最后诊断
在医院，死亡天天可见。大多数时侯，你不是死在自家的床上，就是死在医院的床上。而且，医院的那张床不知死过多少人，那被单不知盖过多少具尸体。床和被单不是一次性的，尽管每次用时都消过毒。但如果你睡在医院的床上，盖着医院的被单，想想是不是有点咯应。但这个地方，有时你又不得不去。
今天的这个故事，和一次特殊的死亡有关。这种类型的死亡一般不会频繁发生，换句话说，就是极少发生，几率大概是万分之三左右。可我刚上班没多久便遇到了，这个产妇在孩子出生后不久便死了。死因据说是“羊水栓塞”，注意，我说的是“据说”，因为我总结了一下，各大医院，只要发生产妇分娩后迅速死亡，往往会给个“羊水栓塞”的诊断，因为“羊水栓塞”病情极为凶险，很难预防，出现后产妇各脏器迅速衰竭，难以控制，属于难以避免的死亡，而非医护人员的责任事故，这样医院比较容易开脱，顶多赔点钱了事。但光医院自己说是“羊水栓塞”也不能让死者家属信服，打官司的时侯，还得依靠病理诊断。
说到病理诊断，我又得插两句。不知道在坐的有几位喜欢看阿瑟.黑利的小说，前几年阿瑟.黑利去世了。他的大多作品我都看了，《航空港》，《汽车城》，《大饭店》，《烈药》，《最后诊断》等等，这些作品非常深入的向读者展示了各行各业的内幕，当然少不了医疗行业，其中《最后诊断》讲的就是医院病理科的故事。病理科总是和病人身上的组织或尸体打交道，陌生人如果刚踏进这个科室的门，感官上会非常的不适，瓶瓶罐罐里总是泡着形形色色的被疾病侵蚀的机体，生命的所有丑陋在这儿都可以见到，在这儿呆的时间长了，一定会影响你的人生观的。是的，人生不仅不过如此，人生的结局还如此可怕，健全的离开这个世界简直是奢侈。
病理医生给出的诊断可以被称为“最后诊断”或“金诊断”，当医生的临床诊断同病理科的诊断冲突时，那就得听病理科的。大多时候，病理科的诊断对制定疾病的治疗方案极其重要，随便举个例子，就拿乳腺癌说吧，有些怀疑乳腺癌的，又不能确诊的，就把病人拉上手术台，切一点疑似病变组织，立即送到病理科做冰冻切片染色，观察是否有癌细胞。这时，病人就躺在手术台上，周围围着一帮医生护士，静静地等着病理科的那个决定命运的电话，如果顺利的话，半个多小时电话就来了。有时病人马上送回病房，所有人一脸轻松，没事。大多数时侯，都接着手术，切割+清扫。因为乳腺癌的发病和雌激素的水平过高有关，早期的手术还要把患者的卵巢给割了，没了它就基本没了雌激素，不容易复发。过两天，你再看到这个病人，“唰”的一下，老了。真的，是“唰”的一下。这个术式太残忍，根本不顾忌患者的生活质量，没几年就基本淘汰了。
又扯远了一点，回到“羊水栓塞”。病理科诊断“羊水栓塞”的证据是，尸检后，在别的组织发现“羊水颗粒”（那是羊水通过血液循环到那里的），尤其是在肺组织发现“羊水颗粒”就可确诊。但是，在这个国家，医院只要想去“运作”，担当法官角色的法医（很多是做病理检查的）也可被搞定。但无论和医院是否有关，大多还是要赔钱的，主要是为了避免被定为“医疗事故”。
（肺组织病理切片，中间黑色箭头所指的就是肺组织中的羊水物质）
回到那个死去的产妇，生前是个营业员，留下一个女孩，当时因为和医院没达成赔偿协议，孩子留在医院，我还负责照管这个小孩一段时间。这个孩子贼能吃，因为没有母乳，只吃配方奶，没两天，就把一袋奶粉给灭了了。护士开玩笑说她是“饿死鬼”投胎。我还见过这孩子的父亲，带个眼镜，很文静的男人，隔一段时间就来看他女儿，没多说话。
当然，后事办妥，孩子被接回家了。再也没见了。
故事不能就此结束，否则感觉不像是个故事。
一晃，到了12年后的前年。我回家，到二姐的办公室。二姐神神秘秘地对我说：“晶晶最近有情况，学习不专心”。晶晶是我的外甥，上6年级。我说：“他能有什么事啊？”二姐说：“他跟班上的一个女生经常偷偷打电话，我通过其他学生了解，这两个人还经常一起上下学。还有，在他书包里还发现一张同学留得字条，说周末有个聚会，约晶晶去，里面还特别提及那个女生也参加”。我说：“他要真这样，那也没办法，你也不能让他不去想啊”。二姐说：“还有，那个女生没妈啊，她妈好像在你们医院生小孩时去世的”。我听后，一身鸡皮疙瘩。一算，确实，我外甥也是那年出生的，就问：“她妈以前干什么的？”“商业大厦的营业员”。哎，这个女生肯定是那个我曾经照看过的女孩。我姐还说，她爸到现在还没结婚，这孩子一直由她姑姑帮着抚养，而且她称她姑姑为“妈妈”。
据二姐说在“妈妈”这个称谓上，这个女孩很洒脱，她提到妈妈时从不难过，她说，别人都有妈妈，我是姑姑带大的，我就喊她妈妈。
确实，没有一点记忆，倒不见得是个坏事。
隔了两天，晚上，我约外甥到公园转转。路上，我问他：“你们班是不是有个女生，生下来就没见过她妈”。外甥一愣，然后笑了笑（我注意了他的表情），说：“有啊，你怎么知道的？”。“这就别问了，她妈去世的时侯，我在场，她出生后我还带过她，不知道她现在什么样？”。“正好，前几天拍了毕业合影，在家”。“好的，过下到你家看看”。“行，但你不要和我妈讲”
到了他家后，我俩进了他房间，把门反锁上，外甥把照片找出来，指了指她，我一看，哎，12岁了，很阳光的女生，感觉比同年龄的孩子要大，有点像她妈。
这时，二姐在门外喊，你俩个躲在里面干嘛？
太神奇了。
好贴。同意小师妹。。:)
半夜看了头皮发麻吖！！！
@Nana
确实有点神奇，主要城市不大
喜欢看这种东西，我就写，正在策划写2篇关于“误诊”的故事；关键文字要“软”，比《科学美国人》还要软，要让从来不了解这个行业的人大概知道我在讲些什么
@大宝
隔行如隔山，见多了，就不怕了
深更半夜，让我独自面对一具尸体，我也有点怕；但如果身边还有一个人的话，我就不怕了；如果那个人是女生的话，我就会表现的非常勇敢
当医生挺好的。我其实特别适合当医生，责任心强、心眼好、逻辑能力还可以、勤奋用功。我没当大夫是因为从小在医院长大，又在医学院的附小上学，看见大学生们成天抱着那么厚的书，要背下来，没完没了，而且当了医生后太累，我就害怕了。现在我挺后悔的，我愿意去当医生，但没有机会了，等我退休以后，如果有条件，我要去学学，看看有没有机会到落后的农村去行医，他们太需要了。还有，更现实一点，如果我将来有了能力，我要给医院投大把的钱，能开办一家医院最好，不行就投给协和医院。这家医院的大夫，无论是医德还是技术，都堪称国内标杆。
你啥时候混泡网的?我们认识吗？
@民老头
你好！
想想以前背那些东西真辛苦啊，有些内容不知背了多少遍才记住，其它专业学生的生活丰富多彩，医学生就整天背、背、背
上班更辛苦，觉总是不够睡，还提心吊胆，总怕出事。所以吓得我都毕业了，到现在还不敢找工作，怕累啊
别投协和了，他们不缺钱，最需要人员和资金的是农村和偏远地区
我好像是去年年底来泡网的。我们不认识 ＾＿＾
@yanhu
协和挺却钱的呀，硬件太差了。大夫收入也不高，我是说，相对于他们的价值，薪水太低了。最难得可贵的是，他们不欺负病人，不乱收费。生个孩子，顺产的话，才一千多块，比区里的妇幼保健院还便宜。偏远地区当然是最缺钱的，但是，唉。。。
部队的医院才不缺钱。
@民老头
不好意思，不太了解协和的情况，只知道身边大医院的医生一点都不缺钱，他们的生活还是不错的。但付出还是挺大的，昨天带一个熟人的孩子去检查听力问题，一个50多岁的博导，周末还上班，门口排着一帮病人。
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