Special Needs Pediatrics——儿科医生的特殊需要

The first time I met Carla, she was sitting on the floor alone in the middle of the lunchroom while the rest of her cabin played outside. Carla was a frizzy-haired 11-year-old girl with autism. It was her first time away from home, and she was struggling to adjust to the new patterns, people, and places. At the same time, as her camp counselor, I was trying desperately to figure out her needs. Carla could not communicate spontaneously, and she responded to my questions only by repeating them. It was difficult helping her transition from one activity to the next, because whenever a game ended, Carla would just flop down on the ground and refuse to budge. I tried singing songs, dancing, and playing "follow the leader, " but nothing uprooted Carla. Then suddenly, after a few days of working with her, I noticed that Carla was fascinated with hands. Although she would not hold people’s hands, she liked to touch them and look at them, and I soon discovered that I could use her interest to motivate her to participate in life around her. For the next two weeks, I transformed my hands into butterfly wings, and the two of us flew around camp together. Although we could not communicate verbally, we found a connection more powerful than conversation, and I discovered how deeply satisfying it is to help other people, particularly those who cannot speak for themselves.

I have dreamed of becoming a physician since childhood, because medicine offers the rare opportunity to combine science and humanism to make a real difference in other people’s lives. I have a longstanding love of science, which led me to major in engineering in college because I enjoyed working on applied scientific questions. Most of my course work and extracurricular activities were science-related, but my interest in medicine solidified, ironically, during the summer when I took my first break from science. During the fall semester of my junior year, I began to feel overwhelmed by conflicting responsibilities in my course work, part-time employment, and various extracurricular activities. I realized that I had spent most of the previous decade enrolled in academic, research, and community service projects to prepare myself for the challenge of medical school, but I had not yet confirmed that aspiration. I tried to focus on what made me happy at the time, and I realized my most beloved experiences occurred while I volunteered at a pre-school with disabled children. Whether I spent my time helping the children swim, reading to them, or simply chasing after them, I always left with the feeling that I had made a small impact on their lives.

I researched camps for children with special needs, and after talking with directors and former counselors at numerous programs, I chose to become a counselor at the Frost Valley YMCA Mainstreaming at Camp program. I started that summer both excited and daunted by what lay ahead. The counselors and directors warned me that the job would be emotionally, mentally, and physically exhausting, but I had no idea what I would encounter. That summer became the hardest and most rewarding time of my life. Every two weeks a new group of children with a wide range of developmental disabilities entered my life and became dependent upon me for almost all of their care. I quickly realized how different each child was and tried to adjust my counseling style to fit their individual needs. Motivating and communicating with children who cannot -- or will not -- reciprocate your efforts requires a great deal of patience and creativity. Working with this special group of children tested me greatly, but I found that the hardest part was saying goodbye at the end of each two-week session.

During my last weeks at Frost Valley, one of my campers, a 19-year-old girl with mental retardation, began having seizures. I recognized her symptoms, but one night her seizures became continuous. We called an ambulance, and I jumped on board so that I could spend the night with her, holding her hand and acting as her medical advocate. Because she looked quite “normal, ” it was difficult for the medical staff to understand that she had the communication skills of a 9-year-old. After I explained her condition several times, however, the staff realized that although Jackie looked “normal, ” she required special care. After a long and scary night, Jackie was released from the hospital and sent back to camp. Fortunately, she recovered completely and was happy and healthy for the rest of her time at camp.

I am sure she will never remember how frightened she was that night -- or even my holding her hand -- but I know I will never forget it. That summer, particularly that night, reaffirmed my desire to become a doctor. I realized how critical it is for medical professional to understand the needs of special populations, to work directly with them and their families. I also understood that I could join my two loves by working as a pediatrician for children with special needs. Caring for a child who cannot tell you what is wrong requires a person with patience, skill, and compassion; it is my dream to become one of those people.

点评：

这篇文章较为出色，原因在于作者利用志愿者的工作经历很好地说明了申请医学院的动机，当中的细节描写使人留下深刻印象。虽然文章的后半部对于Jackie发病一事的叙述略显功力不足，但是整篇文章中，作者对于医学的理解和热情渗透在字里行间，较为真实动人。

译文：

我第一次遇见Carla的时候，她正独坐在餐厅中央的地板上，其它的营友们都在外头玩耍。Carla披一头卷曲的头发，十一岁，患有孤独症。这是她第一次出远门，她正努力去适应新模式，陌生人与陌生的环境。与此同时，作为她的夏令营顾问，我正尽力尝试去盘算她的需要。Carla并不能自然地与人沟通，她对于我的询问的回应，只是把问题复述一次。要带她从一项活动过渡到另一项活动是困难的，因为，每当游戏结束时，Carla就会坐在地板上，不肯离开。我尝试过唱歌，跳舞又或是玩“猜主子”，但对Carla都没用。然后，突然间，在与她一起几天之后，我发现Carla对手非常感兴趣。即使她不能握着别人的手，她也喜欢触摸它或注视它。我马上发现我可以利用她的兴趣激发她参与身边活动的热情。在接下来的两周内，我把我的双手变成了蝴蝶的翅膀，引着我俩流转于学校之中。虽然我们并不能以言辞交流，但我们却建立起了比对话更有力的联系。而且，我发现帮助他人是如此的有满足感，特别是对于那些不能为自己说话的人。

我自小就希望成为一名医生，因为医学提供了弥足珍贵的机会，让我们结合科学与人道主义，从而改变他人的生活。我对科学有着持久的热爱，这致使我在大学期间选修了工程学，因为我喜欢解决应用性科学问题。我所学的课程，所参与的课外活动，大多与科学相关，但是我对于医学的兴趣，讽刺地，却是凝固于我从科学中逃离的日子。大三的那个秋天，我开始被学业，兼职工作，社团活动三者间互相冲突职责压得透不过气。我意识到我在过去的十年间参与的学术，科研，社区服务活动，为我迎接医学院的挑战做好了准备。但是，我并未能确认我对此的渴望。我尝试专注于那些能让我快乐的事情，而当我在一间残障儿童预备学院做志愿者时，我意识到让我最醉心的历程开始了。无论是帮助这些儿童游泳，还是给他们读书，或是简单地跟在他们身后，我总是感到我对他们的生活有着一点一滴的影响。

我为这些有特殊需要的儿童对夏令营作了个调查，在与主管和众多不同项目的前负责人交谈后，我选择了作为一名辅导员，参与到Frost Valley YMCA Mainstreaming at Camp program中。如前头所说的，我在兴奋与沮丧中展开了这个夏天。顾问与主管提醒我，这份工作会非常累，无论是在情绪上，精神上还是身体上，但我并不知道我会遇到什么。这个夏天成了我生命中最艰难，也是最有收获的时光。每两周就会有一组有着各式各样发展缺陷的儿童加入到我的生活中，然后开始对我几乎百般依赖。我很快意识到，每一个儿童之间是如此不一样，我尝试去调整我的询问风格，以适应他们的个性化需要。对这些不能，或是不愿，响应你的努力的孩子进行激励及沟通，需要极大的耐性与创造力。与这些特殊的群体进行协作，是对我的重大考验，但我发现，最难度过的，却是每两周课程结束时道别的一刻。

上周，在Frost Valley，我的一个夏令营队员，一个患有智力迟钝的19岁女孩，开始癫痫发作。我观察到她的症兆，一晚，她的癫痫变得持续不断。我们召了救护车，我也跳了上车，以便在晚上照顾她，我捉紧她的双手，并充当他的医疗辩护人。因为她看上去十分正常，对于医护人员来说，很难理解她只有9岁孩童的沟通能力。当我多次解释她的病况后，医护人员们只是认为，Jackie看上去正常，但是也需要特殊的照料。经过一个漫长而恐惧的夜晚后，Jackie出院回到营地里。所幸的是，她完全好了，健康快乐地与其它人一起度过了营地的余下时光中。

我确信她永不会记得，她那晚是如何地抗争——或是甚至我握住她的手——但我知道，我永远不会忘记。那个夏天，特别是那个晚上，我重新肯定了我成为一名医生的愿望。我认识到与特殊群体及其家人的接触，对于医疗工作者明白特殊群体的需要是如此的重要。照料一个不能告诉你什么是错误的孩子，需要耐心，技巧与恻隐之心；我的梦想就是成为这样的人。