Doctor's thoughts on the cultivation after reading (1)
As a medical student majoring in psychiatry who just entered the medical college, I was fortunate to read Artu Govender's The Cultivation of Doctors.
The author tells more than a dozen stories of his own personal experience in simple and easy-to-understand words, showing the uncertainty faced by doctors and the complicated factors that need to be considered when making a decision from different aspects, and tells that Artu, a young novice doctor, was born in a family of doctors, graduated from a prestigious medical school and entered the dream white giant tower with great ambition. Pick up the scalpel for the first time from the hard scalp; The first tracheotomy and other experiences; Seeing the doctors who have done their duty around them eventually sink; In the face of all kinds of unexplained and incurable diseases, I experienced the loss of life from my own hands ... and told the helplessness of medical workers. Moreover, there are some medical knowledge in it, which is a study for me who is new to clinical practice, and it is also a warning and encouragement.
As an empirical discipline, clinical medicine needs constant practice and summary. "To be honest, the most important talent is to practice, be willing to practice and be willing to practice." "However, every practice is a matter of life and death, so we must realize that such a reality" medicine is not a perfect science, but a constantly changing and elusive knowledge system, and the progressive science guides us. Of course, there are habits and instincts, and we have to rely on some experience and sometimes luck. However, there is always a gap between what we know and what we pursue. However, it is this gap that drives us to do everything harder. Because "I find medicine really wonderful, it is difficult to explain in many aspects, and the risk is so high, but patients trust us and let us play freely." Doctors always face a dilemma, and sometimes they need to make medical decisions in a very short time. Will such decisions bring complications? The inaccurate answer is hard to answer. After all, medical decisions are complicated. When you meet a fork in the road, it is difficult to decide which one to take, just like Artu's first deep vein puncture and his first tracheotomy, which requires doctors to make decisive decisions and dare to practice, "just like tennis players, piano players and computer repairmen. We all need constant practice to master professional skills. " But it's like walking on thin ice, like the contradiction in the abyss. "Perfect as a machine" has become a goal of the medical field. "From the first day we entered the hospital, we knew that doctors are not allowed to make mistakes." The key to perfection is to study more. Only lifelong learning can minimize the possibility of making mistakes. "My father told me that you think you have done well, but soon you will find that someone is doing better than you, because new technologies and people who master new technologies are emerging one after another. You must keep learning new things. Most of what I did today. Medicine is also an exploratory subject, and human understanding of human body and diseases is far from ideal and perfect. "In fact, every doctor has a similar experience: medical technology is constantly improving, and doctors must constantly try and learn new things. Being unable to adapt to new things means reducing the probability of curing patients and preventing them from enjoying the benefits of modern medical progress. However, the learning process inevitably brings trouble. " At the same time, we must also recognize this fact. "Every day, doctors have to face unpredictable situations-insufficient information, vague scientific theories, and a person's knowledge and ability can never be perfect. Even the simplest surgery, doctors can't assure patients that the postoperative state will be better than the original." The textbook talks about the typical symptoms of various diseases, but in clinic, it is impossible to find a person who can see all the typical symptoms, especially many diseases are difficult to differentiate and diagnose. Only through constant practice, accumulation and summarization, and prudence can mistakes be minimized, but doctors have great work intensity and pressure. "Doctors should be stronger and more resistant than most people through harsh medical training, but it turns out that this is not the case." We also have to face disputes between doctors and patients. When troubles arise, we can't get the understanding of outsiders, and the hottest people will also be drowned out by the cold attitude. "Doctors belong to an isolated world, a world that keeps bleeding, experimenting and cutting open the human body. We are a few healthy people living in the patient group, so we are easily isolated, and even our family members find it difficult to understand the world we live in. "
Doctors are often regarded as cold-blooded and impersonal, showing indifference to living patients. In fact, this is one of the professional qualities that a doctor must possess. At least, this superficial indifference is also necessary in medical activities. "Doctors are emotionally calm, can look at all uncertain things rationally, and will not distort the facts because of fear or emotion." We can't get every patient's understanding, but at least we can have a clear conscience!
Gwende also talked about the proposition of surgical robot and man-machine game in the book. In 1996, Director Wolin, a senior expert in charge of cardiac monitoring in the Affiliated Hospital of Rand University, Sweden, competed with a computer recognizer to analyze and recognize 2,24 ECG data (half of which were problem ECG). As a result, "Wolin correctly picked out 62 ECG data, while the computer correctly picked out 738 ECG data, and the computer beat the experts by 2%". In almost all competitions, the computer either tied with human beings or beat human beings. After reading the book, I felt "Doctor". The opponent thinks that "modern medical care is already lacking in human warmth. If technology continues to be supreme, human beings will feel more and more lonely, and patients will often feel that they are just a number on a case." "Perhaps the prospects of digital medical care are incompatible, not complementary", while the other side supports that "doctors may get rid of the troubles of medical errors and care more about patients."
In the team of doctors, there are often some problem doctors who need to be corrected. This paper analyzes Harrison's problem doctors in detail. The history of his spiritual degeneration is analyzed in detail, and the problem doctor will face the censure of his peers, and finally Harrison will be cured in a professional correction center. "We are all the same. When we are sick, doctors are in control of our lives, and doctors are usually imperfect, and they may make mistakes."
Choosing medicine is a lifelong study. As we are entering the clinical stage of study, we shoulder the responsibility in the ideal of overcoming diseases for mankind. I must study hard and use my knowledge and ability to change the fate of a person's life and make this person live a better life.
Doctors' Thoughts on Practice (II)
The Practice of Doctors is an amazing book. Dr. Godwin's magical words can make the real story in the ward seem to be playing out before our eyes. Every case story in the book is full of his profound reflection on medical career and touches the hearts of each of us. In his book, Dr. Gwende gives us a lot of enlightenment on how to cultivate and become an excellent medical staff and how to ease the contradiction between doctors and patients.
Face up to medicine and strive for perfection
"Medicine is ubiquitous in real life, but it remains mysterious and often difficult to ponder. Sometimes we see medicine as too perfect, but in fact, it is not so magical. "
Both we and patients should accept the complexity of clinic, because medicine is a constantly changing and elusive knowledge system. There will always be some gap between what we know and what we pursue, but it is this gap that makes us work harder in everything. We will never go beyond infinity, but we should use our knowledge to choose the most suitable treatment scheme for patients and pursue relative perfection. And all this is inseparable from years of unremitting study and experience.
It is the duty of every pharmacist to provide doctors and patients with reasonable medication advice. We all know that metformin hydrochloride sustained-release tablets are used to treat type II diabetes, but we may not know that metformin can strengthen the anticoagulant effect of anticoagulants (such as warfarin, etc.) and easily lead to bleeding tendency; Shengqi Jiangtang Granule and Tianmai Xiaoke Tablet can also be used to treat diabetes, but we may not know which one is more suitable for patients. Knowledge is endless, so we need to break the conventional thinking, constantly learn new knowledge, and constantly accumulate work experience, so as not to be discouraged when patients consult with drugs.
Listening to communication and putting people first
"With the continuous development of modern medicine and the rapid development of technology, the real test is no longer just to get rid of patients' pain, but whether doctors can provide warm and cordial services with a caring attitude."
In the face of patients, we should abandon the condescending attitude and strive to create a comfortable and confident environment for patients. We can regard patients as our friends, just like Dr. Gwende, and talk to these "old friends" more often to find out what their real needs are and what effect they hope to achieve, and work out a reasonable treatment plan with them on the premise of full communication between doctors and patients. This is not only dedication to our medicine, but also respect for patients.
I like the last case story in the book very much, not only because the two doctors treated Alice with necrotizing fasciitis with superb medical skills, but more importantly, they gave up amputation, the most direct treatment scheme, from Alice's point of view, in order to preserve the whole legs for this young girl and still care about Alice's physical and psychological condition after the patient was cured and discharged from hospital, which fully embodies the people-oriented medical concept.
Do not forget your initiative mind, look at yourself
"After years of working like this, his patience is getting worse and worse, and he gets upset and angry at the slightest situation. Originally, if you want to be a good doctor, you have to bite your teeth and accept it. No matter how busy you are, you have to solve unexpected problems first. However, Harrison has been carried away by his performance, and there have been problems one after another during the operation. "
What Dr. Harrison lacks is to maintain his enthusiasm for medical treatment at first and to examine his own behavior and personality. Excellent medical staff not only assess their professional level, but also their medical ethics and personality. The world calls us angels in white because of our peace of mind, purity of soul and noble medical ethics. The road of medical progress is full of all kinds of unknowns. What we need to do is to look at ourselves objectively at all times, constantly correct mistakes in the process of marching, and maintain the original heart of saving lives and serving patients. I believe that we can all become lovely people in the eyes of patients, and believe that the tense contradiction between doctors and patients can be alleviated to some extent.
Recently, the popular medical documentary "In the World" caused quite a stir, because from the very beginning, the documentary showed us the side of failed surgery. It's not just the patients who are struggling with the disease, but also us. Facing death, we can't stop it, but we have to fight for any chance to "escape" for them. Even if they fail in the end and are questioned by everyone, we are still willing to rush to the front line of saving lives, because there is only one thought in our hearts, that is, saving lives.
the doctor's practice after reading (3)
when I opened the home page of the doctor's practice, I had a strong desire to read on. On this page, a wise scholar is smiling calmly and writing a brief introduction beside him (the youngest health policy adviser in the White House, the key person who influenced the health care reform policy in Austria, and the only doctor on the list of "1 Most Influential People" in the world in Time Magazine). As a medical junior, I can't express the excitement when I saw such an excellent predecessor, and I am of course interested in his works.
With reverence for Dr. Artu, I went on reading. However, to my surprise, the beginning of the book was "I am a rookie". During this period, I saw my idol fade away and grow up as a rookie, which was deeply inspired. Dr. Artu, who can achieve such achievements, should be regarded as a genius in our mouth, but even a genius is just a rookie at first.
Excellent. For example, he made mistakes in the first central venous catheter implantation. When he thought everything was ready, the instructor asked him, "How many platelets are there?" He forgot to check because he was nervous; When he was disinfected, the doctor asked him, "Did you roll the pad cloth for him?" He realized that he had forgotten again; When he was about to start the injection, the doctor asked him, "What about the syringe used to flush the catheter?" He is really confused again. Surgery, like other things, skills and confidence are accumulated from experience. After years of accumulation, he learned appendectomy six months later, amputation one year later, tracheotomy two years later, and now he is trying to learn how to deal with abdominal aortic aneurysm. Genius lies in accumulation, as he said, "I am neither a genius nor a fool, but I can do it through constant practice."
"I know that the operation may go wrong, but I won't hesitate or doubt when I start again." I think this is the charm of a doctor, calm and calm, giving patients the greatest comfort. Of course, such calmness is not innate. It comes from years of practice. Not only residents need to practice constantly to complete the counterattack of novices, but experienced doctors also need to adapt to the development of science and technology and master more advanced new technologies through continuous practice. It can be said that learning is a lifelong learning.
the doctor's practice is to practice all his life until the end of his life.