During the time I didn't write an article, I kept running like a standard surgical robot, thinking that I had seen through the joys and sorrows of the world.
Two weeks ago, I was recommended by the hospital to participate in the publicity and selection organized by the Beijing Health Commission, and one of the links was an impromptu speech, and the topic I drew was: Which moment made you firm in your determination to practice medicine?
For doctors, there are probably countless such moments. At the same time, there are actually many moments that make doctors have self-doubt.
What is the determination? This path is nothing more than going from light to darkness and from darkness to light again and again.
After that day, I kept thinking about it.
Over the years in the hospital, I have seen so many ups and downs in the world, life and death, and I think I have become a surgical machine, how kind can I be?
Just today, after reminiscing about my entire medical experience, I got the answer from three stories.
Story one
The mother who made the director compromise
The first story took place 14 years ago, in the last month of my internship at the Provincial Hospital, where I rotated to pediatric orthopedics.
The staff structure of this department is very peculiar, 3 chief physicians, 1 resident doctor, and after I went, I counted 1 intern.
I've never been so busy, and every baby who comes for surgery, I have to write medical records, physical examinations, and of course, the characteristics of the provincial hospital: the intern doctor is responsible for drawing blood. It is impossible not to do a laboratory test before the operation, and if you want to do the test, you have to draw blood, and the difficulty of drawing blood for the baby can be imagined.
It was a summer, and a chubby baby was pressed into bed by several parents and waited.
Humans have a natural fear of syringes, and babies cry when they see the needle in your hand. The veins can't be seen or touched, the parents are so anxious that they are sweating, I pierced it with a needle according to the conventional position, there was no blood return, and I was also sweating.
At this time, 1 of the 3 directors appeared, and I saw a savior and immediately asked the director to draw it.
The director, wearing a red-striped Paul shirt, did not reproach or frown, took my 5ml syringe, accompanied by a cold light in his eyes, held the needle in one hand, and plunged it straight into the baby's thigh, and then slowly retreated. A stream of venous blood instantly filled the needle, and a slight smile appeared on the corner of the director's mouth.
Femoral vein blood drawn!Director, why are you so powerful? It was a thick blood vessel that barely mutates in a person, and when I returned to the dormitory at night, I looked up all the literature I could find, and practiced repeatedly with a syringe against a pillow.
The next day, under the suspicious gaze of my parents, I hit the nail on the head. It's a skill I've been using for a long time.
Early one Friday morning, a young couple came up the stairs in front of the doctor's office, the man looking and the woman holding a baby in her arms. The man was dressed in black short sleeves, and the woman was breastfeeding, wearing a wide green T-shirt with her hair hastily tied up.
The clothes are very old, and they should have come from the countryside. The man held a note in his hand and asked me if the director was there.
"The director is not here, I went to the operating room early in the morning, and I can't come back until the evening." The husband and wife could not hide their loss, so they could only sit on the stairs blankly.
I continued to write medical records, do physical exams, draw blood, and go to the operating room to help. Passing up the stairs, I saw that the swarthy baby was not crying or making a fuss, the man was anxious, and the woman was haggard. I told the director in the operating room that someone was waiting for him outside the office, and the director let out an oh.
In the afternoon, I went back to the office to sort out the medical records, and the couple was still waiting on the stairs. It's getting dark, and they probably haven't moved, and they may not even have gone to eat.
Also, what if they leave and the director happens to come back?
Image source: Visual China (not the doctor in this article)
Late at night, I went back to the office with the director after the operation, and the family of three was still there. The director invited them into the office and listened to the man's account of the request that he had silently recited many times: the child had acute suppurative osteomyelitis, and the doctor at the county hospital recommended him to come here for surgery.
The man was young and not good at words, so he finished speaking intermittently and handed over the note.
The note had been pinched for a day, and it was already full of wrinkles. On the slip of paper was the handwritten diagnosis of the doctor at the county hospital and the name of the director. Referring patients with handwritten messages is a form of respect among peers.
The woman carried the child to the director, only 6 months old, although fat, but already very weak, with a high fever, and the right calf was red and swollen and even purple.
The husband and wife stood side by side, as if waiting for the child's judgment. The director touched the baby's calf, and the originally weak child immediately cried in pain.
Septic osteomyelitis is a definite infection in the child's leg bone, and an abscess has formed, and surgery is very troublesome. For such a young child, the bones need to be cleaned up, the abscess cavity must be thoroughly flushed, what should be done about the cavity of the calf bone, what should I do if the infection recurs? And the child is already so weak that it is very likely that he will not survive the operation.
The director's face was expressionless, but there was already a hint of rejection between his words: he had no confidence.
Although the couple had been waiting for a day, the director politely declined their request and asked them to take their children to a higher level hospital for a look.
But this pair of young people from the countryside obviously have no other connections except for the kind county hospital doctor. Where else can they go?
No faith is definitely not a word of the director's mind, and with his experience, the child may not survive. For surgeons, there is a huge difference in whether a child's outcome occurs before or after surgery.
I sat quietly and listened to the director say for the last time that I was sorry that I couldn't pick up the child, and I was going to tear off the note in my hand.
Tear off the note to indicate that this is the end of the consultation.
At this moment, the woman who had not said a word suddenly stepped forward, and I thought she was going to kneel to the director, and kneeling was obviously useless at such a time.
But she didn't, she just suddenly grabbed Director Gang's hand and snatched the note back.
It wasn't until years later that I understood the young mother's intentions, that the note was the hope of her child's life. She took the note back because she wanted to tell the director: Although you don't agree, I won't give up.
This novice mother from the countryside explained her persistence in this way.
In an instant, I saw a smile on the corner of Director Gang's mouth, with a kind of helplessness that all beings are suffering, and also with a compromise that I knew I couldn't do: "I will be hospitalized in the emergency department now, and I will work overtime tomorrow Saturday to operate on the child." 」
I wrote medical records overnight, examined my body, and then, hit the nail on the head. After the couple left with the child, the director called the head nurse and the anesthesiology department.
The next day, in the operating room, the director cut open the baby's red and swollen leg bone, extracted a whole tube of pus, and then repeatedly flushed the abscess cavity with antibiotics.
After the operation was completed, the anesthesiologist carried the baby almost all the way and escorted him back to the ward. The operation could not be declared a success, and the tug-of-war between the director and the case had just begun.
It was also my last day of internship at the Provincial Hospital. The baby was temporarily relieved of the pain and slept heavily in the monitoring of the ward. The director said that it had been hard for a while, and invited me and my brother to have a meal at the roadside barbecue stall. It's still the red-striped Paul shirt, or the imperceptible smile,
In the evening of Jinan, the sun is setting and the cicadas are fading. I toasted the director with a glass of wine, saluted the past, and saluted tomorrow.
Photo by the author
Story two
I can't forget the children who look good
The second story is that when I was in another hospital, I was still an intern. It's just that there are plenty of people there, and my role has changed back to just writing medical records.
On that day, the department received a child who had been assisted by the Foundation for surgery. A 2-year-old looks healthy, but has congenital heart disease. What's even more special is that he is an orphan in a welfare home, and he is also responsible for taking care of the staff of the welfare home.
When I examined my child, I found that the seemingly neat clothes were actually stained. His lesion was very simple, and the ultrasound report was only an atrial septal + ventricular septal defect. However, after getting on the operating table and opening the heart, the chief surgeon found that the real lesion was far more than that, and it was a complex malformation that was difficult to characterize.
I didn't participate in the surgery that day, but when I saw the surgeon for the second time, it was already early in the evening, and the surgery was done for the day. The child had returned to the ICU set up in the ward, and I naively thought that although it was difficult, the operation was done.
But the child's heart couldn't hold up at 2 a.m., and after all the medical support had become difficult to maintain circulation, the 2-year-old life came to an end.
Later, during the death discussion, the surgeon reviewed what he saw during the operation to the general practitioners, but as an intern who had not yet officially entered the profession, I did not understand complex congenital heart disease at all.
The discussion passed quickly, and the department continued to admit one heart patient after another, and the 2-year-old orphanage child, with no relatives, no memorials, and I didn't even remember his name. But I remember what he looked like.
After I officially became a cardiac surgeon, I often thought about this young life that was long gone.
In the dark night, when no one is disturbed, I often think of the temperature when I put the stethoscope on his chest, and I think of his crying and white face.
If it is possible for him to survive, he will take this overhauled heart, walk out of the welfare home, and into the dark forest of this society, how will he spend this life of drifting and loneliness?
Story three
5% difference
The third story is what I told at the competition.
That was 12 years ago, and I was already a first-year cardiac surgeon, rotating through pediatric surgery.
The rhythm of surgery in the department is very tight, often the baby who is hospitalized today, immediately completes the medical records and preoperative examination, and the operation will be performed tomorrow, with high efficiency, less cost, and less tossing for parents.
Of course, the premise is simple congenital heart disease.
That day, when I was examining a crying 1-year-old girl, I noticed that something was wrong. Normally, a simple ventricular septal defect would have a baby's oxygen saturation close to 100% in all limbs, but for this child, I couldn't measure it to 95%, and all limbs were the same.
Is there an essential difference between 95% and 98%?
An adult who has a little phlegm in the lungs will also measure 95%. What's more, when measuring, the child often cries, and at this time, the waveform is unstable, and the value will be lower, so it should be fine.
No, if the inspection is not thorough, it is equivalent to not checking completely.
At night, when the child was asleep, I tiptoed and tested again, and it was still less than 95%.
My gut told me there was something wrong with this. I reported to the surgeon late at night and got a reply: the operation is suspended, and the investigation will continue tomorrow.
Later, CT found that the 1-year-old girl had an abnormally growing systemic vein (left superior vena cava) that grew directly to the pulmonary vein, causing a small part of venous blood to mix into the left atrium, and eventually reducing oxygen saturation by no more than 5%.
The surgery became more complicated and the medical records had to be rewritten. When I went down to diagnose it, I found that it didn't even have this diagnosis in the HIS system diagnostic library. After repeated communication with the hospital information center, a fitting diagnosis was finally added: abnormal connection of systemic veins.
The operation went smoothly, and the saturation of this 1-year-old baby after surgery was 100%.
On a night on duty, in the ward's monitoring area, she was crying in the crib, and the nurse tried to reassure her. I tried to hold her in my arms slowly, and in an instant, the baby fell silent.
Image source: Visual China (not a case in this article)
When I looked down again, the child I had personally handled was now asleep peacefully in my white coat. As a cardiac surgeon, soothing a crying child is nothing. But this little life, in my almost paranoid preoperative screening, discovered the secret hidden in her heart.
If, just if, I thought it was a measurement error, and I recorded 100% of it, what would be the outcome of the surgery?
And those are already assumptions, let those waves and wind and rain stay in the past forever.
Among the more than 10,000 surgeries performed in this hospital every year, such efforts can be said to be insignificant, but as a young man who has just started his career, I used my own efforts to protect a young life when I did not have any main surgery qualifications.
How kind do you think doctors can be?
All three stories have been told. Back to the original question: how kind do you think doctors can be?
The author of this article is at the scene of the speech
I give my own answer: because they are in our lives, and we can't ignore them.
Like the children in the three stories, their appearance, if only heard, is difficult to share with their joys and sorrows.
But if you are at the scene, if you see with your own eyes the mother who waited from day to night, and then firmly held the note and refused to give up, if you witnessed the life of the lonely child in the welfare home ending at the age of 2, if you personally felt that a little life saved by you slept quietly in your arms......
The moment they look up at you, it seems as if something has been pierced in an instant. This is the goodness of our hearts.
And kind people always refuse to let go of themselves.
On the road to medicine, fear is a human instinct, and courage is the hymn of doctors.
And you, my friend, you are the real hero.
About author:Deputy Chief Physician of the Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences, 7-year Master of Medicine from Shandong University, Doctor of Medicine from Peking Union Medical College. He is a member of the fourth batch of health science popularization experts of the Beijing Municipal Health Commission, a member of the Capital Health Youth Expert Database, and the third of the Top Ten "Future Stars" of Capital Health.
This article is from Lilac Garden