Shao Kang, an oncologist： Trust is the best way to treat critical illness.
Without thinking about it, most of us can easily count several patients with cancer around us, directly or indirectly. There is a saying: "As long as you live long enough, cancer will find you sooner or later." It can be seen that cancer is not far away from each of us in a long life. So, how can we guard against this "uninvited guest" who doesn’t know when to knock at the door? For patients who have been "visited", how to fight against tumors?
The 28th National Cancer Prevention Publicity Week and China Anti-Cancer Day was held nationwide from April 15th to 21st this year. Recently, Beijing Youth Daily reporter interviewed Shao Kang, chief physician of thoracic surgery department of Cancer Hospital of China Academy of Medical Sciences. He believes that for patients, the most important thing is to trust doctors, so as to achieve the best treatment effect. Whether it is anti-cancer or anti-cancer, it is very important to live happily. Shao Kang also mentioned a concept that is not often mentioned — — Health quotient, "it represents a person’s health wisdom and attitude towards health. Compared with IQ and EQ, the role of health quotient is even more important. Understanding life, loving life, and knowing how to maintain and invest in health can make life more quality. "
After the most difficult and dangerous operation, like climbing a mountain, after successfully reaching the top,
If you meet any mountain lower than it, you will be full of confidence.
After graduating from Wuhan University with a doctor’s degree in surgery, Shao Kang has worked in cancer hospital for nearly 20 years. The reason why Shao Kang chose thoracic surgery is because he likes to challenge himself when he was young. Thoracic surgery is the most difficult and risky of all operations, and the two local high-incidence lung cancer and esophageal cancer are both thoracic surgery diseases. Shao Kang said: "Surgery can relieve the pain of patients in a relatively short time through surgery, and that sense of accomplishment is unparalleled."
It is hard to calculate how many operations have been performed so far. "For those successful operations, there won’t be too many impressions. For those very difficult or extremely dangerous, and even some lessons, it will never be forgotten. " Shao Kang told reporters about a "thrilling" operation: it was a young man in his thirties who had been working in Xinjiang for many years. He was injured during construction two years ago and suffered a comminuted fracture of his left leg. He took out the steel plate six months ago. Later, for unknown reasons, the symptoms of breathlessness appeared, and they became heavier and heavier. "The local hospital suspected that it was a tracheal tumor. Because it could not be cured, it rushed to Beijing. However, searching for thoracic surgery experts in almost all large hospitals in Beijing said that the tumor was too big for surgery. Not long after, he felt that it was more and more difficult to inhale and exhale. On the verge of death, he was rushed to a 3A hospital in Beijing. Unfortunately, there was no way but to burn a small hole in the trachea that was almost completely blocked under the bronchoscope, temporarily alleviating the risk of suffocation. "
After being introduced, he came to the Cancer Hospital of the Chinese Academy of Medical Sciences to find Shao Kang. Shao Kang found that the tumor grew at the lowest end of trachea and had involved carina and right main bronchus. "The operation in this position is the most difficult to do. It is necessary to cut both the trachea and the left and right main bronchi. Because the tumor is as long as 3.5cm, it may be difficult to connect because of too much tension after resection, but it is easy to recur if it is cut less. Because this tumor is not sensitive to radiotherapy and chemotherapy, surgery may be the only means of rescue. "
Shao Kang feels a great responsibility. If he lets go, the patient will die. However, if there is an operation, the risk is extremely high. Once there is an accident, you may not be able to get off the operating table. If there are complications after the operation, the daily cost in the ICU is at least 10,000 yuan, and the family members of the patients even plan to sell their hometown house to collect money for treatment. Shao Kang said: "As the top thoracic surgery room in China, if we choose not to do this difficult operation, the patient will really have no hope."
At present, Shao Kang decided to give a try for the patient. Before the operation, Shao Kang made a variety of simple models, and repeatedly practiced at home to complete the surgical method of completely removing the tumor without cutting the lung (cutting will facilitate anastomosis, but the patient may not be able to do heavy work in the future). But when everything is ready for surgery, there is a problem with anesthesia — — Because such patients are likely to have tracheal collapse after general anesthesia, and the patient may be comatose or even die because of the lack of oxygen supply, which requires anesthesia intubation in a awake state.
"I had to use my personal relationship to find Professor Wang Zhiqiang, who is best at tracheal surgery anesthesia in anesthesiology department. After several mobilizations, he accepted it gladly." The operation finally went on as scheduled, but another unexpected thing happened. "After I cut the 4.1cm trachea and the connected left and right main bronchi, I still found that the distance between the left and right bronchi and trachea was too long and the tension was too great to pull together."
Shao Kang was really nervous at that time, but he quickly calmed down and used his quick wits to let the anesthesiologist bend the patient’s head as much as possible. "This way, the trachea in the neck can be moved down, just right." Finally successfully completed the preoperative design and repeated practice of anastomosis. However, after the operation, Shao Kang was even more worried. "I am afraid that the tension of the anastomosis is large. Once it is opened, the patient may die instantly. Although I have sewed his chin and chest together, and also asked orthopedic experts to make a special bracket to fix his head and keep it bent, I am still afraid of it. I was nervous when I slept at night, for fear of calling and saying that the patient was dying. "
1 day, 2 days, 3 days, until a week later, Shao Kangcai relaxed a little. Fortunately, the patient’s postoperative breathing became unobstructed, and there were no symptoms such as fever, shortness of breath and discomfort. "To be on the safe side, it was not until 21 days later that I took apart the fixed line sewn to the patient’s chin and took off the bracket with a fixed position. At this time, the patient was relieved and the operation was finally successful. "
What makes Shao Kang feel even more gratified is that the patient did not stay in ICU because of his smooth postoperative recovery, and the most critical anastomosis operation was completely done by hand. When the family members were discharged from the hospital, the total cost was only 29,000. This makes it hard for patients and their families with difficult family circumstances to believe. Now, it has been three years since the operation, and the patient has returned to work, once again stirring up the beam of the family. On holidays, he will always send Shao Kang the news of peace.
"The successful completion of such an operation will undoubtedly have a great sense of accomplishment for any doctor." Shao Kang said: "I feel that I have challenged the most difficult and dangerous operation for me. This kind of surgery is like climbing a mountain. After successfully reaching the top, you will be confident if you encounter any mountain lower than it. "
In fact, the growth of every doctor is to accumulate experience in countless successful cases, learn from countless painful lessons, constantly improve and grow up in constant challenges. However, after all, the outcome of difficult surgery is unpredictable, especially when the doctor-patient relationship is tense, medical staff need to pay great courage if they want to meet the difficulties.
Trust is the best way to treat critical illness.
All patients hope that doctors will give them the best treatment and care to the greatest extent, especially when they are suffering from critical illness and facing life and death, they need patients and their families to make correct choices. But in today’s society, medical resources are not abundant. All kinds of false advertisements, rumors and pseudoscientific information are rampant, making it difficult for patients to tell the truth from the false, ranging from being cheated of money to losing their lives.
"In fact, disease is an enemy that patients and doctors face together. The level of doctors is high or low, but there is not a doctor who doesn’t want to cure the patient’s disease. In the face of serious illness, how to achieve the best treatment effect, the first thing is to establish a relationship of mutual trust between doctors and patients, "Shao Kang said." In many cases, due to the lack of trust between doctors and patients, they are indecisive and hesitant, and lose the best treatment opportunity. And when faced with life and death choices, this kind of trust may save lives. For example, in the case above, if the doctor is worried about the failure of the operation, it will have a bad influence on his reputation. If the patient is worried that the risk is too great to operate, the outcome can be imagined. "
Shao Kang said that in recent years, outpatient clinics often encounter patients or their families who are particularly "knowledgeable". They searched and learned a lot of medical information online in advance, and they questioned everywhere in the hospital for fear that the doctor would "pit" themselves. For example, patients with advanced cancer are reluctant to have a CT examination for fear of radiation. Another example is to say a lot of medical terms that he didn’t even understand, but when the doctor asked him a little more deeply, he didn’t understand at all. "Because of the lack of respect and trust for doctors’ professionalism, you have to spend a lot of time explaining, but doctors really don’t have that much time."
When Shao Kang makes a house call, he has to see 40 patients in the morning, which can be said to be an inch of money. It is really too busy to answer every question of each patient in detail. "For the patient, if you feel a word or two from the doctor ‘ Send ’ Well, you should be happy, because it shows that you have nothing to do. There are many complicated patients in the back, and it may take 10 minutes and 20 minutes to set the treatment plan for him. "
Shao Kang emphasized the importance of mutual trust between doctors and patients, because "only mutual trust can jointly take risks and achieve the best treatment effect. There are many uncertainties in the medical process, and no doctor can cure all diseases. Individual patients or their families will secretly take mobile phone recordings when they see a doctor, and sometimes what you say to comfort patients is likely to become ‘ Evidence of crime ’ 。”
Shao Kang admits that there are many reasons why patients don’t trust doctors, but as a doctor, only by improving their professional quality and skills, giving full consideration to patients and giving every patient the best assistance can they form a good reputation among patients and gain the trust of more patients.
Doctors should not only be able to see the "sick", but also the "sick".
With the rapid development of modern medicine, the methods of diagnosis and treatment of cancer are changing with each passing day. Cancer, which once made people turn pale, has now become a common disease and a chronic disease. Nevertheless, when patients learn that they have been diagnosed with cancer, they will still be hit hard. Many family members try their best to hide their illness, but as doctors, do they need to tell their patients the truth?
In Shao Kang’s eyes, it is an art to tell patients about their illness. Only by gaining the full trust of patients can doctors devote themselves to treatment. Shao Kang, when he was young, thought that doctors just had to do their best to cure the disease, but he later discovered that doctors who only cure diseases are not good doctors. Doctors should not only be able to see specific "diseases", but also learn to see sick "people". Treating diseases should not only make patients live long, but also make patients live with dignity and quality. "For example, the patient with severe tracheal tumor in front of him, the whole family depends on him to work to support their families, and the operation can only succeed but not fail. At the same time, there can be no complications in the operation, because once complications occur, even if they are recovered in the future, patients will be unsustainable because of huge debts and postoperative physical exhaustion. Therefore, when making a medical plan, doctors must not only consider the medical profession, but also the patients themselves, weigh the pros and cons, consider them comprehensively, and make the best choice together. "
It is precisely because of such challenges every day that Shao Kang is more enthusiastic about his major. In his eyes, surgery is like artistic creation. "Let the patient recover quickly, the pain is light, the incision is beautiful, the survival time is long, and the quality of life is high." Making simple surgery beautiful and making difficult surgery safe and smooth is the highest realm of pursuing surgical technology. "
Shao Kang said that doctors now have to accept the edification and training of humanistic medicine. Medicine is not only a natural science, but also involves humanities and social sciences. "Modern medicine emphasizes society — Psychology — Biomedical model requires doctors not only to look at the concrete ‘ Sick ’ , but also learn to see the sick ‘ People ’ . Only in this way can we truly achieve ‘ Patient-centered ’ 。”
Then, whether to tell the patient directly about the diagnosis of cancer, Shao Kang said, it varies from person to person: "In fact, everyone has the right to know his illness and cannot be deprived. But for some patients, due to the lack of medical knowledge and great fear of disease, it is really necessary to consider their endurance. A few years ago, a patient in my hometown was diagnosed with lung cancer locally and wanted to come to Beijing for surgery. I made an appointment with him for an outpatient service, but he died less than a week before the patient came to Beijing, and I didn’t know it was ‘ Scared to death ’ . Therefore, some patients with poor psychological quality should be revealed to him step by step, so that he can have a process of accepting and building confidence in treating diseases. "
Shao Kang said that the development of modern medicine has advanced by leaps and bounds. Many incurable diseases have basically been solved now, and cancer is gradually becoming a chronic disease. "Early cancer can basically be completely cured, and a considerable number of patients can be cured through comprehensive treatment in the middle and late stages."
So, how to prevent cancer from coming to you?
Shao Kang emphasized that physical examination is the most important. He said that cancer is like a bad guy. Bad guys always do bad things secretly, which makes people lose a lot unconsciously and even lose their lives. The same is true for cancer. Most cancers have no symptoms in the early stage, which is neither painful nor itchy, and even some cancers have no obvious symptoms in the middle and late stage. Therefore, even if you feel good about yourself, you should have a regular physical examination. Only in this way can you find it early and treat it early. "At present, almost all cancers can be detected early. For example, low-dose spiral CT can screen and find very early lung cancer. In the screening in COVID-19 in the past two years, it is also a blessing for them because many people have done CT and unexpectedly found early lung cancer. "
In the past ten years, there has been a new situation in the incidence of lung cancer. The number of middle-aged women suffering from lung cancer has shown a rapid growth trend, and these people often have no direct smoking or other bad hobbies.
Shao Kang believes that besides environmental and genetic factors, cancer may also have a lot to do with emotional factors. He said that in modern society, the relationship between emotions and diseases is getting closer and closer, and so is cancer: "The stress of work, the tension of colleagues, the disharmony of families, and some changes have a great impact on people, often hurting the immune system. If environmental factors are added, it is easy to lead to cancer. Therefore, it is very important to be optimistic and happy. In the face of life, even if you have Jinshan Yinshan, what’s the point if you are seriously ill? "
Finally, Shao Kang specifically emphasized the importance of "health quotient". "Now everyone emphasizes emotional intelligence and IQ, but in fact, health quotient is more important, because health is the premise of everything. Health quotient represents a person’s mastery of health knowledge, health wisdom and attitude towards health. " A good lifestyle, an open-minded attitude towards life, calmness in the face of impermanence of life, and the spirit of scientific independent thinking in the face of noisy information are very important to a person’s health.
