Emergency room life

After five years as a teacher at the medical school, I went to graduate school because I wanted to be a doctor.

Why do you want to be a doctor? I went to the hospital for an internship. In the 1980s, I saw many people suffering from illness, and doctors can relieve the suffering of patients. I think the profession of doctors is very sacred.

After a few years, I graduated from graduate school and went to a top three hospital in Hangzhou to work as a hematologist. In order to consolidate the doctor's foundation, I also read a doctoral degree, specializing in hematology. Later, the hospital transferred me to the head of the emergency department.

I worked hard in the emergency department, but I got a lot of affirmation. I got the "Hangzhou Top Ten Medical Youth", "Hangzhou May Fourth Youth Medal" and "Zhejiang Outstanding Youth Guardian"... I’m sorry, actually I am very Simple, just want to be a good doctor.

Can save lives, can't save the heart

The emergency room is only a few hundred square meters. Here, the reversal of life and death is sometimes only an instant. Here, there is a life and death. What happens is nothing strange. Great sadness or great joy is straightforward to humanity. It is the epitome of the big society.

One day, the taxi sent an elderly person with a cardiovascular and cerebrovascular accident and a respiratory heartbeat. It is his old wife who came with the old man. We are busy with the airway, chest compressions, opening the infusion line, and nervous rescue. The old wife asks on the side and asks us to save the work while ensuring that the patient can work as usual. At that time, we thought that we had never seen anyone who made such a request when such a life is at stake.

The old man is a senior engineer. The man has been working since he retired. He is in his 70s and has not rested in a day. On the morning of the incident, he went out as usual. When he walked to the gate, he felt chest tight and anxious. He fell and fell home without going home.

After the elderly were rescued, the vital signs were basically stable, but the consciousness was unclear. The next day, their daughter was called back from Shanghai. She told us that she was going to work and could not take care of her father. The old lady also said to us, "I want to take care of him, I can't afford it."

We did not know that they meant it. They told them that the elderly were temporarily sick and needed hospitalization. The old lady proposed to remove all kinds of rescue intubations. It is still rare for a family member to give up a 70-year-old man. This may be related to ideas, and I am beyond reproach.

But what the old lady said then surprised me. "He is alive like this, he is suffering, and I am suffering. Besides, he can't work, isn't that useless?"

In the eyes of his loved ones, the value of his living is just for work, and I feel sad for the patients.

People are really different. There is an old woman who will accompany her husband to see the emergency every year. His wife is now in his 80s. He had a stroke 16 years ago. He has been lying in bed for a long time. The whole person is huddled together, he can't talk, he doesn't have consciousness, he has incontinence, he doesn't eat, he has to grind food into a paste, rely on a The stomach tube is punched in.

The old woman served for 16 years, fearing that he had long-term catheterization and caused infection. He hand-sewn the urine pocket for him. The cloth belt was soft and would not hurt him or soil the body. In her eyes, the old man just can't talk, he knows everything in his heart.

There is something delicious at home, and every time she wants him to taste it. The old woman said that it is the sweetness and bitterness of the three meals on this day. When she feeds him, she always says, " Eat and see, eat and see!" She thought that the world was fresh, and the old man could always make a taste. However, most of the old man couldn't swallow and squatted into the lungs. He licked it and went to the hospital to rescue him.

Every time we and the old woman said, don't feed from the mouth in the future, the old woman always chanted: "He was very bitter when he was young, his children had just made a living, and our days were better. He got the disease."

The story of the old woman and her wife is still going on. Such a couple’s feelings, I am afraid that the current people can’t learn.

People, it is not the same, the weight of life in different people is not the same. Being a doctor can save lives, but it can't save the heart.

Light of life

Life has no turning back. Medical progress, life and death have their own natural laws, not the doctor's ability to be able to save it. Some patients have seen a disease for a lifetime, and there is only one page on the medical record. This page is a death record. If you can keep your life, what is more proud than this?

On a hot day three years ago, when the ambulance was delivered, the patient had no breathing or heartbeat. The car doctor said that they had no vital signs when they arrived. For such patients, we usually still need to be rescued, not for anything else, for that one percent or less of hope for survival, but also for morality.

This Anhui boy, after 40 minutes of cardiopulmonary resuscitation, recovered his heartbeat and had a weak breath. Howling cardiopulmonary resuscitation? It is an uninterrupted chest compression, with advanced life support and mechanical ventilation. Especially for external chest compressions, a young and strong doctor will sweat in 15 minutes. The force of pressing should not be too heavy, nor too light, too heavy ribs will be crushed, too light, the heart can not jump.

In the evening, our three doctors and three nurses were guarded overnight. In the latter half of the night, the young man again breathed twice and the heartbeat suddenly stopped. They were all rescued in time. He is young and we have great hopes. For a whole night, we didn't dare to care, because the breathing curve on the monitor has been unstable, sometimes it is not, and we are always not practical.

At 9 o'clock the next morning, it took 15 hours. When it seemed to be stable, the boy's breathing and heartbeat suddenly stopped. This time, no matter how we rescued, his heart could not jump again.

Looking at the screaming family, and then looking at our weary doctors and nurses, I only feel sad, tears will drop. This is rare in me, and there are grievances, because all our hard work and effort don't have a little bit of return, and that life goes far and wide.

Although these lives only have one page in the medical record book, they have left a deep mark on my heart.

I remember a scientist who said, "Medical science is the science without truth." I will think about the lingering cases that remain in my heart, and hope to find more individualized and more appropriate methods, such as the rescue plan, the dose of medication, etc. If you are bolder, can you save their lives?

Doctors must be calm and rational

Some people say that doctors are hard-hearted, and where they know, feelings and things are a taboo for doctors. In the face of a sudden 12-level typhoon, the doctor is the general in the wind, must be calm and rational.

Most of the ambulances are sent to patients who live on the front line. Life and death are in an instant. Patients often have difficulty speaking. What we see with the naked eye is only a superficial symptom. We must use the appearance and smear. Sometimes only 10 seconds and 20 seconds of thinking time is left for the doctor. The doctor should make a relatively accurate initial diagnosis and emergency treatment in a very short time.

At this point, we usually have no expression, but the heart is surging.

The patient was only 36 years old and came out of Guizhou to work. He knew that he could not do it. He called the home the day before and asked him to set up the hall to wait for him to go back.

Early the next morning, the ticket had not had time to buy, and the people here were mad. The ambulance was sent. After a little inspection, we confirmed that the patient was suffering from severe tuberculosis and respiratory failure. We did a tracheotomy on the spot, intubated, established venous access, stabilized vital signs, stabilized blood pressure, quickly replenished fluids, and promptly consulted the relevant department doctors to quickly develop treatment plans and 24-hour monitoring.

From the beginning of our rescue, his wife has been there.

They have two sons, the big 10 years old, who were drowned when they were pushed into the pond when they were playing. Because of the sadness, the couple left their hometown to work. Most of the migrant workers are physically active. The men are sick. It is very difficult to find a job. They have moved to multiple cities and finally arrived in Hangzhou. They have not found a job in Hangzhou. The disease is getting heavier and heavier, leaving only 40 yuan.

In the face of such patients, each of us is very heavy in mind, medical expenses and critical illness have pushed the family out of their heads. My colleague and I said that we must find a way to save him, at least let him live alive.

On the third day, don't say the cost of treatment, they even became a problem. First, our head nurses gave them food from their own homes, but it was not a long-term solution. After we discussed it, we decided to start donations in the department. It is common for us to make such donations. No one will feel inappropriate. Later, the scope of donations was extended to the entire hospital, and later through the media, there were also people in the community to donate.

After the patient’s family receives the money, they are handed over to the hospital as a treatment fee. Their simplicity made me moved, because we have encountered such a thing, some people get their donations and put them into their pockets immediately, and the medical expenses can be dragged down.

After 12 days, the patient's tracheal intubation was successfully removed, and he was able to eat, and his spirit improved significantly. At the time of discharge from the hospital, the medical expenses will be removed, and there will be more than 10,000 yuan left for them to take home. This makes me feel a little relieved.

On the 15th day, I asked my colleagues to buy them a ticket back to Guizhou, bought the snacks on the road, and sent them to the train.

But I know that the future of this patient is not good. If there is no money for follow-up treatment, go back and wait for death.

How many lives can I save in my life?

One day in the previous year, I had just had dinner at home, the phone rang, and asked me to go to the hospital quickly, saying that the situation was more difficult. Here is a sentence, all the doctors and nurses in the emergency room are the same, the mobile phone is turned on all day, a phone call, no two words, immediately rushed to the hospital to participate in first aid, whether it is the middle of the night or the middle of the night, the next day to work as usual, always like this . All the things at home are given to my wife. She is an ophthalmologist and still understands me.

Arrived in Corey and found no patients on the rescue bed. When asked, the patient sat in a good position. An old man in his 70s was in a good state of mind. He asked him and there was nothing uncomfortable.

As soon as I saw it, his lips were very purple, not ordinary purple. It should be severely hypoxic, and oxygen saturation detection is only less than 90%. If this state of hypoxemia persists, it will cause systemic hypoxia, multiple organ failure, leading to death.

The doctor is already giving him oxygen, but the oxygen saturation has not improved at all. This is not a child's play. Good end, one life, let go, we see more.

The reason is unknown, the doctor is afraid to take the medicine. Symptomatic drugs are available, but the drugs themselves are toxic. If they are used incorrectly, they will not only be ineffective for patients, but will be worse.

The doctor did not find the cause after questioning over and over again. According to experience, the elderly should be nitrite poisoning. The poisons are usually from food. For example, salted and moldy foods may cause food poisoning. However, the elderly and their husbands have denied eating such food.

I was unable to ask questions. I began to look at the medical records of the elderly. I looked at the past page and found that the elderly had seen cholecystitis in the first half of the year. The medical records showed that the elderly refused to open the knife and changed to Chinese medicine. In my heart, I asked the old man if there is any Chinese medicine that needs to be taken separately. The old man thought for a moment, saying that there is a pack of white powder that needs to be washed out. "What is it?" "Saltstone." "That's it!" I called out.

I told the doctor and nurse on the side that all the guards were removed and the blue veins were injected. After 15 minutes, the old man could go home.

Everything as I expected, after the injection of the drug, the oxygen saturation quickly rose to 100%, and the old man's lip color returned to normal. Our young doctors and nurses said: "Director, hello cow!" In fact, I was born in Chinese medicine. When I heard the elderly taking Chinese medicine, I thought of saltpeter. This is a common medicine used by Chinese medicine to treat cholecystitis. The composition of saltpeter is fire nitrate, and the nitrite content is extremely high, which may cause poisoning.

I stood at the door of the department that day and watched the old man walk out of the hospital. There was a calm satisfaction. The thought appeared in my heart: How many lives can I save in my life?

Still want to be a good doctor

Our doctors in the emergency department deal with people who suffer from cardiovascular and cerebrovascular diseases, fall injuries, knife wounds, trauma, drowning, and poisoning. We are commonplace in the eyes of those who are extremely sensitive to the eyes of ordinary people, but their negative effects on our hearts are still there.

Most of us don't sleep well, but we have to watch the time even if we take sleeping pills. We can't just eat them casually. For example, we have to be on duty in the middle of the night. Do you dare to eat in the middle of the night?

Everyone knows the current medical environment. The doctor-patient relationship is tense. There are too many factors from the society. It is not caused by doctors unilaterally and has its social roots. In particular, the crisis of trust between doctors and patients has hindered the doctor's innovation in the treatment of patients. We must communicate with family members at any time and repeatedly seek advice. From a certain perspective, we have lost the initiative to rescue patients.

We have saved a patient with coronary heart disease and a large area of ​​myocardial infarction. When I sent it, I couldn’t see it, but I was saved. Next, the stent implantation surgery must be done as soon as possible, and the patient's family does not trust us and asks to transfer.

Later, I went to a provincial hospital. After the operation was successful, the patient sent the penis to the doctor. The doctor told them that our operation was successful, thanks to the first aid of the hospital in front. Their cardiopulmonary resuscitation was quite successful, and we had the opportunity to have surgery. You still have to thank the doctor at that hospital. Later, the patient came, and said this when he sent the banner.

Sometimes, I really want to say to the patient's family that no matter what the doctor thinks about it in the society, no matter what rumors, among the doctors, the good doctors must be the majority. Which doctor does not want to cure the patient? It is almost the ultimate wish of every doctor to cure the disease. I know that in the moment, maybe no one wants to listen, but this is the truth. Especially when the patient is being rescued, the patient and his family should stand with the doctor. I believe the doctor is good for the patient and for the doctor.

The hard work of the doctor is well known to everyone. For the time being, let me not let go. I don't like to complain, because as a doctor, I must be able to bear something.

It is hard to be a doctor, it is even harder to be a doctor. But as long as the patient can be pulled back from the death line every day, that sense of accomplishment is enough to support me to continue to be a doctor, and to be a good doctor.