老哈佛~~~自愛(二)

我的美國經驗之一：
把三個小孩帶大﹐有太多機會拜訪醫院急診室。
還記得三十年前﹐在眾多出入醫院急診室的經驗中﹐牆上掛著最讓我動容的一張牌子就是：

「…..任何到本院求醫之急症病患﹐不論有無醫療保險﹑有無能力支付費用﹑不分種族﹑國籍﹑身份﹑本院將竭盡全力救治………」
「It’s the law!」

It’s the law! 當我看到這裡﹐忍不住從心口哭了出來。
因為六十年前﹐弟弟小時候發燒抽筋﹐送到省立醫院急診卻不肯收﹐逼得媽媽變賣了僅有的一枚金戒指去付保證金。

弟弟六十歲了﹐而今日的台灣還有這種拒收臨盆產婦的新聞。

不過﹐我今天去看眼睛﹐有著另一層的感動。

女兒送我到大樓進口處就去上班。我乘電梯到十一樓眼科診所。由於時間尚早﹐候診室裡椅子很多卻沒幾個人在等。向櫃檯小姐獻上我的保險卡及駕駛執照﹐她很快就從身後的兩大排資料架中抽出我的病歷夾。
「病歷夾?」我才第一次來耶!

上次看的是一般眼科﹐由於診斷出有青光眼﹐所以把我推薦給青光眼專科高手。在幫我約訂時間的同時﹐已經把我的基本資料和診斷細節轉過來了。
這裡規模不小﹐護士一大堆﹐小診療室也不少﹐一會一個面孔﹐帶著我像坐音樂椅子似地﹐有的做問卷﹑把我一進門填寫的病歷資料確認無誤﹐簽名存擋。另一位小姐帶我去看一段錄影片﹐說明什麼叫青光眼,﹐有那幾種不同的狀況。再帶到一間診療室﹐叫我坐到「就診椅」上﹐先點了眼藥水﹐再檢視瞳孔﹐查看兩眼視力並作了紀錄﹐這才告訴我﹐醫生等下就過來﹐請稍候。

之前﹐一名護士把我的眼鏡借去查驗光度﹐這時送還給我。在等待醫生出現的空擋﹐我看到牆上掛著一些執照證書一類的鏡框。這本來是每個診所都有﹐不過﹐三張哈佛醫學院的金字招牌可不是亂蓋的! 包括1971 年完成四年哈佛的住院醫師﹐(那一年﹐也是我人生值得紀念的一年。八月取得新聞碩士回國﹑九月結婚。) 這時﹐一位溫和俊秀的白髮醫生走進來和我握手並自我介紹。我就問他：
「Are you as young as I am?」
我們都笑了。

經過詳細檢查﹐他證實了先前醫生的正確診斷﹐為了慎重起見﹐點了放大瞳孔的眼藥﹐叫我到候診室去等三十分鐘再檢查。這時﹐陸陸續續已經來了不少人﹐圍著中央的熱帶魚缸分割成兩個等候區﹐大約有二十張椅子都快坐滿。

聽他們的口音, 光是亞裔就包括越南, 菲律賓, 台灣; 此外, 看膚色可見到非裔與白人; 論年齡則從小學生到七老八十的就醫者.....

原來診所裡另外還有兩位醫生。病人也顯得多元。無論族裔﹑經濟層面都有很大的區別﹐可是﹐也都和我一樣﹐進來刷個卡片﹐受到同樣的親切照料。

老哈佛的動人處, 在這一段:
We are committed to providing patients with the
most advanced, progressive, and highest quality
eye care. We will strive to be the
best glaucoma practice in the Pacific Northwest.


後來﹐醫生決定做雷射手術﹐先做右眼﹐用雷射光打一個洞﹐釋放眼壓。下星期再做左眼。

結果發現﹐並非像我同學說的那麼簡單：「啪啪兩槍」。
而且﹐一台綠的光﹑一台紅的光﹐一連「啪啪」了五六百下也不止。
心裡頻呼「上當」。

(待續)

附錄
Murray A. Johnstone, M.D.
Ophthalmology, Ophthalmology (Eye Center)
Accepting New Patients
Accepting New Medicare Patients


Want to make an appointment?
Call Murray A. Johnstone, M.D.'s office directly at (206) 682-3447

Glaucoma Consultants Northwest, http://www.glaucomaconsultantsnorthwest.com
Education and Certification:
Medical School: Washington University, MO
Residency: Harvard Medical School, MA
Fellowship(s): Harvard Medical School, MA
Board Certification(s): Ophthalmology
Additional Qualifications: Glaucoma fellowship trained at Harvard/Massachusetts Eye & Ear Infirmary

Numerous publications in field of medical and surgical management of glaucoma.

Glaucoma referral practice with many years experience dealing with complex glaucoma consultations from other ophthalmologists.

Current active basic research in medical and surgical issues in glaucoma.

Clinical Interests/Special Procedures Performed:
Eye Center, Glaucoma, Molecular Biology
Philosophy of Care:
We are committed to providing patients with the most advanced, progressive, and highest quality eye care. We will strive to be the best glaucoma practice in the Pacific Northwest.

Continued positive change will be the focus of our efforts. We will do this by continually providing the most educated and highest quality staff, management, and doctors so that we will remain the forefront of our specialty.
Personal Interests:
As a young person I had the privilege of inventorying the timber resources of the North Cascades Primitive Area for the Forest Service. It required going to locations on a predefined grid no matter how remote the location. We were constantly crawling through windfalls, devil club and vine maple patches as well as up the sides of steep mountainsides and cliffs. We were far from any normal pattern of travel and I realized much of the time I was likely walking were no human had ever tread. It was an exhilarating experience, but with the current population, such experiences are no longer available in the great Northwest.
I experience an exhilaration similar to that of my youth doing glaucoma research which is now my passion. Friends ask how research can be a recreational activity. The research provides me with the privilege of exploring the dimensions of new worlds in anatomy, physiology and molecular biology. Without the stimulus provided by research efforts these worlds would remain inaccessible to me.
Travel, sports and other activities pale in comparison with the incredible thrill of learning the about recent discoveries in science previously outside the realm of my imagination. The greatest thrill is when explorations lead to discoveries, however small, that were previously beyond the realm of human experience or knowledge.
In my training I was taught that we must give back to our profession. To that end, I personally fund and actively engage in research to understand the causal factors causing blockage of aqueous flow in glaucoma. Such an understanding is essential to finding an eventual cure for the disease.
Evidence from the our research has led to an entirely new model of the aqueous outflow system as a mechanical pump that acts in a manner similar to the lymphatics to return fluid to the vascular system. Evidence indicates that the pump controls intraocular pressure and that an abnormality of the pump causes glaucoma.
We are currently involved in a series of studies further characterizing how the aqueous outflow pump functions to control intraocular pressure. We are also exploring how the pump fails in glaucoma. Recent work includes identification of new mechanisms of action of several glaucoma drugs that control aqueous outflow pump behavior. In addition, we hope our studies will provide an improved understanding of the biomechanics of the pump that will lead to lead to more precisely targeted surgical alternatives.