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Exclusive Interview丨Liu Diem: Everything is beautiful in the heart, and everything is deep in the heart
Ye Ask Ren Medical
Ye Ask Ren Medical Official Pharma Surge No.
2021-04-08 07:25
Shanghai
Originally Posted by Tang Ye Ye Ye Ask Ren Medical
This is the first time that I've ever been to a hospital in Shanghai, and it was the first time that I had been to one of those hospitals in Shanghai, so I'm sure you can tell us about that. >Personality Introduction
Liu Yan, chief physician, doctoral tutor, director of burns and plastic surgery department of Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine; vice-chairman member of the burn surgery branch of the Chinese Medical Association, vice president of China Medical Doctors' Association Burn Surgery Branch. He specializes in the treatment of critical burns, pediatric burns, and all kinds of acute and chronic wound management.
1.The road to medicine
"I had the experience of traveling around the world at a very young age." Liu Diem laughs in the spring sunshine.
Because of his parents' job transfer that year, Diem spent 12 years in Shijiazhuang, Hebei province, and eventually returned to Shanghai with his parents after spending his senior year of high school in Jinhua, Zhejiang province, where he studied on loan for a year. It is because of the teenage life experience in the north, so that Liu Yan's soft and beautiful appearance, hiding a "woman" heart.
Liu Yan's mother did not advocate her daughter to study medicine. Because her mother was an obstetrician and gynecologist herself, she was busy in the clinic all year round, leaving only the back of Diem's hard work. "She knew the uncountable time and effort it takes to be a doctor, so she always advised me not to choose medicine as a lifelong career, but I couldn't seem to resist the charm of medicine."
With an ear to the ground, what Diem really watched was the happiness and joy of those in labor as they held their children and thanked their mothers. "It's a beautiful image of a mother at this time of the year, with a radiance radiating from her body. I think it is worth the mother's effort, and I am afraid that the sense of fulfillment in treating the sick and saving people is hard to compare with other professions."
In 1985, Liu Yan was admitted to Shanghai Second Medical University as she wished. The pace of life in the university, Liu Yan is very adaptable, classroom knowledge, by the Chinese women's volleyball team "five consecutive championships," inspired by her love of volleyball, she became the medical school women's volleyball team setter, and the girls on the team together to take the East China Six Provinces and Cities Volleyball League Championship. After graduation, Liu Yan stayed in Ruijin Hospital. The young girl, who loved to "get her hands dirty," wanted to go to the surgery department, but that year, the surgery department did not recruit girls, so her teacher pointed out a clear path for Diem: the burns department.
The burn unit of Ruijin Hospital has been famous for a long time, and in 1958, it successfully treated Qiu Caikang, a patient with severe burns, which broke the world's stereotype of "burns exceeding 80% of the body surface area cannot survive", and set a precedent for the success of treating patients with large-area burns. Subsequently, under the leadership of Prof. Shi Jixiang and Prof. Yang Zhijun, the core technologies of burns treatment such as early liquid resuscitation based on Ruijin's formula, hybrid grafting for wound repair, and hibernation therapy for stress management were pioneered, forming a Chinese burn treatment model recognized by the international medical community, which significantly improved the cure rate of patients with severe large-area burns, and established the discipline's academic status both at home and abroad.
This is a piece of gold, and doctors often have the opportunity to operate, Liu Yan did not hesitate to join the Department of Burns.
When he first joined the burn unit, he was exposed to many shocking cases. But the fledgling Liu Diem, but has a strong mental capacity, in the tragic situation before and without fear. "This is still thanks to my mother's career, when she 'stayed seed' in the countryside of the health center work, five or six years old, I began to work in the hospital as a volunteer laborers, running around to send some medical supplies, have seen soaked in formalin in the body of the baby, so there is nothing to fear. "
But that doesn't mean Diem won't be shaken by sudden grief.
Liu Diem's voice choked up at the mention of a flower girl.
"She was a young female textile factory worker in her twenties, with big eyes, long eyelashes and a beautiful face. That day she and her lover sat together on the cotton pile to rest, the results of the boy smoking, accidentally ignited the cotton pile, causing a major disaster, large area of severe burns girl, sent to the thigh muscles are burned to collapse open. Because of the severity of the damage, we amputated both of her lower limbs, but in the end we couldn't save her life. I still remember the teardrops that fell from the corners of her eyes when she was seriously ill. The feeling of helplessness in the face of the patient's strong desire to live, but as a doctor unable to do anything about it, haunted me for a long time."
2. Following a mentor
In 1996, when a gas explosion occurred at Xieyi Mine of the Huainan Mining Bureau in Anhui Province, resulting in more than 100 casualties, it was the first time that Diem was dispatched to the scene of a disaster to treat the injured. For the fledgling, it was the battlefield that would usher in the real test.
"We are divided into groups to treat patients, and our treatment group manages more than ten casualties. To the wounded to change the medicine, the wounded sometimes pain screaming, traumatic secretions mixed with the patient's feces and urine, I was comforted, while not hesitating to wipe, clean. A few of the older doctors in the group with me, all exclaimed - how not at all like a Shanghai girl."
Reviewing the young people from the ignorant to the present, Liu Yan bluntly said that her character is a bit easy-going, unlike many young people today have realistic and direct goals, she just "follow the teachers to go forward".
In 1999, Liu Yan began to pursue postgraduate studies in burn surgery, and in five years completed his master's and doctoral studies, doctoral adviser Professor Xu Weishi, is a famous expert in the field of burns in China. "Teacher full of experience, but modest and low-key. The four words "indifferent and clear-minded" are the best annotation for him. His dedication to his studies and his rigorous and prudent attitude to governance had a great influence on me. Mr. Lao has a profound cultural background. Long-term extensive reading of literature and the accumulation of clinical front-line work endowed him with a keen eye for discovering problems and the ability to solve them. Although he has been retired for many years, every time I visit him, he can still offer pertinent advice on the development of the department and the grasp of the direction of research."
Liu Diem had also heard many of his predecessors talk about saving Qiu Caikang's life. Qiu Caikang is a steelmaking worker at the third plant of Shangsteel, a late night in 1958, because the main buckle of the traveling crane crane loosened, resulting in 10 and a half tons of boiling iron fell ...... instantly, this 30-year-old steelworker 89.3% of the skin on the whole body surface was burned, including deep burns in an area of 23%, the human epidermis seems to be charcoal, the head is swollen like a balloon. Life is at stake.
According to the theory of Evans, the famous American authority on burns at the time, it was difficult for him to survive, both from the area of the burns and from the depth of the burns. At that time, there was no burns department and no independent wards. In order to reduce the possibility of cross-infection, the hospital purposely evacuated the wards on the fourth floor of the former Infection Department building as a special ward for admitting Qiu Caikang. Director of Surgery Fu Peibin and Dong Fangzhong visited Qiu Caikang in the ward as soon as they had time. Shi Jixiang, Yang Zhijun and other doctors also took turns to guard the ward. At that time, there was no 24-hour monitor, so the doctors and nurses stayed awake day and night to monitor Qiu Caikang's vital signs and changes in his condition in shifts. Hibernation therapy, phage therapy ...... to cope with the constant changes in the condition, they came up with a way. Because each change of medicine turn over for the patient is a great pain, Ruijin Hospital medical staff and technicians *** with the design, manufacturing the first domestic turn over the bed ......
These stories, often listen to Liu Diem feverish: "Ruijin Burns Department of the older generation is very remarkable, in In that penniless era, out of their extreme desire to save the lives of their 'class brothers' and out of their selfless dedication to the cause, they worked hard in the clinic and created countless miracles. Many of their experiences and life-saving concepts are still relevant today."
Yes, the history of the singable Ruijin Burn Unit, and the countless predecessors of the burn unit, lit a torch for her."
In 2004, Diem went to the United States to study. She admits that the time spent spinning like a "gyroscope" laid a solid foundation for scientific research.
"One person is responsible for many subjects, and many experiments are scheduled on the same day. The animals, the cells, the rhythms were all over the place. Between experiments, it is reading literature. Only the evening 'movie time' is the relaxation moment of the day. netflix has me as a member probably quite a loss, probably watched off hundreds of movies and TV series. I sometimes mention this experience of mine to graduate students, telling them that it takes such a purgatorial rebirth to make it in all aspects of medicine, teaching, and research."
3. Always comforting
"The treatment of patients with extensive burns requires many repeated surgeries. In the first step, the necrotic tissue of the burn is removed and covered with a biological dressing; later, the patient's residual autologous skin is used, and all the burn wounds are eventually covered by repeated skin grafting surgeries over and over again."
At first, she followed her seniors in the department on the surgery, and slowly, in comprehension, she thought and worked independently. "When I was an assistant, all I could think about was how to assist the senior doctors well and be able to make them finish the surgery in the most comfortable position. When you do surgery independently, the pressure is different, because the life and death of the injured person is all on your own, and all you can think about is that no matter how difficult it is, you must save him." Diem said.
The burn unit is actually an "internal and external" unit. Burn doctors need to have the surgeon's "decisive, fearless", but also need to patients with infection, organ function damage, internal environmental disorders and other problems of internal medicine treatment. The long process of treatment of extensive burns is a test for doctors, patients and families. Liu Diem talked about a vicious case.
It was a chemical plant worker in Taizhou, Jiangsu province, who suffered 93 percent deep burns from sulfuric acid spewed out of his work. The local hospital had limited conditions and had to be transported long distances to Ruijin Hospital. When the patient arrived, he had a large area of scorching all over his body, corneal injuries, and was almost in a state of shock. After aggressive fluid resuscitation and passing the shock period, a long and repeated surgery was started. In the later stages of treatment, the skin implanted on the wound was lysed several times due to the infection of multiple drug-resistant bacteria, and the patient's general condition recurred from time to time. Doctors had to do a good job of saving the patient's life, but also had to deal with the concerns of the patient's family and organization about the outcome of the treatment, the future quality of life, the cost of treatment and many other issues. No matter which step of the function is not done well, all the previous work may be lost. This time to do is to give the patient, the family to persist in the confidence.
Pediatric burns account for almost one-third of the patients admitted to the burn unit, and remorse, panic, anxiety and suspicion are common emotions among many children's parents. "I often encounter emotional parents in the hospital corridors, they will run up and beg me to help their children. Some parents hold thick books in their hands, jotting down densely packed questions; some mothers often sob uncontrollably while talking about their illnesses, and some will even hug me and cry. At this time, in addition to answering questions and explaining doubts, a gentle hug and a pat on their back is a kind of comfort."
In order to reduce the incidence of pediatric burns, Liu Yan and her team have spent a lot of effort on popularizing the scientific mission of pediatric burn prevention and synthetic first aid.
"In 2018, a number of experts in our department edited and participated in the burn prevention mission, "Famous Doctors Advice on How to Prevent and Control Burns". The department's medical and nursing staff wrote and directed ""Three Treasures of Burns" of the mother-in-law and daughter-in-law competition", which won the first prize in the Fifth Shanghai Youth Medical Science Popularization Competition. The department has also started its own WeChat public number to publicize burn prevention knowledge. Every doctor and nurse in the department is a publicizer of burn prevention and first aid knowledge. In addition to that, our voices are all over radio stations, newspapers, WeChat public number, Jitterbug and other platforms." Liu Diem says they are passionate about what they are doing to "break their own rice bowls".
4. Carrying a heavy burden
In 2018, Liu Yan took up the post of director of the burns and orthopedics department at Ruijin Hospital, picking up the heavy responsibility of managing the entire department.
"The pressure is really quite strong. Ruijin's burn unit is a "hall of fame" for burns in China, and its reputation has spread far and wide. How to maintain the status of the discipline is a problem faced by every leader of the discipline. In fact, many people's memories of the burns department of Ruijin Hospital are still stuck in the great deeds of Qiu Caikang, a successful steel worker, and every time I hear people talk about Qiu Caikang, it is a kind of stimulus for me to remind us that we are not doing a good job now." Diem believes that for the department to grow, it must have innovative results in addition to maintaining its clinical strengths.
And in the face of the overall incidence of burns has decreased dramatically in the environment, how to do a good job in the transformation and development of the discipline, but also in front of Liu Diem's problem.
The first fire of the new official is to prepare for the construction of Ruijin burn specialty medical consortium, this medical consortium covers 11 provinces and cities across the country, 25 second- and third-tier hospitals burns department of the specialty consortium, the furthest hospitals, including Qinghai, Heilongjiang, Xinjiang and other regions. "The burn specialty consortium has two main directions of work, one of which is medical cooperation, including the promotion of hierarchical diagnosis and homogenization of medical care, and the promotion of telemedicine, tele-education and two-way referral. And I prefer to build it into a platform for peer academic exchanges, multi-center clinical research design and implementation."
In addition to the construction of the medical consortium, Liu Diem repositioned clearly the direction of subspecialties including critical burns treatment, pediatric burns, wound repair, and rehabilitation. "Critical burn treatment has always been the traditional strength of Ruijin Burns, while trauma repair is a shortcoming of our department. We sent the young doctors in the department out to learn flap technology, and now several colleagues in the department have been able to skillfully apply this technology to the repair of all kinds of complex wounds, which has greatly improved the level of trauma repair in the department and made up for this short board."
Leading a team of 22 people, Diem has always upheld a fair and tolerant management style.
"I don't look at people with colored glasses. Strive to create opportunities for every young person to develop, as long as it is good for the development of the department and contribute, the department will reuse you."
Oral transcript
Ye asked Renmedic: Parents of pediatric burns are often very anxious and can fall into deep self-blame, how do you calm parents?
Liu Diem: Striving for the best therapeutic effect is the best way to pacify the parents. One of the focuses of the department's clinical work and clinical research in the past few years has been the treatment of pediatric deep burn wounds. How to make a comprehensive consideration between trauma management, pediatric growth and development, and long-term scar treatment, so as to maximize the benefit and minimize the harm to the burned child as much as possible. In addition, mention must be made of our nurses in the burn unit, who, as an unaccompanied, closed management ward, are extremely gentle and patient with the elderly and children in the ward. The "Youth Commando", a group of young doctors and nurses in the department, has organized "Love Accompaniment" public welfare lectures, and from time to time in the outpatient clinics and wards to teach parents about treatment and nursing experience.
As a parent, you can best understand the soft heart of parents towards their children. By treating our sick children with the heart of a parent to a child, the parents of the children will feel it and will be pacified by it.
Ye asked the doctor: How can I be a good doctor in the burn unit?
Liu Diem: Everything is beautiful when the heart is beautiful, and everything is deep when the love is deep. Love is the foundation of a good doctor. With love, you can realize the suffering of the patients, and then you will try to do everything to improve yourself and help the patients to solve their problems.
Ye asked Dr. Ren: Has the burn unit changed since 1958?
Liu Diem: Diagnostic techniques, monitoring methods and treatments have been greatly enriched. The department has purchased a lot of new instruments and equipment in the past few years. Including monitoring and treatment instruments for critically ill burn patients, which allows us to assess the patient's general condition more intuitively and objectively, and realize more accurate treatment. In addition, the means of wound repair are constantly being enriched, which not only allows patients to survive, but also gives them a better quality of life.
Ye asked Renmedicine: Clinicians in the department also face the problem of how to balance clinical and scientific research, what is your opinion? How is the time allocated?
Liu Diem: It seems that the discussion on whether doctors should do scientific research never stops, and I always feel that this is a question that does not need to be debated. The essence of scientific research is to explore the unknown and find answers to questions. 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 hospitals like Ruijin, both clinical and scientific research are indispensable. Clinical research is the tentacle of research, the source of inspiration for research, and the scientific research way of thinking and working habits formed through rigorous training will improve the ability of doctors to find and solve clinical problems. The development of Ruijin's burns department is an example of synergistic development of clinical and scientific research. The older generation discovered problems in long-term clinical work - refined the problems, conducted basic research - and then returned to the clinic for verification, and in the process discovered new scientific problems. The most gratifying thing for me now is that the older generation has been working on the frontline for a long time in the clinic. What I find most gratifying now is that the middle-aged and young doctors in the department have a higher motivation and action to do clinical and scientific research.
Ye asked Dr. Ren: Have you ever received a special gift from a patient?
Liu Diem: It was once said that burns are a poor man's disease. The clinic has received eggs, dried plums, greens, corn and old hens brought by patients from afar. What I still have is a hairpin with red roses in a pink plastic shell given to me by a three-year-old patient, which was probably the most precious thing in the child's heart, as it was for me.
Interview/Ye ask Ren doctor Editing/Yin Yifei
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