发哨子的人 WHISTLE-BLOWER

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发哨子的人 WHISTLE-BLOWER

原创 人物记者 人物

Original, journalist, People Magazine

文|龚菁琦 By Gong Jingqi

编辑|金石 Editor | Jin Shi

摄影|尹夕远 photograph | Yin Xiyuan

前言

2019年12月30日,艾芬曾拿到过一份不明肺炎病人的病毒检测报告,她用红色圈出「SARS 冠状病毒」字样,当大学同学问起时,她将这份报告拍下来传给了这位同是医生的同学。当晚,这份报告传遍了武汉的医生圈,转发这份报告的人就包括那 8位被警方训诫的医生。

 

On December 30,2019, Ai Fen received a report from an unidentified pneumonia patient. She circled the word "SARS-like coronavirus" in red. Asked by a college classmate, she photographed the report and sent it to her fellow doctor. That night, the report was circulated among doctors in Wuhan, including the eight who had been admonished by the police.

 

这给艾芬带来了麻烦,作为传播的源头,她被医院纪委约谈,遭受了「前所未有的、严厉的斥责」,称她是作为专业人士在造谣。

 

This caused a problem for Ai Fen, who was questioned by the hospital's Discipline Inspection Board since she's the source of the spread, and she suffered from "an unprecedented and severe reprimand". The Board claimed that Ai Fen, as a specialist, was spreading rumors.

 

此前的一些报道,艾芬被称为「又一个被训诫的女医生浮出水面」,也有人将她称为「吹哨人」,艾芬纠正了这个说法,她说自己不是吹哨人,是那个「发哨子的人」。

 

In previous reports, Ai Fen has been described as "another admonished female doctor known to the public, " or as a "whistle-blower, " which she corrected by saying she was not the whistle-blower, but the one who distributed whistles.

 

这是《人物》3 月刊封面《武汉医生》的第二篇报道。

 

This is the second report from the cover of People Magazine's March issue of Wuhan Doctor.

 

接到武汉市中心医院急诊科主任艾芬同意采访的短信是3月1日凌晨5点,大约半小时后,3月1日凌晨5点32分,她的同事、甲状腺乳腺外科主任江学庆因感染新冠肺炎去世。两天后,该院眼科副主任梅仲明过世,他和李文亮是同一科室。

 

It was 5:00 a.m. on March 1 when we got the text message from Ai Fen, head of Emergency Department of Wuhan Central Hospital agreeing to an interview. About half an hour later, at 5:32 a.m. on March 1, her colleague Jiang Xueqing, the head of Thyroid and Breast Department, died of Covid-19. Two days later, the hospital deputy director of Ophthalmology Mei Zhongming passed away. He and Li Wenliang worked in the same department.

 

截止 2020年3月9日,武汉市中心医院已有4位医护人员因感染新冠肺炎去世——疫情发生以来,这家离华南海鲜市场只几公里的医院成为了武汉市职工感染人数最多的医院之一,据媒体报道医院超过 200人被感染,其中包括三个副院长和多名职能部门主任,多个科室主任目前正在用ECMO维持。

 

As of March 9, 2020, four medical staff of Wuhan Central Hospital had died from Covid-19. -- as a result of the outbreak of the disease, The hospital, just a few kilometers from The Huanan Seafood Wholesale Market, has become one of the most infected hospitals in Wuhan, with more than 200 people reported to have been infected, including three vice deans and several department heads, multiple department heads are currently undergoing ECMO treatment.

 

死亡的阴影笼罩着这家武汉市最大的三甲医院,有医生告诉《人物》,在医院的大群里,几乎没有人说话,只在私下默默悼念、讨论。

 

In the shadow of death over Wuhan's biggest grade A tertiary hospital. A doctor told People Magazine that there was almost no conversations in several big WeChat groups of the hospital. Mourning and discussion are done privately.

 

悲剧原本有机会避免。2019 年 12 月 30 日,艾芬曾拿到过一份不明肺炎病人的病毒检测报 告,她用红色圈出「SARS 冠状病毒」字样,当大学同学问起时,她将这份报告拍下来传给 了这位同是医生的同学。当晚,这份报告传遍了武汉的医生圈,转发这份报告的人就包括那 8 位被警方训诫的医生。

 

Tragedy could have been avoided. On December 30,2019, Ai Fen received a report from an unidentified pneumonia patient. She circled the word "SARS-like coronavirus" in red. Asked by a college classmate, she photographed the report and sent it to her fellow doctor. That night, the report was circulated among doctors in Wuhan, including the eight who had been admonished by the police.

 

这给艾芬带来了麻烦,作为传播的源头,她被医院纪委约谈,遭受了「前所未有的、严厉的斥责」,称她是作为专业人士在造谣。

 

This caused a problem for Ai Fen, who was questioned by the hospital's Discipline Inspection Board since she's the source of the spread, and she suffered from "an unprecedented and severe reprimand". The Board claimed that Ai Fen, as a specialist, was spreading rumors.

 

3 月 2 日下午,艾芬在武汉市中心医院南京路院区接受了《人物》的专访。她一个人坐在急诊室办公室中,曾经一天接诊超过1500位患者的急诊科此时已恢复了安静,急诊大厅里只躺着一名流浪汉。

 

In the afternoon of March 2, Ai Fen was interviewed by People Magazine in the Nanjing Road Section of Wuhan Central Hospital. She sat alone in the office of the emergency room, where more than 1,500 patients had been treated in one day. It was now quiet again, with only one homeless man lying in the lobby.

 

此前的一些报道,艾芬被称为「又一个被训诫的女医生浮出水面」,也有人将她称为「吹哨人」,艾芬纠正了这个说法,她说自己不是吹哨人,是那个「发哨子的人」。采访中,艾芬数 次提起「后悔」这个词,她后悔当初被约谈后没有继续吹响哨声,特别是对于过世的同事,「早知道有今天,我管他批评不批评,『老子』到处说,是不是?」

 

In previous reports, Ai Fen has been described as "another admonished female doctor known to the public, " or as a "whistle-blower, " which she corrected by saying she was not the whistle-blower, but the one who distributed whistles. During the interview, Ai Fen mentioned the word "regret" several times. She regretted not having continued to blow the whistle after she was admonished, especially for her deceased colleagues. "If I had foreseen this day, I wouldn't have cared if they criticized me or not. I would spread this information everywhere, right?"

 

关于武汉市中心医院和艾芬本人在过去的两个多月中到底经历了什么?以下,是艾芬的讲述

 

What has Ai Fen experienced in the past two months in Wuhan Center Hospital? Here is the narrative from Ai Fen:

前所未有的训斥 unprecedented reprimand

去年12月16日,我们南京路院区急诊科接诊了一位病人。莫名其妙高烧,一直用药都不好,体温动都不动一下。22 号就转到了呼吸科,做了纤维支气管镜取了肺泡灌洗液,送去外面做高通量测序,后来口头报出来是冠状病毒。当时,具体管床的同事在我耳边嚼了几遍:艾主任,那个人报的是冠状病毒。后来我们才知道那个病人是在华南海鲜做事的。

 

On December 16 last year, we admitted a patient in the Emergency Department of Nanjing Road Section who had inexplicable high fever. Medication did not even changed his temperature. On the 22nd, he was transferred to Department of Respiratory. They collected his bronchoalveolar lavage fluid(BALF) with fiberoptic bronchoscopy, and sent it out for high-throughput sequencing. It was then verbally reported as coronavirus. At that time, the physician in charge of the patient kept telling me several times: it's coronavirus. Later we learned that the patient was working in The Huanan Seafood Wholesale Market.

 

紧接着12月27日,南京路院区又来了一个病人,是我们科一位医生的侄儿,40 多岁,没有任何基础疾病,肺部一塌糊涂,血氧饱和只有 90%,在下面其他医院已经治疗了将近10天左右都没有任何好转,病人收到了呼吸科监护室住院。同样做了纤维支气管镜取了肺泡灌洗液送去检测。

 

Then, on December 27, another patient was admitted to Nanjing Road Section. He was the nephew of a doctor in my department. He was in his 40s without underlying diseases, his lungs was in very poor condition, and his oxygen saturation was only 90%. He did not get better after a 10 day long treatment in a local hospital, and he was then admitted to the Intensive Care Unit of Department of Respiratory. They also collected his bronchoalveolar lavage fluid(BALF) with fiberoptic bronchoscopy to do the lab test.

 

12月30日那天中午,我在同济医院工作的同学发了一张微信对话截图给我,截图上写着:「最近不要去华南啊,那里蛮多人高烧……」他问我是不是真的,当时,我正在电脑上看一个很典型的肺部感染患者的 CT,我就把 CT 录了一段 11 秒钟的视频传给他,告诉他这是上午来我们急诊的一个病人,也是华南海鲜市场的。

 

At noon on December 30, my classmate at Tongji Hospital sent me a screenshot of a conversation on Wechat. The screenshot said: "Don't go to The Huanan Seafood Wholesale Market recently, there are quite a lot of people with high fever there... " He asked me if it was true. I was checking a CT scan of a typical lung infection of a patient on my computer, and I sent him an 11 second video of the scan, telling him that the patient came to my Emergency Department this morning, and he also worked in The Huanan Seafood Wholesale Market.

 

当天下午4点刚过,同事给我看了一份报告,上面写的是:SARS冠状病毒、绿脓假单胞菌、46 种口腔/呼吸道定植菌。我仔细看了很多遍报告,下面的注释写着:SARS 冠状病毒是一种单股正链RNA病毒。该病毒主要传播方式为近距离飞沫传播或接触患者呼吸道分泌物,可引起的一种具有明显传染性,可累及多个脏器系统的特殊肺炎,也称非典型肺炎。

 

Around 4 p.m. that day, my colleague showed me a report that read: SARS coronavirus, pseudomonas Aeruginosa, 46 oral and respiratory colonization bacteria. I read the report carefully many times, and the following note read: SARS coronavirus is a single, positive-strand RNA virus. The virus is mainly transmitted by close droplets or by contact with the respiratory secretions of infected persons, causing a particularly contagious form of pneumonia involving multiple organ systems, also known as atypical pneumonia.

 

当时,我吓出了一身冷汗,这是一个很可怕的东西。病人收在呼吸科,按道理应该呼吸科上报这个情况,但是为了保险和重视起见,我还是立刻打电话上报给了医院公共卫生科和院感科。当时我们医院呼吸科主任正好从我门口过,他是参加过非典的人,我把他抓住,说,我们有个病人收到你们科室,发现了这个东西。他当时一看就说,那就麻烦了。我就知道这个事情麻烦了。

 

At that time, I was so shocked, this was a very terrible thing. The patient was admitted to Department of Respiratory, and Department of Respiratory was supposed to report this. For consideration of security and attention, I immediately called the Public Health Department and the Infection Control Department of my hospital. The head of Department of Respiratory who once fought the SARS was walking past my office, and I grabbed him saying, "one of our patients was admitted to your department and we found this. ". He was like, "that's a problem then. ". I knew this was gonna be a huge issue.

 

给医院打完电话,我也给我同学传了这份报告,特意在「SARS 冠状病毒、绿脓假单胞菌、46 种口腔/呼吸道定植菌」这一排字上画了个红圈,目的是提醒他注意、重视。我也把报告发在了科室医生群里面,提醒大家注意防范。

 

After I called the hospital, I also sent the report to my classmate. I drew a red circle on "SARS coronavirus, pseudomonas Aeruginosa, 46 kinds of oral / respiratory colonization bacteria" to remind him to pay attention to this. I also shared the report in the wechat group of Department Doctors to remind them to take precautions.

 

当天晚上,这个东西就传遍了,各处传的截屏都是我画红圈的那个照片,包括后来知道李文亮传在群里的也是那份。我心里当时就想可能坏事儿了。10点20,医院发来了信息,是转市卫健委的通知,大意就是关于不明原因肺炎,不要随意对外发布,避免引起群众恐慌,如果因为信息泄露引发恐慌,要追责。

 

This thing spread all over that night, the screenshots shared around was the picture that I drew red circle on. The one that Li Wenliang shared in the group chat was also that picture. And I wondered if I would then get into trouble. At 10:20, the hospital sent a message, forwarded from Wuhan's Health Commission, the general idea was: don't release the unexplained pneumonia to the public, otherwise, this may cause panic. Those who released the information and caused panic would be held accountable.

 

我当时心里就很害怕,立刻把这条信息转给了我同学。过了大概一个小时,医院又来了一份通知,再次强调群内的相关消息不能外传。一天后,1月1日晚上11点46分,医院监察科科长给我发了条消息,让我第二天早上过去一下。

 

I was so scared that I immediately sent the message to my classmates. After about an hour, the hospital sent another notice, again emphasizing that the relevant information in the group should not be shared. The next day, at 11:46 p.m. on January 1, the chief of Discipline Inspection Board of the hospital sent me a message asking me to come by the next morning.

 

那一晚上我都没有睡着,很担忧,翻来覆去地想,但又觉得凡事总有两面性,即便造成不良影响,但提醒武汉的医务人员注意防范也不一定是个坏事。第二天早上8点多一点,还没有等我交完班,催我过去的电话就打来了。

 

That night I could not sleep, I was very worried, thinking over and over again. Then I felt that each coin has two sides, reminding Wuhan medical staff to take precautions might not be a bad thing. The next morning, the call came at around 8:00 a.m. before I had finished my shift, urging me to come.

 

之后的约谈,我遭受了前所未有的、非常严厉的斥责。

 

In the interview that followed, I suffered from an unprecedented and severe reprimand.

 

当时,谈话的领导说,「我们出去开会都抬不起头,某某某主任批评我们医院那个艾芬,作为武汉市中心医院急诊科主任,你是专业人士,怎么能够没有原则没有组织纪律造谣生事?」 这是原话。让我回去跟科室的200多号人一个个地口头传达到位,不能发微信、短信传达,只能当面聊或者打电话,不许说关于这个肺炎的任何事情,「连自己的老公都不能说」……

 

At that time, the leader said, "We feel ashamed when going out for a meeting. Some leader criticized Ai Fen: as the head of the Emergency Department of Wuhan Central Hospital, as a specialist, how could she spread rumors without principles and discipline? " That's what they said. They asked me to go back to my department and informed each of them one by one of what I have learned. Wechat and SMS were not allowed, only face-to-face conversation or phone call were permitted. And anything about the pneumonia would be a ban, “talking this with husband is also not allowed”...

 

我整个人一下子就懵了,他不是批评你这个人工作不努力,而是好像整个武汉市发展的大好局面被我一个人破坏了。我当时有一种很绝望的感觉,我是一个平时认认真真、勤勤恳恳工作的人,我觉得自己做的事情都是按规矩来的,都是有道理的,我犯了什么错?我看到了这个报告,我也上报医院了,我和我的同学,同行之间对于某一个病人的情况进行交流,没有透露病人的任何私人信息,就相当于是医学生之间讨论一个病案,当你作为一个临床的医生,已经知道在病人身上发现了一种很重要的病毒,别的医生问起,你怎么可能不说呢?这是你当医生的本能,对不对?我做错什么了?我做了一个医生、一个人正常应该做的事情,换作是任何人我觉得都会这么做。

 

He wasn't criticizing you for not working hard, he was just saying, it's like I'm the only one who's sabotaging the entire Wuhan's nice situation. I had a sense of despair, I'd been working seriously and diligently. I think the things I did make sense, I followed the rules and I made a mistake? I saw this report, and I also reported it to the hospital. My classmates and colleagues and I exchanged information about the case of a patient. Without revealing any personal information about the patient, it was like discussing a medical case among medical students. When you, as a clinician, already knew that an serious virus had been found in a patient, how could you not tell other doctors what you knew when they asked about it? That's what doctors instinctively do, ritht? What did I do wrong? I did what a doctor and a person would normally do, which is what I think anyone would do the same.

 

我当时的情绪也很激动,说,这个事是我做的,跟其余人都没有关系,你们干脆把我抓去坐牢吧。我说我现在这个状态不适合在这个岗位上继续工作了,想要休息一段时间。领导没有同意,说这个时候正是考验我的时候。

 

I was very emotional at that time, I told them that I would be responsible for this, others had nothing to do with it. You could simply put me in jail. I said I would not be able to continue my role in this position, and I needed to take a break. The leader did not agree, saying that was the right time to test me.

 

当天晚上回家,我记得蛮清楚,进门后就跟我老公讲,我要是出了什么事情,你就好好地把孩子带大。因为我的二宝还很小,才1岁多。他当时觉得莫名其妙,我没有跟他说自己被训话的事,1月20 号,钟南山说了人传人之后,我才跟他说那天发生了什么。那期间,我只是提醒家人不要去人多的地方,出门要戴口罩。

 

When I got home that night, I remember telling my husband, if anything happens to me, you take good care of the kids. My second baby is very young, just over a year old. He was confused and I didn't tell him I was being admonished. I didn't tell him what happened until January 20, after Zhong Nanshan confirmed that there existed human-to-human transmission. During that time, I simply reminded my family not to go to crowded places and to wear masks when going out.

Other Departments外围科室

很多人担心我也是那 8 个人之一被叫去训诫。实际上我没有被公安局训诫,后来有好朋友问我,你是不是吹哨人?我说我不是吹哨人,我是那个发哨子的人。

 

Many people were worried that I was one of those eight people being admonished. In fact, I was not admonished by the police. Later, a good friend asked if I was the whistle-blower or not. I said I was not the whistle-blower, but the one who distributed whistles.

 

但那次约谈对我的打击很大,非常大。回来后我感觉整个人心都垮了,真的是强打着精神,认真做事,后来所有的人再来问我,我就不能回答了。

 

But that interview hit me very hard. When I came back, I felt like my heart was breaking. I forced myself to be energetic to do things seriously. I couldn't answer the questions later asked by other people.

 

我能做的就是先让急诊科重视防护。我们急诊科 200 多人,从1月1号开始,我就叫大家加强防护,所有的人必须戴口罩、戴帽子、用手快消。记得有一天交班有个男护士没戴口罩, 我马上就当场骂他「以后不戴口罩就不要来上班了」。

 

All I could do was to let my department pay enough attention to precautions. My department had over 200 people, and since January 1st, I've been telling everyone to enhance precautions. Everyone was required to wear masks, hats, and use hand sanitizer. I remember one day a male nurse did not wear a mask at the shift. I immediately scolded him, "you don't need to work if you continue to work without a mask".

 

1月9号,我下班时看见预检台一个病人对着大家咳,从那天后,我就要求他们必须给来看病的病人发口罩,一人发一个,这个时候不要节约钱,当时外面在说没有人传人,我又要在这里强调戴口罩加强防护,都是很矛盾的。

 

On January 9, when I got off work, I saw a patient at the pre-examination table coughing . From that day on, I asked them to hand out masks to each patient who came to see the doctor. At this time, don't save money. Outside, I said there was no human-to-human transmission. Inside, I emphasized that we needed to enhance precautions by wearing masks. That was very contradictory.

 

那段时间确实很压抑,非常痛苦。有医生提出来要把隔离衣穿外头,医院里开会说不让,说隔离衣穿外头会造成恐慌。我就让科室的人把隔离服穿白大褂里面,这是不符合规范的,很荒谬的。

 

It was a very stressful time, a very painful time. A doctor suggested that we needed to wear isolation gowns. Hospital meeting denied this suggestion, saying that would cause panic. So I asked my staff to wear the isolation gowns inside the coats, though that did not comply with the rules and was ridiculous.

 

我们眼睁睁地看着病人越来越多,传播区域的半径越来越大,先是华南海鲜市场附近可能跟它有关系,然后就传传传,半径越来越大。很多是家庭传染的,最先的7个人当中就有妈妈给儿子送饭得的病。有诊所的老板得病,也是来打针的病人传给他的,都是重得不得了。我就知道肯定有人传人。如果没有人传人,华南海鲜市场1月1日就关闭了,怎么病人会越来越多呢?

 

We were seeing more and more patients, at first we thought The Huanan Seafood Wholesale Market played an important role, but then the area of transmission spread fast. Many family infections occurred, one of the first 7 cases got infected when a mother sent food to her son. A boss of a clinic got sick, and he was infected from a patient who came for treatment. They all had serious symptoms. I then surely knew there existed human-to-human transmission. The Huanan Seafood Wholesale Market was closed on January 1, why did we see more and more infected patients if there was no human-to-human transmission?

 

很多时候我都在想,如果他们当时不那样训斥我,心平气和地问一下这件事情的来龙去脉,再请别的呼吸科专家一起沟通一下,也许局面会好一些,我至少可以在医院内部多交流一下。 如果是1月1号大家都这样引起警惕,就不会有那么多悲剧了。

 

Very often, I think it would have been better if they hadn't yelled at me. What if they nicely asked me about what I did, and then invited experts from Department of Respiratory to discuss it? At least I could have communicated more inside my hospital. There wouldn't have been so much tragedy if we we all on alert since January 1st.

 

1月3号下午,在南京路院区,泌尿外科的医生们聚集在一起回顾老主任的工作历程,参会的胡卫峰医生今年43 岁,现在正在抢救;1月8号下午,南京路院区22楼,江学庆主任还组织了武汉市甲乳患者康复联欢会;1月11号早上,科室跟我汇报急诊科抢救室护士胡紫薇感染,她应该是中心医院第一个被感染的护士,我第一时间给医务科科长打电话汇报,然后医院紧急开了会,会上指示把「两下肺感染,病毒性肺炎?」的报告改成「两肺散在感染」;1月16号最后一次周会上,一位副院长还在说:「大家都要有一点医学常识,某些高年资的医生不要自己把自己搞得吓死人的。」另一位领导上台继续说:「没有人传人,可防可治可控。」 一天后,1月17号,江学庆住院,10天后插管、上ECMO。

 

In the afternoon of January 3, Nanjing Road Section, doctors of Urology Department gathered to review the work history of the old director Gu. Dr. Hu Weifeng, 43, who is now undergoing emergency treatment, attended the meeting. In the afternoon of January 8, 22nd floor, Nanjing Road Section, Dr. Jiang Xueqing organized a rehabilitation party for Wuhan thyroid and breast patients. In the morning of January 11, my staff reported to me that Hu Ziwei, a nurse in the Emergency Department, was infected. She could be the first nurse at the Central Hospital to be infected. The first thing I did was to call the dean of Office of Medical Affairs , and the hospital had an emergency meeting. As the meeting required, "double lung infection, viral pneumonia?" was modified as "two lungs are infected?" At the last weekly meeting on January 16th, one of the vice-deans of the hospital said, "everyone should have some medical knowledge. Some senior doctors shouldn't make themselves scary. ". Another leader went on to say, "there is no human-to-human transmission. It can be prevented, treated and controlled. The next day, on January 17, Jiang was hospitalized. 10 days later, he underwent ECMO treatment.

 

中心医院的代价这么大,就是跟我们的医务人员没有信息透明化有关。你看倒下的人,急诊科和呼吸科的倒是没有那么重的,因为我们有防护意识,并且一生病就赶紧休息治疗。重的 都是外围科室,李文亮是眼科的,江学庆是甲乳科的。

 

The the Central Hospital lost heavily, this is related to the lack of transparency of our medical staff. Those infected of Emergency Department and Department of Respiratory did not experience very serious symptoms, it was because that we took precautions, and once you got sick, you immediately relaxed yourself and got treatment. Other departments suffered seriously, Li Wenliang worked in Ophthalmology Department, Jiang Xueqing worked in Thyroid and Breast Department.

 

江学庆真的非常好的一个人,医术很高,全院的两个中国医师奖之一。而且我们还是邻居,我们一个单元,我住四十几楼,他住三十几楼,关系都很好,但是平时因为工作太忙,就只能开会、搞医院活动时候见见面。他是个工作狂,要么就在手术室,要么就在看门诊。谁也不会特意跑去跟他说,江主任,你要注意,戴口罩。他也没有时间和精力打听这些事,他肯定就大意了:「有什么关系?就是个肺炎。」这个是他们科室的人告诉我的。

 

Jiang Xueqing was really a very good person, he mastered great medical skill. We only had two doctors who won“Chinese physicians Award”, Jiang was one of them. We were neighbors, we lived in the same unit. I lives on forty floor, he lived on thirty floor, we maintained good relationship. We could only meet at meetings or hospital activities because we were both too busy. He's a workaholic. He's either in the O.R. or in the clinic. No one would specifically remind him of wearing mask. He did not have the time or energy to inquire about these things, and he must have been careless: "Does it matter? It's just pneumonia. " that's what someone in his department told me.

 

如果这些医生都能够得到及时的提醒,或许就不会有这一天。所以,作为当事人的我非常后悔,早知道有今天,我管他批评不批评我,「老子」到处说,是不是?

 

If these doctors had been reminded of the dangers in time, these might not have happened. So I regret very much, if I had known this day, I wouldn't have cared if they criticized me or not. I would spread this information everywhere, right?"

 

虽然和李文亮同在一个医院,一直到去世之前我都不认得他,因为医院 4000 多号人太多了,平时也忙。他去世前的那天晚上,ICU 的主任跟我打电话借急诊科的心脏按压器,说李文亮要抢救,我一听这个消息大吃一惊,李文亮这个事整个过程我不了解,但是他的病情跟他受训斥之后心情不好有没有关系?这我要打个问号,因为受训的感觉我感同身受。

 

Although I work in the same hospital with Li Wenliang, I didn't know him before his death. The hospital has more than 4,000 employee, and we’re all busy. The night before his death, the director of the ICU called me to borrow the heart pump and told me that Li Wenliang needed to be rescued. I was shocked when I heard the news. I didn't know the details of Li Wenliang, but was there any relations between his illness and the bad mood after being admonished? I'm not sure about that because I exactly know how it feels after admonishment.

 

后来,事情发展到这一步,证明李文亮是对的时候,他的心情我非常能理解,可能跟我的心情一样,不是激动、高兴,而是后悔,后悔当初就应该继续大声疾呼,应该在所有的人问我们的时候,继续说。很多很多次我都在想,如果时间能够倒回来该多好。

 

Later, it turned out that Li Wenliang was right. I could feel his mood. Perhaps like my mood, I was not excited nor happy, I regret a lot. I should shouted out the truth. We should continued to tell the truth when asked about it. Many times I told myself that it would be great if time could go backwards.

活着就是好的 It’s good to be alive

在1月23日封城前一天的晚上,有相关部门的朋友打电话问我武汉市急诊病人的真实情况。我说你代表私人,还是代表公家。他说我代表私人。我说代表个人就告诉你真话,1月21号,我们急诊科接诊1523个病人,是往常最多时的 3 倍,其中发烧的有 655 个人。

 

In the night of January 23rd, the night before the lockdown, a friend from the relevant department called me to ask the truth about emergency patients in Wuhan. I asked if he wanted to know the truth on behalf of himself or if he was on behalf of the government. He said “private”. And I said I would tell you the truth since you just represent yourself. On January 21st, we had 1,523 patients in the emergency department, three times the usual number, 655 of whom had fevers.

 

那段时间急诊科的状况,经历过的人一辈子都忘不了,甚至会颠覆你的所有人生观。

 

People who experienced that period of time in Emergency Department would remember this forever, it even would change your outlook on life.

 

如果说这是打仗,急诊科就在最前线。但当时的情况是,后面的病区已经饱和了,基本上一个病人都不收,ICU也坚决不收,说里面有干净的病人,一进去就污染了。病人不断地往急诊科涌,后面的路又不通,就全部堆在急诊科。病人来看病,一排队随便就是几个小时,我们也完全没法下班,发热门诊和急诊也都不分了,大厅里堆满了病人,抢救室输液室里到处都是病人。

 

If this was a war, the Emergency Department was on the front lines. But the situation at that time was: other wards was not able to admit more patients. Almost no one could be admitted, ICU resolutely said NO because once infected patients were admitted, other patients would be infected. Without more beds available from other department, patients all stayed in Emergency Department. In order to get treatment, the patients needed to wait at least several hours, and we couldn't get out of work. The Fever Clinic and the Emergency Department were in a mess. The lobby and the transfusion room were full of people.

 

 

还有的病人家属来了,说要一张床,我的爸爸在汽车里面不行了,因为那时候地下车库已封, 他车子也堵着开不进来。我没办法,带着人和设备跑去汽车里去,一看,人已经死了,你说 是什么感受,很难受很难受。这个人就死在汽车里,连下车的机会都没有。

 

Someone came and asked for a bed, and told us that his father was going to die in the car. The underground parking was locked, and his car was stuck in the traffic jam. I could only took my staff and equipment to run to the car, but the man had died. Tell me how I felt. I felt very very bad. The man did not even have the chance to leave the car, he died inside the car.

 

还有一位老人,老伴刚在金银潭医院去世了,她的儿子、女儿都被感染了,在打针,照顾她的是女婿,一来我看她病得非常重,联系呼吸科给收进去住院,她女婿一看就是个有文化有素质的人,过来跟我说谢谢医生等等的,我心里一紧,说快去,根本耽误不了了。结果送去就去世了。一句谢谢虽然几秒钟,但也耽误了几秒。这句谢谢压得我很沉重。

 

There was also an old man whose husband had just died in Jinyintan hospital. Her son and daughter were both infected and were undergoing treatment. Her son-in-law was taking care of her. First, I saw that she was very sick and contacted Department of Respiratory for admission. Her son-in-law, a man seemed well-educated, came to say thanks. I was very worried then and said let’s go right now. After being admitted, she pass away. The “Thanks” took only few seconds, but it also wasted few seconds. I felt very stressful about that "thanks" .

 

还有很多人把自己的家人送到监护室的时候,就是他们见的最后一面,你永远见不着了。

 

When many others sent their family members to ICU, that’s the last time they met. You could no longer meet them again.

 

我记得大年三十的早上我来交班,我说我们来照个相,纪念一下这个大年三十,还发了个朋友圈。那天,大家都没有说什么祝福,这种时候,活着就是好的。

 

I remember the morning of New Year's Eve, I said let’s take a photo, to commemorate this New Year's Eve during the shift. And I shared this in my Wechat moments. That day, no one expressed blessing. It was nice enough to be alive at that time.

 

以前,你如果有一点失误,比如没有及时打针,病人都可能还去闹,现在没人了,没有人跟你吵,没有人跟你闹了,所有人都被这种突然来的打击击垮了,搞蒙了。

 

In the past, if you made a mistake, such as not transfusing for the patient in time, the patient may came to a quarrel. No one did so at that time. Everyone was shocked to confusion due to the sudden virus.

病人死了,很少看到家属有很伤心地哭的,因为太多了,太多了。有些家属也不会说医生求求你救救我的家人,而是跟医生说,唉,那就快点解脱吧,已经到了这个地步。因为这时候每个人怕的都是自己被感染。

 

When patients died, it was rare to see family members cry, because there were too many deaths. Instead of saying “doctor, please save him or her”, some said “let him or her go. we've come this far”. Because everyone was afraid of being infected at that time.

 

一天发热门诊门口的排队,要排5个小时。正排着一个女的倒下了,看她穿着皮衣,背着包包,穿着高跟鞋,应该是很讲究的一个中年女性,可是没有人敢上前去扶她,就在地上躺了很久。只得我去喊护士、医生来去扶她。

 

One day, the patients needed to queue up for 5 hours in front of the fever clinic. A woman suddenly fell over. She was dressed in leather, carrying a bag, and wearing high heels. She looked like a delicate middle-aged woman, but no one dared to help her. She lied on the ground for long time. I asked the nurse and the doctor to help her.

 

1月30号我早上来上班,一个白发老人的儿子 32岁死了,他就盯着看医生给他开死亡证明。根本没有眼泪,怎么哭?没办法哭。看他的打扮,可能就是一个外来的打工的,没有任何渠道去反映。没有确诊,他的儿子,就变成了一张死亡证明。

 

I came into work in the morning of January 30th, and the son of a white haired old man, who was 32 years old, died. He just stared at the doctor and waited for the death certificate. He did not cry. How could he cry? He could not cry. Judging from his look, he might be a worker from other areas. He did not have any route to tell his problems. Without a diagnosis, his son became a death certificate.

 

这也是我想要去呼吁一下的。在急诊科死亡的病人都是没有诊断、没办法确诊的病例,等这个疫情过去之后,我希望能给他们一个交代,给他们的家庭一些安抚,我们的病人很可怜的,很可怜。

 

That's what I'd like to call on. The patients who died in the Emergency Department were undiagnosed. I hope they will be given explanation, and their families should be given comfort. Our patients were so poor.

标题内容

做了这么多年医生,我一直觉得没有什么困难能够打倒我,这也和我的经历、个性有关。

 

Having been a doctor for so many years, I have always felt that no difficulty could defeat me. It also has something to do with my experience and personality.

 

9岁那年我爸爸就胃癌去世了,那个时候我就想着长大了当个医生去救别人的命。后来高考的时候,我的志愿填的全部都是医学专业,最后考取了同济医学院。1997 年我大学毕业,就到了中心医院,之前在心血管内科工作,2010 年到急诊科当主任的。

 

My Dad died of stomach cancer when I was 9, and I wanted to grow up to be a doctor and save people's lives. When I finished the college entrance examination, I filled all the choices as medical professional, and finally I was accepted by the Tongji Medical College. I graduated from college in 1997 and started to work in the Central Hospital. I used to work in Cardiology Department before becoming the head of the Emergency Department in 2010.

 

我觉得急诊科就像我的一个孩子一样,我把它搞成这么大,搞得大家团结起来,做成这个局面不容易,所以很珍惜,非常珍惜这个集体。

 

I feel that the Emergency Department is just like one of my children. I cultivate it to be so strong. My staff are very united. It is not easy to have today, so I cherish my community a lot.

 

前几天,我的一个护士发朋友圈说,好怀念以前忙碌的大急诊,那种忙跟这种忙完全是两个概念。

 

A few days ago, one of my nurses shared this on her Wechat moment “I miss the busy emergency before so much. That kind of busyness is completely different from what we are experiencing now.”

 

在这次疫情之前,心梗、脑梗、消化道出血、外伤等等这些才是我们急诊的范畴。那种忙是 有成就感的忙,目的明确,针对各种类型的病人都有很通畅的流程,很成熟,下一步干什么, 怎么做,出了问题找哪一个。而这一次是这么多危重病人没办法去处理,没办法收住院,而且我们医务人员还在这种风险之中,这种忙真的很无奈,很痛心。

 

Prior to this outbreak, heart attack, cerebral infarction, gastrointestinal bleeding, trauma, and so on were our areas of emergency care. That kind of busyness offers a sense of accomplishment. We have clear goal, we have work flow facing all kinds of patients. We know what to do and how do to. But this time, so many critically ill patients were not undergoing effective treatment, they could not be admitted to hospitals, and our medical staff were also in this risk. This kind of busyness was helpless and heartbreaking.

 

有一天早上8点,我们科一个年轻医生跟我发微信,也是蛮有性格的,说我今天不来上班了,不舒服。因为我们这里都有规矩的,你不舒服要提前跟我说好安排,你到8点钟跟我说,我到哪里去找人。他在微信中对我发脾气,说大量的高度疑似病例被你领导的急诊科放回社会,我们这是作孽!我理解他是因为作为医生的良知,但我也急了,我说你可以去告我,如果你 是急诊科主任,你该怎么办?

 

One morning at 8:00, a young doctor in my department sent me a message on Wechat, saying that he wasn't feeling well so he would not go to work that day. He was quite a characteristic man. We all have rules in my department, you should have informed me of your illness before today, so that I could arrange the shift. Where did I find another person to replace since you told me this at 8a.m. that morning? He lost his temper with me on Wechat, saying that large number of highly suspicious cases have been released back to the society by the Emergency Department under your leadership, we are doing a terrible thing! I understood he lost his temper because of his conscience as a doctor, but I lost my temper either, and I said you could sue me, what would you do if you are the head of Emergency Department?

 

后来,这个医生休息了几天后,还是照样来工作。他不是说怕死怕累,而是遇到这种情况,一下子面对这么多病人感到很崩溃。

 

Later, after a few days' rest, the doctor came back to work as usual. He behaved so not because of being of afraid of death or fatigue. He was freaking out facing so many patients.

 

作为医生来说,特别是后面很多来支援的医生,根本心理上受不了,碰到这种情况懵了,有的医生、护士就哭。一个是哭别人,再一个也是哭自己,因为每个人都不知道什么时候就轮 到自己感染。

 

As a doctor, especially for those doctors who later came to support us, they could not bear these psychologically. They were too shocked not to know what to do. Some doctors and nurses just cried. They cried for others, they cried for themselves because they did not know if they would be the next one to be infected.

 

大概在1月中下旬,医院的领导也陆陆续续地都病倒了,包括我们的门办主任,三位副院长。医务科科长的女儿也病了,他也在家里休息。所以基本上那一段时间是没有人管你,你就在那儿战斗吧,就是那种感觉。

 

Around mid to late January, hospital leaders also got sick one by one, including our head of Outpatient Office and 3 vice deans of the hospital. The daughter of dean of Office of Medical Affairs got sick, he rested at home. The feeling was like, you just fight there, no one was in charge of you.

 

我身边的人也开始一个接一个地倒掉。1月18日,早上8点半,我们倒的第一个医生,他说主任我中招了,不烧,只做了 CT,肺部一大坨磨玻璃。不一会儿,隔离病房负责的一个责任护士,告诉我说他也倒了。晚上,我们的护士长也倒了。我当时非常真实的第一感觉是 ——幸运,因为倒得早,可以早点下战场。

 

People around me got sick one by one too. January 18th, 8:30 a.m. , our first doctor, he said “Dean, I am infected. I do not have high fever but I did a CT scan, my lung showed large ground-glass opacity”. At night, my head nurse got sick. What I truly felt was--you are lucky to be sick, because you can leave the battlefield earlier.

 

这三个人我都密切接触过,我就是抱着必倒的信念每天在工作,结果一直没倒。全院的人都 觉得我是个奇迹。我自己分析了一下,可能是因为我本身有哮喘,在用一些吸入性的激素,可能会抑制这些病毒在肺内沉积。

 

I've been in close contact with all three of them, and I've been working every day with the belief that I'm going to get sick. But I did not get infected, the whole hospital believed that I was the miracle. I analyzed for myself, it's probably because I have asthma, and I've been taking some inhaled steroids, which might inhibit the virus from become more in my lungs.

 

我总觉得我们做急诊的人都算是有情怀的人——在中国的医院,急诊科的地位在所有科室当中应该是比较低的,因为大家觉得急诊,无非就是个通道,把病人收进去就行了。这次抗疫中,这种忽视也一直都存在。

 

I always think of us who work in Emergency Department as sentimentalists--Emergency Departments usually rank in relatively low level in all Chinese hospitals. People think that Emergency Department is just a transit to admit patients to other departments. This kind of neglect is the same during this outbreak.

 

早期的时候,物资不够,有时候分给急诊科的防护服质量非常差,看到我们的护士竟然穿着这种衣服上班,我很生气,在周会群里面发脾气。后来还是好多主任把他们自己科室藏的衣服都给我了。

 

In the early days, there were not enough supplies, and sometimes the quality of protective clothing distributed to the Emergency Department was very poor. I was angry when I saw our nurses wearing such clothes to work. I lost my temper in the weekly meeting wechat group. Then a bunch of heads gave me the clothes they had in their department.

 

还有吃饭问题。病人多的时候管理混乱,他们根本想不到急诊科还差东西吃,很多科室下班了都有吃的喝的,摆一大排,我们这里什么都没有,发热门诊的微信群里,有医生抱怨,「我们急诊科只有纸尿裤……」我们在最前线战斗,结果是这样,有时候心里真的很气。

 

Eating was another problem. We were in a mess when we had too many patients. They would not believe that we were in lack of food supply. Many department staff had enough food and drink when they finished their shift, we had nothing here. Some complaint in the high fever clinic wechat group “we only had diapers in Emergency Department”. We had such a life when fighting on the front lines, sometimes it really pissed me off.

 

我们这个集体真的是很好,大家都是只有生病了才下火线。这次,我们急诊科有 40多个人感染了。我把所有生病的人建了一个群,本来叫「急诊生病群」,护士长说不吉利,改成「急诊加油群」。就是生病的人也没有很悲伤、很绝望、很抱怨的心态,都是蛮积极的,就是大家互相帮助,共度难关那种心态。

 

My community was really good, everyone kept fighting unless they got sick. This time, more than 40 of my staff got infected in my Emergency Department. I set up a wechat group and invited all the sick doctors to join the group, the name was initially called “The Sick of Emergency Department”. The head nurse said it was not lucky and changed it to "Cheer UP Emergency Department" . Even sick people was not very sad, very desperate, very complaining. They were all quite optimistic, they helped each other to fight the difficulties.

 

这些孩子们、年轻人都非常好,就是跟着我受委屈了。我也希望这次疫情过后,国家能加大 对急诊科的投入,在很多国家的医疗体系中,急诊专业都是非常受重视的。

 

These young people are very good, but they suffered too much with me. I also hope that the state can increase investment in Emergency Departments after this outbreak. Emergency medicine is very important in many countries’ health care system.

不能达到的幸福 Unattainable happiness

2月17号,我收到了一条微信,是那个同济医院的同学发给我的,他跟我说「对不起」,我说:幸好你传出去了,及时提醒了一部分人。他如果不传出去的话,可能就没有李文亮他们这8个人,知道的人可能就会更少。

 

February 17, I received a Wechat message, it was from that classmate who works in Tongji Hospital. he told me "I'm sorry" . I said: “Fortunately you spread it out, and reminded some people in time. If he didn't spread the truth, there night not be the other eight persons including Li Wenliang, then fewer people would know the truth.

 

这次,我们有三个女医生全家感染。两个女医生的公公、婆婆加老公感染,一个女医生的爸 爸、妈妈、姐姐、老公,加她自己 5 个人感染。大家都觉得这么早就发现这个病毒,结果却是这样,造成这么大的损失,代价太惨重了。

 

Three female doctors of us, their whole families were infected this time. Two female doctor's father-in-law, mother-in-law and husband were infected. A female doctor's father, mother, sister, husband, and herself 5 people were infected. Everyone thought why would we face such a result since we had known this virus so early. The cost is too damn high with so much loss.

 

这种代价体现在方方面面。除了去世的人,患病的人也在承受。

 

The cost is felt in many ways. In addition to the dead, the sick suffer too.

 

我们「急诊加油群」里,大家经常会交流身体状况,有人问心率总在 120 次/分,要不要紧?那肯定要紧,一动就心慌,这对他们终身都会有影响的,以后年纪大了会不会心衰?这都不好说。以后别人可以去爬山,出去旅游,他们可能就不行,那都是有可能的。

 

In our Cheer UP Emergency Department group, we often talked about our physical condition. Some people asked if it's OK to have a heart rate of 120 beats per minute for long time? That was definitely serious. That might would have an impact on their entire life. Would they suffer from heart failure when they get older? It is hard to say. Other people can climb the hills, travel around. It is possible that they would no longer be able to do so.

 

还有武汉。你说我们武汉是个多热闹的地方,现在一路上都是安安静静的,很多东西买不到,还搞得全国都来支援。前几天广西的一个医疗队的护士在工作的时候突然昏迷了,抢救,后 来人心跳有了,但还是在昏迷。她如果不来的话,在家里可以过得好好的,也不会出这种意外。所以,我觉得我们欠大家的人情,真的是。

 

Wuhan used to be a bustling place, now you feel quietness everywhere, and many things are sold out. The whole country is supporting Wuhan. A few days ago, a nurse of a medical team from Guangxi suddenly fell into a coma while she was working. If she hadn't come, she would have been fine at home, and this would not have happened. So I think we owe them, really.

 

经历过这次的疫情,对医院里很多人的打击都非常大。我下面好几个医务人员都有了辞职的想法,包括一些骨干。大家之前对于这个职业的那些观念、常识都难免有点动摇——就是你这么努力工作到底对不对?就像江学庆一样,他工作太认真,太对病人好,每一年的过年过节都在做手术。今天有人发一个江学庆女儿写的微信,说她爸爸的时间全部给了病人。

 

After this outbreak, it hit a lot of people in the hospital very hard. Several of my medical staff, including some of my key staff members, were considering resigning. They start to wonder if these concepts, common senses on this occupation were right or wrong--you have been working so hard, right or wrong? Like Jiang Xueqing, he worked too hard and was too patient-friendly. He had been doing surgery every festival. Today, someone shared on the wechat moment a message written by Jiang Xueqing's daughter, saying that all her father's time was given to the patient.

 

我自己也有过无数次的念头,是不是也回到家做个家庭主妇?疫情之后,我基本上没回家,和我老公住在外面,我妹妹在家帮我照顾孩子。我的二宝都不认得我了,他看视频对我没感觉,我很失落,我生这个二胎不容易,出生的时候他有10斤,妊娠糖尿病我也得了,原本我还一直喂奶的,这一次也断了奶——做这个决定的时候,我有点难过,我老公就跟我说,他说人的一生能够遇到一件这样的事情,并且你不光是参与者,你还要带一个团队去打这场仗,那也是一件很有意义的事情,等将来一切都恢复正常以后大家再去回忆,也是一个很宝贵的经历。

 

I've had such a thought thousands of times--should I go back home to be a housewife? I almost didn't go home since the outbreak, I lived outside with my husband. My sister helped me to take care of my kids. My little baby could not even recognize me when we saw each other in video chat. I was so upset. It was not easy giving birth to my little baby, I had gestational diabetes. He was 10 jin(5kg) when he was born. I used to breastfeed him but I had to stop it. I was sad when making the decision. My husband said “It’s a meaningful thing to do for anyone who could have a chance to face such a thing. You don’t simply participate in this, you have to lead a team to fight. It would be a valuable experience to remember when everything goes back to normal in life.”

 

2月21号早上领导和我谈话,其实我想问几个问题,比如有没有觉得那天批评我批评错了?我希望能够给我一个道歉。但是我不敢问。没有人在任何场合跟我说表示抱歉这句话。但我依然觉得,这次的事情更加说明了每个人还是要坚持自己独立的思想,因为要有人站出来说真话,必须要有人,这个世界必须要有不同的声音,是吧?

 

In the morning of February 21st, my leader talked to me. In fact, I would like to ask a few questions, such as do you feel that the admonishment on me was wrong. I was hoping they could say sorry to me. I dared not. No one has ever said sorry to me on any occasion. But I still think that this incident let us know that everyone should stick to their own independent thinking, because someone has to stand out telling the truth, someone has to, and the world needs a different voice, right?

 

作为武汉人,我们哪一个不热爱自己的城市?我们现在回想起来以前过得那种最普通的生活,是多么奢侈的幸福。我现在觉得把宝宝抱着,陪他出去玩一下滑梯或者跟老公出去看个电影,在以前再平常都不过,到现在来说都是一种幸福,都是不能达到的幸福。

 

As Wuhan people, which one of us does not love their city? We now look back to the most ordinary of lives, it was luxurious happiness. Holding my baby, accompanying him to play the children's slide, hanging out for a movie with husband, these were just ordinary life. But now, it’s happiness to me, unattainable happiness.

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