Chapter 27 Twenty-six, great doctor

Hippocrates: See you. From 1990 to 1998, I studied medicine seriously at Peking Union Medical College for eight years. I went to Doctor of Medicine in serious courses, from DNA, RNA to cells to tissue to gross anatomy, from physiology to pathology to pharmacology, from traditional Chinese medicine to internal medicine to neurology. Department to psychiatry to obstetrics and gynecology.More than ten years ago, after studying medicine for eight years, after drinking, vomiting, and sitting and thinking, I decided not to be a doctor anymore. At that time, I decided not to be a doctor for two main reasons.

The first reason is to doubt what a doctor can do. In the last three years of my medical studies, I studied ovarian cancer at the level of genetics and histology. The more I researched, the more I felt that life and death were too closely related. It can even be said that digging to the root, life and death are originally one thing, not two.Most diseases cannot be cured, and they need to rely on their own immunity to cure themselves.I watched the ovarian cancer patients I followed for three years, surgery, chemotherapy, recurrence, reoperation, and rechemotherapy. Within three years, no matter what the doctor did, half of them died slowly and painfully, with infinite nostalgia for life. And the unsure of death, die.

The second reason is the worry that being a doctor is getting harder and harder. In fact, after studying pediatrics for a while, I basically understood that medicine has never been a pure science, and medicine should always be: To cure, sometimes. To alleviate, more often. To comfort, always (cure occasionally, relieve often, always can comfort).What I was worried about at the time was, besides the spiritual joy of saving lives and healing the wounded, what else can doctors gain by doing so?Without sufficient financial foundation at all, how long can doctors be happy?Above the structure and anatomical structure of the human body, there are diseases; above the diseases, there are patients; next to the patients, there are doctors; above the doctors, there are hospitals; above the hospitals, there are the Ministry of Health, the Development and Reform Commission, and the Ministry of Finance; There are the Insurance Regulatory Commission and the Ministry of Social Security.In modern society, doctors treating patients has never been a simple business activity.In terms of medical and health care, the country emphasizes average, equality, "universal access to medical care", emphasizes planning and regulation, and stays away from the market. "Drugs are already so expensive, it can only lower the income of doctors, and hospitals can only support doctors with medicines." Doctors in the United States have better incomes, but not only are lawsuits rampant, but they also cannot fundamentally solve the problem of the balance between fairness and efficiency. : "If a new life-saving drug is produced, the cost is 100,000, and the price is 10 million, is it reasonable? Should it be controlled? The new drug is priced at 10 million, should it be given to patients who can afford it, or should it be given to everyone who is applicable What about sick patients? Is it reasonable that 30% of the medical expenses in the United States are spent on people who will die within two years?"

After graduating from medical school, after more than ten years of not touching medical care, the main health indicators (life expectancy, neonatal mortality, etc.) are getting better and better, but the medical environment seems to be more and more worrying: the overall quality is deteriorating rapidly The group of doctors and nurses, the group of accelerated aging patients who vent their dissatisfaction on the individual doctors and nurses, and the self-righteous media that only join in the fun, seek sensationalism, and basically do not think deeply. As in the past, medical students continue to be poor and cannot afford to invite beautiful nurses to eat supper.Compared with the past, the little doctor is even poorer.Housing prices are five to ten times higher than in the past. I used to buy a small house of more than 20 to 30 square meters on the edge of Beijing's third ring road and commute to get off work by bicycle.Now I’m buying a small house of 20 to 30 square meters in Yanjiao, Hebei, which is the “Pan-Beijing” area. It’s too far away, and it’s impossible to commute by bike. I’m pregnant, and I’m afraid of premature birth due to crowded subways and buses. I want to buy a QQ car instead of a Beijing car. A purchase restriction order has been issued.The little doctor was an associate professor, and there were more than forty full professors in the same department in the hospital. There was less than one operation a week, and each operation started after five o'clock in the afternoon.Compared with the past, the doctor’s registration fee has increased a bit, and it is still around the price of a fashion magazine. He still has to see dozens of patients in the morning, and he still has to urinate, shit, and starve. Allow a few minutes for the consultation.Large hospitals continue to look like wartime hospitals or post-disaster hospitals. From night to day, large hospitals are full of patients and their family members who accompany the patients. All they see are temporary beds and hanging bottles.Patients continue not to be cared for like humans, and not many doctors have the time and patience to comfort, relieve, and heal.

Unlike in the past, in addition to poverty, doctors began to worry about their lives, and some patients who could not enjoy basic services began to do it. "A few years ago, we only got angry every few months, but now it has become every few days. In one month, a doctor was hacked to death by a patient, and a hospital director's genitals were kicked to pieces. People's Hospital A certain director was beaten to a bone, and Nanchang Medical Center fought with hundreds of doctors.” “In view of the increasing threat to personal safety, the doctors in our department are already preparing to form a group to learn Kung Fu. The options provided by the coaches are: Wing Chun, Taekwondo, Fighting, Sanda. Don't know which one to learn?"

The phenomenon of illness is as symbiotic as life, and the profession of doctors is as old as assassins, prostitutes and wizards. How can doctors basically live a decent life?How to make patients basically have dignity like human beings?I reread your doctor's oath written 2400 years ago for answers. 2400 years ago, you swore: "I, Hippocrates, testify that Apollo, Esclepis and the gods of heaven and earth bear witness." Therefore, first, doctors should be in awe, respect God, heaven and earth, conscience and moral law in their hearts.Even in the face of the sharp edge of extreme poverty, even in the face of the sharp edge of the sick, we must not forget the awe and do nothing.

2,400 years ago, you swore: "Whoever teaches me medical skills, I should respect him as I respect my own parents. For the medical skills I have, whether it can be expressed orally or in writing, I must pass them on. To my sons and daughters, to the sons and daughters of my teacher, and to the students who swear to abide by this oath; except for these three cases, it will not be passed on to others." Therefore, secondly, medicine is a craft, and doctors must continue this craft, unite with sincerity, and love each other. 2,400 years ago, you made an oath: "I will, within the scope of my judgment and my ability, abide by the moral principles for the benefit of the sick, and put an end to all depraved and harmful actions... wherever I go , and regardless of whether the patients in need of treatment are men or women, free people or slaves, I treat them equally, and seeking their happiness is my only purpose."

So, third, the interests of patients are higher than those of doctors.Patients are human beings first, and all patients are equal in the face of illness.Doctors should not have any sense of difference. There is no distinction between rich and poor, high or low on the hospital bed or on the operating table. Although doctors cannot guarantee that patients will enjoy the same medicine, they can at least guarantee to give patients the same comfort and care. In addition to your oath, I think, in order to "let Apollo, Esclepis, the god of medicine, and the gods of heaven and earth grant me the supreme glory of life and medical skills", doctors must have enough income.The medical system of any good developing country adopts a dual-track system, which does not overemphasize absolute fairness. While ensuring basic medical care, it also provides high-end medical services to meet differentiated medical needs.I firmly believe that there are enough people willing to pay a reasonable price for their medical care in this fast-growing country that contributes 25% of LV's sales every year.How to establish this dual-track system will not be detailed here.

Before the basic changes in the system, the system and the world, I still suggest that doctors should learn to protect themselves in the face of sharp knives and practice hard to escape.While studying medical skills every day, he also studied Lingbo Weibu and 50-meter accelerated turn-back running.For the convenience of escaping, it is recommended to refer to Hufu riding and shooting, and change the white coat into white trousers. Hippocrates, do you have a better way? Goodbye Feng Tang