Sunday, 11 October 2020

人間依舊笑春風

 

人間依舊笑春風 --- 王春波醫生

期數: 
 2015年06月號
醫生: 
 王春波醫生

撰文:  陳秀清

 

Some people are old at 18 and some are young at 90...time is a concept that human created.
有些人18歲已經老了,有些人90歲還很年輕。時間只是人類創造的一個概念。    
日裔美籍藝術家及音樂家
小野洋子


一個簡單數字,足以讓生命殞落,也能令人谷底重生,就看局中人如何解讀。

飯局裡,一名藥廠銷售經理自豪地說:「醫生,我很有大志,打算讀25年書,連Master也讀了,然後拼命工作25年,然後便享受25年。75年的人生,我已經鋪排好了!」

閱老人無數的王春波醫生聽罷嗤之以鼻,回應:「你神經病!你知不知道很多人49歲便中風、心臟病死了?還享受甚麼?就算你不是49歲中風癱瘓,到50歲時突然不用工作,慘了,你才發覺因為50年來都沒玩過,你根本就不懂得玩,也沒體力玩,沒心去玩,沒嗜好去玩,你坐在那裡做甚麼呢?你根本不知道甚麼叫玩!」

「那做5天,玩兩天,準對了吧!還是做8小時,玩8小時,睡8小時?」經理疑惑。

「不是!是邊做邊玩,寓工作於娛樂!俞琤有句名言:『有甚麼好過人家給你十多萬回公司玩?』對嗎?所以我覺得你不要想著退休才玩,趁年輕吧!」今年60歲,剛從公營醫療退休,現於私營老人科診所執業,閒時最愛賽帆船、跑山、行毅行者、跑馬拉松,連工作也帶著玩樂心情的王醫生笑說。

眉宇間,讓人看不清那早就模糊的年齡界線。

 

「做人,當然是,邊做,邊玩!就算上班你也要覺得是享受!」不為年齡定界限,愈年長,愈好動,體能要求再高的,都是他心頭好。王醫生說,只因投身老人科34年,從長者身上,他看到,也學懂太多。
曾有一位男長者病人,某天好做不做,竟伸手摸護士屁股。

王醫生:「伯伯,你為何這樣頑皮?」

伯伯:「我喜歡呀!」

不值所為,王醫生開口教訓:「你這樣不行,會拉你坐監的。」

伯伯:「坐就坐吧,我都八、九十歲了,能坐多久?」


生命短暫  還等甚麼?

王醫生回憶:「那刻,我當然覺得他真是太過分!但是,很多這些例子,讓我想到,原來我們做人,有時該做自己喜歡、想做的事,尤其當發現生命短暫,人生那樣寶貴,還等甚麼呢?」

不少朋友試圖干預:「你這樣不行,你太過任性!」王醫生總不慍不火回應:「對不起!以我的個性,不會作奸犯科,殺人放火,當然也不會摸護士屁股,那為何不去做自己喜歡做的事?」

彷彿換了個角度,倒數的生命就沒有終站,連暮氣沉沉的老人病房,也可以是樂園。

一次巡房,剛好遇見一位中風入院的75歲老伯,獨臥床上,容顏憔悴。他曾是公司大老闆,當時得令,但中風過後,鬥志全失,完全不肯做運動,連物理治療師碰上他,也只能舉手投降。剛好經過的王醫生便走近他身旁,簡單說了幾句:「伯伯,看你情況不是如此差,CT Scan看到腦部受傷範圍不算大,雖然中風的區域剛好就癱瘓了手腳的活動能力,但你的思考和策劃能力應沒問題,我看你是可以重新走路的,起碼有七成以上機會出院,一定要加把勁!」

老伯突然眼前一亮,任務完成的王醫生早已走遠。一星期後再度巡房,剛想離開時,護士卻趕上,說:「醫生先別走,有個病人一定要見你。」然後引領王醫生到該病人床前。只見病人拿著四腳助行器,很辛苦地撐起身體,真的走了幾步給他看。「他說一定要走給你看!」護士在旁補充。王醫生一看,終於喚起回憶:「真是感動了!原來他就是上星期那位中風病人。」


復元路上  勿忘自己

鼓勵病人那刻,王醫生當然心中有數。「坦白說,以我的經驗,如果中風頭兩天都沒死,基本上七成也可以重新走路,只差用甚麼工具來走,這是Common sense吧!我只是講出事實,病人勝算是高的。既然有七成機會贏,為何不告訴他?」

潛台詞是:醫療技術再進步,復元路上,病人也別忘了自己。「不是血管能不能通,血塊能不能溶解那樣簡單,你心態不同,後果也不一樣。你是有正能量的,不是情緒低落的,結果可以有很大分別。」

還有一個患末期慢性支氣管炎的老伯,帶著隨身氧氣罩來找王醫生,絕望地說:「我看了很多醫生,都說我沒得救,其中一個更說我只有六個月命。」看罷所有報告,檢查過後,王醫生笑說:「不是吧!你又不是患癌,為何判你6個月命?你又沒有肺炎,以你這種習慣缺氧的狀態,就算用枕頭壓著你,也很難令你窒息,照我看,你起碼有3年命。」

病人真的相信,結果往後每3個月,便會到律敦治醫院找王醫生覆診。「其他日子,他從來不出門,但覆診前一晚,他必然睡不著,第二天也一定早起,換好西裝,租了部小型貨車,帶備製氧機,便直抵醫院。」
除了定期跟進病情,王醫生當然還安排物理治療師及職業治療師教他做「節能」運動,指導他如何換氣、慢行。「還有事情可做的嘛,那就不要放棄!」最終病人也活了兩年零九個月,才撒手塵寰。


分分秒秒  在走鋼線

撒下希望種子,挽回自我放棄的生命,看似輕易。有所不知,王醫生其實分分秒秒也在走鋼線。

十多年前,`一個85歲伯伯由女兒帶來求診,表徵是最近經常手震,懷疑患上柏金遜症。

「我幫他檢查,確定不是柏金遜症,正想說出喜訊,順手拿了伯伯的肺片一看,嚇死!肺中間有個像杯那麼大的腫瘤,但病人卻一聲咳嗽也沒有。」王醫生故作輕鬆地說:「伯伯,你吸煙太多,吸壞肺了。但不要緊,你先出去坐坐,我開藥給你。」待診症室只剩女兒一人,才坦白交代實情。

「看到肺片上的陰影嗎?那個九成九是腫瘤。他手震就是因為腫瘤已開始侵蝕身體,影響機能。」女兒大驚,說:「醫生,你一定不能告訴他。你知不知道我爸爸很怕死,是怕得驚人。」


逃避現實  足不出戶

原來,他父親永遠不去殯儀館。平常只要一看到所住的唐樓,有任何一戶掛了白燈籠,那個月他就足不出戶。「所以如果你說了(他患癌),他隨時會跳樓死。」女兒道出真相。王醫生解釋:「但我是有責任講的。」

女兒請求他說得有技巧些,並問目前自己有何可做,王醫生也不再繞圈:「他到了這個年紀,腫瘤那麼大,一割便會死。雖然癌症未必擴散了,但病情也不樂觀。你唯一可做的是給他好吃的,帶他去享受,天天陪他,別又想著看中醫針灸推拿氣功,又腫瘤科化療電療,這只會令他更辛苦。」隨後,王醫生再把伯伯叫進來,說:「吸煙令你的肺『花』了,發炎也頗嚴重,所以不單服藥,還要看看哪裡發炎,然後處理。」也就安排他去做電腦掃描。結果一如所料,是肺癌四期。

女兒亦不敢怠慢,短短半年已帶他去了三次旅行,伯伯開心得每次覆診,都讚她孝順。但半年後一次回來覆診,他卻大罵王醫生:「你甚麼醫生來的,我看了你半年,吃藥後一次比一次差,愈來愈氣促,愈來愈腳腫,愈來愈手震。」王醫生建議再照一照肺,看看出了甚麼問題,一照便發現肺積水,便跟病人解釋:「你肺的問題真的比較差,現在有些積水,我建議你入院放水,不然只會一直氣促。」與此同時,他亦跟胸肺科醫生商討,最終得出要向患者言明病情的結論。


瀕臨絕望  靜待死亡

兩位醫生坐下來,跟病人談了兩個小時,解釋了很多,但對方只問一個問題:「你不用說那麼多,只要告訴我:『我是不是沒得醫?』」

「不是。我們有很多藥物可以舒緩、控制……」王醫生答得肯定。

病人瀕臨絕望:「不用說了,我知道是沒得醫的了,你們走吧!」然後要求出院。

當天下午2點出院,不足24小時,他翌日早上10點又再入院,而且整個人陷入半昏迷。「問她女兒發生何事,女兒說:『我也不知道。只知他昨天回到家,不吃東西,不喝水,就在那裡定神坐著,問他做甚麼?他說在那裡等死,很怕自己死了也不知道……』」結果他就真的2天後,便離開人世。

是赤裸裸的壞消息,觸發他內心潛藏的恐懼,令他更快自我放棄?假如將秘密留守到生命最後一刻,結局可會改寫?

「做醫生,我其實是在踩線。醫學上,有事不能不告訴病人,隱瞞病情是種欺騙,是違法的,會害了病人,我也會被控告。萬一我不說,病人突然死了,才發現他床底下藏了幾千萬,或者他在外面原來有幾頭家,地契又不知道放了在哪裡,引發家人爭產,那就大事情了!我的責任不應該是隱瞞所有。當然你問我,我也覺得伯伯其實應該是知道的,他第二、三次覆診,看我一直在看那張肺片,應該也心知不妙,只不過一直在逃避罷了……」


死而復生  珍惜所有

同樣曾面對死亡威脅,王醫生卻是一副戰鬥格,寸步不讓。

一向帶有乙肝病毒的他,84年突然肝炎病發,而且一發難收。「我瘦了30磅,肝酵素700多800度,正常人是20度。最可怕的是肝科教授親自打電話給我,說:『王春波,你的肝癌指數72度,正常人是0至4度,明天早上你最好來照超聲波。』」

當時兒子只得2歲,王醫生將一份40萬的保單交給太太,囑咐她將兒子養育成人,和太太哭了一整晚,明天一早便隻身前往醫院接受肝癌檢測。

「結果照來照去,也照不到;那便再驗Cancer marker(癌指數),最後是0,沒事。」

未知是技術出錯,還是指數因某種原因曾短暫升高,可以肯定的是,這個「死而復生」的難得經歷,令他體會生命及健康的可貴。

「肝病纏繞了我7年。我以為自己快病死,那7年裡便晚晚早睡,發現愈睡愈累,但終於看到肝功能慢慢變好,期間有兩個人啟發了我……」


玩樂心情  遊戲人間

一個是早已移民外國的律敦治醫院前顧問醫生。王醫生當時曾向他訴苦,說自己揹著肝炎這個計時炸彈,也不知道何時會惡化為肝硬化、肝癌。對方答:「怕甚麼?反正都沒得醫了,你就鍛鍊好自己,以後就算肝硬化也能撐得久一點。」他也就接受意見,終發現原來日間多做些運動,晚上更好睡,早上會更精神。「原來睡覺是一個很重要的修補過程,你睡得好,細胞便會修補得好,便甚麼硬化也會變好。」

剛好那時又讓他遇上一位病人,40歲,肝硬化,因為有腹水,腹部脹得猶如懷孕30周。「我循例問他平常有沒有運動,他說自己一天游40個直池。他知道自己一定要游,因為第一,人會精神些,第二,明知自己的肝會一直差下去,如果還不鍛鍊,身體只會更差。」

兩個實例,如導航明燈,激發了王醫生由92年起,參加他形容為人生中「最辛苦」、「最自作孽」的十公里、全馬、半馬,甚至跑山。

「我今年會走第20次毅行者,雖然曾試過走23個小時,但今年我說過要走29個小時……」

除了體能活動,他也是電腦專才,創辦了香港醫療資訊學會、香港電子健康聯盟,自85年開辦電腦班,不少醫生也上過他的電腦課。

正是興趣多多,生命也不足夠燃燒,但他自有一套應對方法。

「不要做無聊事,也別看太多電視劇。先做自己喜歡做的事,再做一些不做便會『死人冧樓』的事,其他的都不要做。」

就在有限時光裡,繼續以玩樂心情,笑度人間的春夏秋冬。

「就好像我那樣,邊工作邊遊戲,退了休後便工作少些,遊戲多些,你這樣跟玩到斷氣那天,其實是沒有分別的。」

Lead by your own decisions

 

Once upon a time, there were a father and his young son having bought a donkey from the market and back home. They were happy walking together with the donkey held by the rope.


Then a passer by commented : silly you, why don't you ride on the donkey to save some energy? That's what the donkey's for. The dad thought for a while and thought the passer by was right. So he sat on the back of the donkey and kept riding.


Then another passer by came and commented : silly you, why don't you let your son ride on the donkey instead of you?  You are a stronger man and your son should get benefits. The dad thought for a while and thought the passer by was right. So he alighted and let his son ride on the back of the donkey.


Then a third passer by came and commented : silly you, your son is dangerously placed on the donkey's back. You risk your son by falling off the donkey. You should hold him tight. The dad thought for a while and thought the pass by was right. So he sat together with his son on the donkey and held him tight.


Then a forth passer by came and yelled : crazy you. You are torturing the donkey. The dad thought for while......


So the son and the dad alighted. They together held the animal with four hands with the donkey in the air and labored back home.


Man! Live by your own judgement and instinct. Nothing is right or wrong. People often accused you at their angles of view point. If you follow every others comments, you are not living a Life of Your own. But you live others' lives, which have absolutely nothing to do with your life.


Live your own Life.

Hurdles

 

Life is a series of hurdles.  The journey of life carries lots of hurdles.  And these hurdles get more frequent as you age.  However, remember, you can pass every hurdle by different means: you can boldly jump over it, you can cunningly limbo under it, you can be safely carried over by another able person, you can circumvent by going via the side of it, or you can even just stand there and wait for the hurdle to decay and disappears.  Time always heals.  There is only one thing that you should not do -- never retreat and think that you cannot get through this hurdle.  For you will always get through the hurdles, except the very LAST one, at the time of death, when it doesn't matter any more.  So, don't be frightened of hurdles.  


March on with bravery.

Sea Pea

 

Why do I call my self Sea Pea?  Simple reason, my initials.


A pea in the sea, as free as can be.


海豆大哥哥,成日笑呵呵!



This came as a thought in 1975 when I first wrote in the Caduceus, a student magazine of my alma  mater of the life of a university student in HKU.  Instead of using my original name, why can't I use a rhyme of my initials.


This  has been followed with me for 45 years, never failed, never lost.  


Life is meant for myself.  Not for anybody else.  To love thyself is my first motto.  Yes, that  might sound selfish, but if you cannot love yourself, how can you love any others?  

Rapids

 

Life is like a river with rapids.  People originate from the origin of the river, gradually carried down by the stream.  Some would choose to play laissez faire, just being carried.  Some would choose to swim against the currents to their wished points of abode.  Some would get drowned.  Most would keep their heads up to breathe.


But in the end, different people with different styles will end up flushing into the deep blue sea which is the destiny.


Swim in your own style, for the end is the same.

Zero Sum Game

 

Life is fair! Don't envy others that they are privileged and you are deprived.  It never occurs this way.


What you see in their surface is not the whole truth.  People often show the good side of theirs and hide all their sorrows and sins behind the scene.


If you lost in a casino, you might end up winning in love affairs.  (Chinese saying)


I never believe there exists a perfect man. If a man appears to be 100% good, I can guarantee that this man is also 100% bad.  As he needs to disguise to be good, in order to hide his bad.  More stories to tell later.


Life is a zero sum game.  A mongolism boy is stupid, yet he is happy.  A clever boy is cute, yet he is filled with pressure and sorrows.


You might win a fortune like a tycoon, yet he will be threatened by gangsters, kidnappers and criminals all the time.


Be contented.  You will end up the same naked as you are born naked.  Man in the heaven, Money in the Bank (Hong Kong saying)


I love the yin-yang, for it reflects the truth of the universe.  What is black, will be accompanied with White.  What is evil, will be accompanied with good, and vice versa.


Trust your own instinct and work according to your gut feelings.  For there is nothing right or wrong in this world,


Zero sum game in the end.  Why bother?

Swings

 

There are  ups and downs in life.  Like a swing in motion.  You will laugh out loud when the swing get to its height. Yet you will be bored when the swing stays in the low. Unmotioned.  And often needs a push from your buddies.  That's what friends are for.


One thing for sure. It can't stay up forever, when it reaches to the peak, it will come down soon.  No denies.  No sustained up trend.


And when it is falling, it will swing up again.  It always will.  Just wait.  Just wait patiently.  Use your efforts to push it up.  Use your friends' energies to push it up.  It will go up.  


But, if you dont' give it any effort, it will stay down. Down down down.  But it will not be forever, as a passer by will always try to help.  


So, friends, keep the swing moving.  And expect the ups and downs. 

Decision to alley anxiety

 



The worse thing in life is that you feel lost! Do not know how to proceed.  Pondering.  Indecisive.  Fear to go on.  Hesitation.  Loss of control.  Totally puppet-ed.


To alley this anxiety or cross road, the only solution is to find a decision.  A firm decision of how to move on.


A decision might be right or wrong.  And they will yield either good or bad outcomes.  But in my understanding, Any good outcomes will carry bad effects.  And any bad outcomes might carry good return.


塞翁失馬, 焉知非福.
塞翁得馬, 焉知非禍!


And in a zero sum game, bad outcomes will bring good outcomes. and good outcomes will bring bad outcomes.


失敗乃成功之母!  Failure is the mother of Success.


So any decision will be a good decision ultimately.  So why bother to ponder.


Just make a firm decision.
For I know it will bring either a bad out good outcomes, but that doesn't matter, as the end will be the same.


Decision making will abort indecisiveness, worries, hesitation and anxiety.  And is a cure to a lot of moody conditions.


Decide NOW !

My 5 Golden Rules in Exercise

After my significant illness in 1984, I took 5 years for complete rest and suddenly realized this is not good.  So, after 1990, I engaged in progressive exercise program designed on my own.  From brisk walking, to hiking, to 10km-21km-42km distance running, to trailwalker, to ocean sailing.


I followed these golden rules all these 20 years:

1. PERSISTENCE.  Ten out of 10 persons understand exercise is good.  Yet, only Three out of 10 persons will regularly exercise.  Persistence is the most important rule.  Best is of course daily for 30  minutes or more.  I can only make 5 mornings or more.  People will argue that they are busy and can't participate in a persistent manner. I counter argue that I am even busier person, and all National Leaders, CEO of multinational company do regular exercise.  Why can't you?

2. INCREMENTAL.  People often ask what duration or strength should they perform exercise.  I often answer, there is no fixed rule, but there is a rule that you start from the minimal.  A few seconds are good, then working up gradually, by a weekly or bi-weekly steps to higher grounds.  Like more time duration, more weights added, more lapse or distance.  You must get a breakthrough and personal best, or at least aiming for them.  My friends swims for 20 laps and was proud, but at a snailing pace, it benefits little.

3. INTERVAL SPRINT.  I recommend exercising not at a regular pace. But rather took bursts and relaxation at intervals.  Start with 30 seconds strenuous followed by 30-60 seconds relaxed jogs or swim.  Then work up to it.  Experts said it will improve 70% of your VOMax.   Your heart and lungs can then work to its best by pushing towards threshold.  Of course, you can't burst your lungs, if you do it gradually working up.  Experts sprints at top speed for 10 minutes, then slow jog for 5 minutes, then repeat.

4. BREAK THE THRESHOLD or RETREAT and TRY AGAIN.  Contrary to the incremental approach, you can't reach infinity of time or strength.  There comes a time you feel too much. There comes a time you are tired that  morning.  There comes a time you are lazy and stop for some time.  So, when they occur, step down 20% at your previous level and work up again.  If you feel too tough, step down the next day by 20% and work up again.  Soon, you will find breaking on threshold after another.  Personal best breaking is always my dream.  I can still break my distance running PB from age 30 to 57.

5. CROSS TRAINING.  Never just perform one form of exercise.  Always do cross training by adopting different exercise at the same time.  Running or hiking alone will hurt your knees, unless you perform gym work up for your quadriceps, your back and your shoulders.  Foot ballers will not just train in football fields, they need swimming and gym work.

I stick to these principles and hope to sustain them as long as I could, as heavy as I could, as happy as I could.