Author: Cao Bin, China-Japan Hospital
After graduating from the seven-to-eight-year program of Concordia Medical College, I stayed at Union Medical College to work in the Internal Medicine Department. In fact, for me, there is no difference between working and not working, because before graduation, I lived in the hut on the 5th floor of the nurse building of Union Hospital, and after graduation, I went to work, I still lived on that floor, and I still lived in the hut, no difference. I didn't feel like I had graduated, I didn't feel any difference between before graduation and after graduation, and I didn't leave Concordia until after I got married. Why has graduation not changed anything for me?
Then I wondered what was the reason? It is because the environment in which we live and work and the professions we do are different from others.
I don't know if everyone agrees with this? That is to say, the environment in which we live and work is the hospital, and this working environment and our profession are not the same as the nature of work in most industries.
The hospital is more like a school, and the doctors and nurses are more like students, for a lifetime. I'm 48 years old and I don't feel like I've grown up. I'm still learning, as long as I'm still wearing this white coat one day, I have to learn, which is where our profession is different from other professions.
I feel like I'm a lot older in 2020 than I was in 2019, and it's really obvious. How did this "growing up" come about? It is because in the first half of 2020, I experienced the "new crown virus". This experience had a great impact on me, and it can be said that it was soaked in every bit and every drop of me.
On February 5, 2020, Cao Bin explained the drug clinical trial project in Wuhan
My understanding of life, my views on my colleagues, my requirements for my students, my requirements for my son, and my communication with my daughter-in-law... Everyone is still young, and after slowly starting a family, they will realize that for a family, the decision of this family atmosphere and vitality lies in the husband and father.
<h1 class="pgc-h-arrow-right" data-track="16" > rules</h1>
The title of this article is "Rules and Culture." Rules in the narrow sense are diagnostic norms and policy regulations for our doctors.
Doctors and nurses, who have been educated in medicine for many years, started with the study of anatomy, why should they learn this knowledge? Because this knowledge is condensed into our diagnosis and treatment norms. The diagnosis and treatment norms have been accumulated by the predecessors for decades and hundreds of years. That's the rule.
Some of these rules are mandatory for every doctor in every discipline. Let me give you a very simple example: the doctor is on night shift, a patient has a fever, the nurse on duty calls the doctor on duty, tells the doctor that the patient has a fever, what should the doctor do?
There are two different kinds of doctors, one does not even open the door, directly to the nurse to say "give a piece of paracetamol"; the second kind of doctor quickly get up, walk to the patient's bedside, and carefully ask the patient what is uncomfortable? What time does the fever start? How high is the burn? Sweating? Cold or not? Take the blood pressure to measure the patient's blood pressure, measure his pulse...
What do the rules tell us? When the condition of an inpatient patient changes, the doctor on duty must immediately go to the patient's bedside to ask about the patient's symptoms, examine the body, and make a judgment, based on the judgment to deal with. This is called a rule.
What about doctors who don't obey the rules? I'm sorry, but such a person can no longer be a doctor. Did this matter cause any damage to the patient? No. Is the patient dead? Not dead. Disabled? Nor does it. However, this incident directly led to the resignation of the doctor on duty. Why? He violated the bottom line of being a doctor, the doctor on duty does not see the patient, how do you deal with it? This is called a rule.
Can the rules be changed? Can change! All the rules, every rule is based on our existing evidence-based medical evidence. With the progress of science and technology, it is possible to change when there is more updated evidence to support it. However, if you want to change the rules, you must have very good evidence, which is very important.
In the first half of 2020, we saw a large number of treatments without evidence, sometimes hearsay, sometimes a family statement of an expert, which became a treatment plan, which is completely undesirable. As young doctors, when you grow up, you must develop the mentality that for all rules, you must look at the evidence behind them and see whether the chain of evidence is sufficient. When you see a patient, your superior doctor gives you instructions, and you must ask him back: Do you have evidence? Don't dare to say. We must cultivate this kind of thinking, even if this superior doctor is very grumpy and not so easy to get along with. You don't dare to say to his face that he is wrong, but think about it in your heart, is there evidence for this instruction he gave you? As long as he is a doctor who pays attention to the rules, he must be good at thinking, and he must not follow the crowd. If you only know how to answer "yes" and become a person who pushes step by step and says one sentence after another, then I am sorry, there is no future. Or that you have chosen the wrong profession, and the position of doctor and nurse is not for you. A person does not live for many years, and this profession is the most correct choice for your limited survival period. Once you choose the wrong profession, it directly determines that this life is a failure. In other words, you're sentenced to death directly, but you wait a little longer. I'm sorry, we shouldn't have talked about death to everyone when we were so young. But the clearest answer to every life is that I will die.
This is what I call the "rules" for everyone.
What I said just now is only a very narrow part, in fact, there are many different rules, for example, that day I checked the room and saw a young male doctor wearing shorts to work in the ward, I called him over, I said you know, you can't wear shorts to work in the hospital. He said he didn't know. He did not know that this was a problem that occurred in our quality education, and it was a very serious mistake.
As you know, stand up straight, this is the rule; sit up straight, this is the rule; when others talk, I listen carefully, this is the rule; as long as you enter the gate of the Sino-Japanese Hospital, boys are not allowed to wear shorts, this is the rule; girls are not allowed to wear heavy makeup, this is the rule. Because the objects you face are different, because you are facing patients, your demeanor, your posture, your language, and your clothing must be suitable for such a place, and it must be suitable for the patients you are facing. That's the first question I want to talk to you about – rules.
<h1 class="pgc-h-arrow-right" data-track="31" > culture</h1>
The second issue is culture. What is culture? My understanding is that the so-called culture is the values, honor, or shame that a group of people believe in and enforce. First of all, we must believe in common values, and secondly, we must know to consciously maintain values and cherish honor.
Hospitals have all kinds of rules and regulations, medical departments, nursing departments, scientific research departments, education departments... All departments have rules. Article by article, it is not formulated for whom, nor for whom, but for the collective. One by one, there are also shortcomings. It is impossible to make any system satisfy everyone and make everyone happy.
Cao Bin
Any system is designed to minimize dissatisfaction. For example, hospitals regulate 8:00 a.m. to go to work. I met a basic research scientist in a meeting this morning who asked me what time of day do you go to work every day? I replied that I would be in the hospital before 7 o'clock. He said: I can't do it, I don't get to the lab until 10 o'clock.
The scientist's father is a retired old doctor, and his father urges him to work in the back every morning. Because his father was a doctor. So, our profession requires us to go to the hospital before 8 o'clock, and even some departments have shifts at 7:30 or 7 o'clock, can we make everyone happy? No. But for the sake of the whole group and the team, this must be demanded. There are similar systems.
Recognizing the culture of the hospital, from now on, should be believed, and I think everyone will inevitably believe that as long as you work hard, as long as you pay, you will be able to harvest what you deserve.
I am 48 years old this year, one day I was chatting with young comrade Corey, everyone feels that life is very stressful, I understand very well, especially these colleagues who graduated from schools in other provinces and cities and came to Beijing to apply for jobs.
I am also a foreigner, after graduation, I first lived in the nurse building of Union Hospital, and rented a house after marriage, in Tongzhou.
After work, I walked from Xiehe Hospital to Wangfujing, took Dasi Road, sat on the East Fourth Ring Road, and took a bus after getting off. At that time, there were only two buses, one was 311 and one was 312, sitting on 312 all the way to the top of Xinhua Avenue, and after getting off the bus, you had to take a "small bungee jump" to get home. One and a half hours each way, this was the first place of my life to settle down.
After having children, we moved from Tongzhou to Fengtai, from Fengtai to Changping, from Changping to Dongcheng, from Dongcheng to Chaoyang, from Chaoyang to Haidian, from Haidian to Xicheng, from Xicheng back to Chaoyang. This is the trajectory of my life as a 48-year-old doctor, after graduating from college, to the present in Beijing.
Now if a young doctor wants to graduate today and buy a big house tomorrow, it is basically impossible except that his parents are very rich, and you simply don't think about it. Because you have received higher education, as long as you work hard step by step and steadily, there will be everything you should have.
I think that some of the good cultural elements that young doctors have or partially possess, and will inevitably have in the future, are probably the following:
First, honesty. Since childhood, our parents have taught us not to lie, to ensure that we do not cheat on exams when we go to school, and not to cheat when we give homework to teachers. What is not easy is that after work, in the face of a complex society, you can maintain honesty for a lifetime, which is very, very difficult. As an adult, if you want to live a lifetime with peace of mind in the future, this must be done. A lot of times it feels like "I lied and others don't know", but at least one person knows, and that's yourself. The most important thing for people is to live with peace of mind. Who else but yourself knows? God knows, not that no one knows. You live for yourself, not for others, not for teachers, not for your parents, not for the head of the department, but for yourself.
Second, equality. A young man came to me a while ago, and went to the office with his head bowed and his waist. I said you stood up straight, lifted your head up, and watched me talk. You are an individual and everyone is equal. You are equal with anyone next to you, someone older than you, someone younger than you. That is to say, if you put on a white coat and enter the various departments, the hospital should pay you a salary, because you pay for your labor and do not owe anyone. If we owe anyone, we only owe it to our parents, because they have raised us and nurtured us, and we owe no one anything else. Straighten your waist and raise your head so that you are a dignified person.
Third, self-confidence. Self-confidence is not self-esteem. In English, self-confidence is Self-confidence and self-esteem is Self-esteem. Self-esteem, if you can grasp it more accurately, this is a good quality. But many people are not sure about the degree of self-esteem, which is troublesome. Just like twisting a clock, twisting it a little harder becomes a bad thing. I have seen some comrades, because the leader went to the department to inspect the work, did not look at him, did not sleep all night, and the next day also called the hospital and asked: "The dean did not shake hands with me when he left yesterday, nor did he look at me. "That's self-esteem. Colleagues between the big grin, say a deep shallow, can accept, how good. Self-esteem doesn't help anything. There are two other emotions in English, one is anxiety and the other is angel. These two emotions are part of our lives. What does anxiety mean? Anxiety and tension, even depression, these emotions can be expressed by this word. Another emotion is anger, and the self-respecting person is too easy to get angry, and the more I say it's okay, the more he has it. Therefore, self-confidence rather than self-esteem.
So where does confidence come from? There is only one way, to experience things. Experiences are the most precious, especially those that are particularly difficult and particularly devastating. Two people, going through very, very difficult things, one broke down, sorry, no self-confidence. The other survived and had self-confidence. This is the third cultural element.
Fourth, reading. A lot of new knowledge, simple truths, such as if you want to know how the legal system of ancient Rome was perfect, you need to read books, which is very important. Read books that interest you, keep your interests, and keep your love for life and life. Where is the greatest "joy" of people? I think the greatest "pleasure" is to be needed by others. However, it is true that every hospital, some departments have such a person, this person does not have the slightest merit. Please stay away from this person, and don't be such a person. If you encounter such people, don't stay away because they are contagious. Originally, you still have a little idea of helping your colleagues, but after being infected by such people, you will lose this advantage of being willing to help others. Why? Because I help others, being needed by others, is not rewarded, it comes from the heart. This sense of gain and happiness without talking about return is the strongest.
<h1 class="pgc-h-arrow-right" data-track="52" > weakness of human nature</h1>
Today I am going to talk to you about these two things, one is the rules, and the other is the culture. Here's a little more, to talk about the weaknesses of human nature. I think there are three weaknesses of human nature, the first is laziness, standing is not as good as sitting, sitting is not as good as lying down, everyone, including myself, has lazy times. The second is greed. The third is self-centeredness.
The first is laziness. Everyone is willing to do light work, but laziness must have a certain limit, that is to say, the work that should be done, after the completion of the day, lazy, this is no problem. But what's the problem? It's the difference between people and people. Now everyone is on a starting line, after 10 years, 20 years will open the gap, the main reason is that those who run faster are relatively less lazy people, and those who run slower are because they are too lazy, and this is your own reason. Maybe you meet a strong group leader, a strong director or a professor, he will supervise it, but the main thing is on his own, this is no way.
The second is greed. What is greed? We all do this, myself included. Originally, I was not very hungry when I went out to the meeting, but when I arrived at the dinner point, I served a large table of dishes and had to eat. When you are not hungry, eating those things is completely harmful to the body, which is called greed.
What is very important to people? It's about knowing what you want. What's the hardest part? It's people who have to know what they don't want or can't ask for. This requires rules and social norms.
Greed, especially when people have some power in their hands in the future, and some power that can dominate others, greed becomes very dangerous. Many fallen leaders said they were very innocent, and he said to the people who came to censorship: I don't want it, he has to let me take it, force me to take it. It seems very pitiful, but in fact it is still greedy, you close the door, can the giver break through the door? Hit you? Not so, comrades. Or is it because you want to take it yourself? Right? In particular, we should pay attention to the fact that greed runs through every bit of our life and work.
The third is self-centeredness. Everyone cares about their own name, when my name should be in it but it doesn't, uncomfortable, uncomfortable when the name is written wrong, uncomfortable when my opinion is not respected by others. I wrote an article that was reprinted by others, I was happy to see the number of clicks every day, in fact, what is the difference between others reading 1000 times and watching 2000 times? It makes no difference, but there is a vain worm in my heart. It's a question of the ego.
Of course, I am not letting everyone lose the pursuit of academics and careers, I want to remind young people that they need to succeed. But don't worry too much about that. Because the answer in life is clear, everyone has to know that they have half a pound. Don't take yourself too seriously, other people's evaluation of yourself, can't hear, that is, it really didn't happen, that is, there is no other person's evaluation of you in the world; if you accidentally hear it, then listen to it. Because everyone's evaluation of the other person is too casual to be worth caring about. Putting his evaluation into your heart, it's not worth it. You don't deserve to take an irrelevant person's evaluation to influence your personal life. If you don't want to be affected by the outside world, you can only make a very objective evaluation of yourself, don't take yourself too seriously, only by doing this, can you really live yourself. Only when you live yourself is you truly successful, and nothing else is called success.
From now on, everyone has become a member of the Sino-Japanese Hospital and a colleague of Dr. Cao Bin. Hospitals need your knowledge, your emotions, your culture to be imported into this family. The Sino-Japanese Hospital is like a person, and we get fresh nutrition and blood from the outside, so that the "person" of the Sino-Japanese Hospital can remain healthy. According to classical physics, a system can only tend to die if it does not have external input. This was Schrödinger's theory of entropy, Austria's most famous physicist, and the man's head was printed on Austrian banknotes. If you are interested, you can go to know.
I would like to recommend a book to you, which is a very important book by Schrödinger, and the title is "What Is Life".
Chief physician, professor, doctoral supervisor, vice president of China-Japan Friendship Hospital, director of the Department of Respiratory and Critical Care Medicine, deputy director of the National Respiratory Medicine Center, vice president of the Institute of Respiratory Diseases of the Chinese Academy of Medical Sciences.
He is currently a member of the Faculty of the Chinese Academy of Medical Sciences, the Chairman-designate of the Respiratory Diseases Branch of the Chinese Medical Association, the Deputy Editor-in-Chief of ClinicalRespiratory Journal, the Advisory Editorial Board of EBioMedicine, the Member of the Scientific Committee of Clinical MicrobiologyandInfection (CMI), and the Member of the Antiviral Group (AVG) of the International Society of Influenza and Respiratory Viral Infections (ISIRV). He has won the 2020 National Advanced Individual in The Fight against the New Crown Pneumonia Epidemic, the 2018 Outstanding Respiratory Academic Contribution Award, the 2017 National Science and Technology Progress Award (Special Prize), and the 2014 Wu Jieping-Paul Janssen Medical Pharmacy Award. He has long been committed to the research of key scientific issues of acute respiratory infections and emerging respiratory infectious diseases, systematically elucidated the characteristics of viral pneumonia diseases, and took the lead in proposing the concept of "viral infection poisoning", which has important value for the treatment of serious viral infections; as the first or responsible author (including joint) he published 8 papers in LEMONT and NEJM, and 4 results were written into WHO and NIH guidelines, took the lead in formulating Chinese pneumonia and influenza diagnosis and treatment guidelines, and participated in the formulation of WHO new crown pneumonia guidelines
This article is selected from the book "Juvenile Breathing" jointly planned and published by the Youth Committee of the Respiratory Physicians Branch of the Chinese Medical Doctor Association, the Youth Committee of the Respiratory Disease Branch of the Chinese Medical Association and the Physician Daily. From now on, the wonderful content of the book will be published one after another, so stay tuned!