Lu Xiao (first from left) and medical students (Courtesy of Tencent Video/Photo)
Lu Xiao is a bit like the kind of doctor in the American drama, who does not smile when he appears, and cannot be distracted and dozing under his eyes. He secretly observed the young doctor's every move, and if he made a mistake, he would be criticized. To do not do well is to be bad, and he should not listen to sophistry.
The eight new medical students had mixed experiences. Due to the filming of the workplace observation reality show "Heartwarming Offer 3", they were arranged to receive intensive training at the Second Affiliated Hospital of Zhejiang University School of Medicine. The early stage of the specialty study was relatively stable, and when it came to the emergency department, Lu Xiao, the deputy chief physician, was responsible for teaching. The first is to randomly check the questions, how to answer, Lu Xiao does not say no, but from his silence or rhetorical questions can guess one or two. To the only student who answered correctly, Lu Xiao only said one sentence: "Yes." ”
As long as Lu Xiao was there, the air in the clinic seemed a little depressed. Asked about their experience in the emergency room, the medical students concluded, "scolding, scolding every day" and "I can't tell who scolded anymore."
The rest of the hospital is a cure, while the emergency department is lifesaver. Here, to be both fast and accurate, there is not so much time to explain. In Lu Xiao's view, if you really don't understand, you can ask him, but if you don't focus and don't take it seriously, he won't allow it.
In an interview with a reporter from Southern Weekend, Lu Xiao was embarrassed to say that he almost cried two days ago that he had almost trained a doctor from outside the hospital. The other party dozed off during the round, saying that he had little interest in emergency room. Lu Xiao is very angry, even if he learns 10% in the emergency department, there will be benefits in the future.
Some hospitals have invisible chains of contempt, and some young doctors are biased against emergency care as important as specialists. Lin Yan, a cardiovascular physician at the Second Hospital of Zhejiang University, said that this chain of contempt is "low-level and boring", and the emergency department tests the comprehensive quality of doctors.
"Xiao Ye" is a legend in the second courtyard of Zhejiang University, like to wear brightly colored collection shoes and spray some perfume every day. He was the first to sign up for Wuhan to support, and the last to return. Emergency department doctor Jiang Libing remembers that once the emergency ICU (intensive care ward) was admitted to a 12-year-old girl with serious trauma, and she could not see her family, Lu Xiao bought a doll and put it at her bedside. "Don't look at his beard, he looks like five big and three thick, in fact, his heart is very thin and fine."
In the emergency department, sometimes you have to see all the sufferings of the world in one day. In one episode, a thirty-year-old female patient with a malignant tumor in her brain relapsed and could not be treated, and her young husband could only cry helplessly outside the emergency room door. Later, another man was paraplegic, his son was only eight years old, and his wife had just become pregnant. Late at night, doctors took turns rescuing a patient, and CPR was pressed for thirty minutes, but he was still unable to return to heaven.
Back in the clinic, the medical students stopped talking. Lu Xiao asked them, have they ever seen the sunrise at the entrance of the emergency room? He took them out to see. This is Lu Xiao's habit for many years, every time he finishes the night shift, he will drive across the river bridge and watch the sun slowly climb up.
Lu Xiao (first from left) Stills (Courtesy of Tencent Video/Photo)
Here's what Lu Xiao said: Snatched back from the hands of the Grim Reaper
When filming the show, the director team did not tell me their background at all, after the first day of the thorough spot check, the result was unexpected, my scalp was numb, how did this bring?
To be honest, their ability to deal with acute and critical illness is still blank. The director of the previous specialty belt is more gentle, the contrast is large, and I think that my side is particularly fierce. But I said, unlike your previous department, I am the heaviest emergency patient on the front line, and there is no way to do it. If you can adapt, you can adapt, and if you can't adapt, you can only adapt.
Just the scalp, you don't come to tell me you're tired, tell me you can't figure it out, you're tired. I'm more tired than you, and I'll have to look at the eight of you alone.
In my usual teaching work, I am indeed more severe. To let them know that you are in the emergency department, to try to avoid making mistakes, I can allow you to be incompetent, if you really don't know or don't understand, you can come to me, but if your attitude or concentration is not enough, mess things up, I will definitely criticize you. Medicine is a serious matter.
Two days ago, when we checked the room, I almost cried when A doctor from the outside hospital almost cried. He was a bit dozing off, and I watched him for twenty minutes, and after it was over, he said he wasn't our emergency department major and wasn't particularly interested in this stuff. I said that even if you can learn 10%, it will be good for you. When I visited a French hospital, I could only understand 10% of them, and I listened hard. Now we speak Mandarin, you can always understand it, right?
You do it, I look at you and give you the bottom. In fact, they are afraid that there is no teacher watching from the side. Many young doctors, once wrong, there will be shadows, the first time failed, the second time failed, the third time never dared to do it again. He doubted his own abilities. At this time, you have to encourage him, you just happen to run into a particularly difficult patient, it is not very normal, I may fail, no one can guarantee success 100%.
Emergency doctors must be bold and careful, you have to dare to do it, and you have to grasp the details when doing it. Many of our things are walking on the extreme operation of the tightrope, the specialty can be elective surgery, there is a lot of preoperative preparation and advance filing, we are impossible, on the spot have to adapt.
When encountering urgent and critically ill patients, many doctors work for two or three years without knowing how to respond, which is very normal. A mature emergency department physician may have to train for at least 5 years.
The status and salary of emergency department doctors in European and American countries are very high, it requires strong professionalism, and not everyone is suitable for doing it. China's emergency medicine has only a history of more than thirty years, and talent training and specialization are many years later than foreign countries. The brain drain of emergency physicians across the country is more serious, and good talents may feel too much pressure to give up, whether it is mental or physical pressure.
We also have older doctors who probably don't be on duty so often when they're older. Several doctors in our department have also transferred to other departments or done administrative positions due to various reasons such as physical health. I prefer to pounce on the clinic, my personality is not suitable for administrative positions, and I may be in the emergency department for a lifetime.
When going to work, it must be fast and decisive, the patient will continue to come in, must be analyzed as quickly as possible, give solutions, give him where he is going. There is no way to force you to go fast. The doctors and nurses in the emergency department sometimes look very fierce and stern, and their attitude is not very good, in fact, he does not have time to explain more to you. Our colleagues are used to very fast speech speed, walk fast, and often use running.
Sometimes from early to late afternoon, the time is gone, the sky is dark, has been rescuing, may not have eaten lunch, just drank a few sips of water. Some patients are more critically ill, psychologically stressed, and anxious.
But I personally feel that anxiety is not enough confidence in yourself, and when your ability is strong enough for these patients to be able to handle it and be very clear, you will not be anxious. The source of anxiety is that you have no bottom for these patients, may not be able to do it, or is afraid of making mistakes. The one I saw the most was our young doctor, who felt that he couldn't do this or that, walking around, dangling around, very anxious.
When I encounter something beyond my reach, I also panic. Previously, there was an explosion of liquefied gas tank trucks, and helicopters and ambulances transported a number of critically ill patients at the same time, all of which were large-scale burns and explosion injuries.
That's out of my range, I have no bottom. But it's not easy for others to see that I'm already the group leader, and if I show panic, the people below will panic too.
There was a patient, and the local hospital said it must not have been saved. After sending it over, it was really not easy, I and the team did not sleep for 72 hours, soaked in the hospital every day, treated for three weeks, and finally got better. We snatched the wounded back from death. In this way, the patient can only rely on you to guard him, and really keep it.
Some professions can be used as a job, but doctors cannot
After the epidemic, our emergency room and emergency care unit were closed and managed, and after the family brought serious patients in, they could not be seen. All the conversations about the condition, including the changes in the condition, are for us to tell the family. The conversation is very important, one is to let the family understand the condition, and the other is to let the family understand that our doctor is trying to treat him.
We now talk a lot of doctors, one by one, all talk about "dead", this will also die, that will also die. As soon as I heard this, it would come to fire. I often say to them, you talk like this, what else will the patient's family treat? Pull it straight back, no need to live. You have to give people confidence, if you don't give confidence, how can people continue to treat?
When a dilemma arises, including emergency surgery or treatment options, many patients' families will ask the question: Doctor, if this is your family, how would you choose?
In fact, many doctors are not willing to answer this question, and it is not my family, how can I answer this question? But I will answer. Most of the patients, I will tell them from my point of view. He may not necessarily take your approach, but he will feel that the doctor is really seeing the patient as if he were his own relative. You give a very pertinent opinion, he will not pinch you, the doctor said whatever you want. At this time, he is not evading responsibility, he just wants to ask for help, that is when he is most helpless.
I have a feeling that when you have a very good tacit understanding with your family, you respect him, and he will respect you. After mutual respect, you will be comfortable because your family trusts you.
Some time ago, an old lady treated us for more than two months, and finally the person left. She has three daughters, is very filial, and is at the door of the guardianship every day. After their mother was injured, they were very guilty, and their mother was so old that she had not enjoyed a day of happiness and left without thinking. After the people left, the little daughter cried and fainted.
At that time, we regarded the old lady as a relative, and I went home every night at ninety o'clock to see her, and I came to see her on weekends. Unfortunately, many complications have appeared in her. Her family understood us very well and said, Director Lu, we know that you have really tried your best.
The old lady's bed-tube doctor, a third-grade student in our emergency room, cried three times for the old lady. When the old lady left, she deliberately sent a circle of friends and sent the door of the guardianship room. I went to comfort her, and she gave me the impression that although she was sad, she wanted to learn more and find ways to better rescue others later.
In the show, the guests said quite reasonably, over time, your sensitivity will decline, that is inevitable. But I think that sensitive land still has to be kept there, and I like the two children of Xiangya (Medical College), Li Buyan and Wang Weihang, these two children are very real. But also to grasp this degree, Li Buyan is a little too much, that time the pressure to the back, the patient did not rescue back, his whole body is trembling, he does have a shadow.
Very few doctors will not be able to bear it, may not dry, or go to other auxiliary departments and departments with less high-pressure environments. Everyone's psychological quality, ability to resist pressure, and psychological endurance are different.
You must always remember why you studied medicine in the first place, and you can't forget it because of the long time. The original intention remains there, and there will always be self-motivation and the psychology of serving the patient. If this is gone, you're just treating the doctor as a job, which is scary. There are some professions where you can think of it as a job, no problem, I leave after work, but the doctor can't, he deals with life.
The number of emergency department visits is at least 8-10 times that of foreign countries
I am now mainly responsible for emergency care unit rescue work, rotating 24-hour shifts every 5 days. In fact, more than 24 hours, from 8 o'clock this morning to work, the next day at 8 o'clock to hand over the patients received yesterday to the next class of doctors, especially serious patients to see again, basically until noon the next day to leave work.
During the National Day filming "Heartwarming Offer", I went to a daytime plus night shift, left the hospital at 11 o'clock at night, almost arrived home, just drove to the elevated, the surrounding hospital has a serious trauma patient to consult, I drove back. It was early in the morning when I got home, and I went to work again at 8 o'clock in the morning. Such things are very common, there is no way, the patient is the most important, can only go.
Usually there are accidents at night, so we dare not turn off the phone at night, and the mobile phone has to be kept open 24 hours a day. I kept telling the doctors below that if something happened, call me as soon as possible, and don't be afraid to disturb my rest. Sometimes I keep staring at my phone, and I don't want to look at it, and I don't look at it and I don't feel at ease.
Chinese doctors are really hard at work, taking care of the health of 1.3 billion people. Our population base is too large, the number of doctors is not so much, especially in large hospitals, top hospitals, many patients are rushing to the top three hospitals, the number of patients is particularly large.
I visited in London and ran three emergency rooms, they have family doctors, unless it is trauma, myocardial infarction, cerebral infarction, these are very urgent diseases, generally headaches and brain fever or discomfort have to see a family doctor first. They see 10 patients a day as an emergency department doctor, which is a long delay. I took the consultation over there, and the director asked me to pick up a few patients, and the consultation had to be asked for half an hour to forty minutes. In China, we receive at least 8-10 times more emergency department visits a day than they do.
I am a Hangzhou native, no one in the family to study medicine, when volunteering, yin and yang, and good relations of classmates agreed to apply for medical school together, and finally was released pigeons, he did not report, I reported. Originally I wanted to study English literature, but it was not so practical. In fact, at that time, I didn't understand that studying medicine was so tiring.
I chose emergency medicine myself as a graduate student. Of course, I also know that being an emergency department doctor is especially tiring, and many colleagues and friends around me ask me, why don't you choose a specialty, and choose a specialty with such a high pressure in the emergency department? After so many years of work, I feel that I am also adapted, at least I still love this profession, and I can save the lives of patients in the first time.
Our cultivation at that time was not the same as it is now. In 2008 and 2009, I was a graduate student at the Long March Hospital affiliated to the Second Military Medical University, which can be said to be a kind of "barbaric" training, throwing you in the emergency room to exercise, and the clinical exercise is more sufficient. After working for two or three years, I can basically practice to the level of an average doctor for six or seven years, and I will grow up faster.
Now most graduate students are mainly based on scientific research, although the country's training is now more and more rigorous and formalized, but the clinical training is still a little backward compared with European and American countries, the country has been grasping this aspect of the problem, how to improve the clinical ability of young people. Without saying the big truth, let's talk about ourselves, we often say that the purpose of cultivating students well is to have a good doctor to see us when we are old in the future.
At that time, Corey's professors and teachers were very responsible and capable, and at that time, they wanted to become people like them. I later taught students like them. There is a professor Chen Dechang, who is now the (standing) chairman of the Chinese Medical Association's Critical Care Medical Society, who is very strict and may train students to cry every time.
I know that he has no malice, that is, he can't see people sloppily, and he is not careful and serious. What impressed me most about him was that his basic knowledge was very solid, and he was able to integrate pathophysiology and clinical knowledge every round, and wake us up at key points, and I admired him. He was okay with me, and he didn't reprimand me in particular.
I like to watch a few unpopular American medical dramas, one called "Black Alert", which is about emergency department doctors. There is also "Night Shift Doctor", the medical professionalism is very strong, I estimate that the screenwriter is a medical professional, and is a big bull, writing a lot of advanced things into it, and even as a guide to see a doctor.
Sometimes it's quite "perverted", I went to work for a day and came home to see this stuff. Do your family say that you are "sick" and that it is not enough to go to work?
Lu Xiao punctures patients (Photo/Photo provided by Tencent Video)
Without waiting for your emotions to adjust well, the next class came again
In the past, in the military medical school, the Second Army University was the first to go to the Wenchuan earthquake, at that time I was particularly envious, I also signed up, but I could not go, the regular military doctors could go, sitting on the military plane directly into the Yingxiu.
When disaster strikes, it is the medical staff who rush to the front line, which is our mission and responsibility. My colleagues from the Second Hospital of Zhejiang University and I arrived in Wuhan in early February, when the city was already closed, there were many critically ill patients, and the ICU's treatment capacity was not enough, so we transformed the entire ward into an ICU.
We received dozens of patients in two days, all of which were particularly serious, and such serious patients may only have a few a day in the intensive care unit. There was a lot of pressure and no one had ever experienced such a situation.
The most we brought to Wuhan was sleeping pills and a psychologist. We were on night shift, got up in the middle of the night to get dressed and go to the hospital, it was particularly cold, afraid of cold, it was snowing in Wuhan at that time, there was no air conditioning, and my hands and feet were frozen.
At that time, I always wondered if I could do as much as possible to bring a glimmer of life to the patient. For doctors, there is no good way to treat is the most helpless, some patients are very sober, you have to communicate with him, they are very anxious, there is no family to accompany.
New crown patients have a very strange point, called silent hypoxemia (silent chest), the average person with hypoxia will have chest tightness, shortness of breath, heart rate acceleration these clinical manifestations, but the new crown pneumonia will not be manifested in the early stage. His indicators are bad, but he feels ok on his own. Theoretically, such patients should not even have the strength to eat, but they can still inhale oxygen to eat.
We can see those indicators and imaging tests, and we know a lot. They often ask me, Doctor, am I dying? It was really sad at that time. Some patients came back, some patients didn't come back.
I still remember those details, the nurse informed that the 1 bed was gone, you go to see it, it was really gone, it was pronounced dead. After half an hour, the 3 beds are gone, and you can only declare death if you look at it again. That's how the previous nights came. That kind of helpless, dark moment, I just want the sky to be bright, I can't stay any longer.
Later, we watched Wuhan slowly get better, from the empty streets to the time to unseal, and it was busy again. Eight months later, I attended the emergency national annual meeting and returned to Wuhan again to make an anti-epidemic report on behalf of emergency physicians in Zhejiang Province. Back in Wuhan sitting in a taxi, the driver heard that I was a doctor who had supported Wuhan, and I was very excited. The city is back to life and we feel it's well worth it.
I've had difficulties before. There is a period of continuous encounter with patients who are not good, and the family members do not understand you very much, feel that you have not worked hard, and it is very likely that the leaders also feel that you are not doing a good job, and at that time it will be very depressed. Every doctor more or less encounters such a thing.
Our emergency department is sometimes very sad, and before you can adjust your emotions, the next class is coming. You can only tell yourself that I have a new task and I have to cheer up. When you're done, you'll think about that again when you're free.
If the next one is saved, it will certainly be particularly happy. In fact, so far, less than 10% of the world's diseases are curable, and many diseases cannot be cured. Just like this month, I have three or four consecutive shifts, some patients have not been rescued, some have encountered car accidents, obviously people have flattened, it is impossible to save back. You have to accept that fact.
Every time I leave work, I drive home, and the hospital comes out with a bridge over the Qiantang River, on which you can see a beautiful sunrise. Every time you come back from work and see this sunrise, you will feel that it is still very beautiful and promising.
Many times just after the night shift, the nerves are still in a state of excitement, can not sleep. This habit I brought back from France, I like to sit on the side of the road, watch the various pedestrians walk past, there is no purpose, just look, can watch for half an hour.
Sometimes I would go to the side of the road café after work to sit down, or go to the West Lake and drive around. A lot of things will happen in a class, whether good or bad, there will be a lot of people, can be rescued, can not be rescued back, this time need to empty themselves. Go back and take a break and feel like you can fight the next day.
Southern Weekend reporter Li Muyan