whistler

Note: The original article was published on the WeChat public account Renwumag1980 and Weibo on March 10, 2020, and was immediately deleted from the entire network . This time it is reproduced from notion*, and the screenshot is from Douban**. If there is any infringement, please contact this account.

* https://www.notion.so/00a9beeb2fe54dfe84a55141a5f592cf?v=cf2bfae990fc4207a8710a40ffeb7f3c

** https://www.douban.com/group/topic/167226098/

On December 30, 2019, Ai Fen received a virus test report of a patient with unknown pneumonia. She circled the word "SARS coronavirus" in red. When her college classmates asked about it, she took a photo of the report and passed it on. Gave it to this classmate who is also a doctor. That night, the report spread throughout the doctor circle in Wuhan, and those who forwarded the report included the eight doctors who were reprimanded by the police.

This brought trouble to Ai Fen. As the source of the dissemination, she was interviewed by the hospital's Disciplinary Committee and suffered "unprecedented and severe reprimands", saying that she was spreading rumors as a professional.

In some previous reports, Ai Fen was called "another female doctor who was admonished and surfaced", and some people called her a "whistleblower". Ai Fen corrected this statement, saying that she was not a whistleblower. It's the "Whistler".

This is the second report of "Wuhan Doctor" on the cover of "People" in March.

Text｜ Gong Jingqi

Editor｜ Jinshi

Photography｜ Yin Xiyuan

Received a text message from Ai Fen, Director of the Emergency Department of Wuhan Central Hospital agreeing to the interview, at 5 am on March 1. About half an hour later, at 5:32 am on March 1, her colleague Jiang Xueqing, director of thyroid and breast surgery, died of infection. Death from new coronary pneumonia. Two days later, Mei Zhongming, deputy director of the ophthalmology department of the hospital, passed away. He and Li Wenliang were in the same department.

As of March 9, 2020, 4 medical staff in Wuhan Central Hospital have died of COVID-19 infection. Since the outbreak, this hospital, which is only a few kilometers away from the South China Seafood Market, has become the hospital with the largest number of employees infected in Wuhan. One, according to media reports, more than 200 people in the hospital were infected, including three vice presidents and directors of several functional departments. The directors of several departments are currently being maintained with ECMO.

The shadow of death hangs over the largest tertiary hospital in Wuhan. A doctor told Renren that in the large crowd at the hospital, almost no one spoke, only mourning and discussing in private.

Tragedy could have been avoided. On December 30, 2019, Ai Fen received a virus test report of a patient with unknown pneumonia. She circled the word "SARS coronavirus" in red. When her college classmates asked about it, she took a photo of the report and passed it on. Gave it to this classmate who is also a doctor. That night, the report spread throughout the doctor circle in Wuhan, and those who forwarded the report included the eight doctors who were reprimanded by the police.

This brought trouble to Ai Fen. As the source of the dissemination, she was interviewed by the hospital's Disciplinary Committee and suffered "unprecedented and severe reprimands", saying that she was spreading rumors as a professional.

On the afternoon of March 2, Ai Fen accepted an exclusive interview with "People" at the Nanjing Road Campus of Wuhan Central Hospital. She was sitting alone in the office of the emergency room. The emergency department, which had received more than 1,500 patients a day, had now returned to silence. There was only one homeless man lying in the emergency room.

In some previous reports, Ai Fen was called "another female doctor who was admonished and surfaced", and some people called her a "whistleblower". Ai Fen corrected this statement, saying that she was not a whistleblower. It's the "Whistler". During the interview, Ai Fen mentioned the word "regret" several times. She regretted that she didn't continue to blow the whistle after being interviewed, especially for the deceased colleague. ’ said it everywhere, didn’t it?”

What has happened to Wuhan Central Hospital and Ai Fen himself in the past two months? The following is Ai Fen’s narration——

Ai Fen

unprecedented reprimand

On December 16 last year, the emergency department of our Nanjing Road Campus received a patient. I have a high fever for no reason, and I have been taking medicines that are not good, and my body temperature does not move. On the 22nd, I was transferred to the Department of Respiratory Medicine. I had a fiberoptic bronchoscopy and took alveolar lavage fluid, and sent it outside for high-throughput sequencing. Later, it was reported verbally that it was a coronavirus. At that time, the colleague in charge of the bed whispered in my ear several times: Director Ai, that person reported the coronavirus. Later we found out that the patient worked in Huanan Seafood.

Then on December 27, another patient came to the Nanjing Road hospital. He was the nephew of a doctor in our department. He was in his 40s and had no underlying diseases. His lungs were in a mess and his blood oxygen saturation was only 90%. The hospital has been treated for about 10 days without any improvement, and the patient was admitted to the respiratory intensive care unit. Fiberoptic bronchoscopy was also done to take alveolar lavage fluid and send it for testing.

At noon on December 30th, a classmate of mine who worked at Tongji Hospital sent me a screenshot of a WeChat conversation, which read: "Don't go to South China recently, there are a lot of people with high fevers..." He asked me if it was true. Yes, at that time, I was watching a CT of a typical patient with lung infection on the computer, so I recorded an 11-second video of the CT and sent it to him, telling him that this was a patient who came to our emergency room in the morning, and it was also in South China. seafood market.

Just after 4 p.m. that day, my colleague showed me a report that said: SARS coronavirus, Pseudomonas aeruginosa, 46 types of oral/respiratory colonization bacteria. I read the report carefully many times, and the note below reads: SARS coronavirus is a single-stranded positive-sense RNA virus. The main mode of transmission of the virus is close-range droplet transmission or contact with respiratory secretions of patients, which can cause a special pneumonia that is obviously contagious and can affect multiple organ systems, also known as atypical pneumonia.

At that time, I broke out in a cold sweat, it was a terrible thing. The patient was admitted to the respiratory department, and the respiratory department should report this situation logically, but for the sake of safety and attention, I immediately called and reported it to the public health department and hospital infection department of the hospital. At that time, the director of the respiratory department of our hospital happened to pass by my door. He was a person who participated in SARS. I caught him and said, we have a patient who received your department and found this thing. When he saw it, he said that it would be troublesome. I knew this was troublesome.

After calling the hospital, I also passed on this report to my classmates, and specially drew a red circle on the typesetting of "SARS coronavirus, Pseudomonas aeruginosa, 46 kinds of oral/respiratory colonization bacteria" for the purpose of It is to remind him to pay attention and pay attention. I also posted the report to the group of doctors in the department to remind everyone to take precautions.

That night, this thing spread all over the world, and the screenshots that were circulated everywhere were the photo I circled in red, including the one that I found out later that Li Wenliang had posted it in the group. I thought at the time that something might be wrong. At 10:20, the hospital sent a message, which was a notice from the Municipal Health and Health Commission. The general idea was that it was about pneumonia of unknown cause. Don’t release it to the outside world at will to avoid causing panic among the masses. If the information leaks and causes panic, you must be held accountable.

I was very scared at the time, and immediately forwarded this information to my classmates. About an hour later, the hospital sent another notice, emphasizing once again that relevant news within the group cannot be spread outside. One day later, at 11:46 p.m. on January 1, the head of the hospital’s supervision department sent me a message asking me to come over the next morning.

I didn't fall asleep that night. I was very worried and thought over and over again, but I also felt that everything has two sides. Even if it caused adverse effects, it is not necessarily a bad thing to remind the medical staff in Wuhan to take precautions. At a little after 8 o'clock the next morning, before I finished my shift, a phone call came urging me to go.

In the subsequent interview, I suffered an unprecedented and very severe reprimand.

At that time, the leader of the conversation said, "We can't even hold our heads up when we go out to a meeting. The director of such and such criticized Ai Fen of our hospital. As the director of the emergency department of Wuhan Central Hospital, you are a professional. How can you spread rumors without principles and discipline? What?" This is the exact words. Let me go back and communicate with more than 200 people in the department orally one by one. I can’t send WeChat or text messages. I can only talk face to face or make phone calls. I’m not allowed to say anything about the pneumonia. “Even my husband can’t say anything.” ...

I was dumbfounded all of a sudden. He didn't criticize you for not working hard, but it seemed that the good situation of the development of the whole Wuhan city was ruined by me alone. I had a feeling of despair at the time. I was a conscientious and diligent person who worked hard. I felt that everything I did was in accordance with the rules and made sense. What mistakes did I make? I saw this report, and I also reported it to the hospital. I communicated with my classmates and colleagues about the situation of a certain patient without disclosing any private information of the patient, which is equivalent to discussing a medical case among medical students. As a clinical doctor, you already know that a very important virus has been found in a patient. When other doctors asked, how could you not say it? It's your instinct as a doctor, isn't it? What am I did wrong? I did what a doctor and a person should normally do, which I think anyone would do.

I was also very emotional at the time, and said, I did this thing, and it has nothing to do with the rest of the people, so why don't you just arrest me and go to jail. I said that my current state is not suitable for continuing to work in this position, and I want to take a break. The leader did not agree, saying that this is the time to test me.

When I went home that night, I remember very clearly that I told my husband after entering the door that if something happened to me, you should bring up the child properly. Because my second baby is still very young, just over 1 year old. He felt baffled at the time, and I didn't tell him about my being reprimanded. On January 20, after Zhong Nanshan said human-to-human transmission, I told him what happened that day. During that period, I just reminded my family not to go to crowded places and to wear a mask when going out.

Peripheral departments

Many people worried that I was one of those 8 people who was called to admonish me. In fact, I was not reprimanded by the Public Security Bureau. Later, a good friend asked me, are you a whistleblower? I said I'm not the whistler, I'm the whistler.

But that interview hit me hard, very hard. After I came back, I felt that my whole heart was broken. I really worked hard and worked hard. Later, when all the people came to ask me, I couldn't answer.

What I can do is first let the emergency department pay attention to protection. There are more than 200 people in our emergency department. From January 1st, I asked everyone to strengthen their protection. All people must wear masks and hats, and quickly disinfect with hands. I remember one day when a male nurse didn’t wear a mask during the shift, I immediately scolded him on the spot, “Don’t come to work if you don’t wear a mask.”

On January 9th, when I got off work, I saw a patient coughing at everyone at the pre-screening desk. From that day on, I asked them to distribute masks to the patients who came to see the doctor, one for each person. Don’t save money at this time. At that time, people said There is no human-to-human transmission, and I want to emphasize here that wearing a mask to strengthen protection is very contradictory.

It was really depressing and painful during that time. Some doctors proposed to wear isolation gowns outside, but the hospital held a meeting and said no, saying that wearing gowns outside would cause panic. I asked the people in the department to wear the isolation suits under the white coats. This is not in compliance with the norms and is ridiculous.

We watched more and more patients, and the radius of the transmission area became larger and larger. First, the vicinity of the South China Seafood Market may have something to do with it, and then it spread, and the radius became larger and larger. Many of them were transmitted in the family. Among the first seven people, the mother got the disease from delivering meals to her son. The boss of a clinic got sick, and it was passed on to him by patients who came for injections, and they were all very serious. I knew it must have been passed on from person to person. If there is no human-to-human transmission, the Huanan seafood market will be closed on January 1. How can there be more and more patients?

Many times I was thinking, if they didn't reprimand me like that, and calmly asked the ins and outs of this matter, and then asked other respiratory specialists to communicate with each other, maybe the situation would be better, and I could at least have more exchanges within the hospital one time. If it was on January 1st that everyone was so vigilant, there would not be so many tragedies.

On the afternoon of January 3rd, in the Nanjing Road Hospital, the doctors of the Department of Urology gathered together to review the work history of the old director. Dr. Hu Weifeng, who attended the meeting, is 43 years old and is now in the rescue; on the afternoon of January 8th, the Nanjing Road Hospital On the 22nd floor, director Jiang Xueqing also organized a recovery party for breast cancer patients in Wuhan; on the morning of January 11, the department reported to me that Hu Ziwei, a nurse in the emergency room of the emergency department, was infected. She should be the first nurse to be infected in the central hospital. Immediately called the chief of the medical department to report, and then the hospital held an emergency meeting. At the meeting, he was instructed to change the report of "Two lung infections, viral pneumonia?" to "Scattered infection in both lungs"; At a weekly meeting, a deputy director was still saying: "Everyone should have a little medical knowledge, and some senior doctors should not scare themselves to death." Another leader came to the stage and continued: " There is no human-to-human transmission, so it is preventable, curable and controllable.” One day later, on January 17, Jiang Xueqing was hospitalized, and 10 days later he was intubated and put on ECMO.

The high cost of the central hospital is related to the fact that our medical staff do not have information transparency. Look at the fallen people, the emergency department and the respiratory department are not so serious, because we have a sense of protection, and we have to rest and treat as soon as we get sick. The most important ones are the peripheral departments, Li Wenliang is in the ophthalmology department, and Jiang Xueqing is in the nail and breast department.

Jiang Xueqing is really a very good person with high medical skills, one of the two Chinese physician awards in the whole hospital. And we are still neighbors, we are in the same unit, I live on the 40th floor, and he lives on the 30th floor, and we have a good relationship, but because of the busy work, we can only see each other during meetings and hospital activities. He is a workaholic, either in the operating room or in the outpatient clinic. No one would go to him on purpose and tell him, Director Jiang, you have to pay attention and wear a mask. He didn't have the time and energy to inquire about these things, so he must have been careless: "What's the matter? It's just pneumonia." This was told to me by someone in their department.

If these doctors could have been reminded in time, perhaps this day would not have happened. Therefore, as the person involved, I regret it very much. If I had known this day, I would care whether he criticized me or not. "Lao Tzu" said it everywhere, right?

Although I was in the same hospital as Li Wenliang, I didn't recognize him until he passed away, because there are too many people in the hospital with more than 4,000 people, and they are usually busy. The night before his death, the director of the ICU called me to borrow a heart presser from the emergency department, saying that Li Wenliang was going to be rescued. I was shocked when I heard the news. Is it okay to be in a bad mood after a reprimand? I have to put a question mark on this, because I feel the same as the feeling of training.

Later, when the matter developed to this point and Li Wenliang was proved to be right, I can understand his mood very well. It may be the same as mine. It is not excited or happy, but regretful. Regret should have continued to speak out in the first place. When people ask us, keep talking. Many, many times I have wondered how great it would be to turn back time.

it's good to be alive

On the night before the closure of the city on January 23, a friend from the relevant department called me to ask me about the real situation of emergency patients in Wuhan. I said you represent the private or the public. He said I represent a private person. I will tell you the truth on behalf of individuals. On January 21, our emergency department received 1,523 patients, three times the usual maximum, and 655 of them had a fever.

The situation in the emergency department during that time, those who experienced it will never forget it for the rest of their lives, and it will even subvert all your outlook on life.

If this is a war, the emergency department is at the forefront. But the situation at that time was that the back wards were already saturated, basically no patients were accepted, and the ICU was also determined not to accept them, saying that there were clean patients inside, and they would be polluted as soon as they entered. Patients kept rushing to the emergency department, and the road behind was blocked, so they all piled up in the emergency department. When patients come to see a doctor, they line up for hours, and we can't get off work at all. There is no distinction between the fever clinic and the emergency department. The hall is full of patients, and the infusion room in the emergency room is full of patients.

Some family members of the patients came and asked for a bed. My father couldn't do it in the car, because the underground garage was closed at that time, and his car was blocked and he couldn't get in. I had no choice but to take people and equipment and ran into the car. When I saw that the person was dead, how would you feel? It was very uncomfortable. The man died in the car without even a chance to get out of the car.

There was also an old man whose wife had just passed away in Jinyintan Hospital. Her son and daughter were infected and were receiving injections. Her son-in-law was taking care of her. When I came here, I saw that she was very ill, so I contacted the respiratory department and admitted her to the hospital. Her son-in-law saw that he was a man of culture and quality. He came to me and said thank you doctor and so on. As a result, he was sent and died. Although it took a few seconds to say thank you, it was also delayed for a few seconds. This thank you weighed heavily on me.

There are also many people who send their family members to the intensive care unit, which is the last time they see each other, and you will never see them again.

I remember that I came to take over the shift on the morning of the New Year's Eve, and I said that we would take a photo to commemorate this New Year's Eve, and I also sent a circle of friends. That day, no one said any blessings. At this time, it is good to be alive.

In the past, if you made a little mistake, such as not getting an injection in time, the patient might still make a fuss, but now there is no one, no one is arguing with you, no one is arguing with you, and everyone is overwhelmed by this sudden blow Yes, confused.

When a patient dies, it is rare to see family members crying very sadly, because there are too many, too many. Some family members will not say that the doctor begs you to save my family, but tell the doctor, alas, let's get rid of it quickly, it has reached this point. Because at this time, everyone is afraid of being infected.

It takes 5 hours to line up at the gate of the fever clinic a day. A woman fell down in a row. She was wearing a leather jacket, carrying a bag, and high-heeled shoes. She should be a very elegant middle-aged woman, but no one dared to step forward to help her, so she lay on the ground for a long time. I had to call the nurse and the doctor to help her.

When I came to work in the morning on January 30, the son of a white-haired old man died at the age of 32. He stared at the doctor to issue a death certificate for him. No tears at all, why cry? Can't cry. Judging by his attire, he may be a migrant worker, and there is no channel to report it. Without a diagnosis, his son became a death certificate.

This is what I want to appeal to. The patients who died in the emergency department were all undiagnosed and undiagnosed cases. After the epidemic is over, I hope to give them an explanation and give their families some comfort. Our patients are very poor, very pitiful.

"Lucky"

Having been a doctor for so many years, I have always felt that no difficulty can overwhelm me, which is also related to my experience and personality.

When I was 9 years old, my father died of stomach cancer. At that time, I wanted to grow up and become a doctor to save other people's lives. Later, during the college entrance examination, all my volunteers filled in were medical majors, and finally got admitted to Tongji Medical College. After graduating from university in 1997, I went to the Central Hospital. Before that, I worked in the Department of Cardiovascular Medicine. In 2010, I became the director of the Emergency Department.

I think the emergency department is like one of my children. I have made it so big and made everyone unite. It is not easy to make this situation, so I cherish it very much, cherish this group very much.

A few days ago, one of my nurses posted on Moments that she missed the busy emergency department in the past. That kind of busyness and this kind of busyness are completely different concepts.

Before this epidemic, myocardial infarction, cerebral infarction, gastrointestinal bleeding, trauma, etc. were the scope of our emergency department. That kind of busyness is busy with a sense of accomplishment, with a clear purpose, a smooth process for various types of patients, very mature, what to do next, how to do it, and who to find if there is a problem. But this time, there are so many critically ill patients who can't be dealt with, can't be admitted to the hospital, and our medical staff are still at risk. This kind of busyness is really helpless and sad.

One morning at 8:00 a.m., a young doctor in our department sent me a WeChat message, which was also very personal, saying that I would not come to work today and felt uncomfortable. Because we have rules here, if you feel uncomfortable, you should tell me to make arrangements in advance, and you tell me at 8 o'clock, where can I find someone. He lost his temper with me on WeChat, saying that a large number of highly suspected cases were sent back to the society by the emergency department you led, and we are doing evil! I understand that it is because of his conscience as a doctor, but I was also anxious, and I said you can sue me, what should you do if you are the director of the emergency department?

Later, after a few days of rest, the doctor still came to work. He didn't mean that he was afraid of death and tiredness, but that he felt devastated when faced with so many patients in such a situation.

As a doctor, especially the many doctors who came to support later, they couldn't stand it psychologically. When they encountered this situation, they were stunned, and some doctors and nurses cried. One is to cry for others, and the other is to cry for oneself, because everyone does not know when it is their turn to be infected.

Around mid-to-late January, the leaders of the hospital also fell ill one after another, including the director of our department office and three vice presidents. The daughter of the head of the medical department is also sick, and he is also resting at home. So basically no one cares about you during that period of time, you just fight there, that's the feeling.

People around me also started to fall one by one. On January 18th, at 8:30 in the morning, the first doctor we visited, he said that the director had been recruited, and he didn’t have a fever, so he only had a CT scan, and there was a big lump of ground glass in his lungs. After a while, a responsible nurse in charge of the isolation ward told me that he also collapsed. At night, our head nurse also collapsed. My very real first feeling at the time was—lucky, because I fell early and could leave the battlefield earlier.

I have been in close contact with these three people. I just work every day with the belief that I will fail, but I have not failed. Everyone in the hospital thought I was a miracle. I analyzed it myself. It may be because I have asthma and I am using some inhaled hormones, which may inhibit the deposition of these viruses in the lungs.

I always feel that those of us who work in the emergency department are people with feelings—in Chinese hospitals, the status of the emergency department should be relatively low among all departments, because everyone thinks that the emergency department is nothing more than a channel, and it is enough to admit patients. up. In this fight against the epidemic, this kind of neglect has always existed.

In the early days, there were not enough supplies, and sometimes the quality of protective clothing distributed to the emergency department was very poor. Seeing our nurses wearing such clothes to work, I was very angry and lost my temper in the Zhou Huiqun. Later, many directors gave me all the clothes hidden in their own departments.

There is also the problem of eating. When there are many patients, the management is chaotic. They never thought that the emergency department is short of food. Many departments have food and drink after work. There is a big row. We have nothing here. In the WeChat group of the fever clinic, some doctors complained, "We only have diapers in the emergency department..." We fought at the forefront, and the result was like this, and sometimes I was really angry.

Our group is really good. Everyone only goes off the line when they are sick. This time, more than 40 people in our emergency department were infected. I created a group for all the sick people. It was originally called "Emergency Sick Group". The head nurse said it was unlucky and changed it to "Emergency Refueling Group". Even those who are sick do not have a very sad, desperate, or complaining mentality. They are all quite positive, that is, the mentality of everyone helping each other and overcoming difficulties together.

These children and young people are very good, but they followed me and were wronged. I also hope that after this epidemic, the country can increase investment in emergency departments. In the medical systems of many countries, emergency departments are highly valued.

unattainable happiness

On February 17th, I received a WeChat message from my classmate from Tongji Hospital. He said "I'm sorry" to me, and I said: Fortunately, you spread the word and reminded some people in time. If he didn't spread the word, there might not be Li Wenliang and the others, and even fewer people would know about it.

This time, we had three female doctors whose whole family was infected. The father-in-law, mother-in-law, and husband of two female doctors were infected, and the father, mother, sister, and husband of a female doctor, plus herself, were infected. Everyone thought that the virus was discovered so early, but it turned out to be like this. It caused such a huge loss, and the price was too heavy.

This cost is reflected in all aspects. In addition to the dead, the sick are also suffering.

In our "emergency refueling group", everyone often communicates about their physical condition. Some people ask if the heart rate is always 120 beats per minute, does it matter? That must be important, flustered when they move, this will have an impact on them for life, will they have heart failure when they get older? It's hard to say. In the future, others may be able to climb mountains and travel, but they may not be able to do so. That is all possible.

And Wuhan. You said that our Wuhan is such a lively place, but now the road is quiet and quiet, many things cannot be bought, and the whole country has come to support. A few days ago, a nurse from a medical team in Guangxi suddenly fell into a coma while working. After rescue, her heartbeat recovered, but she was still in a coma. If she didn't come, she could have a good life at home, and there would be no such accident. So, I think we owe everybody, really.

Having experienced this epidemic, it has hit many people in the hospital very hard. Several medical staff under me have the idea of resigning, including some backbones. Everyone's previous concepts and common sense about this profession are inevitably a little shaken-is it true that you work so hard? Just like Jiang Xueqing, he works too hard and treats patients too well. He performs surgery every year during the Chinese New Year. Today someone sent a WeChat message written by Jiang Xueqing's daughter, saying that her father gave all of his time to the patient.

I myself have thought countless times, should I also go home and be a housewife? After the epidemic, I basically didn't go home. I lived outside with my husband, and my sister helped me take care of the children at home. My second baby doesn’t recognize me anymore, he doesn’t feel anything about me after watching the video, I’m very disappointed, it’s not easy for me to give birth to this second child, he weighed 10 pounds when he was born, I also got gestational diabetes, I was still breastfeeding , I also weaned this time - when I made this decision, I was a little sad. My husband told me that he said that such a thing can happen in a person's life, and you are not only a participant, you also have to It is also a very meaningful thing to take a team to fight this battle. It is also a very precious experience for everyone to recall when everything returns to normal in the future.

On the morning of February 21st, the leader talked to me. In fact, I wanted to ask a few questions, such as, do you think it was wrong to criticize me that day? I wish I could give an apology. But I dare not ask. No one ever said sorry to me on any occasion. But I still think that this incident further shows that everyone still has to insist on their own independent thinking, because if someone wants to stand up and tell the truth, there must be someone, and the world must have different voices, right?

As a Wuhan native, which one of us does not love our city? Now we recall how extravagant happiness we lived in the most ordinary life before. Now I feel that holding the baby, going out with him to play on the slide or going out to watch a movie with my husband was nothing more than normal in the past, but now it is a kind of happiness, which is an unattainable happiness.