Source: Xinhua Daily Telegraph
Before the operation, the patient's wife wrote a line of small words on her husband's hand, and Lin Song recorded it with a camera. All pictures are provided by the respondents
Lin Song strictly abides by the surgical procedure and insists on performing every operation in the best condition.
The rounds every morning on weekdays have become an important means for Lin Song to understand the patient's condition in detail.
As a neurosurgeon, he must think and weigh rationally for every diagnosis and every treatment plan; but before making the final decision with the patient, he will also ask himself a sentimental question: "If this is your parents, if this is your child, how are you going to treat it?"
Patients and their families are the most indispensable comrades, "We must treat it sincerely." Patients stand on the same front and on the same standpoint as the patients, so that they can win those fierce battles. "
" Have you seen "Operation Red Sea"? The attack team in the fourth ward of Neurosurgery is like the Dragon Commando inside, facing the most dangerous enemies." Da Xu (pseudonym) is a "military fan" and is also a patient who visited the neurosurgery department of Beijing Tiantan Hospital (hereinafter referred to as Tiantan Hospital). His attending doctor is Lin Song, director of the Fourth ward. To use Da Xu's metaphor, Director Lin should be regarded as the "captain" and "sniper" of this "command team".
Brain glioma, high-difficulty deep tumor, central nervous system lymphoma... These diseases that seem strange and terrifying to ordinary people are the "enemy" that this "command" confronts. Brain glioma is commonly known as brain cancer. Due to its high risk of surgery, difficult treatment, and short survival period, it has been terrifying for many years.
Lin Song never hides the viciousness of the "enemy". "If the human craniocerebral brain is compared to a round target, many patients we treat, whose tumors are near the critical position of the ten rings at the bull's eye." Director Lin told reporters, "When performing the operation, it is necessary to remove the tumor as thoroughly as possible, and to the greatest extent that the patient's neurological function is not damaged and less damaged. It is indeed extremely difficult."
"Let patients in need be treated with the disease."
Yang Kaiyuan, currently studying for a second grade in , Capital Medical University, . He, like his classmates Li Mingxiao and senior brother Huang Wei, are young blood from the "fighting collective" of the Fourth Ward. After fastening the last button on the white coat, the "charge" sounded. At 7:50 in the morning, they squeezed out sideways from the elevator loaded in the outpatient building at almost the same time. They were surrounded by patients waiting for the hospital and their families. The patients who were anxious to get a plus even pulled their sleeves.
"As long as you need it, Director Lin will usually add it; in neurosurgery, the first diagnosis is important, the surgery is important, and the postoperative re-examination and treatment are equally important, so as long as you come, you must try to make people get sick." Huang Wei spoke very quickly and had a slightly southern accent, but his pronunciation and expression were very clear. This was what he practiced in communicating with patients in the fourth ward over the years.
Arrive at work early in the morning and make the next week's surgery arrangements. Lin Song quickly rushed to the outpatient building and sat in front of the computer to welcome the first patient of the day.
"Look at your movie, it's pretty good, it has no recurrence." Director Lin first prescribed a "peace of mind", and the female patient's frowns spread out. "But looking at the test results, the endocrine system was still affected, so the dosage needs to be adjusted next." Lin Song explained to the patient why she had been feeling unwell recently, reminded her that she would have to undergo an endocrine examination every time she went to the neurosurgery for a follow-up visit, and repeated the adjusted medication method twice. Yang Kaiyuan, who was standing beside him, quickly recorded it on the patient's medical record. At the same time, Li Mingxiao began to change the film and introduced the situation of the next patient. After writing the medical records, Yang Kaiyuan helped the patient put the various examination results into the bag containing the image report; when the female patient thanked her, Li Mingxiao also followed her out and explained some precautions for her reexamination, medication and daily life.
Lin Song and his young assistants worked together, scrambling to time, racing against time, and constantly. The whole process took 4 minutes from the first patient to the second patient's entrance.
"Many patients come from afar to see a doctor. We must improve efficiency. Whether it is surgery or outpatient, the quality must be required. We must not only help every patient solve the problem as soon as possible, but also let patients in need take a look."
Lin Song rarely drinks water when he goes out of the clinic, and saves all the time he can save for the patients; but he will not miss any links that cannot be saved. These essential links include understanding the condition, checking the film and various examination results, proposing next treatment plans, prescribing test forms, prescribing medicines, etc., as well as using comforting words and even small jokes to relieve the patient's anxiety.
"Director Lin, just this movie, can you give a preliminary judgment on whether my mother's tumor is malignant or benign?" A man in his 30s came to see the doctor with his mother who is nearly 60 years old. The son stared at Lin Song straight, and there was almost no pause or breathing when he asked; the mother sat down without saying a word.
"I think it's benign." The family members spoke anxiously, and Lin Song answered simply, "You young man, how could you ask this in front of your mother?" After Lin Song said, the man was a little embarrassed and slowed down a little, saying that before the physical examination results came out, he felt something was wrong with his mother. "My mother has always been in a small business, but she was too lazy to even settle the bill some time ago. Later, when I found out such a situation, I told my mother at home that no matter how bad the result was, you must be mentally prepared."
After hearing his description, Lin Song asked the patient, "You are too lazy to settle the bill, have you given all the money recently?" The depressed mother was amused and said that that was not enough. Lin Song took the test form prescribed by Yang Kaiyuan, handed it to his son, and told him, "There are no tests yet, and I can't make an accurate judgment. Don't scare your mother first. After finishing the examination, come back to see me."
After many years of medical practice, Lin Song understands the patients' worries and family members' entanglements best. "The incidence of anxiety disorders in China now exceeds 6%. Among patients and families in neurosurgery, this proportion is even higher." Therefore, in Lin Song's eyes, a qualified doctor not only uses medical skills to treat physical diseases, but also needs to resolve heart disease through communication.
"Always stand on the patient's standpoint"
In the morning, Lin Song spent an average of about 4 minutes to consult each patient, but there was also one or two minutes to "end the battle". "See quickly" often means "good news."
"The old man is in his seventies. Can you tell the operation he had three years ago?" Lin Song asked Yang Kaiyuan, and Xiao Yang shook his head with a smile. Lin Song also laughed, "There is nothing wrong. The old man can go home with peace of mind. Regular re-examinations have to be done, so don't always go to Beijing." After learning that he was recovering well, the old man was very happy and straightened his back and said, "Thank you, Dr. Lin, I have a good brain now, and I can play chess again." Director Lin took over the conversation, "I always lost before, but I always win now, right?"
"This time, you don't need your parents and girlfriend to accompany you, so I came to Beijing for re-examination? The recovery is very good, the indicators are normal, the wounds are no longer visible, and the person is fat, are you happy?"
"This tumor has basically nothing to do if it does not recur for 3 months after surgery, just follow-up examination on time. Hand pain and headache may be caused by excessive anxiety. Remember to let your daughter take you to see the psychologist when you go back."
"All indicators are fine. Go back to normal life and do whatever you should do!"
"Congratulations, the operation is very successful!"
A chat, a reminder, and a congratulation - the patient's recovery can always bring short-term ease and great happiness to this tense clinic.
But not every patient is so lucky.
"It depends on the situation and it will be recurrence and requires surgery. Go to the anesthesia department to take a look. Come over after reading it quickly. I will issue you the hospitalization form. Xiao Huang, go and tell me what to do with the procedures. For specific precautions, go to the inpatient department to ask Director Cui Yong." When encountering patients with dangerous conditions, Lin Song will speed up his speech and direct the entire "combat team" to enter an emergency state.
12:18, the family of a tumor patient almost rushed into Lin Song's clinic. Because of the poor mental state and always sleeping, the patient did not come that day. After understanding the situation, Lin Song said, "Based on the location of the tumor, surgery is not the fundamental solution to the problem. It is not that it cannot be removed, but once it is removed, the patient's quality of life will be very poor, which is likely to cause severe disability."Lin Song took out a piece of paper, wrote down several feasible treatment plans while talking, and analyzed the pros and cons one by one, and compared the possible effects and risks in detail. He asked the family to take the paper back and discuss it with the patients.
After the family left, the atmosphere in the clinic was a bit heavy. "Many patients have told me, 'If I am paralyzed after the operation, it would be better to let me die directly'. "Lin Song opened his mouth to instruct the young people around him: "So we choose the treatment plan and always consider it from the patient's standpoint. "
" always stands on the patient's standpoint" is Lin Song's motto. Among the 50 patients he treated that morning, there were elderly people over 70 years old and teenagers who had just turned 14. As a neurosurgeon doctor, he had to think and weigh rationally when making every diagnosis and proposed every treatment plan. Over the years, he also asked himself to ask himself a sentimental question before making the final decision with the patients: "If this is your parents, if this is your child, how are you going to treat it?"
For the "Jiulong Commando" led by Director Lin, patients and their families are the most indispensable comrades in the army. "We must treat patients sincerely and stand on the same front and position as the patients, so that we can win those fierce battles. "
A few years ago, Lin Song received a middle-aged male patient with brain glioma, but his condition was not very good. The patient's wife didn't talk much, but during the communication between doctors and patients, what she said most to Lin Song was, "I understand, I take responsibility, I believe." "
Before the operation officially began, the nurse found a line of small words on the pale big hand of the male patient, "My son and I are waiting for you to go home, come on!" That was written by his wife in tears when the man was pushed onto the flat car that morning.
These few short words moved Lin Song. Afterwards, he wrote in an article, "This is the promise of a couple to face the god of death together. This is the expectation of a happy family for the whole family's health and safety, and this is the supreme trust and entrustment to me, an ordinary doctor... Thanks to all the medical staff, the operation was very successful. The pale big hands can hold the hands of the wife and children and the hope of the whole family again. "
"Search for Dr. Cui Yong" is a common term in Ward 4.
Cui Yong, deputy chief physician of neurosurgery. The name contains the word Yong, but he is gentle and elegant. He wears a pair of gold-rimmed glasses and has a good temper on his face. Some patients recalled that they have come to Director Cui many times, from the risk of surgery, whether they need to receive radiotherapy to how to adjust chemotherapy drugs, and consulted him with all kinds of details about major and minor matters, but it seems that he has never been too anxious.
In the "Assault Team" in Ward 4, Cui Yong plays the "political commissar" It is his responsibility to communicate with the patient's "comrades-in-arms" and do ideological work when necessary. In the face of the interview, Cui Yong said that what he usually does is small things, but Lin Song remembers every time they fought side by side -
Not long ago, a 21-year-old boy from Yunnan was admitted to the fourth ward. The operation went smoothly and achieved the expected results. But after the completion, something happened that surprised Lin Song and Cui Yong - the young man could not speak anymore.
"The examination results showed that they were normal and there should be no symptoms of aphasia. "Lin Song and Cui Yong analyzed the reasons and believed that the young man was not a nervous system problem, but was under too much psychological pressure." He heard from other patients in the ward that removing tumors may cause hemiplegia and aphasia , so he gave himself psychological hints in this regard. "Director Lin discussed with Cui Yong and decided to use hints to cure hints. "We gave the young man a high pressure oxygen. This treatment promotes functional recovery. Some patients with hemiplegia and aphasia will indeed use it. "Cui Yong told the young man, "Just do it, it will be fine immediately. "Sure enough, the young man received a hyperbaric oxygen treatment and his language function returned to normal that day.
In the years since he worked in the fourth ward, "political commissar" Cui Yong has accumulated rich experience in doctor-patient communication, but he emphasized that the most important thing is to face the patient sincerely. "Many patients treated in neurosurgery are critically ill. If they lose confidence, people will collapse suddenly; so we must actively communicate with patients and families, establish mutual trust between doctors and patients, and give patients hope. Only with hope can he cooperate with you and achieve better results."
" For the sake of the patient, I have to grow more skills"
"Growing skills" is what Lin Song often talks about.
In 1979, Lin Song was admitted to Inner Mongolia Medical College because of his parents' words "You can study medicine, and when we get old, we will have a support." He was ignorantly admitted to Inner Mongolia Medical College . When he first entered the school, he was "hit" by the profound and profound medicine. Since then, he has witnessed the rapid development of neurosurgery. This witnessing process is also the process of his continuous development of skills and improving medical skills.
"I still remember that at the earliest, there was an old saying among patients, saying, "If you enter neurosurgery, you will either die or be disabled." "The words are rough and not rough. In that era, the surgical conditions and treatment methods for cranial brain tumors were quite limited.
In the early 1990s, Lin Song came from his hometown to Beijing Tiantan Hospital for further studies. From a further study student to a graduate student, from a graduate student to a doctoral student, from a doctoral student to now "teaching students", Lin Song kept walking and going further and further on the road of "growing skills". What does it mean to have skills? Lin Song set a goal for the team is, "You dare to do the surgery that others dare not do", and "others can't do it well You have to do the surgery well.
In order to accurately snipe the vicious "enemy", no matter how busy you work every day, Lin Song has to take some time to practice a set of push-ups to enhance muscle strength, improve hand stability and accuracy of tumor removal.
Previously, an American neurosurgeon expert came to Tiantan Hospital for communication. Seeing the situation of the fourth ward carrying out brain glioma surgery, he sighed: "You did a great job. We are afraid of risks in the United States and rarely remove so many of them. "With a look at the article published in the first-class American neurosurgery journal, some experts also said that when the glioma in the central area of the brain is removed, half, or two-thirds, will be removed, and the part close to the functional area will be retained. "In similar cases, we perform surgery as clean as possible, and the incidence of hemiplegia after surgery is lower than in the United States. "Lin Song said confidently.
The ability to perform surgery cannot satisfy Lin Song. "Some patients' tumors have been completely metastasized and are not suitable for surgery at all; some patients with relapsed immunity has been severely reduced, and they cannot even withstand large doses of chemotherapy. How should they be treated at this time?" The problems found in clinical practice turned into the direction of Lin Song and the "commanders" in the fourth ward to conduct scientific research.
This New Year's Day, a couple came to Beijing with their child Xiaoyu who could no longer walk and hung up Lin Song's number. Lin Song still remembers that in the clinic, Xiaoyu's mother was in tears and learned that the child was suffering from a diffuse midline glioma that lost the opportunity to operate, and had developed to the most serious level 4, with an average survival period of only 6 to 8 months. The young mother was desperate.
Lin Song communicated with the patient's family and asked them if they were willing to try to adjust The treatment of immune function.
Xiaoyu's parents agreed. Lin Song led the "Command Team" to start a new battle - the team injected the child with targeted drugs to fight against immunosuppressive functions.
"After about 10 injections, we took the child out of the hospital and went home. We found that he could walk from the room to the living room to watch TV! Another day, I hugged him and walked back from the downstairs. He said to me, 'Dad, I want to try it myself', but he actually climbed to the third floor alone!" Father Li Xiang still finds it unbelievable about the changes in the child.
After nearly 6 months of treatment, Xiaoyu's tumor shrank to one-fifth of the original. Although it did not completely disappear, the symptoms have improved significantly. "I can eat it. I have grown three or four centimeters in the past six months, gained 4 kilograms, and my eyes were shining again. "
When Xiaoyu was mentioned, Lin Song couldn't hide his happiness for the little patient, "The first time the child was brought to me, and he came by himself during the re-examination. "
At present, Lin Song and his team have carried out immunotherapy for more than 20 patients with brain glioblastoma. Xiaoyu is not the only "orphan case" that has achieved good efficacy. The results of scientific research can ultimately serve patients clinically, which makes Lin Song feel relieved.
In the international community, the average survival period of the most malignant grade 4 glioblastoma is 16 months, while the average survival period of such patients treated by the "Jiaolong Team" is more than 27 months.
Compared with personal achievements and honorary titles, what Lin Song cares most about is whether the patient's survival period can be improved and the patient's life will be happier; and what makes this optimistic and cheerful Inner Mongolia man the most sad is whether the patient is being treated with full efforts or is it difficult to retain. Although I have been used to life and death in neurosurgery for more than 20 years, and I also know that many cranial and brain tumors, including brain glioma, are still incurable diseases, whenever a patient leaves, Lin Song will inevitably blame himself, "I also comfort myself, we have tried our best and the family has tried our best, but I still feel that I am incompetent. For these patients, I have to gain more skills." (Reporter Lei Kun, Intern Huang Wei)
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