Start your career in medicine
Liu Yan spent 12 years in Shijiazhuang, Hebei Province, as a child, and after a year of borrowing from Jinhua, Zhejiang Province, in his third year of high school, he eventually returned to Shanghai with his parents. Perhaps because of the teenager's life experience in the north, Liu Yanjuanxiu's appearance hid a "female man's" heart.
Liu Yan's mother is an obstetrician and gynecologist, and her mother, who has been busy with clinical practice for many years, leaves Liu Yan with only a hard back. "She knows that the time and energy it takes to be a doctor is innumerable, so she once advised me not to choose medicine as a lifelong career, but I seemed to be unable to resist the charm of medicine."
What Liu Yan really watched was the happiness and joy of those pregnant women holding their children and thanking their mothers. "At this time, the mother has a beautiful image and a radiance on her body. I think that the mother's efforts are worth it, and the sense of achievement in treating the sick and saving people is probably incomparable to other professions. ”
In 1985, Liu Yan was admitted to Shanghai Second Medical University as he wished. The rhythm of university learning and life, Liu Yan is very adaptable, the classroom knowledge is at ease, inspired by the "five consecutive championships" of the Chinese women's volleyball team, she loves volleyball, became the second pass of the medical school women's volleyball team, and won the championship of the volleyball league in six provinces and one city in East China with the girls in the team. After graduation, Liu Yan stayed in Ruijin Hospital. This young girl who loves to "do it" is bent on going to surgery, but that year the surgery did not recruit girls, fortunately, the teacher pointed out a clear path for Liu Yan: the burn department.
The Burn Department of Ruijin Hospital has been famous for a long time. In 1958, Qiu Caikang, a patient with severe burns, was successfully treated, breaking the conclusion that "the burn area exceeded 80% of the body surface area in the world at that time and could not survive", and opened a precedent for the successful treatment of large-scale burn patients. Under the leadership of Professor Shi Jixiang and Professor Yang Zhijun, the core technologies of burn treatment such as early liquid resuscitation technology, mixed transplant wound repair technology, and stress regulation technology based on hibernation treatment based on Ruijin formula were pioneered, forming a Chinese burn treatment model recognized by the international medical community, significantly improving the healing rate of patients with severe large-scale burns, and laying the academic status of "Ruijin Burn" at home and abroad.
This is a proper golden signboard, doctors often have the opportunity to operate, Liu Yan did not hesitate to join the burn department.
When I first entered the burn department, I was exposed to many shocking cases. However, Liu Yan, who is just starting out, has a strong psychological endurance and has no fear before the tragic situation. This is also due to the influence of my mother's profession, when my mother worked in a rural health center, and since I was five or six years old, I have been working as a "volunteer worker" in the hospital, running around to deliver some medical supplies, and I have seen the corpses of babies soaked in formalin, so there is nothing to be afraid of. ”
But this does not mean that Liu Yan will not be shaken by the sudden sadness.
At the mention of a flower girl, Liu Yan's voice choked.
"She is a young female worker in a textile factory, only in her twenties, with big eyes, long eyelashes and a beautiful face. That day she sat on the cotton heap with her lover to rest, and as a result, when the boy smoked, he accidentally ignited the cotton heap, causing a catastrophe, and the thigh muscles of the thighs were burned when the girl with a large area of severe burns was sent. Because the damage was so severe, we amputated her lower limbs, but in the end we were unable to save her life. I still remember tears slipping from the corners of her eyes when she was seriously ill. In the face of the patient's strong desire to survive, as a doctor, I am helpless, and this feeling of helplessness has plagued me for a long time. ”
The predecessors are like a torch
In 1996, the Anhui Huainan Mining Bureau Xie Yi Mine gas explosion accident occurred, killing more than 100 casualties, that was the first time Liu Yan was sent to the disaster site to treat the wounded. For her fledgling, it was a battlefield and a real test. "Everyone treats patients in small groups, and our treatment team is in charge of more than a dozen wounded people. When changing the medicine for the wounded, the wounded sometimes cried out in pain, and the wound secretions were mixed with the patient's feces and urine, and I did not hesitate to wipe and clean while comforting. Several of the older doctors in my group lamented that they didn't look like a Shanghai girl at all."
Looking back from the ignorant young people to the present, Liu Yan bluntly said that her personality is a bit at ease with the encounter, unlike many young people at present who have realistic and direct goals, she just "follows the teachers forward".
In 1999, Liu Yan began to study for graduate students in burn surgery, and completed his master's and doctoral studies in five years, and his doctoral supervisor, Professor Xu Weishi, is a famous expert in the field of burns in China. "The teacher is full of economy, but modest and low-key. The four words of Tampo Mingzhi are the best commentary on him. His rigorous and prudent attitude of studying had a great impact on me." "Mr. Old man has a deep cultural heritage. Long-term extensive literature reading and the accumulation of clinical front-line work have given him a keen eye to find problems and the ability to solve problems. Although he has been retired for many years, every time he visits him, he can make pertinent opinions on the development of the department and our grasp of the direction of our research."
Liu Yan had also heard many seniors talk about the past of saving Qiu Caikang in those years. Qiu Caikang was a steelmaking worker at the No. 3 Shanggang Steel Factory, and late one night in 1958, due to the loosening of the main buckle of the crane, 10 and a half tons of boiling molten iron fell... In an instant, 89.3% of the skin of the 30-year-old steel worker's entire body was burned, of which 23% of the deep burn area was burned, the human epidermis was like coke, the head was swollen like a balloon, and his life was in danger. According to Evans, the famous American authority on burn disciplines at that time, he could not survive from both the burn area and the burn depth. At that time, the hospital did not have a burn department, nor did it have a separate ward, in order to reduce the possibility of cross-infection, the hospital deliberately evacuated the ward on the fourth floor of the original infection department building as a special ward for the treatment of Qiu Caikang. Fu Peibin and Dong Fangzhong, the chief of surgery, visited the ward as soon as they had time. Shi Jixiang, Yang Zhijun and other doctors also took turns on duty to guard, at that time there was no 24-hour monitor, it was the doctors and nurses who did not sleep day and night, and took turns to monitor Qiu Caikang's vital signs and changes in condition. Hibernation therapy, bacteriophage therapy ... In response to the constant changes in their condition, they came up with a solution. Because every time the dressing change is a great pain for the patient, the medical staff and technicians of Ruijin Hospital jointly designed and created the first turnover bed in China...
These stories are often heard by Liu Yan' blood boiling: "The old generation of medical personnel burned by Ruijin is very remarkable, and in that era of poverty and whiteness, they created countless miracles in the clinic out of their extreme desire to save the lives of their 'class brothers' and out of selfless dedication to their causes." Many of their experiences, their ideas for salvation, are still relevant today." "The history of the Singing and Weeping Ruijin Burn Department and the countless predecessors of the Burn Department are like a torch."
In 2004, Liu Yan went to the United States to study. She admits that that period of time like a "gyroscope" laid a solid foundation for scientific research.
"One person is responsible for multiple projects and schedules multiple experiments on the same day. Animals, cells, rhythmically lined up. The interval between experiments is to read the literature. Only the "movie time" in the evening is a relaxing moment of the day. Netflix has my membership is probably quite a loss, watching hundreds of movies, TV series probably some." I sometimes talk to graduate students about this experience and tell them that if they want to stay in a hospital like Ruijin, they can achieve success in medicine, teaching, and research, and they need such an experience of purgatory rebirth. ”
Both inside and outside, always comforting
"The treatment of patients with large burns requires repeated surgeries. The first step is to remove the necrotic tissue of the burn and cover it with a biological dressing; later, using the patient's remaining autologous skin, through repeated skin grafting surgery, finally covering all burn wounds." At first, it was to follow the predecessors in the department to the operation, and slowly, in the understanding, independent thinking, independent completion. "When I was an assistant, I was full of thoughts about how to assist the superior doctor and let the superior doctor complete the operation in the most comfortable position." When you do the operation independently, the pressure is different, because the life and death of the injured person are all tied to himself, and he thinks that no matter how difficult it is, he must be saved. ”
The Burn Department is actually a department that "doubles" both inside and outside. Burn doctors must have the surgeon's "killing decision, not afraid of danger", but also need to carry out internal medical treatment for patient infections, organ function damage, internal environmental disorders and other issues. The long process of treating large-scale burns is a test for doctors, patients and families. Liu Yan talked about a dangerous case.
It was a chemical plant worker in Taizhou, Jiangsu Province, who accidentally spewed out sulfuric acid at work and caused 93% deep burns. The local hospital has limited conditions and can only be transferred to Ruijin Hospital for long distances. When the patient arrives, he has a large area of eschar, cornea injuries, and is almost in a state of shock. After active fluid resuscitation and a period of shock, a long and repeated operation began. In the later stage of treatment, due to the infection of multi-drug resistant bacteria on the wound, the skin planted on it was dissolved many times, and the systemic disease was repeated from time to time. Doctors should not only do a good job in the treatment of patients, but also deal with the concerns of patients' families and units about the results of treatment, future quality of life, treatment costs and many other issues. No matter which step of the function is not done well, it may be abandoned. At this time, what to do is to give patients and families the confidence to persevere.
Pediatric burns account for almost one-third of the patients admitted to the burn department, and regret, panic, anxiety, and suspicion are common emotions among many parents of children. "I often run into emotional parents in the hospital corridors who would come up to me and ask me to help their children. Some parents hold thick books in their hands and remember dense problems; some mothers often cry silently while talking about their illness, and some even hold me and cry. At this time, in addition to answering questions and explaining doubts, a gentle hug and patting their backs is a comfort. ”
In order to reduce the occurrence of pediatric burn incidents, Liu Yan and her team have spent a lot of effort on the popularization of pediatric burn prevention and synthetic first aid.
"In 2018, a number of experts in our department edited and participated in the compilation of the "How to Prevent Burns by Famous Doctors" of burn prevention education. The "Mother-in-law and Daughter-in-law Competition of the "Three Treasures of Burns" compiled and directed by the department medical care won the first prize of the Fifth Shanghai Youth Medical Science Popularization Competition. The department also opened its own WeChat public account to publicize the knowledge of burn prevention and education. Every doctor in the department is a publicist for burn prevention and first aid science knowledge. In addition, our voices are all over radio stations, newspapers, WeChat public accounts, Douyin and other platforms. Liu Yan said that we are enthusiastically doing the "smashing our own rice bowl" thing.
Liu Yan also kept a hairpin in the drawer, she said, a three-year-old patient sent a hairpin with red roses in a pink plastic shell, "that is probably the most precious thing in this child's mind, for me, the same."
Become a female leader of the temple-level discipline
In 2018, Liu Yan took up the post of director of the Burn Plastic Surgery Department of Ruijin Hospital, taking on the heavy responsibility of managing the entire department.
"The pressure is really quite great. Ruijin Burn Department is a "temple" level department of China's burn specialty, and it is well-known. How to maintain the status of the discipline is a problem that every discipline leader has to face. In fact, many people's memories of the burn department of Ruijin Hospital are still stuck in the great deeds of rescuing the successful steelmaking worker Qiu Caikang in those years, "Every time I hear everyone say Qiu Caikang, it is a kind of stimulation to me, reminding us that our current work is not done well." For the department to develop, in addition to maintaining clinical advantages, there must be innovative results.
In the face of the environment of a significant reduction in the overall incidence of burns, how to do a good job in the transformation and development of the discipline is also a problem in front of Liu Yan.
The first fire of the new official's appointment was to prepare for the establishment of the Ruijin Burn Specialist Medical Association, a specialized consortium covering the burn departments of 11 provinces and cities and 25 second- and third-level hospitals across the country, and the farthest hospitals include Qinghai, Heilongjiang, Xinjiang and other regions. "There are two main work directions of the burn specialist medical association, one of which is medical cooperation, including promoting graded diagnosis and treatment and homogeneous medical treatment, and promoting telemedicine, distance education, two-way referral and other work. And I hope to build it into a platform for peer academic exchange, multi-center clinical research design and implementation. ”
In addition to the construction of the medical association, Liu Yan re-positioned the sub-specialty direction including critical burn treatment, pediatric burns, wound repair, and rehabilitation treatment. "Critical burn treatment has always been the traditional advantage of Ruijin Burn Department, and wound repair is the weakness of our department. We sent young doctors from Corey out to learn flap techniques, and now Corey's "F4" has been able to skillfully apply this technique to the repair of various complex wounds, which has greatly improved the level of wound repair in the department. This short board is made up. ”
For the balance of clinical and scientific research, Liu Yan believes that the essence of scientific research is to explore the unknown and find answers to problems, from this point of view, no matter what level of doctor you are, you may encounter problems that need to be "researched and solved". For doctors in top domestic hospitals like Ruijin, clinical and scientific research are indispensable. Clinical is the tentacle of scientific research, is the source of scientific research inspiration, through the strict cultivation of scientific research thinking and work habits, will improve the ability of doctors to find and solve clinical problems. The development of Ruijin burn discipline is an example of the coordinated development of clinical and scientific research, and the older generation has found problems in long-term clinical frontline work - refining problems, conducting basic research - and then returning to the clinic for verification, and in the process discovering new scientific problems. What makes Liu Yan happy is that the middle and young doctors in Corey now have a higher motivation and action to do clinical and scientific research.
Leading a team of 22 people, Liu Yan has always adhered to a fair and tolerant management style.
"I don't look at people with colored glasses. Strive to create development opportunities for every young person, as long as it is beneficial and contributes to the development of the department, the department will reuse you. ”
Diagnostic techniques, surveillance methods and treatment methods are now greatly enriched. The department has purchased many new instruments and equipment in recent years. Including monitoring and treatment instruments for critically ill burn patients, we can more intuitively and objectively assess the patient's overall condition and achieve more accurate treatment. In addition, wound repair methods are constantly enriched, which not only allows patients to survive, but also allows them to have a better quality of life.
The beauty of the heart is beautiful, and the depth of love is deep. Liu Yan said that love is the foundation of a good doctor. Only with love can we appreciate the suffering of patients, and only then can we think of all ways to improve ourselves and help patients solve problems.
Written by | Tang Ye
Edited | Ear abundance