In the public's impression, doctors seem to be a vivid profession. In life, they often have cleanliness, pay attention to hygiene and take the lead in resisting junk food; They will have rich social relations and a decent life, and they will never lack friends. In the face of diseases, doctors have a strong heart and firm perseverance, and will face difficulties. In the eyes of ordinary people, doctors are synonymous with elites.
But is this the truth? In the doctor's speech conference "Jian Xiao", we can see many things that subvert people's cognition of doctors:
People's misunderstanding of the profession of doctor goes far beyond this. Many times, doctors who work outside the clinic and operating room can't see their contribution. It is also difficult for people to understand the real inner world of doctors when dealing with human diseases, aging and death.
Treat yourself with junk food.
People always see such doctors in film and television dramas. They wear clean pens, and their white coats are always new. If it's a man, he must have neat hair that looks like a lot of hair gel, and a refreshing beard that is carefully taken care of every day. If it is a woman, in addition to flowing hair, she will wear delicate makeup. Even if she goes home to sleep at night, she will still hang on her face like a semi-permanent.
However, is the real doctor really like this?
Li Li, a medical student in the First Affiliated Hospital of Zhengzhou University, said that a medical student in the training period should be like this: the hair is slightly greasy, but it must be washed before it is shiny; There are two dark circles under the eyes, accompanied by dull complexion and scattered acne on the forehead and nose. You will see these young doctors gradually lose canvas shoes and sneakers, and put on a pair of broken shoes that they wear all the year round-a single item known for its ugliness and difficulty in matching.
Yang Jizhou, an orthopedic surgeon at Dongzhimen Hospital, was born in 1980s. He is also a fashion insulator. "Basically, this summer, a pair of jeans, a pair of casual pants and two pairs of pants are worn in turn. After arriving at the hospital, they are all work clothes, which means they are worn on the way back and forth. "
Why is the doctor image in TV series so different from that in reality? If you know a doctor's daily work schedule, you can understand why they look a little sloppy.
A day in Yang Jizhou begins at 6: 00 a.m.10. His orthopedics belongs to surgery. Every working day, he needs to arrive at the hospital at 7: 20 and start his day's work from rounds. Monday, Wednesday and Friday are operation days, and one operation after another fills the whole day; Tuesday and Thursday are outpatient days, and he has to see dozens of patients a day. According to the system design of the hospital, there are about 30 appointment numbers in the specialist clinic, but there will be some old patients or additional appointment numbers at noon, so the consultation time will be extended to 2: 30 pm. After that, he can have lunch. After work in the afternoon, at 5 o'clock, the work is not over yet, and we must continue to make rounds, make doctor's orders, and then hand them over to other doctors.
▲? Sometimes when I am too tired, the doctor will just sit on the floor and rest. Figure/vision china
Even when I came home from work, the doctor was still working. Many patients will consult online in the middle of the night, and the situation of critically ill patients in the ward needs continuous attention. Yang Jizhou has teaching and scientific research tasks, which need to be completed within the whole time.
Li Li's work in the training stage is rather trivial. In the morning, he will make rounds, change medicine, write doctor's orders, write medical records and leave the hospital. In the afternoon, he helped the surgeon to perform multiple operations in succession and stood for three or four hours. His evening time is also reserved for study and scientific research. When there is no patient's phone number, he collects cases and specimens, does experiments, writes graduation thesis and prepares for exams.
In addition, many doctors have to work night shifts, and their schedules are passive and irregular. Many doctors are in a state of lack of rest, although it seems that every doctor has a neat addiction. "There is a strong sense of sterility, but the lounge is a mess. If you are tired, just take a break and sleep here for a while. "
Time is precious to doctors. Whether at home or in the hospital, it is normal to eat in 5 minutes or 10 minutes. It is difficult for doctors to participate in parenting. Yang Jizhou's son is still in primary school. Every morning when his son goes to school, he visits the hospital. After school, he is still on the operating table or in the consulting room. In these years, he didn't send his son to school, and he didn't even know the exact time to go to school.
Gu Shijie, an anesthesiologist, has no time to fall in love and is still single. He felt that the doctor's fatigue was a kind of helplessness. "I'm so tired that I just want to stay at home and read after work." Because there is no time to think about how to rest, how to play and what to eat has become the most important thing. "Only dinner is something I can decide for myself. I don't need to eat so fast. I will treat myself to a hamburger and fried chicken, both of which are junk food. "
▲? The medical staff eat takeout in the small lounge. Figure/vision china
Many efforts have been ignored.
People know little about the profession of doctors, and there are jobs and contributions that are rarely seen in the huge and elaborate system of hospitals.
Zhang Shimin worked in the laboratory of Union Medical College Hospital for 43 years. In this famous hospital in China, there are hundreds of tests of various types. Every day, he and five colleagues in the team test more than 2,000 samples, including blood, urine samples, feces and various bacteria and fungi.
He still works in the window, receiving samples of patients' feces. Once, he saw the patient wrap the plastic container containing urine with paper, and then handed it to him. The patient thinks that urine is dirty, but he thinks it is completely unnecessary: normal urine is even sterile when it is first discharged.
Zhang Shimin has long been used to dealing with excrement. "We often handle the patient's specimens, wash our hands and turn around to eat. We regard it as a specimen that can reflect the patient's health information and don't think about anything else. "
According to a laboratory doctor, after dozens of tests, urine can be an important basis for judging kidney diseases, urinary system diseases and metabolic diseases. More importantly, blood, in the laboratory, 80% of the tests are related to this, involving hundreds of kinds. Also can be used as a basis, and people don't like feces.
Three years ago, Zhang Shimin encountered a somewhat special situation. In the clinician's description, the patient felt sick, nauseous and vomited, and metal was found in the stool, as well as ascites. These symptoms add up to more than a dozen, which are irrelevant and difficult to contact, and it is even more difficult to judge the root cause of the problem. Clinicians have no choice but to entrust Zhang Shimin to test patients.
Because the condition was too complicated, a week later, Union Medical College Hospital held a general consultation. When it was the clinical laboratory's turn to report, Zhang Shimin mentioned that he had found three kinds of parasites in the patient's feces. According to the examination results provided by him, the doctor determined the cause, and the patient was cured and discharged after 3 months.
For doctors, laboratory doctors are "doctors' doctors". Modern medicine stresses evidence. Many diseases cannot be diagnosed by looking and touching. Thousands of laboratory test reports can reflect the changes of patients' bodies with accurate data, which is the first diagnosis that patients receive after entering the hospital.
Sometimes, when encountering some difficult situations, Zhang Shimin will also discuss with several colleagues why the images displayed by the instrument are different and what is the relationship with what is seen under the microscope. He will also communicate the patient's background with the clinician and then verify whether the report can be sent to the patient. Similar to the laboratory, there are radiology and pathology departments, which are the best assistants of doctors.
Although the work of laboratory doctors is so important, Zhang Shimin found "the window for collecting specimens is very interesting. You will see some people call us' master', some people call us' nurse', some people call us' hello', and some people call us' doctor' without calling anything. " These names directly represent the public's impression of the laboratory.
The laboratory has biosafety requirements, and patients are not allowed to enter at will. It is difficult for people to know what the complete inspection process is like and how many people are involved in the inspection. Therefore, "when ordinary patients go to see a doctor, they will thank the doctor when they are well, but few people think of the laboratory doctor."
▲? Modern laboratory, routine blood testing assembly line. Figure/provided by respondents
In view of the fact that there are three kinds of parasites in his body, Zhang Shimin bought five related books at his own expense 100 yuan, and stayed up late to study after work, only to realize that these symptoms may be related to parasites. "It is also very troublesome to apply for book approval. I thought 100 yuan, that is, I went out for a meal, so I bought it directly, but it helped me a lot. " Now, there is a whole shelf of medical books in Zhang Shimin's home, all of which are related to the detection and diagnosis of various diseases.
During the epidemic in COVID-19, hospitals should quickly develop methods to detect COVID-19, realize rapid detection, and complete a large number of screening for tens of thousands and hundreds of thousands of people. These achievements are inseparable from the development of technology and the efforts of laboratory doctors.
For more clinicians, those efforts outside the operating table are usually invisible.
Everyone is equal before the doctor. Doctors should patiently explain their illness to each patient and provide treatment plans. Yang Jizhou believes that "this is a very emotional thing."
But after returning home, his family has a cold and fever, and he will directly say, "Nothing, just take medicine." When these two attitudes are compared, the family will feel that "you are too cold to take me seriously". Family members think that doctors care more about patients than themselves.
Yang Jizhou occasionally meets some patients who are difficult to communicate with. Even if he has emotions, he should maintain his professionalism, but sometimes these emotions are not adjusted well and will be brought back to his family. "I can't help but say a few words when I see my child being naughty. I regretted it when I finished. It's not easy for children. I won't make a fire. This happens all the time. "
In his view, "doctors are actually service personnel."
▲? Figure/vision china
Doctors also have a helpless side
People think that a doctor is a decent and well-paid job, but according to Lilac Garden? According to the Survey Report on Hospital Salary in China in 2020 released by Lilac Talent, the average salary of national specialists in first-tier cities is 253,000, that in second-and third-tier cities is 1.9 million, and that in low-tier cities is 1.28 million. It is difficult to match the workload of doctors. Li Li said, "Doctors have many things to do and great responsibilities."
A few days ago, there were several cases of COVID-19 in Fangshan District. A colleague in Yang Jizhou happens to live in the same community as one of the infected people. Colleagues came home from work on Friday night and found the community closed. If he continues to go home at this time, he will be restricted from traveling and working at home. For doctors, this is actually equivalent to a rare and justified vacation opportunity. But considering that the patients in the hospital still needed him, he didn't go home, turned back to the hospital, and then lived in the hospital lounge. Yang Jizhou said, "When he needs to make a choice, his first consideration is the patient."
Everyone thinks that doctors can do anything. In fact, doctors will feel very weak when facing patients.
When Li Li was in the hospital, she received a woman with unbearable abdominal pain in the middle of the night. After diagnosis, she found a small intestine rupture. Her husband accompanied her to have a check-up and looked very anxious. After examination, Li Li found that the woman had obvious blunt trauma in her abdomen. When asked why he was injured, the patient kept silent. Li Li speculated that she might have been subjected to domestic violence, but she could not directly expose it at that time.
In the examination questions of medical students, the most common question is medical ethics: If you find your husband infected with HIV without your wife's knowledge, will you tell your wife about it? The correct answer is: no.
Patients are not only individuals, but also people in family and society. The job of a doctor is to treat patients, but everyone has their own considerations and choices, and doctors should always respect the subjectivity of patients.
People think that doctors are fighting diseases fearlessly, but in the face of diseases, doctors are more awed.
Many people don't know that many diseases cannot be completely cured. The cure that people understand is actually "maintenance". It is impossible for a person who has been ill to restore his physical function to the state before he got sick.
Li Li, for example, has developed incurable pathological myopia. "The principle of myopia surgery is either thinning the cornea or implanting an intraocular lens in the eye to achieve the effect of wearing a certain degree of glasses. You look all right, but you're not cured. People who have undergone myopia surgery should be very careful to protect their eyes, otherwise it is easy to be nearsighted again. "
Many diseases will have unacceptable consequences once the best time for treatment is delayed.
Yang Jizhou met a patient while studying for a master's degree. Before being sent to the hospital, he didn't find the seriousness of the problem, delayed for a few days and missed the best rescue time. Walking out of the operating room, he didn't speak all day. "This scene has hit me hard and I feel that people are too small."
▲? Figure/vision china
The anesthesiologist Gu Shijie has repeatedly encountered the situation that "people are dying and sent to the hospital for rescue". "The doctor knows what is helpless, but the family members are unwilling to give up. At this time, they are helpless, and all their efforts are futile and desperate. "
Because of the professional nature, doctors are people who directly face the aging and death of people. Lili's roommate works in ICU. "He took care of six patients and walked four times a week. The whole person collapsed."
Because of the great pressure and intensity of work, some people will leave hospitals and operating tables and engage in medical-related work. Some of Li Li's classmates went to medical journals as editors, and some went to pharmaceutical manufacturers to do clinical evaluation of new drugs.
Lili feels that she is a deserter. When he was divided into departments, he chose ophthalmology because "there are not many deaths and illnesses here." He gradually learned how to face death in medicine. In a book, he saw the research of cancer experts and found that patients' psychological changes will be divided into four levels when facing the news of their cancer. The first layer is unbelievable, feeling that the hospital is misdiagnosed; The second layer is anger. Why me? The third level is bargaining. I am willing to give all my income to God and let me live for another 20 years. The fourth layer is to accept this result. In fact, this is also a psychological change when people face death.
Li Li said, "After reading this book, you will be more open-minded."
Yang Jizhou is still willing to be a doctor who faces death and makes a decisive decision. "It is a great sense of accomplishment to be able to save a person's life and alleviate the pain of the human body." At the same time, medicine is a constantly developing discipline, and every doctor must keep his own study habits, which is both a challenge and an important source of happiness for him. "Even if you are at the forefront, you should be brave enough to update your knowledge and key technologies and accept new things. As doctors, we should have an inclusive system. I enjoy it very much. "
Zhang Shimin just retired last month, but he thinks he can continue his studies. In addition to exchanging work experience with colleagues in hospitals or schools from time to time, he also opened an account in Weibo, and whenever he has time, he publishes his own photos of specimens taken under a microscope.
There are often pictures of medical hair growth @ He, ask him: "Teacher, help me see what this is?" Fecal smears of five-month-old children. "He will reply after careful observation:" This is not something that should be in the feces. Take another look.
▲? Uric acid crystallizes under microscope. Figure/Weibo, Zhang Shimin
For them, doctors are not only a profession, but also a lifelong lifestyle. This means that one must keep learning and self-renewal for a long time.
In "Unable to Frame the Challenge", we can clearly see what more specific difficulties an ordinary person will encounter if he wants to become a doctor. For them, from the day they choose to be doctors, challenges are everywhere.