6.11.05

離線生活 (三)

診症室外的候診大堂擴建了,後面一堵用玻璃磚砌成的牆給拆去,連接天花的駁囗有一道黑漆填充物的新痕,右面隔開電梯大堂的牆亦折了,現下能多放二三十個座位,或更多吧。感觀上,候診大堂和通往同樓的另一部門和洗手間的走道顯得比較融和起來,隔離顯得沒那麼在意。光線的確充裕了一點,沒那麽侷促似地。而他們終於把那「柔和」的罐頭音樂關上了。

我把先得付款打印的覆診紙放到出納處一個小窗口中的收集箱中,逕自往廁所撒尿,想洗一把臉。那種尿臊的腥惡讓我再次肯定,這是精神科診所。我到過急診室、內科、深切治療科、血科、腫瘤科的廁所,商場、酒店、大學、街邊、茶餐廳、孟加拉、巴林、倫敦、雅典、巴黎等地的各式公共廁所都去過,只有精神科診所和精神科病院有那種惡刺的臭。我們的身體是化工廠一般,徹底糜壞。

坐在堂中一條圓柱之後幾排座位的中間,可以望見入囗和出納及其餘的人。我很快察覺候診的人當中,多了好些祛生的面孔。我有一種想法,它似乎正在應驗。

納悶拿過旁的椅上擱著的過期《明週》,還未翻完開頭的彩頁,就累了。除了等待總是不耐煩的護士直呼我的名字,我在看同病相憐、不相憐的其它人。大致上還是那種區別:上了中年因長期服藥而給毀了的,和不甘自己和前者一樣標籤的。

長期服藥、注射、進出病院的人,總是眼神呆滯、目光往極遠處看而不見,嘴巴半閉半開似笑不笑,肩頸僵硬神經兮兮的模樣,癡肥臃腫或極之瘦削,坐立不安、衣衫不整。那是長期吃藥的後遺而非病況的癥狀。除了老弱者有社工或老人院看護陪同,他們多數沒家人陪伴,即使有,他們的家人抑是因尷尬而愈顯得厭煩,抑是對醫護人員唯唯諾諾。

其餘看來病歷較淺的就像在地鐵公事上會碰見的一般人一樣,在翻八掛雜誌、講手機。清楚知道見完醫生拿過藥,會往上班或約會,逛商場或回家做飯。

有一位二十歲左右的漂亮女子坐到我的鄰座。我看著她的側臉,嫩白的耳畔敏感會讓人看見一樣。是我多餘的暇想,她似乎還未知道,將她這樣年輕漂女的女子,一樣不知就裡來到這裡,開展了精神病患的事業征途。

「這陣子怎樣?」
(CCTV在操作中)
「可以啦,現在回母校當研究助理。合約做到十二月。」坐在男人背後的實習學生聽到學校堂正的名字探頭要看我一眼。
「那之前那份合約呢?」
「八月底完了,現在他們給我一些 Free Lance工作。」
「那十二月過後怎打算?」
「怎打算?要想想看吧。」
「那即是怎樣?讀書那件事進展如何?」
「告吹了,我的老師返老家啦!就是要想想,抑是要籌謀全心往外面讀書,抑是找些Free Lance工作怎麽。要考慮的多著,經濟呀、屋企人的發展、負擔……」
「……」
「嗱,你的問題就是穩定。」
「怎麽才算穩定?」
「生活呀、工作呀、感情呀、家庭呀各方面。」
「哈!全香港有多少人能做到?」實習學生聽到這又探頭看我一眼。
「對呀,香港有很多人都有問題,只是他們不知道罷了。」
「那麼他們應該全都來這裡看病了罷,你這個department也可以多開幾個職位。」
「嘿,假使你不一直吃藥,你能畢業嗎?」
「我比較關心如何逐步減少藥份,不那麼依賴它。」
「待你穩定些吧,現下藥份照舊。」
「我忘了上次有否驗血。」
「夠半年了,今天再驗。十二個星期後見你。」

男人把藥單和驗血的指示遞給我,打發我走。坐在男人背後的實習學生這又探頭看我一眼。

一個程序以後是另一個程序。你必得服膺程序。程序中,你的身體髮膚、你的情感欲望,衍生一組數據、給載入表格、標籤存檔,構成政經文化版圖上的一個位置,隨時被演譯、隨身被取代。

短期非公務員合約制的「醫護技術助理」給我抽血撿驗的時候問我:
「你吃這個藥多久了?」
「就是太久了吧。」
「有準時吃吧。」
「昨晚十一時許。」我知道要驗血前十二小時吃,結果才比較準確。
「他們有監查著的,你不能吃的他們不會處方給你。」
「也不是,早陣子就回收了我一直吃著的一種;後來換的另一種最近又爆出了新聞。」

拿藥的時候配藥員對著咪高峯向隔在玻璃屏外的女子吐出一句話:
「這是醫生新開給你的嗎?鋰劑每晚半粒,狂燥症吃的。」

我無法想到,將她這樣年輕女子能夠如何答話之際,我看見那個方才坐在候診室鄰座,寧靜的她,也在鄰窗拿過一大包 Sulpiride和其它甚麼,走出了擠擁著貧病傷困的藥房,在午間的陽光中。

延伸閱讀
1991年聯合國通過保護精神病患者和改善精神保健原則
關於電擊治療(electo-convulsive therapy)的爭議
有關醫管局藥物名冊

11:54

14 Comments:

Blogger tugboatcaptain said...

這是文明或是什麼呢?
我是反西藥的
除了藥,應該有alternative吧?
看BEAUTIFUL MIND時我多希望主角停藥後眼見的都是真事,不是假象

7/11/05  
Anonymous 匿名 said...

不如試試中藥

7/11/05  
Anonymous 阿晨 said...

智良,

每次讀您的寫關於病的文總是心痛,您真的不想試針灸嗎?

我現在差不多完全好番了,前所未有的自在。
我又發現,有兩個老師,其中一個是我的mentor,都有很嚴重的panic disorder,他們一直也是靠針灸的。

記得六年前去見精神科醫生(我是看私家的,因他是爸的好朋友的弟弟,他很好人,只是要很小的診金,但我的子宮瘤是去政府的,所是很明白你說醫院內的情況),很辛若的,不只是我自己的病,也是看見其他病人的情況。在一個不到二百呎的空間裡,大家排排坐,展示著不一樣的軌跡,卻像是要被相同的藥物磨平。

我見到有一些要打針的,目光呆滯,靈魂根本就不在那裡。

我很害怕,而我的病就是害怕。驚恐症。

現在我都很好了,當然不只是針灸,也得自己的努力,去努力面對自己很多的問題,和找問題的根源,與她們對話,然後,放開。

放開。

可以的話,去試針灸好嗎?不只是試治療,而是也要從他們的角度了解身心,因為都是身心的事。

可以的話,讀這個好嗎?http://aahsun.com/wpblog/?p=36

試試一些不同的方法(於生存),是很重要的。我在今年年頭的時候,甚至有suicide tendency,差不多幾日就要哭一次,每個月的子宮內模異位痛得很利害,只可靠止痛藥為生,整個人都反了,瘦了廿磅,連帶panic disorder一起回來(我最初病是在99年),我當時很desperate,我以為,又要回到吃精神科藥的日子。

但針灸救了我一命。

很不想您這樣繼續下去呢。我suffer過,是那麼難受。

請不要再讀那些藥物報告了,去了解針灸是怎樣幫助身體好嗎?這不只是因為我們要明白其原理,治療才會更有效,而是,當我們可以用另外不同的方法思考,是自我治療的最根本。

試試啦,智良,可以嗎?
那麼多年了,真的不忍心。

7/11/05  
Blogger 李智良 said...

阿晨,

今早回到工作的地方讀到你的留言,轉眼,回到家裡能夠坐下來,已近午夜,六小時後又得滾出家門,熬車上班。每天花四小時交通,食無定時,夾在老外老闆與年輕學子中間,扮演知識的傳介,幕後做到氣咳、幕前要seem good,非常壓力,並且意識到知識與權力的勾當関係...... 我覺得病的是我們的社會鼓吹的生活方式和價值,不是我們。

謝謝你的關心,阿母介紹我往看經絡治療,又推拿又拔罐又刮沙,感覺好了一點,但未見顯著,又疴到七彩,謂排毒云。長久下來的西藥,可以想見成身是毒。試著看。

不是不服停服西藥,問題是長久下來,我的身體我的化學平衡已完全給它們逆轉了而運作,譬如SSRI讓血清素的re-uptake延緩,腦子適應了這一重運作,就會拼命釋出更多的血清素以返回原先的水平,一旦SSRI抗鬱素給拿走,就更容易狂燥發作。這在文獻詳有記錄,我的醫生是完全知道的,鋰劑, Seroxat等的藥理亦然。我的雞尾酒配方,A舒緩B药,C幫助B藥的果效,D药又控制住A藥的作用,令這更加複雜...... 我唯有很慢很慢的減省藥份

停藥復發的機會比沒吃藥的病人更高,這就是「治療」。到復發的話,又新一輪的「治療」、新一輪的「命名」。

我總是不忿、哀愁,而我的病就是不忿與哀愁。

我那麽憤怒,不單因為我是受害者,而是我察覺到和我相似、比我更受罪的案件比目皆是!那幾乎是一個階級系统而盲目的壓廹另一個階級。

資訊極之不平均,醫院系統官僚、割裂地理解「人」的程現,操作的欠缺透明,社會的茫視...... 令醫生變成那麼權威,又不需為診斷負責... 無數人在全不知情、權利被故意輕視的情況下「成為」精神病患,往後就長期周旋於社工、舍監、醫生、輔導員之間。

我可以告訴你,他們許多因為「治療」而喪失工作、社交,於是他們又落入綜援網,又由於沒有工作–社交,他們就不會得到所謂新藥,又由於他們教育、生活、住屋水平較差,他們病情的進展又不會好得怎樣...如此循環,就是這些Self-fulfilling Prophecy 令醫藥業、社工、官僚更進一步合理化他們的論述。

我那麼不忿,你叫盲字都唔識嘅阿婆點識用醫院大堂的電腦終端機查考自己服用的藥品是否在標準藥品名單內?那已經不止是精神科的獨特情況了,這才發覺許多內科藥、血科藥、抗癌藥都給劃作專用藥品一類而不受安全網保障!

他們是衝著長期病人來!

8/11/05  
Blogger CAN said...

保重呀, 智良兄!

我的工作是攪中醫(服務)的, 有些病真係可以試試中醫(不過要搵真係有料的), 就算唔得都當調理補身囉...(不過我攪的中醫服務相當昂貴, 兩條野大約三日藥, 慈善機構喎...嘿嘿嘿...)

8/11/05  
Blogger 李智良 said...

can,

兩條野即係200?2000?
問題的歸結依然是「論述---權力---行政」的三為一體,價格當然是醫療選擇的一個重要因素,即使人人當負擔得起某一水平的服務,那「三為一體」仍然未有拆解,醫藥業依然可以製造更多病人,病人依然處於受宰制的位置。更深層看,病人和病,即使有完善的醫藥服務,他們/它只是某一條公式裡的一個演譯符號,永遠相對於日常/恆常/正常,而成為被談論、被採集、被論說涵蓋的一種「例外」。這樣下去,我們離人性地理解生活只會逾離愈遠。我們忘記了差異、變異迸發的力量和生存形態其實才是生活向前冒進的原動力,硬要削足適履,把差異、把不同能力的人強制放於程序和劃一的價值裡,只會停滯不前,人人變成機械人,一個型號淘汰另一個型號。

8/11/05  
Blogger 李智良 said...

晨這句真是道破心事

"不只是我自己的病,也是看見其他病人的情況。在一個不到二百呎的空間裡,大家排排坐,展示著不一樣的軌跡,卻像是要被相同的藥物磨平。"

那天在診所,我真想跟身旁的女孩談談作為精神病患的前途,但幾十個人,一人一個島!就像一同坐公車地鐵上班、下班,一齊中眼瞓,日日奴役,同一種受罪,卻無以溝通,甚至彼此不願與彼此同坐。好痛苦的感覺。

8/11/05  
Anonymous 阿晨 said...

智良,

你說的所有我都明白,真的,那個西方醫學系統的權力關係。當然也了解你為什麼這樣憤怒。

我也很憤怒。

但我們一面繼續了解西方醫學的問題,一面也要為自己著想呢。我不是說你立刻停藥,這不是一時一刻的事,而是找一個好的針灸師,叫自己有D耐性,用起碼6-9月的時間,去試試治療,拔罐刮沙不同針灸,針灸是把你的身體調整,然後我們可以自療。

錢是一個問題,但這也是為了長遠的目標,令自己可以健康起來。那我們便可以做都更多。

智良,真的不忍心,請你試試好嗎?

我們都應該快樂呀,不是嗎?

前天寫了,「銀光滿地」 ,想到我好幾個mentally challenged的朋友,當然也想起你,大家的日子那麼難過,這是不應該的,送給所有身心受苦的朋友。

http://www.aahsun.com/blogger.htm

13/11/05  
Blogger 李智良 said...

晨,

我也想起散落各處的友人,尤其在香港交通咁發達資訊咁方使卻很「遠」的朋友...

有時我寫的東西有人話激、有人話憤慨、有人話唔明等等,其實我愛;我唔愛又洗乜去刨文去聽人講嘢背後的委婉或陽謀?三唔識七既人我都愛,但不合於禮。有些事情人人話「無計」但其實我們或多或少在逃避自由。

妳的留言和網志我都看進心裡,我聽見妳和幾位網路上相見的朋友的聲音,感動之餘,就會問自己問題,在當下的位置、在生活的版圖上的這個諸多設限但還未絕然的位置上,我可以如何。

人總是有感到孤絕的時候,但其實不。我們的社會如斯運行如斯要求我們,是因為我們好像那麼,零散。

我還在想著下一步的走向,如果你有醫師介紹請電郵給我。

13/11/05  
Anonymous 匿名 said...

Hi, I am chuliu. I wonder if you remember me. I left a message on your previous blog article. I am relocating to hk and i know that you seem don't like western medication for mental disease. But I would like to know if I get my hk id, how long do I have to wait (in queue) for a visit to mental department of public hospital? I am in hk now and wonder about source of meds. I am buying sulpiride from drgustore for my supply. Thanks.

17/11/05  
Blogger 李智良 said...

chuliu,

sulpiride is really toxic and damaging to your internal organism; you think it works only because you are developing a dependence on it, like any other psychiatric drugs

there was not a diseace nor illness behind symtomps - it is just a exploitive narrative of your body and mind

to answer your question:
go to any general clinic and speak ENGLISH to discuss with the doctor and ask him to write a letter to refer you to a psychiatry out-paitent centre near where you live;

you will be enrolled and wait about 3 months to 1 and a half year before you actually see you psychiatrist, and then you are in the procedure of a never-ending career of being discriminated, being experimented upon, and being censored for being who you are... and mind you, usually, your psychiatrist will be relocated to a different clinic EVERY 6 months! so you end up seeing different psychiatrists almost every time, who have to take up your case anew

if you cannot wait, have someone send you to the emergency ward of any hospital and tell the directing nurse that you are suicidal and hallucinating and have been acting strange; then you will wait about 1 hour to 6 hours before you end up locked in a psychiatric ward;

i am telling you all this from my experience. so

good luck suffering! i decided to end this half-life without too much damage before it is too late; i really hope you take my suggestions

love and solidarity!

18/11/05  
Blogger chuliu said...

chuliu here. Thanks for your reply though very scary. I really hope things won't happen to me like you described. I think I understand your point of medication being toxic and damaging but I don't know about that I feel it helps just because of my dependence on it. I developed visual and audio hallucinations in my teenage and if not for the medications, I would be still hallucinated. I need the medication to stay productive and stop me from being psyched. I have taken the meds for over 17 years and now I am in my mid 30s. I know the meds do have side effects like my hyper-prolactinmania and others. Luckily I only developed hyper-prolactinmaina and none of the others.

From reading your blog, I came to know that you are taking other different medications from mine and maybe those have severe adverse side effects on you, like those containing lithiom could be really harmful and cause dependence on it. I also notice that you are quite aggressive and sometimes rebel, which I tell from your blog about various topics, like office pc privacy issue, and opposition against use of meds on mental disease, etc. Novertheless, you seem to be coping well in that you keep this blog and that you write. From your blog, if you don't tell me, I wouldn't know that you are mental-illed. I hope you will keep on the path and do well no matter which path that is, be that a med free life for you.

I will keep you updated if I get to pay a visit to a psychiatrist in Hong Kong.

18/11/05  
Blogger 李智良 said...

chuliu,

i could be sacastic and bitter sometimes but you get the point... we really don't need that sort of medication FOREVER, and the damage done does not justify its harm on our life and well-being, not just our body...

the medication do helps when things get critical, but we really should not rely on them FOREVER, the damage do not justify its "merit," that label, and that constant self-doubt could be killing you in other ways...

we should sort our way out, decide our priority, learn to love ourself and adjust our way of living/ diet/ emotional balance...

i know hallucinations is terrible, i was psychotic also for some time and was dellusional about everything... but it is our life, we need not to be in that ill-interested system of dehumanising exploits called psychiatry;

and i think we could be less terrible if understanding and compassion are promoted... we were "treated" with medication of critical adverse damage under dis-information, and misleading advice... and we surrender our right as a person under that system...

many others who are less knowledgable or less priviledged, or less literate are being exploited because of that, it is pain-staking just to think of that... i really wish you could be more informed and make your choice with perspective

take care my friend and look after yourself, use other methods to take away the real cause of your issues, not just using "science" to adjust to an ill/stressful life

may peace be with you

19/11/05  
Blogger chuliu said...

Lee,

I was under a little stress today while I was taking an exam in city U of Hong Kong. I was hallucinating in the testing room and was worried I would fail the exam. I hate those people in my hallucinations especially when they appear in the crucial moment shoting loud. They could cost me an exam which I spent months preparing for. Luckily I was able to concentrate and expel them from my mind.

Today has been all dilusional to me. I don't know what to believe. When the hallucinations showed up and these weird thoughts came to me, I told myself to behave rational and act in common sense. I was in a dilemma whether to believe and act in rational way or just trust my own feeling, that the things happened in hallucinations made sense. It was like telling myself that my brain was not functioning and that I should behave in certain ways to make me rational and normal, with my own brain.

I guess life for us(the mentally-challenged) is to make a balance between hallucinating world and real world, meds and side effects, living and sacrificing. I suppose there will not always be a answer to everything. Maybe I should stop seeking for the ture answer to the things in my hallucinations, was that the supposed answer that common sense tells me, or that my own feeling tells me. Just trying to survive.

If possible, I too would want to escape from taking meds. Trust me. I tried spiritualist, hypnotherapy, etc. None really helped. I did learn to believe in God, supposedly there should be a creator of all things and I believe he is virtuous and just. I prayed, not necessarily to Jesus, but to the real creator. If he is there to listen.

Good night

20/11/05  

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