正文 第四十二章(第2页/共3页)
气机失调,胃气不降,所以会恶心呕吐。寒则凝,凝则不通,不通则痛。我扫了一眼药架子,拿了温中的小建中合剂,还有小柴胡颗粒。小柴胡颗粒虽然常用来治疗感冒,但里面有半夏和生姜的成份,用来降逆止呕、温胃散寒应该也是可以的。当场就让孩子把药服下,又给他艾灸了二十分钟。灸完后,小男孩儿肚子已经不疼了,恶心感觉也减轻。
患者走后,我坐在桌前,嘴角控制不住的上扬,甚至欢喜地坐立难安。以前只觉得恋爱的感觉最甜蜜,现在觉得行医的快乐才更真实。层次越高的热爱,更能够恒定不变,带给人的快乐更持久。我不敢说爱情有多崇高,但我失恋的空虚被行医中获得快乐填得满满当当。
慢慢地,我开始对中医产生浓厚的兴趣。开始只是照着父亲的方子循规蹈矩地抓药,后来拿着他的方子还能给他挑出毛病来。再后来,我们两个经常因为辩证下药而争得面红耳赤。
乡下的卫生室里,不像医院门诊那样专业,分的那么详细。像个全科一样,什么患者都会碰到。有时候遇到棘手的病,没有把握,就让患者去医院瞧瞧,他们往往还不乐意。他们便缠着大夫,让大夫给想想办法。大夫就无奈,只能多看看书,翻翻以前老大夫留下来的病案,给开个方子拿点药,试试效果。这种稳定的信托关系,使得患者更能遵医嘱,医生也得到了实践机会,在其中慢慢地提升自己的能力。
以前在学校,老师总是讲患者可不会按照课本长病。但是在三甲医院里,患者的病好像还都算挺标准,在课本里翻一翻都能对应起来。像妇科里的排卵期出血,在二甲医院实习时从没见过,在三甲医院规培时却屡见不鲜。而且遇到那种患者,主任们都会饶有兴趣地跟我们仔细的讲一讲,还会拿出一张纸来画激素升降曲线来展示。在卫生室里,我很少见到那种患者了。感冒的患者,一点点轻微的症状,就自己要求打针输液,说是好得快。我每次都和他们据理力争,讲感冒是一个自限性疾病,就算不管它,七天以后也自己痊愈。有的患者会听,有的不听,坚持己见。我特意看过其他大夫的处方笺,肌注的药品基本上就是激素地塞米松还有抗生素,还有退热的安痛定。输液的处方笺也是,基本上每个人的处方一致,都是抗生素、激素、维生素等。抗生素滥用在基层非常常见,有的患者一进门就要阿莫西林。问他哪里不舒服需要阿莫西林,就说自己有点感冒。遇到这种情况,我会利用自己的处方权对其限制用药,劝他们换成中成药服用。但有些基层医生,不会多问,要什么就拿什么。因为一些基层医生本来就是那种用药习惯,小小的一包药里,就会有地塞米松、阿莫西林等。患者本来是不懂药的,患者的用药习惯可以说是医生帮助养成的。不知道时间久了,我会不会被同化,为了追求速效也养成这样的用药习惯。村庄里的墙面上,印刷着“不忘初心,牢记使命”的大字,人来人往,希望一路前行,初心不变。
中午的阳光透过窗户晒进来,在墙上投出一块明亮的光斑。我偎依在椅子上,眯着眼睛小憩。阳光打在脸上,暖洋洋的。脑子一沉,即将陷入沉睡时,一声响亮的喷嚏声将我惊醒。
一个二十多岁的男生吸了吸鼻子,双手揣在裤兜里,“感冒了,打一针~”
我皱皱眉
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