第一次在英國掛急診，致電 NHS 111 尋求醫療建議

前陣子身體不舒服，而導致錯過了朋友揪團的 Enyford 健行，原本以為休息幾天就應該沒事了，但那在胸口靠近心臟得灼熱感，不舒服還是持續沒有消散，從 Google 搜尋胸悶胸痛的結果，永遠都是那萬年不變的心肌梗塞，心臟病變等詞條，實在是讓我心驚膽跳。

忘記不了的那星期四，早晨身體微恙跟著朋友在住家附近散步，在吃完從漢堡王買回來的餐點後，胸悶的感覺又更加劇了，尤其是靠近心臟那個區域，那不舒服感甚至輻射到左手臂去。

實在覺得異常奇怪，覺得有必要去看醫生，按照英國的免費醫療系統 (NHS, National Healthcare Service) 分級制度，若非緊急情況都是先去找所註冊的 GP surgery 家庭醫生，但因為武漢病毒疫情 (COVID-19) 緣故，現在無法直接預約看診時段，而是得先在該診所網站輸入症狀描述，以及回答網站跳出來的機械式問題，診所才會決定是否需要幫你安排看診。但自己所提交的症狀描述，但卻得到請儘速尋求 111 或是 999 協助，無法安排任何的看診⋯⋯。

於是乎打電話給 111 尋求幫助，經過本地的 111 醫療中心職員的資料確認，請求中文翻譯 (Mandarin interpreter) 來描述自己的狀況，在醫療串的問題之後，該職員說會將我的案件轉交給醫生，請等待之後的醫生來電，心裡覺得似乎狀況有點不妙呢？

Machine: Thank you for calling NHS one one one, please press nine to continue.

(Press nine)

Machine: First, let’s look out where you are, if you’re in London, please say the name of the London borough or nearest tube or train station.

Me: Canada

Machine: I think you are near Canada Water, answering only yes or no, is that right?

Me: Yes

Machine: If you are calling about coronavirus testing, please hang up and redial one one nine or go online at NHS UK Forward slash coronavirus. The NHS one one one service does not manage coronavirus testing enquiries.

Machine: There may be a short course while we connect you to your local NHS one one one provider.

(Transferring the call)

Machine: Please enter your age in years or the age of the person you are calling about.

(Typing the age)

Machine: Due to heavy demand, if you are not calling about coronavirus, please contact your own practice in the first instance.

Machine: If you have already contacted your GP practice, please hold.

Machine: Please listen carefully to the following four options.

Machine: if you are the person you are calling about is unwell, please press one.

Machine: If you need urgent dental care, please press two.

Machine: If you have run out of your usual medicines prescribed on the NHS and you cannot contact your GP or usual pharmacy, please press three for all other inquiries.

Machine: Please stay on the line.

Machine: This call is recorded for quality purposes, an interpreter is essential, a request for critical records might be shared with any staff asking for you to with your GP unless you request otherwise. You may be contracted to participate in the survey as your views are important to us. Please stay on the line and your call will be answered shortly.

(Waiting for the transfer)

Me: Good afternoon

111: Good afternoon, You’re through to NHS. My name is Lee and I’ll be your health adviser. Is for yourself somebody else?

Me: For myself, and can I ask for a Mandarin interpreter, because when I’m afraid my English skills maybe not good to describe my symptoms.

111: Yes, that’s absolutely fine. Can I start by taking your date of birth and setup the detail first?

Me: Yeah, 19th of May, 19xx.

111: Ok, that would be a moment.

111: I just confirm your surname for me

Me: Yes, the surname is Wang, W-A-N-G.

111: Okay, I am searching for that, and your first name?

Me: Siyuan, S for Sierra, I for India, Y for Yankee, U for Uniform, A for Alpha and N for November

111: That’s lovely, thank you. Can just confirm your home address for me?

Me: Yes, the postcode is S-E-1-6 7-B for Bravo-L for Lima

111: I’m just going to have a quick look on the computer for you. Is your house at 15?

Me: Yes.

111: Okay, now what are we going to do then, is that we just take a contact number from you, just in case we get disconnected. And I have to call you back. What’s your mobile number?

Me: It’s the current one.

111: Yep, yep. Okay, just bear with me.

111: Ok, and the GP practice where you register, please?

Me: the Park Medical Centre.

111: All right, let’s just bear with me a moment.

111: Okay, right now what’s the language are you, Siyuan?

Me: In Mandarin.

111: Mandarin. Okay, so what I’m going to do, I’m going to put you on hold for a few seconds, OK? I’m just going to link up with one of the interpreters. And then we can go from there. All right?

Me: Okay

111: Okay, So wait few seconds, thank you.

(The interpreter Jenny joined, and start talking my symptoms)

…

111: Ok, so Jenny, please translate what will happen now, is you will receive a call back from a doctor, a nurse or a paramedic, and they will call back to discuss the information with regards to what’s going on in more clinical detail.

…

111: Lovely, and thank you for the call. Jenny. Thank you for the help.

Me: Thank you very much.

過沒有多久便接到醫生來電，一樣要求有中文翻譯的陪伴來描述症狀，當然如果能直接理解醫生的問題，便能直接用英文回覆，另外有注意到翻譯有多加些其他症狀描述，但自己用中文說沒有提到該些症狀的情況發生，只好再用英文更正一下描述。

Me: Hi, this is Siyuan

Dr: Hi, Mr. Wang. Dr. Mohammed from NHS 111 returning your call. Confirm your date of birth and address

Me: Yeah, my date of birth is 19 of May, 19xx.

Dr: Yes, confirm your address, please

Me: Yes, the postcode is SE16 7BL, flat xx, Ritchie House.

Dr: Is that where you are at the moment?

Me: Yes.

Dr: Are you living with anybody or alone?

Me: I am living in the shared-flat

Dr: Of course, I’m knowing about you, but tell me in your own words, the main reason for your call.

Me: Sorry, would you say that again?

Dr: Would help if I get an interpreter?

Me: Yes, Mandarin, please.

Dr: Let me get an interpreter. We will call you back, keep the line free of it, OK?

Me: Yeah, OK.

(Hang-up the phone, and call back soon)

(Discuss my situation with the interpreter and doctor)

最後醫生說明有點擔心狀況，建議趕緊去緊急護理中心 (UCC, Urgent Care Centre)，安排心電圖檢查 (ECG)，除了幫忙尋找最近的醫院，還詢問有沒有人可以陪我去，能不能安排計程車或是 Uber 前往，而不是搭乘公共交通過去醫院，還說需不需要晚點打電話確認有沒有到 UCC⋯⋯。也說明如果有其他症狀發生，例如下顎 (jaw) 也開始不舒服，甚至出現冒冷汗 (sweating) 的情況，要立刻打 999。

當下聽完是很傻眼，簡單換衣服與戴上口罩，趕緊呼叫一台 Uber 前往位於滑鐵盧的聖湯瑪斯醫院 (St Thomas’ Hospital in Waterloo)，也還請司機送到離 UCC 入口最近的地方下車，一進門就是跟櫃台掛號 (check-in)，這時候就沒有中文翻譯，完全靠自己說明症狀與來意後，工作人員詢問有沒有 Convid-19 症狀，測量體溫、血壓心跳、與血氧濃度等常規化檢查，還一說明要自己放鬆不要太焦慮，不然那心跳與血跳都異常的高啊。也同時跟工作人員確認，原來若 111 沒有幫忙安排應診，醫院也拿不到剛剛在電話與醫生的對話記錄。

之後便是給予表格填寫基本資料，等待叫號再次確認輸入資料，便在外頭等待區等待檢查。不知道是否因狀況比較緊急，亦或是當時 UCC 沒有太多緊急處理的案件，很快地就被安排進入診間，脫光上衣做心電圖檢查。接著跟著拿著心電圖結果與個人資料的護理師 (?) ，深入位於醫院中心的診間休息區，等待與醫師的會診。

被醫師領到小診間後，便是開始描述自己的症狀，在沒有中文翻譯協助下，用盡已知的英文單字搭配肢體語言，讓醫師理解並記錄到電腦裡，體感時間有經過 20 分鐘之久，期間醫師她非常友善與客氣，完全沒有催處或是不耐煩，儘管過程中有時沒有聽懂她的問題，也會很有耐心改用簡單英文再描敘一次問題。

幸好初步診斷與心電圖判定下，並不是心臟相關的疾病，而可能是因為胃食道逆流所造成的不適，俗稱燒心 (Heartburn) 的問題，但醫師還是幫我安排抽血檢查，以排除是心臟的相關疾病。只是由於自身血管細小，醫師她似乎經驗不夠多而抽不到血，改找其他同事協助抽兩管血，算是白白挨兩針，後續還因為針頭問題而有一管血無法安排檢驗，那又是另外一個故事的啊。

也許因為這樣，當醫師嘗試寫下有什麼藥物，之後可以去藥局買來舒緩症狀時，因找不到一般紙張，而只能寫在擦手紙時，才調侃說「That’s the St. Thomas’s quaility」，真是令我哭笑不得。

其後又在急診室待了一個多小時等待血液報告，同時也觀察急診室診間的病人，算算那段時間不到十個病人進入該診區，但是至少有五個醫療人員在該區域工作，不知道是否是因為分級制度關係，抑或是白天比較不忙錄，沒有太多急診病人。

最後拿著醫師開的處方 (prescription)，在醫院的藥房花費 £18.30 取藥，急診費用則是由 NHS 支出，回家前買麥當勞雞塊與可樂壓壓驚，結束有驚無險的第一次英國急診初體驗⋯⋯。