, “What’s that?” Oh, this is where luck comes in. I said “Oh, here! Have a cigar. I thought you would probably want a cigar. And…” She said “What? You’re an oncologist, you’re a doctor, and you’re telling me to have a cigar?” “That’s…Well, you know…” this was where I gained luck, “Well, I was thinking about that life in general, everyone should have a cigar, unless you have once or twice in your life. What would that hurt? You know…It’s fun, and the worst it can do is to make your cloth stink, you know…and you’ll pay for the dry cleaning…” You know what she did? She laughed. She ran from anger to laughter out of a silly CIGAR!! You know who also laughed----her daughter, who was in the room witnessing the whole thing. Flashing forward for about three years, and now I am in a grocery store. You know, I’m pushing up a shopping cart by myself and I hear “Doctor Granai, Doctor Granai!” You know, I don’t hear that because I have a bad memory, and I’m not committed to know who this is or if you can count on it. But I don’t want to embarrass them and I don’t want to embarrass me. So, what would I do? Or, what would you do? I kept on walking as if I didn’t hear them. So as pushing into things… No, she wouldn’t stop, she came all the way after me and got in front me, “Doctor Granai…” “Oh… Hi!” “Err… I want to thank you” I don’t know she’s the patient or she’s the patient’s family member. “I want to thank you”, so after being know under script, I am sure she saw right through me. “Oh, you… You know, you’re welcome…” “I want to thank you for what you did for my mother.” Well，now I know it not her the patient. But I don’t know her mother's being alive or dead, and how can I forget something that important, some one’s life, about the death of her mother. “Well, I’m… I’m glad, I’m happy, so…” I say. “Remember the time”, she say, “when you came into the room and offered my mother a cigar?” Of course, I remember that and I say, “Yes.” Then she say, “And you know that, Doctor Granai, we didn’t know for sure if you were serious about that, but we took your advice and we went out of the side of our lobby. And it was in January, we got the long chairs out and we put them in the snow and we tried to smoke that cigar. You know, we didn’t smoke it very well, but we laughed all. But what I want to thank you for was giving us the order, a doctor’s order to start smoking. What that really did for me, Doctor Granai, was getting me the last happy memory with my mother.” When she said that, I got phrase-stumbled. It wasn’t me, it was luck, it was a cigar. But it made simple point that we, in our privilege of being present with people, get the opportunity and make a connection for them. It’s so easy to do.

This is another patient, this is Jerry. Jerry had ovarian cancer for about eight years. We took care of her, we did surgery on her, we treated her with chemotherapy many times. So, every time we treated the cancer we would go away for a while and we come back. But sooner or later, the cancer came back and chemotherapy failed. And I happened to be at Jerry’s bedside, and, a few days before she died. We became friends in those years and I knew her entire family. And she said, “You know, Skip, I'm ready to die. I wouldn’t be eight years ago but that’s OKAY now. You know, my husband is in his sixties, and he wouldn’t be ready for that before but I have been walking through that and I think that’s OKAY. And my kids, well, they’re all grown. And I think, because of what we were able to do for their graduation and all the things I’ve seen with them, now that can be OKAY. So, I’m ready! I’m ready to die and I want to thank you for the time…” she said. “But…” she paused, and she said, “But, what about Michael?” She said, “You know, Michael he is only thirteen! And you know how boys are in that age, a little awkward. Michael and his mum, they are not getting along really well now. Sometimes Michael comes home from school, you know, where is actually by my house. He comes in and, boys don’t talk a lot, you know. But sometimes we make cookies or we just watch TV…” “Skip,” she says, “What can happen to Michael?” A few days later, I was attending Jerry’s funeral in a small town called Roland Island. She was a wonderful woman, so the whole town turned out for the funeral, and there was a reception at her house after the funeral, and I went. In the middle of all these people, with the corner of my eye, I saw the thirteen-year-old issue-boy in the corner of the room. I’ve met all of the Jerry’s family but I did not ever meet Michael. I was afraid, I didn’t really want to lock over to him, he's taken on this importance, so I didn’t dare. But somehow I thought I had to, so I walked over and I stood before him and I said, “Michael…” He looked up, he didn’t say anything but I knew it was him. I got phase-stumbled. But here is what the luck came out, “Somehow I just… So, Michael, I… I was one of your grandmother’s doctors, and she wanted me to tell you that she loves and loved you above all, and she’ll always be with you.” That’s all what I think to say.

What is the doctor’s roll anyway? You know what I’ve reluctantly come to believe----It all depends. It’s kind of like cheering. When the team is winning, you cheer for the offends, you cheer for the science; When the team is loosing, you cheer for the defends; and if you are still loosing, you cheer simply for spirit. Doctors are advocators, they are cheerers, they are advocators for the best that the moment can provide. Every moment is different. Sometimes you are cheering for the science, sometimes you are there to provide the pinnacle question. What is the pinnacle question----Did my life have meaning? They say that the question is in everyone’s mind, just prior to their dying. But no one ever expresses that, they don’t ask the question. But we know that it is there, because when we are invited into their intimate moment, we have a chance to address that question actively with them, even know that they don’t ask us. And we can help them to understand no matter what, no matter how disruptured their life might be in some ways, everyone’s life has meaning somewhere----if you can help them connect to experience, to that memory. You bring them peace like nothing else can. But being there, those intimate moments, brings us fear, and it probably should----that’s the time to remember when Jerry told me about a year before she died. There’s no such doctor, there’s no such person who can do this, we’re only people, we don’t know, in neither of us two, no one would know better what to say and what you do, because no one really knows what to say. In knowing that, you are not alone, may bring you peace in those difficult moments, because you have to be there.

We now invite you to take a series of Shanghai-morning introspective questions about what you might have reassessed your lives recently… So, where is that leave us? It’s in our personal own assessments as doctors, as people. Maybe to ask this sort of periodical questions is the best thing we can do, which could be done and ended up. Yes, could be, but is it?

Life is not a straight line. It’s anything but, as the best I can see, in most of the time we don’t know where we are going, and surely we don’t know if we will get there. How many, for example, in this room literally know what will happen to you in the next fifteen minutes? That’s scary, and of uncertainty. The things that asked of you and you don’t have the answers----that’s scary. But you can count on people who, despite that fear, go forward on behalf of the others----that’s amazing! Think for a minute, in the goodness of the work you do. What’s the number that you have touched by the work you do (touched in a positive way)? My guess is there is not a number on this slide that comes close to the answer. Think about it, by caring for one patient and that patient has children, and their children have children, and all the lived that touched by every one in that adequation; By teaching one student, and all the lives they touch; By a book, an article or a paper, a research project, something you do that is read all over the world and affects behavior; By being kind to a child… as a DOCTOR, or for that matter, just an every-day person. What links us together, as doctors and nurses, as people? What links us together from one generation to the next? A couple of things for sure: knowledge and the transfer of wisdom. Knowledge leads to reevaluation. You can compare that knowledge to what you want to stop, and change to where you need to progress. Think of what knowledge brought us——wonderful things: nothing should be off the table and reevaluation, NOTHING!!! We should always be willing to look at and compare the current knowledge to see if it is still real. Because reevaluation can lead to change and that can lead the progress. Of course it can and in a lot it does, but the question is: dos it always? Just because there is a new fact or new something, should we change who we are around that fact? The truth is, as the best I can see, that P values will bring us and science will bring us to someplace and there is no answer after that point. How do you perceive that? For the best part of our people like you, as you perceive on behalf of others, despite the personal fear you go forward and give service to others, knowing that you may not do perfectly but you’re trying your hardest——and that’s the best of HUMAN SPIRIT, and that’s what we want to SALUTE.

In this closing segment, we’d like to SALUTE YOU! We’d like to salute you with a...poem, if you will. It is titled: PERCEIVED FOR BIRDS. It’s really not a poem, you know. It’s a TOAST…to YOU!

Could it be that: down is up, wrong is right, dark is not night…（这首诗录到这里就开始断断续续，实在没本事听写下来，3分钟后诗念完，这个演讲也在爆发的掌声中结束）

1．南京路锦江之星

伯爵上将：我还剩下一些零食，分一些给今天去崂山的人吧。

小臧臧：我们就把部分行李寄存在总台，下午回来拿。

味觉：我们回来后，下午和你们在台东路附近的美达尔餐厅回合吃饭，谁先到谁就抢桌子吧。

伯爵上将：我们怎么去呢？先去天主教堂，再去基督教堂，然后是信号山……

2．去圣埃米尔教堂的出租车上

司机：TMD，塞车成了这个样子……

司机（很不耐烦）：NND，真TMD的不畅！

3．圣埃米尔教堂

伯爵上将：这么多人在拍婚纱照。

小租租：还有韩国人。

伯爵上将：现在这里不开放呀，门口说里面在安装管风琴。

小租租：好可惜，真的很想进去看看。那就帮我在大门口拍一张吧。

4．去基督教堂的路上

伯爵上将：就走路去吧，不远。我很会看地图的哦！

小租租：那个房子好大，是干啥的？

伯爵上将：人大和政协的楼。拍一张吧。

（小租租一路拍录相）

伯爵上将：回去以后给我一些看看。

小租租：好，这次是录进SD卡的，直接就是MPEG4，用风暴影音就可以放。

（小租租一面拍一面过马路）

伯爵上将：当心被撞，撞了我一个人可救不了，扔你在马路上……

5．基督教堂

伯爵上将：看，门票还是明信片。收藏起来。

小租租：大堂里好安静。上面写道：主已复活。

伯爵上将：去钟楼看看。从这里可以看到下面。

小租租：从花园拍教堂南面，这里可以看到信号山。夷，对面两个人也是上海人呀。

6．信号山

伯爵上将：从这个喷水池可以看到基督教堂的顶，帮我这里拍一张。

小租租：山顶的回廊里有很多信号介绍。从山顶可以看到电视塔。

伯爵上将：再去旋转观测台看看。

小租租：这里人好多，像个会转的小食堂，还有股食堂的油味道。

伯爵上将：我觉得头晕，我们下去吧。

小租租：夷，下山的路上又遇到了昨天那个崂山上的烧香客，今天还穿着那灯笼裤，还背着那个有五个点的怪包，只是鞋子换成了凉鞋子。

伯爵上将：是伐？要不要上去认识一下，就说：“唉，你似不似昨天在崂三搔香？”

7．总督府花园门口

伯爵上将：这是学生证……

卖门票的人：厄，怎么是01年入学的？

伯爵上将：我们是读七年的，这个是05年还注册过的……

小租租：我们是本科和研究生联读的……（才发现说错话了）

卖门票的人：既然是研究生阶段了，那就不能用了。

伯爵上将：恶，这次你真的说错话了，只好付全额门票了。

8．总督府

伯爵上将：上面说里面不准拍照和摄像。

小租租（看了一下里面一群在拍照的人）：他们既然能，那我们也可以，我还要全程录相。

小租租：这里有总督以前用过的枪橱，里面的两支枪是毛瑟98K吗？

伯爵上将：趁现在人少，我们快点拍照。这地方人少拍照效果最好。

伯爵上将：看那室内花园，以后我要是也有一个就好了。

9．总督府后花园

小租租：回廊修一下就好了。

伯爵上将：这样更有沧桑感。这地方比那房子里面更好看。爬上这个土坡，我们拍些照片。

10．总督府外面的小路

伯爵上将：这里真是太棒了，比思南路还要幽静。

小租租：周围的房子也是以前正宗由德国人造的。只是后来的人维护不利，远看没啥，近看屋檐的木头有些已经烂了。

伯爵上将：我们就不打的了吧，坐一下青岛的公交车。

小租租（接到了小臧臧的电话）：啊？你们在樱桃园吃樱桃？帮我们带，好呀好呀，谢谢！

11．公交车上

小租租：不是空调车吗？票价只要1元？

伯爵上将：是位子太小了，还是我们带的包太大了？

12．炮台山

伯爵上将：再用学生证吧，可别讲豁边了哦……

卖门票的人：这里大学学生证不能用……

伯爵上将：德国人的指挥部在山上。

（爬了十几分钟，总算到了）

小租租：这个指挥部里面好阴凉！门口还有两个德国兵雕像，当中有鹰形标志。

（小租租一路拍录相）

伯爵上将：怎么连厕所也要拍？

小租租：啥都要拍下，哈哈！

小租租：冷死了，我要穿外套了。

伯爵上将：上来呀，这里有个好玩的旋转窥视台。

小租租：总觉得这些观察孔应该放上机关枪……

伯爵上将：转呀转呀，据说从这里可以看到海边……夷，外面有一男一女搂抱在一起。恩，还是不要再转了。

小租租：这个东西转的时候声音好响，不知道人家听见了没？

13．去台东路的路上

伯爵上将：像喝点咖啡，哪里有呢？我们一面走一面找吧。最好是连锁咖啡店之类的。

小租租：啊呀！！（被马路上的水泥桩绊倒了，身体右侧先落地）为啥路上全是水泥桩？还好照相机和DV都在腰包左边，没事。

伯爵上将：还是不要去电视塔了。

14．青岛的步行街

伯爵上将：看呀，好多好多人。很像上海南京路的那个步行街呀。

小租租：今天是礼拜六。人太多了，感觉更像七浦路。

伯爵上将：看那个骨科医院，居然建在一排商店上面，规模还不小呢！拍下来给叔叔看看。

小租租：这里没有星巴克了。我们去必胜客吧，下午茶里面也有咖啡。

15．必胜客

女招待：要什么？（递上了菜单）

小租租：两份下午茶，A套的。我要冰的清咖。

伯爵上将：我要××××（又忘了他点了什么，是个加奶加糖的咖啡）

伯爵上将：服务态度明显不如昨天的星巴克嘛。

小租租：我还要续杯，再来一些咖啡。

16．美达尔餐厅

小租租：我们就要里面的位子吧，我不喜欢露天吃晚饭。

伯爵上将：我们就等他们回来了。

（等了一个多小时，中间睡着了十分钟不到，另外四位同志总算来了）

味觉：我和张羽萍点菜去。

小臧臧：这是给你们的樱桃，二十二块一箱。我们在樱桃园吃了个饱。

小租租：恩，还真甜呢！

（开始吃饭）

小租租：恶，左侧扁桃体被虾虎煎包的硬底划伤了……

17．去机场的路上

司机：………………（讲了好多爱国的豪言）

小租租（坐在司机旁边）：厄，对啊对啊……师傅您真是个爱国的人！

司机：那当然。这次地震也让老外知道了，我们国家的80后还是很团结的！

小租租心想：看上去是这样的……但愿我们真的是这样的……

伯爵上将：机场快到了。流亭机场，流亭流亭……

小租租：人们常问：“这个流婷 / 敏婷 / 疏婷是怎么吃的？”，我们只好回答：“对不起，这个药叫毓婷（紧急避孕药）”。

18．流亭机场

小租租：夷，又看见那个灯笼裤烧香客了。原来他们一帮是四个人。太有缘了。

伯爵上将：你看呀，那个灯笼裤开始打牌了。

19．飞机上

灯笼裤烧香客：哦，这里是我的位子吧……

小租租：夷，又是这个人。小花：实在是太有缘了，应该要名片哦。

1．去崂山的面包车上

临时导游：欢迎大家来青岛……………………（一大串废话）

小租租心想：这么个喋喋不休的讲话机器……拜托你停一下好不好？

司机：这路怎么开呀？这边？

临时导游：是那边。不好意思，这司机也是刚来，不太认路，没我指路他要开错的。

临时导游：那边就是石老人海滩了，我们现在先去一个傍边的刀具厂参观，这个是一定要去的，不用你们花钱，去就行。

味觉和叶丽静：我们不去，为什么擅自安排我们的行程？

临时导游：不用你们花任何费用，只要大家进去一下就行。要不下午再去？

小臧臧：我们还是先去崂山吧，下午再说。

小租租心想：这下完了，是不是要经历报纸上豆腐干文章里头的故事？

2．崂山

小花：那个水库，能上去拍照就好了。

小臧臧：好像是上不去的，入口锁了。

小租租：看呀，我正在拍一个人，她从水库顶上走来……然后就直接跨过了被锁上的小铁门。

3．崂山半途的一个道观（名字忘了）

张羽萍：大家一起在这门口拍照吧。

伯爵上将：我是个虔诚的信徒，还是给你们拍吧。

味觉：看，路边有草莓一样的野果！

小租租：拿来吃吃看，恶，没味道，不吃了。

味觉：那这个绿色的果子如何呢？呸，是酸的……

4．崂山近明霞洞的露天小店

小臧臧：大家休息一下，来点冰的东西？

小租租：我要吃山楂，啊这个冰工厂不错呀。

味觉：累死了，问问那边下来的人，还有多远？上面好玩吗？

下来的人：四百级台阶。不太好玩。

伯爵上将：我们下去还是上去？

小臧臧：还是去看看吧，四百级不算多。

5．崂山明霞洞

解说员：……………………（介绍这个洞的由来）那瞎眼和尚从此转当道士，名紫阳真人，在此修行，大做善事，最后眼睛复明了，皇帝封其为护国天师。

小租租心想：那岂不是说佛祖不如太上老君灵验？

解说员：现在我们进到紫阳真人曾经修行打坐的石床上看看，那边的游客，进去以后请不要摄像。

小租租：哦，好好，不拍了不拍了。

解说员：……………………（介绍这个石床）紫阳真人的这个石床，后来的邱楚佶和张三丰也来此修行，也在这个石床上修炼。

叶丽静：真有这两个人吗？

小租租：道士也喜欢去各地进修啊，那这地方还是三级甲等道观哦，武当山就只是二级甲等了。

小租租：看外面的那个道士，穿着旅游鞋，还在打手机，耳朵上有洞。（然后一眼撇见一个烧香客，穿着灯笼裤，背包上有五个圆点，好滑稽的人）

6．再次来到崂山近明霞洞的露天小店

小臧臧：再吃点冷饮吧。

伯爵上将：这次我也要吃山楂。

小租租：我就吃黄桃冰片吧。阿亚，嘴唇被冰冻住了，撤下一小块皮。

小花：索道开放吗？我走不动了。夷，有个穿灯笼裤的人下来了，去索道方向了，等人家回来后问一下。

小租租：夷，又是那个灯笼裤烧香客。（过了好一会儿）灯笼裤怎么还没回来？

伯爵上将：人家在坡下的小店吃饭……

7．崂山附近的海滩边的饭店

味觉：我们点了海肠，就是那种一条的红色的，一刀砍下去还有血会出来的……

小租租：这个就是海肠呀，似乎炒过以后缩水很多哦。

伯爵上将：虾酱蒸蛋，闻上去好腥气。

小臧臧：我尝尝，恶，好咸！！！

小租租：不会吧，我也来试试，恶，不是一点点咸！！！

8．崂山附近的海滩

小租租：我还是不下水……这水，我跟你们说，真的很冷的！！！

味觉：那我们就去了，你帮我们看鞋看包。

小租租：靠！把所有的包都挂我脖子上了，我成了卖包的了！

小租租：夷，海滩上有人骑马，还有人开沙滩车……这马是什么种的？

海滩骑手：蒙古马。

味觉：替我保管一小会儿，这是海带。

临时导游：这海带是可以吃的。

味觉：恩，那就吃了。味道不错呀，你们要吗？

9．石老人海滩旁边的刀具厂

临时导游：大家就去一下吧，算是给了面子。

小臧臧：那就去吧。

刀具厂解说员：我们的刀……………………（讲了好多如何锋利的介绍），砍钢管都不会卷刃。你们谁要上来试试？

大家都走了，一言不发。

10．石老人海滩旁的某海鲜店

临时导游：大家再去一下这里，进去再出来就行，不必买任何东西。

味觉：我们不去。

伯爵上将：我们还是去一下吧。

（小租租和伯爵上将去了，又回来了）

小臧臧：下面请一定带我们去石老人海滩，别去其它地方了

11．石老人海滩

伯爵上将：这里的沙滩有脚印了，不止鞋印。

12．啤酒街的老馋鬼餐厅

小租租：旁边的好像是韩国人。讲话真难听，还是日本人讲话好听一点。

小花：看，有乐队可以点唱。那个打节奏的人表现high极了！

叶丽静：韩国人点了四首歌，我们也免费听了四支曲子。

13．家乐福

小租租：这次只有我们两个了，还是帮大家把明天喝的给准备好吧。

伯爵上将：我也买点海货带回去，扔到科室的上让人家自己来吃。

小租租：有崂山矿泉水，试一下，没什么特别的味道。

14．家乐福对面的星巴克

伯爵上将：我要××××（忘了他点了什么了）

女招待：这个是我们的新品，****（也忘了具体名字，因为除了清咖我其它的很少喝），怎么样？

伯爵上将：好的。

小租租：我要美国咖啡，有冰的吗？

男招待：有，Ice Americano，怎样？

小租租：好，就这个吧。

（开始站在吧台前等待）

女招待：你们不像这里的人，香港来的？

伯爵上将：上海来的。

女招待：您点的咖啡来了，请就座。

（伯爵上将找了个座位坐下，小租租继续等，等了很长时间）

女招待：你们觉得青岛怎样？

小租租：蛮好玩的，就是这个天气还不能游泳。听说这里房价也不低。

男招待：是呀是呀，这里是二类城市的收入，一类城市的消费。

（小租租站不动了，先坐了过去）

女招待：不好意思，让您久等，给您送来这咖啡。

小租租：你们的服务态度真好。头一次在星巴克享受到服务员送咖啡上桌，上海的星巴克只有推广新产品的时候才有试尝样品送上来。

（喝完咖啡要走了）

女招待：谢谢光顾，请您走好，希望在青岛玩得开心!

伯爵上将：服务态度好得一塌糊涂。你不觉得这女的长得有点像超人？

15．南京路锦江之星

小租租：今天累死了。

伯爵上将：我们步行了11Km多。明天他们还要去崂山北面。

小租租：没力气了。

伯爵上将：那我们两个去老城区兜吧。

小租租：好呀好呀，我要去天主教堂。

伯爵上将：恩，我要去炮台山和总督府。

2008年5月末和几位同学一起去青岛小玩了一次，算是大家对完成论文答辩的自我奖赏。

 

第一天：

1．闽江街

小臧臧：所有的房子窗都朝南，所以这就是南面，所以我们就从那里走。

2．云宵路

味觉：这里的菜都很淡……只有蛤蜊是有点味道的。

小臧臧：点了馒头，真的像人的头一样大。来，大家切片吃了吧。

伯爵上将：虾虎，看上去很像喇蛄呀。什么，哪个喇？喇端端的“喇”呀。

小租租：这洗手的水，看着像茶水，还有茶叶一样的东西……

叶丽静：点了饺子，40元一盆，一共40个。

味觉：看那边的青岛人，长得没济南人好看……

3．五四广场

叶丽静：那个火炬，像假的一样……

伯爵上将：今天天气不好，像是有沙尘暴，海水不够蓝。

4．栈桥

小租租：似乎出租车都要多收一块钱，是不是燃油费啥的？

小贩：来呀来呀，你们几个一起租个船，畅游栈桥一圈啦！……啥，你们要包车呀，我们也有的，这边这边……

小租租：栈桥两边的海滩上有人，但水里没有游泳的。

伯爵上将：这个地方没啥好拍的，还有垃圾桶……我们去海军博物馆吗？

小臧臧：那男同志和女同志们就分开吧，我们去海军博物馆，你们去海底世界。

小租租：上个厕所1元钱，看门的塞给我一包餐巾纸，似乎等于1元钱买餐巾纸以后再免费如厕。

4．海军博物馆

小臧臧：为什么呀……学生证放在另一个包里了，啊，你们都能半价……

伯爵上将：这个地方像个坟场，东西堆放杂乱。

小臧臧：这个是中国古代的炮。这门比较大，叫大炮；那门比较小，叫小炮；抄榴应该用小炮。

小租租：这船所有的门都不开，唯一看得到里面的铁栏杆门里头有人在晒裤子。

伯爵上将：为什么大炮都长得一个样子？

小臧臧：这些船早该退役了……居然还用到1992年。

小租租：噢，上舷梯咯，抄起MP40……

小臧臧：这个是舰长坐的观测位子吗？怎么啥都看不见？是不是舰长都很高呢？

伯爵上将：潜艇不是来享受的，这地方呆上一个礼拜人准疯掉。

5．小青岛公园

伯爵上将：那里有四只不怕人的猫猫。

6．八大关/第二海水浴场

伯爵上将：这里太漂亮了，人生的终极梦想末过于有一幢在这里的房子，可以随时去海里游泳。

小租租：公主楼在哪里呢？我们都转了两圈了。

小臧臧：我问过了，那家肾病医院就是公主楼。

伯爵上将：校长故居……

小臧臧：海水好冷！

小租租：沙滩上只有鞋印，没有脚印，这时候不能游泳呀……后面是校长故居，让那两个人帮我们拍张照。

伯爵上将：人家好像是韩国人耶，嘴里的话听不懂。

7．第一海水浴场

味觉：这些东西说是烤的，怎么都像是微波炉里头转出来的？老板，我们强烈要求把这些放在炉子上烤一下，否则不是烧烤！

小花：这烤鱿鱼的味道好怪呀！

小租租：还是隔壁那家的味道做得好。要不我们两家的菜一起吃？

伯爵上将：吃来吃去，还是烤鸡翅的味道比较能接受。

叶丽静：老板，结帐……325？就给你300，不二价，我们走！

老板：这……这个……

8．家乐福

张羽萍：这个蛤蜊干好合算呀，打半折！

小租租：这些能免费品尝吗？

味觉：当然可以的咯，吃个这个咋样？恩，味道不错。

小租租：这个是干贝哦，标价……320/Kg，我们几个已经吃了四粒了。

小租租：不仅有崂山矿泉水，居然还有崂山可乐……

味觉：这包紫菜闻起来真香！可以把它放在枕头下面。

9．南京路锦江之星旅店

伯爵上将：啥？你们海货都买啦？我明天也要去。

伯爵上将：为啥电视节目都看不了？

    因为所有人手都顺利集齐，我们就准备在8～11号全程参加APCOC和COGI会议。之前先去花旗银行大厦的拜耳先灵医药办事处开了个小会，负责APCOC会务的公司派了项目经理和大家讲了志愿者值班安排的事情，我是10号上午，剩下的时间就可以自由参会。

开会的内容很不错，而且有同传。正好借这个同传耳机可以把演讲内容录音。整个会议给我的感觉就是：国外的医生很多都能说会道，可以当场把专业和情感发挥得恰到好处，虽然偶尔有些人表演得作做了些，但更多的人可以用几句话感染场下的人。在此之前国内的会议也参加不少，有些还是国内顶级的，但演讲内容和在学校里上大课无异，大多数让人听了想睡觉，或内容没有变化，往往是今年讲这个，明年也讲这个。大家做医生时间长了虽然都会在情感接受度方面强国一般的人，但有时很有必要把注意力从技术和学术上移开一下。人和人的有效交流可以创造出意想不到的效果，这虽然有点投机，但在很多情况下一个技术学术一般但嘴巴能说的医生的确笔一个不太爱多说却很有本事的同行更能安全行医。人文修养的欠缺，我到这时方在有所感悟。其实人文修养提高了，你的学术表达能力自然就会更吸引人，写文章的技巧也会增强，而随着临床工作进展的顺利，技术上的提高就是时间问题了。

这次两个会开下来，不仅见识了什么是国际会议，拗到了和郎景和等国内牛皮大老级人物的合影，还意外结识了中国妇产科网的朋友们。这个网最早由北京协和医院的龚晓明医生创办，近几年不断有全国各地的中、青年妇产科医生凭自己在网络、联络等方面的特长以管理员的身份加入网站建设，网站的影响力不断扩大（一年以前就看到过有值班医生为了从那网上下载专业电子书而拼命发帖赚积分）。一开始是管理员李慧琳医生在会间休息的时候叫住我的，随即就和版主龚晓明等医生们认识了。当天还认识了作为网站上海地区联络人的张蕾，是来自红房子医院的。当天就和各位同志们一起吃了个饭，谈了很多，大家都觉得很有必要通过这个网站来进一步提高广大妇产科医师的素质，不仅是技术和学术的，更有人文的。能够加入这么个团队，我感到很荣幸。

    本来还是应该在门诊和峥嵘医生一起的，但因为计划生育病房缺人，他们直接通过科教科把我拉去凑数。那里的主任是长征来的军医方爱华，副主任陈勤芳，主治医是去年从香港进修回来的史宏，进修医是周晨，住院总是奚吉，住院医是朱爱琳，还有一个从B超室过来轮转的俞惠医生。这里人手看上去不少，但要分成两个组来做事，所以少一个就会在排班等问题上造成很多麻烦。

刚去的时候有点不适应节奏。那地方查房完了以后就先收一日病房的病人，然后下去开刀，再回来收一般的住院病人。开刀主要是吸宫、刮宫、羊膜腔内注射、抽羊水等，偶尔也会有个腔镜或开腹切子宫啥的，但仅仅是偶尔。这里除了羊膜腔注射，其它都不可能让你做，下去开刀唯一的工作就是登记，纯粹秘书的活儿。不过这也好，除了在人家肚子上打打针，我把登记的事情做好了就在一旁看俞惠或方主任搭的B超，也可以选择留在病房专门收病人。我更喜欢后面的那种，因为只要活儿干完了你就可以去休息室睡到吃中饭，吃了饭以后可以再睡。到了下午很有可能不再有病人，把第二天的术前谈话、出院小结等做好了，大家就可以坐在桌子上茄三壶。

这个月的值班问题又出了一件让大家不爽的小事。真的是件小事——值班的手机坏了。送去修的时候供应商说是因为进水而损毁，不负责保修，而支付维修费的钱不如买个新的。但为了买个新的，某上层领导不愿意出这笔钱。于是我们就被叫去医务科开会，科长先让大家自己招供出哪个人把手机弄进水的，未果；于是就决定按人数分摊新手机的费用。这个手机一直就断断续续地有问题，可能不是直接进水造成的，天热的时候放在衣服口袋里，水汽也可能渗进去。但不论怎么说，不先去追究设备科，而又向临床的人发难。虽然这么个手机没几钱，但大家还是觉得这么做实在小家子气，起码在上海没有其它医院会因同样的问题作出这样的处理。

    从现在起可以暂别住院科室了，到了门诊以后人一下子觉得时间宽裕了。每天可以八点上班，中午肯定有两个小时的休息，下午可以三点半就下班。门诊负责带我的是主治医张峥嵘（女的），一个心肠很好的人。因为她也看性病门诊，所以和她一起坐堂，除了一般的妇科门诊疾病，性病诊治方面也长进不少，当然，比起老军医来还是差远啦……

这个月见了几个前厅大腺脓肿的，切开后真是很臭很臭的，液体颜色褐绿，有时脓肿内张力过高，切开的时候必须小心，免得被臭水溅到。也看到了正宗的晚期宫颈癌，而且的外生型的，那菜花都溃烂出血了，眼睛一看到这个，剩下的病理也仅仅是仪式了，为了证据而做的检查。

性病门诊里面“好东西”比较多。由于病人是预约的，要是人数少，我就自己拿出一本皮肤病图谱来个“高级扫盲”。来看病的多是年纪很轻的人，有些是男女同来的，隔壁就是个男性科诊室。有意思的是，大多数梅毒病人都是警察陪来的，而警察自己也会到隔壁去看病……视觉上最具冲击力的非大面积HPV感染莫属，那疣状物为实壮观，只能先用药再等缩小点了再去打激光灭了。

这个月老板要我们抽出几个人去下月在浦东开的APCOC年会当志愿者，回报是可以免费全程参加APCOC年会以及接下来的COGI会议。后来国妇婴这边的人手准备好了，老板给了我一个全体志愿者名单，有红房子、市一、仁济的，再一看最后一个瑞金的，居然是以前在新华的时候为大家管账的大头同志！真实好巧呀。

    这个月沈虹要准备去香港Queen Mary’s 医院进修的事情，因为有很多文件和申请书要我帮着写，因此就让我稍微少去做些跟刀的苦活儿，病房里的病人我们也尽量延长周期以减轻劳动量，所以在妇科的最后一个月是比较轻松的。

由于邱叔叔还没从上个月连续的切口开裂意外中恢复过来，因此和他上台还是什么机会都没有，唯一能够表现一下的就是缝皮的时候你来打结。到了离开科室的前一天，他开完刀突然想起我就要离开了，便让我来缝皮，想到以前邱叔叔连自己缝的皮也要因为看上去不整齐而拆了重来，我还是识相地主动要求继续打结。反正研究生阶段在妇科的操作也就只能到这个水平，我也就不强求了，开刀以后要开几十年，还是为今后保留点兴趣，免得做太多过早倒胃口。实在中午觉得无聊了，就拿出丝线在办公室的桌子靠背上面打双手结玩儿，很多地方就留下了小辫子。

新的宿舍已经可以用了，只是里面的新家具气味还是很重，为避免造血细胞突变，我尽量每天回家或在休息室睡。忽然发现，医院住院部里面外网速度最快的是十一和十楼，九楼居次，六楼第三，而七楼就比较慢，八楼的好像是坏了速度简直和电话拨号一样。因为暂时没有啥写文章的事情了，这个月下了班除了看点书，自己就去幻想游戏搜了一下，发现了两个比较有意思的飞行射击游戏。一个是太平洋英雄II，开美国人的飞机从航母上出发去炸日本人的军舰，还是很有真实感的，但自己的飞机好像太经打了一点，埃了几十枪还像没事一样。另一个是红色王牌中队，开一战的老爷飞机，可以用协约国也可以用同盟国，虽然画面有点动漫的感觉，但真实度很高，有些特别的任务就算是超级王牌（比如德国红男爵或是英国哈滋爵士）要是被敌机从正面击中也有可能发动机爆炸，而一般的飞机如果是侦察型的那顶多只能埃七、八枪，战斗机则稍微耐打一些，但被防空炮打中还是要完蛋的。这个游戏的难度很大，一开始操纵飞机相当困难，老爷飞机惯性特别大，而且没有辅助准星，完全自己靠感觉瞄准。不过有难度就是有意思，到现在这个游戏我还没有删。

到这个月为止，妇科和产科的临床轮转就完全结束了，所有可学的技能也掌握了绝大多数。后面的轮转科室就轻松多了，而且由于下一届的研究生已经到临床了，我们把接听生殖热线这个让人不舒服的活儿给踢掉了——虽然值一次这个班的酬金是普通值班的五倍，但我实在不愿意半夜因为这种无聊的“男女问题”而受到骚扰。

插入一个小内容：郎景和在第二届中国医师协会妇产科分会年会上作的“中国妇产科医师现状调查”录音