My Days in the Plastic Surgery Department | 在整形科的日子

Written by: Wang Li | 王莉

Translatedby:CamilaTay

Editor’s Note:
This article is excerpted from Haha! Britain — a charitable bilingual publication co-produced by The Mothers’ Bridge of Love (MBL) and River Cam Breeze. The book is a lively collaboration between 42 Chinese authors living in the UK and 36 university-based volunteer translators. With wit and warmth, the stories capture the everyday realities of Chinese communities in Britain, offering an honest look at the cultural clashes, humour, and adaptation that arise in the space between Chinese and British ways of life. Haha! Britain has been warmly endorsed by several well-known figures in UK-China relations, including Stephen Perry (former Chairman of the 48 Group Club), Luise Schäfer OBE (former British diplomat and Chamber of Commerce chair), Professor Hugo De Burgh (former BBC editor and academic), and British scholar Martin Jacques. The book’s title was handwritten by celebrated British-Chinese artist Qu Leilei, its cover illustrated by bestselling Chinese author and poet Feng Tang, and the postscript contributed by Xue Mo, a prominent voice in contemporary Chinese literature.

Illustrated by Tian Tian

In my five years in the plastic surgery department, I’ve experienced a range of emotions – joy, anger, worry, sadness and fear. I’m immensely grateful for this experience, which I hold dear. Though I’ve never undergone plastic surgery, I feel like the experience of working in the field has made me a completely different person, inside and out.

1.     Background

Medical professionals are often portrayed on TV as quick on their feet, with nurses instinctively handing over surgical tools with just a glance from the surgeon. I’ve always admired this seamless coordination. My fascination grew while watching the TV series Qi Ren Qi An (translated as “Strange People, Strange Cases”), particularly the chemistry between the medical student, played by Carman Lee, and the handsome doctor.

Driven by curiosity and admiration, I pursued a career in surgery, eventually landing a job in the Plastic Surgery department at the West Wing of John Radcliffe Hospital in Oxford. The department originally began as the Radcliffe Infirmary (RI), Oxford’s first hospital, which opened in 1770. The RI has a rich history, including serving as a military hospital during WWI and being the site where the first dose of penicillin was injected into a human patient. When the RI closed in 2007, the department moved to the newly constructed West Wing, which now boasts world-class facilities in neurosurgery, plastic surgery, pediatrics, ophthalmology and ENT.

The move from RI was controversial, with many senior employees opposing it and even resigning. Some referred to the new facility as “JR2”, which they likened to the humiliation of the Jingkang Incident in Chinesehistory, which involved the siege, fall and sacking of the Song capital city of Kaifeng in imperial China as well as the abduction and relegation of the dynasty’s emperor Qinzong. Even years later, colleagues frequently reminisced about the RI, and I often felt a pang of sadness for not having been part of that chapter.

After making it through the interview, background check and physical examination, I started my new job on November 2nd. I vividly remember walking through the autumn leaves, feeling both anxious and excited. A middle-aged man commented on my determined footsteps, which I initially took as a compliment, though I now suspect he was being sarcastic because my loud footsteps likely disturbed him.

At the hospital, I was greeted by K, the head nurse of the plastic surgery department, who introduced me to the team. My first impression of the operating room was one of awe – it was far more spacious and bright than what I had seen during my internship at a hospital in Beijing. The facility had three distinct rooms: the anesthetic room, the preparation room, and the disposal room. K explained that our department focused not on cosmetic surgery but on reconstructive procedures for conditions like craniofacial deformities, cleft lips, hand deformities, mastectomies and trauma repairs. She proudly said: “Our team offers treatment for patients from head to toe. It will be a great learning experience and you will have plenty of opportunities to develop your skills, but of course, we will be very busy.” With that, a journey filled with challenges and discovery began.

2.     Facing off against “bossy” superiors

As a newcomer, I underwent a six-month training programme, including three months of classes and three months of rotations. My first major surgery was a mastectomy with free flap reconstruction. In this procedure, one of the patient’s breasts is removed, and a section of muscle from around the navel area is used to reconstruct a breast. The advantage of this surgery is that the patient ends up with a perfect breast and a flat abdomen, killing two birds with one stone.

The chief surgeon, known for his temper, made me nervous even before the surgery began. Despite my best efforts, I made a mistake during the operation, and the surgeon responded angrily. “Give me your hand,” he said, before slapping the instrument into it. I was feeling both scared and angry, so I followed his instructions and slammed the vascular clamp onto his hand. Perhaps I had used too much force, as the tool came loose the moment it reached the chief surgeon. He looked at me with a deadly glare.

As a shy and inexperienced newbie, I often felt bullied by my colleagues, and the thought of working with this aggressive surgeon caused me many sleepless nights. Yet I refused to quit, telling myself, “I love this job. I will not leave because of anyone.”

Over time, I realised that the surgeon’s anger stemmed from the stress and complexity of the surgeries. He might have expected more support from me and was frustrated by my inexperience. As the Chinese saying goes, he might have “hated the iron for not becoming steel”, which means to feel resentful towards someone for failing to meet expectations and impatient to see improvement.

Recognising the need for better communication, I devised a strategy to take the initiative in the operating room. During our next surgery, I kept the circulating nurse informed and even instructed her to fetch additional tools when needed. To my surprise, the surgeon remained calm throughout, and later specifically requested me to assist him in future surgeries. During one operation, I noticed he was struggling to cut a particular tissue. Before he could lose his temper, I decided that I should step in to do something, and loudly instructed the circulating nurse to grab a new pair of surgical scissors. When she told me that there were none left, I responded even more loudly, “If there are none, you can borrow them from another department, or even from another hospital.” The circulating nurse began to giggle and signalled to me that I was overacting. Meanwhile, the overbearing surgeon responded calmly that he would just work with that pair of scissors.

Working with this surgeon made me realise the importance of communication. Raised in China, I was taught to be humble and keep a low- profile. I assumed that “speaking less and doing more” was the optimal approach in everything. However, it appeared that especially outside of China, “speaking less” could sometimes lead one to being seen as a “sick cat”, a Chinese term that means a weak person. In this context, being humble could lead to one being perceived as lacking confidence, and it is important to actively express oneself.

3.     Interacting with passive bosses

Not all surgeons are overbearing. I once assisted Alex, a British surgeon with Australian training, known for his easygoing nature and love for playing pop songs during surgery – I have him to thank for introducing me to my first Taylor Swift song. During the end of a muscle transplant surgery for a young patient who had been in a car accident, I was taking account of all the medical instruments and noticed something missing. It seemed like the green film that is placed under the blood vessels to give the surgeon a clearer view for suturing could have been left inside the patient’s wound. When I alerted Alex, he calmly thanked me, and we re-opened the leg to check. He removed the fingernail-sized film without issue, and reassured me that while the mistake wouldn’t have harmed the patient significantly, it would have weighed heavily on our conscience.

After hearing this, I felt extremely touched. How did he understand my inner thoughts so well? I knew that he believed I was an upright person, and I would always live in guilt if I made a mistake. His affirmation gave me immense strength. Any time I face a similar situation that leaves me conflicted, I ask myself, “If I do this, will I be able to sleep soundly for the rest of my life?” This is probably why I particularly love the phrase, “No guilt in life, no fear in death” – my lifelong pursuit.

4.     The “tall, rich and handsome” doctor and the damsel in distress

This story happened over a decade ago, yet it remains a classic memory often shared during gatherings with current and former colleagues. At that time, I was Dr. Adam’s scrub nurse. Dr. Adam, a young and witty chief surgeon, exuded sophistication while maintaining a low profile. Known as the “tall, rich and handsome” doctor, he had a fan-base of nurses across all ages and departments.

I was about two months pregnant then, though none of my colleagues knew. One morning, after preparing the medical instruments, I suddenly felt dizzy, my vision darkened, and I whispered, “I’m about to faint.” Dr. Adam, who was standing behind me, quickly supported me and gently laid me down on the ground. As I lay there with my vision completely gone, I could hear his calm voice urging me to move my legs gently. He asked, “Did you add sugar to your tea this morning?” I replied, “No.” Then, he inquired if I was on my period. Quietly, I told him, “I’m pregnant.” With the enthusiasm of announcing good news, he exclaimed, “Well done!”

My eyes flew open in shock. Initially, I did not plan on announcing my pregnancy in such a way, but it was too late. The department head and a few colleagues rushed over upon hearing the news. The situation felt incredibly awkward, and I wished I could disappear. As a colleague escorted me to the sick bay, the first thing she asked was, “Why didn’t you stay on the ground longer? You missed such a good opportunity.” She jokingly added that if she had fainted, she would have told Dr. Adam she couldn’t breathe. I laughed and replied, “That wouldn’t work – there’s a respirator right there; why would Dr. Adam be needed?”

After fainting during my shift as Dr. Adam’s scrub nurse, I was “forced” to go home and rest. I told my supervisor, “I’m fine, I can keep working. I just have a little low blood pressure.” I’ll never forget her reply, “I’m not just responsible for you; I’m responsible for the patient too. Someone who doesn’t have enough blood flowing in their veins can’t serve others.” Her words were logical, clear and compelling. I later found myself using the same reasoning when advising colleagues and friends. At that time, I was focused on working hard, but her words enlightened me – I realised that resting was the better way to be responsible to the patients. When I got home, I lay down with determination, reminding myself, “Only by taking care of yourself can you take care of others.” My mother had often told me this, and it turns out she was right.

These stories are just a few of the unforgettable moments from my time in the plastic surgery department. Countless more memories, though they fade with time, still spring to mind unexpectedly, transforming into a magical force that inspires and empowers me to face life positively.

The National Health Service (NHS) in the UK is full of talented individuals with interesting and compassionate souls. Perhaps it is because everyone has an understanding and acceptance of mortality that they embrace life with more respect and a lighter heart. It was common to hear in my department that we need to treat our patients as if they are our family.

For example, a doctor who performed cleft lip surgeries for children always used the smallest surgical needles to stitch the lips of the young patients. He explained, “Lips are extremely important to girls. The quality of the stitching will directly impact her first kiss in the future.” Another doctor who performed head and neck surgeries would always say a little prayer while cleaning a patient’s wound after a tumour removal. As he poured the saline on the patient’s wound, he would chant, “Die, cancer, die!” Every time I heard this, a quote from one of John Green’s novels would come to me, “The world is not a wish granting factory.”

To me, the relationship between patients and medical staff is one of mutual healing. We care for their illnesses, while they remind us to cherish our loved ones and appreciate the blessing of good health.

About the author

Wang Li, a registered nurse in the UK, joined Oxford University Hospitals in 2008. She worked as an instrument nurse in plastic surgery for five years before transitioning to an anesthesia nurse role. She is currently a Senior Specialist Nurse in Preoperative Assessment. She loves life and work and enjoys recording and sharing interesting stories from her life.

在整形外科的五年，喜怒忧思悲恐惊，每一款都在舌尖上细细品尝过，我非常感谢和珍惜这段宝贵的经历。虽然我没在自己身上动过一刀一线，但离开时我觉得整个人从内到外被重塑一般。一个个大大小小的情景历历在目……

1. 背景

每次在电视上看到手术室里，医生和护士眼一对，手一伸，护士“啪”的一下把剪刀递过去的镜头，我都对那位传递手术器械的人充满敬意。他们是如何知道要传递什么工具的呢？我曾经在观看当时非常热门的电视剧《奇人奇案》时，对这个过程产生了莫名的崇拜之情。之后，看到李若彤和那位帅哥在手术台上如此默契地协作，我的崇拜之情更加强烈了。

带着这份好奇和崇拜，我把找工作的简历全部投在了手术室，非常幸运地拿到了位于牛津的医院西翼楼（West Wing）整形外科手术室的工作机会。这个科室的前身是建于 1770 年的约翰·拉德克利夫医院（Radcliffe Infirmary），在一战期间曾经做过战地医院，1941 年世界上第一支青霉素就是在这家医院给病人试用的。后来约翰·拉德克利夫医院被牛津大学合并，于是全部科室在 2007 年搬到了牛津原约翰·拉德克利夫医院西边新建的大楼西翼楼。这里拥有具备世界一流技术的脑外科、整形外科、儿科、眼科和五官科。

约翰·拉德克利夫医院闪耀的前世和独立的运行模式是每一位员工的骄傲，以至于搬到新的地址以后，一些老人在情感上无法接受，相继离开。更有甚者把西翼楼唤作“约翰·拉德克利夫二号”，这对于老员工来说丝毫不亚于“靖康之耻”。我工作的时候早已时过境迁，但是一天之中至少能听到三次有人提及在原约翰·拉德克利夫医院的日子。我也会时常暗自惋惜没有机会早点参与西翼楼的前传。

经过了面试、材料审核、体检，我终于等来了新工作报到的第一天。我清楚地记得那是 11 月 2 日，我穿着一件大红色的风衣，踏过路边的落叶，秋风吹着我新烫的卷发，我心情复杂，激动又紧张地走进了西翼楼。我穿着那双其乐牌（Clarks）新鞋走在医院的走廊里，发出“咣咣”的声响和回音。记得当时迎面走来的一个中年男人说：“Your footsteps sound so determined.（你的脚步听起来很坚定）。”我当时还以为这是夸奖，于是走得更加“坚定”了。现在想来，当时的脚步声可能是烦到他了，他说的是反话吧。

我按照地址走到前台，说明了情况，前台的秘书找来了一位英国中年女性，卷卷的短发却是走路带风，微笑着来到我跟前，主动伸手自我介绍，“我叫 K，是整形科的护士长，欢迎加入我们整形科。”K 带我到了更衣室，换好衣服，径直到了手术室。我心里想着，这就是《奇人奇案》里面李若彤和那个男神工作的地方吗？这就是我梦想的地方啊！这里看上去比当年我在北京实习的 XX 医院的手术室更加宽敞明亮，而且还是三室一厅。三室是指麻醉室（病人麻醉的地方）、准备室（刷手护士准备器械的地方）、处置室（扔医疗垃圾的地方）。我记得当年 XX 医院的病人好像是直接在手术室被麻醉的。

K 介绍说，我们的整形科不是公众想象的那种美容外科，我们的病例主要包括颅脑畸形修复、兔唇修复、手修复、乳腺癌引起的乳房切除和重建、皮肤癌的切除与重建以及各种软组织创伤修复。她骄傲地说，“我们这里的手术没有固定的部位，从头到脚都有，非常锻炼技能，当然我们也会非常忙。”

于是在那个陪着枫叶飘零的晚秋，我开始了在整形科“摸爬滚打”的历练和探索。

2.     过招“霸道”主刀

我的经验有限，开始在整形科手术室接受了为期六个月的培训，包含三个月的上课和三个月的巡回。六个月后，我终于获得了上手术台的机会。一开始是小手术，累积经验，之后开始接触大手术。至今，我还清晰地记得我参与的第一台大手术是乳房切除和自由皮瓣移植手术。这个手术是把病人的一侧乳房切掉，然后在腹部肚脐周围切除一段肌肉用来重建一个乳房。这个手术的好处是术后病人有完美的乳房和平坦的小腹，一举两得。正如有句谚语说的一样，“每一片乌云都有金边。”

那天手术的主刀医生在大家口中是个脾气暴躁的主任。我从前一天起就开始紧张。手术中，即便我处处小心、时时留意，但还是没有逃过他的训斥。在我给他递血管夹把手时，他终于爆发了，很大声地说：“把你的手伸过来，”然后，他“啪”的一下把血管夹把手拍在我手上，说：“你要这样递给我才对。”我又怕又气，于是按照他的指示，“啪”的一下把血管夹把手拍到他的手上。大抵是我用了过大的力气，以至于已经放到他手上的血管夹都被震掉了，他狠狠地瞪了我一眼。至今我还记得当时我们对峙的眼神。

由于我是新人，英语不够自信，性格又不很强势，因而时常受到同事的排挤和欺负，以至于有的同事会把最难对付的病例调配给我。每到周二，想到周三要参与霸道医生的手术，我就睡不好觉，感到特别的焦虑。偶尔我也会想离开那个手术室，可是我又不断地问自己，“如果离开了，你会甘心吗？”我内心的回答非常坚定，“不，因为我喜欢这份工作。我不能因为某个人而离开。做错事的人才是应该离开的人。”

之后，我就开始想办法改变这种困境。经过我的分析、观察和思考，我发现这位霸道医生发脾气的原因并不是来自我，而是因为手术的复杂而感到紧张。真没有想到他也有对自己的不自信。我意识到，他之所以对我这样发脾气，可能是因为他希望能够得到我更多的支持和协助，而我作为一个新人能力有限，有种“恨铁不成钢”的着急吧。

我意识到我们需要更多的交流和互相支持。于是，我制定了新的策略。再次合作时，我“喧宾夺主”，从开始消毒到铺无菌台，我全程不停地跟巡回护士交流，而且及时提醒她传递手术器械。没想到，洗过手后，主刀医生竟然平和地问我：“我能帮你什么吗？”我未作声，心里想着，“我走你的路，让你无路可走。”手术中，我看到他剪某个组织很费劲，就在他发火之前先发制人，大声地让巡回护士去拿把新剪刀，巡回护士说：“没有了。”于是，我用更大的声音说，“没有了你去其他科室借，不行就去其他医院借。”巡回护士在那儿偷笑，手语暗示我“演”得过了。这时，霸道医生像小猫咪一样，轻声细语地说，“没关系的，这把剪刀将就着能用。”

谁都没有想到，霸道医生在这次手术中全程都没有“发飙”。后来，他还主动点名让我上他的手术。我在“江湖”上站稳了脚跟，连那些被他骂过的老员工也逐渐对我友好起来，时不时地打趣，把霸道医生唤作我的朋友。

经过此事，我也意识到了交流的重要性。我在国内长大，接受的教育是做人要谦虚和低调，我也一直认为“少说话、多做事”才是良好的作风。但是，特别是在国外，“少说话”有的时候会被当成“病猫”。这样说来，谦虚用错了地方会被当成不自信。我明白了，在必要的时候，要积极地表达自己。国外的字典里没有“悟”字，只有“YES”或“NO”。

3.     遇上“佛系”主刀

终于有一次，我“赢”来了不用和霸道医生合作的日子。这次的主刀医生亚历克斯是一个在澳大利亚受过培训的英国人。亚历克斯性格特别好，非常开朗，而且他手术时会放着最流行的音乐缓解压力。我第一次听泰勒·斯威夫特的歌，也是从在他的歌单里“淘”来的。每每看到大家都喜欢和他搭班，我就开玩笑地说，“他肯定是随身携带了澳洲的阳光”。

这台手术病人是一个遭遇车祸的年轻人，需要做双腿的肌肉移植，就是从大腿上切下一块肌肉，移植到小腿上。这是一台全天的长时手术，开始进行得非常顺利，午饭前就完成了左腿的移植。亚历克斯嘱咐助手医生先把左腿缝好，午饭后再开始右腿的工作。在助手医生开始缝合左腿时，我做缝合前的器械和材料清点。可是在我还没清点完时，左腿就已经缝合完毕。点到最后时，我发现做背景的绿色胶片（移植连接血管时都要在血管的下面放绿色的胶片，这样可以帮助医生以更清晰的视野来缝合血管）不见了。我突然意识到这个绿色胶片可能没有从伤口中取出。于是，我把自己的想法和担忧告诉了亚历克斯。亚历克斯说，“谢谢你告诉我。没关系，打开看看就知道了。”助手医生劝慰我说，“别担心，是我的错。”亚历克斯说，“谁都没有错，我们是一个团队。”助手医生把左腿的伤口打开，从里面取出了指甲盖那般大小的绿色胶片。幸好这个小小的胶片在手术完成前被发现，又很及时地取出，不算是“医疗事故”。

手术结束后，我询问亚历克斯倘若胶片未取出的后果，亚历克斯说，“对病人的影响其实不大。但是你今晚回到家和以后的每一天，都会受到良心的谴责。它对我们医护人员内心的伤害远远大于对病人的伤害。”我当时听了特别感动，他怎么如此了解我的内心想法呢？！我知道他相信我是一个内心坦荡的人，如果做错事会必会受到良心的谴责。他的肯定，给我了无穷的力量。以后每次遇到纠结的事情，我都会问自己，“如果做下去，今晚和以后的每一天会不会心有不安？”我想，这也是为什么我很喜欢一句歌词：“No guilt in life, no fear in death.（一生无憾，临死不惧。）”这不就是我自己对人生的终极追求嘛。

4.     “高富帅”医生英雄救美

这个故事已经是十多年前的事了，但仍是每次和前同事聚会时的经典回忆。

那段时间我是亚当医生的刷手护士，亚当医生是年轻的主任医师，文雅、幽默，是个低调的“高富帅”，科里的老少护士都是他的粉丝。

那段时间我刚刚怀孕两个月左右，其他的同事还都不知道这件事。一天早晨，我在准备完器械以后，突然感觉眼前发黑，开始头晕。我说，“我要晕倒了。”这时，站在我身后的亚当医生伸出胳膊搂住了我的腰，我的头先倒在他怀里，他慢慢地把我放倒在地上平躺。我躺下后，眼睛什么都看不见，只听到他温柔的声音叫我轻轻地抖动双脚，然后又问：“你早上喝放糖的茶了吗？”我说：“没有。”他又询问我是不是在例假期间，我非常小声地告诉他：“我怀孕了。”他像是宣布喜讯一样大声地说：“Well done!（太棒了！）”

我吓得眼睛一下子睁开了，差点从地上坐起来。我本来不想用这种方式公开自己怀孕的消息，但为时已晚。部门负责人和几个同事已经闻讯赶来，我当时觉得非常尴尬，恨不得从地缝里消   失。同事把我扶到休息室，问我的第一句话却是“为什么不在地上多躺会儿，浪费了这么好的机会？”然后花痴般地说梦话，如果晕倒的是她，她肯定会告诉亚当医生，她无法呼吸。我笑着说： “你这招没用啊，边上就是呼吸机，哪里用得着亚当医生？”

本来那天我是亚当医生的刷手护士，结果一晕倒，被“强制”回家躺了一天。我跟上司说：“我没事，可以继续工作的，只是有点低血压。”上司的回答令我至今难以忘怀：“我不光要为你负责，我也要为病人负责。一个血管都快空了的人是不能为其他人服务的。”她的话逻辑清楚，掷地有声，像一股清流。后来，我也经常会用同样的话劝说同事和朋友。我当时想的是要努力工作，她的话让我顿时觉得回家休息才是对病人更好的负责。那天回到家，我理直气壮地躺平。“把自己照顾好了，才能照顾别人。”这话其实妈妈以前也跟我说过，看来听妈妈的话永远没错。

以上几个故事只是印象颇为深刻、让人难以忘怀的一些片段。在整形科的日子里，还有太多零星点滴的记忆碎片。随着时间的推移，这些片段似乎在脑海里慢慢消散，但又在某个不经意的瞬间，转换成神奇的力量，深深地影响着我，鼓舞我更加积极地面对生活。

英国国家医疗系统（NHS）里面人才济济，有太多有趣和有爱的灵魂。大抵是因为大家都明白死亡是无法逃避的事实，所以对生命更有敬畏之心，反而活得更加从容。在我工作的科室里，大家经常说，“要像对待亲人一样治疗病人”。比如一个做儿童兔唇手术的医生，向来都是用最小号的缝针非常仔细地给小病号们缝合嘴唇。他说，“嘴唇对女孩子来说是多么重要啊！缝线的水平会直接影响到她未来的初吻。”还有一个做头颈外科的医生，每次在给病人切完肿瘤之后，都会在冲洗伤口的时候做一个小祷告。他会一边往伤口上倒盐水，一般念叨着：“Die, cancer die!（癌症去死吧！）”每次听到他在祷告，我都想起约翰·格林（John Green）小说里写的一句话：“The world is not a wish granting factory.（这个世界不是圆梦的工厂。）”

于我而言，病人和医护人员之间是双向治愈的。我们在治疗他们的疾病，而他们时刻都在提醒着我们要珍惜身边的亲人和朋友，拥有健康的生活是多么难得啊。

作者介绍

王莉，英国注册护士，2008 年入职于牛津大学医院，曾经在整形外科做过五年的器械护士，后改做麻醉护士，现在是高级术前评估专科护士。她热爱生活和工作，喜欢记录和分享身边有趣的故事。