Author: Xiao Yang
At first I thought that the pain was inevitable, but the moment when the woman gave birth. Later, I found that this pain is more like the background of life.
The British drama "Pain Is Inevitable" recently ended its first season. Douban scored 9.4, and nearly 30,000 people gave 5 stars of praise. The genre of the film is marked as "comedy", but many people want to cry when they watch the film, laughing and laughing.
The entire series is based on Adam Kay's memoir, Absolute Laughter: The Doctor's Journal of abandoned business. Obstetrician and gynecologist Adam Kay (played by Ben Whishaw), stuck in a spinning medical machine, is forever overwhelmed, but still strives to maintain professionalism and empathy every day.
Each episode of "Dr. House" and "Good Doctor" cracks a difficult disease, so that people can see the superior intelligence and superb medical technology of medical staff. And "Pain Is Inevitable" shows the audience the cruel reality under the aura of front-line medical workers.
At first I thought that the pain was inevitable, but the moment when the woman gave birth. Listening to Adam's narration, I found that pain is more like the background of life, and happiness is at best attached.
Doctors trapped in the system
As a junior obstetrician and gynecologist, Adam works 97 hours a week, treating hundreds of patients in half a day and calling three pagers in turns.
In the face of couples who are so ignorant that they are maddening, pregnant women who want to eat placenta raw, and young men and women who surprise "small holes and large things", this medical worker always tries to maintain a "professional" indifference.
Every day, he was covered with various human body fluids, his underwear was soaked with the blood of others three times a week, and he was often called for surgery just before leaving work. I left work in the early hours of the morning, sat in the cab, and fell asleep tired before the car started.
Wear a shirt to the hospital and scrap it in a second.
Adam said, "Here, you're basically rowing a big boat by yourself, and the big boat is still on fire, and no one has time to teach you how to row." ”
The big ship is both an obstetrics and gynaecology ward and the UK's National Health Service (NHS).
As one of the largest healthcare systems in the world, the NHS aims to provide people with free basic health care "cradle to grave". For nearly 10 years, the NHS has been controversial over under-budget, staff shortages and operational inefficiencies.
In the obstetrics and gynecology ward in the series, the emergency signal bell rings incorrectly every ten minutes, and the ceiling is leaking for 4 years and no one repairs it. Old wards are only whitewashed to a small extent prior to a visit by Ministry of Health officials.
In addition to the "lack of money", public hospitals are also "short of people". There is always an emergency in the ward, there is always a shortage of manpower, and young doctors are in a state of "on time". Adam had to squeeze out time for his best friend's wedding party, and as a result, his boss called him back to work. Frontline health workers use their flesh and blood to patch systems every day.
Don't think that if you work so hard, you can get a good income. Adam calculated that the hourly salary of a junior doctor was lower than the meter charge in a hospital parking lot. Five or six years after graduation, peers have lived in large houses and gradually settled into families. Adam still couldn't afford to rent a house closer to the hospital, and the car was so dilapidated that even the car thieves hated it.
If it is so hard, why should you be an obstetrician and gynecologist?
Adam wrote in his autobiography: "Obstetrics and gynecology is the only place that excites me and really looks forward to it." "Every time a baby is successfully delivered, he will quietly snap a 1 in a small note in the locker.
The office of his superior, Mr. Lockhart, has a wall with photographs of babies delivered by his own hands, a wall of awards for obstetricians and gynecologists. However, the obstetrics and gynecology ward is not only full of hope for new life, but also lurks in the shadow of death.
As another outspoken obstetrician-gynecologist put it, "By the time you retire, the babies who die under you will be able to fill a bus."
A misdiagnosis by Adam runs through the plot of the first season. Those bloody scenes kept flashing back, and guilt flooded into Adam's life like a tidal wave, hitting Adam's self-confidence and drowning out his intimate relationship with his partner.
Caught between high-intensity work and harsh environment for a long time, all front-line medical staff in the film are like Adam, with a miserable look of exhaustion and hard work. (Except, of course, Adam's boss, who drives a sports car to work, is a little more relaxed.) ）
They squeeze private time to the limit, so that more babies can come to the world safely, and they buy more time for patients to spend with relatives and friends. However, some patients' families will understand the doctor's efforts, and some will only coldly drop a sentence "Your salary is given by the taxpayer.".
Adam once said, "A great doctor has to have a fat heart and a dilated aorta in order to keep pumping out overflowing compassion and kindness to the world." "Patients sent to the hospital have cardiac arrest, there are doctors to do cardiopulmonary resuscitation, so who will save the physically and mentally exhausted doctors?
Healing and depressing
Once you enter the medical door, it is as deep as the sea. In the UK, in order to obtain a practicing qualification, in addition to 5 years of medical school courses, you must also complete 2 years of basic training, during which you change positions every 4 months, and successfully pass 2 medical professional examinations.
The adaptation added the role of Shu Di, an intern doctor. Every day she went to the hospital to commute to work, she had to carry a review book and a calendar year's real questions. As the workload increases, Shu Di is working and preparing for the exam almost every minute and every second. After only three or four hours of sleep in two days, she gradually became gloomy, emotional, and manic.
On the night of learning that she had passed the exam, Shu Di was on duty alone. She checked out the patient's ectopic pregnancy in time, and then numbly stopped the bleeding of the pregnant woman who gave birth. Seeing that this new colleague can grow rapidly, Adam showed a happy smile, and the chief doctor no longer spared praise.
The sky is getting whiter and the night shift is over. Shu Di walked out of the hospital gate and broke the "fourth wall" to the audience and said, "I'm sorry, I really tried." ”
That same day, she committed suicide.
Obviously, if you insist on it a little longer, you can get through it, so why don't you continue to work? Shu Di was trapped in the quagmire of overwork, but she didn't find out by herself.
Burn-out (also known as "burnout") was first included in the ICD-10 list of the International Classification of Diseases by the World Health Organization in 2019. WHO considers overwork to be an "occupational phenomenon" rather than a disease.
WHO defines overwork as "a syndrome that has not been successfully controlled due to long-term work stress". This syndrome consists of three characteristics: low work efficiency, frequent lack of energy or exhaustion, negative attitudes toward work, or cynicism.
The difference between stress and overwork. /@Fairy’s heart
At the end of the season, the physically and mentally exhausted male protagonist chooses to return to work in a public hospital, but the real Adam is not. After 6 years of vocational training and 6 years of ward work, and about to be promoted to consultant doctor in 2011, Adam finally took off his white coat and turned to sitcom.
He suffered from a surgical mistake and often woke up in the middle of the night in a cold sweat, as if returning to the cold operating room. For more than a year after his resignation, he was in a depressed mood. Didn't go out, didn't interact with friends, and lost weight. He said he threw himself into his new job and felt "alive."
Lead actor Ben Whishaw and Adam Kay.
Friends and family didn't quite understand why Adam had abandoned the doctor at first. Until 2016, British doctors launched a massive strike over a new round of health care reform by the government. When politicians criticized doctors for their insatiable greed, Adam published an "Open Letter to the Health Minister" in solidarity with his former peers.
Adam re-examines his medical experience and publishes "The Journal of abandoned doctors who absolutely laugh and spray", using amazing details that cannot be made up in dog blood dramas, and lifting the fig leaf of British public medical care between poisonous tongues.
Burnout society, who can escape?
It's been 11 years since Adam resigned, and instead of alleviating the overwork of medical workers, it has taken a sharp turn for the worse in the three-year COVID-19 pandemic.
Healthcare workers around the world are leaving their jobs in droves, citing exhaustion and burnout. The Lancet sub-journal, Foreword to Nursing Research, warns that "the future of global healthcare is in jeopardy."
A 2021 survey of more than 10,000 doctors by the U.S. medical website Medscape found that more than 70 percent of doctors said that overwork had a moderate impact on their lives, and 10 percent of respondents considered whether to give up practicing medicine.
Severe overwork even causes doctors to have suicidal thoughts. 1% of doctors attempt suicide, 13% of doctors have had suicidal thoughts, and obstetrics and gynecology, orthopedics, otolaryngology doctors have the highest proportion of suicidal thoughts.
Since the outbreak, the UK's public healthcare system has been overloaded, the waiting time for appointments for consultations has been extended, and patients and their families have often vented their grievances on doctors. A survey released by the British Medical Association in August showed that half of doctors had witnessed intimidation or violence against patients by their colleagues or personally.
These devastating workplace environments force front-line doctors to quit their jobs. According to the official statistics of the NHS in the UK, an average of 3 family doctors resigned every day in the UK in the fourth quarter of 2021, and it is expected that by 2023, there will be a gap of 7,000 health care jobs in the UK.
To be on time, to be professional and perfect, to make "customers" satisfied, to be accurate and measured, but also to continue to learn to recharge. 24 hours a day, most of the thoughts are entangled in work, and there is no time to love people and love themselves.
This is basically Adam's work schedule in the series, and it is also a workplace portrayal of contemporary workers.
Han Bingzhe mentioned in "The Weary Society" that today's human beings seem to be injected with stimulants as a whole, evolving into a performance machine, trying to maximize their own efficacy. At this time, life is reduced to an effect that triggers excessive fatigue and burnout.
From Echenberg's point of view, the Korean-American philosopher extends: "Burnout syndrome is not an expression of the exhausted self, but an expression of a tired, burned-out mind." ”
People repeat "Yes, I can, I can" and engage in self-exploitation day and night. You want to say "no" to overtime, you want to quit the competition, you want to live a life without dispute, but you don't want to give the world to those you despise.
After leaving the medical system, Adam once told the media: "One cannot really stop being a doctor." When you see an injured cyclist on the side of the road, you'll trot over and reply to friends who text one by one to consult with pregnant friends. ”
Acknowledging the overwork in the system and facing up to the physical and mental wear and tear is not to escape the questioning of life, but to find the wound and create an opportunity for healing. The pain in life is inevitable, but I hope that overwork can be prevented.
bibliography
[1] Why are British doctors so miserable because of their perpetual lack of sleep and overwork? From the British drama "Pain Is Inevitable" to 丨 interface news
[2] This Going to Hurt: Writes the bitterness of obstetricians and gynecologists
[3] Adam Kay:‘If I had kids I would put them off studying medicine’丨The Guardian
[4] I'm so tired, I really can't stand it! 丨Fairy's Heart
[5] How to know that you are "overworked" And your body and mind are about to be hollowed out 丨 BBC
[6] Fear of 'burnout' as doctors suffer from 'burnout' NHS faces GP shortage due to three resignations a day丨 The Mirror
[7] Lancet Sub-Journal fights burnout 丨China Net
[8] The pandemic has exacerbated doctors' burnout, with 1% of doctors in the United States trying to commit suicide