南昌大学大二医学生《柳叶刀》(IF=60)发文获“威克利·伍连德奖”!| 附中英全文

本文经授权转载自柳叶刀TheLancet,原文有改动

北京时间1月8日,国际四大医学期刊之一的《柳叶刀》The Lancet)(IF=60.39)发布了2020年威克利·伍连德奖,今年的获奖文章来自南昌大学的二年级医学生韦芊。文章题为《你也有隐秘的角落吗?》Do you also have a hidden corner?

韦芊,南昌大学医学院玛丽女王学院大二医学生,院学生会办公室部委

柳叶刀》发表评论文章称,作为一名将被训练成为医生的年轻人,韦芊回顾了自己在这个特殊的时期所经历的过程和内心的挣扎,这篇文章不仅让每位医疗卫生工作者所作出的牺牲闪耀了光芒,而且还完美体现了中国所有医务人员在开始接受医学教育时所做的誓言的意义。通过这篇文章,我们希望能够激励下一代医疗卫生工作者,并激发对中国医学教育转型和改革的思考。

《柳叶刀》点评文章:将接力棒传递给下一代医疗卫生工作者
2019年,《柳叶刀》首次设立威克利-伍连德奖(The Wakley-Wu Lien Teh Prize),旨在让中国的医疗卫生工作者分享他们自己的从医故事。中国医科大学附属第一医院麻醉科医生谭文斐撰写的《给父亲的一封信》获得该奖。详见:
以下为韦芊《你也有隐秘的角落吗?》中文原文及英文译文
你也有隐秘的角落吗?
韦芊
呆坐,放空……
当我决定提笔揭开心中那隐秘的角落时,离我爸摔门而去已过去了整整400天。400天前,我在高考志愿表上填满了临床医学专业,而一个工科专业都没写时,作为机器人控制领域专家的老爸,脸上写满了女不承父业的绝望。
2019年9月12日,这是我第一次站在正对南昌大学医学院一号门的白求恩广场,其立柱上赫然刻着四个大字——“德高医精”。7:00,我向着朝阳,对着国旗,右手握拳,大声宣誓——我志愿献身医学,忠于人民,恪守医德……自此,我成为了一名真正的医学生。如果没有这场疫情,我会一直天真地以为成为一名救死扶伤的医生并不难。可是这场疫情却让我看到了心中那隐秘的角落。
2020年1月13日,我放假回家。如今回想,这个日子离疫情开始暴发不远了。而当时我只是想着如何应对老爸劝我转专业的明枪暗箭。苦和累本就是学医的常态,更何况我修的是中英双学位。才刚上大一,似懂非懂的英文加上全新的专业知识将我“杀得个片甲不留”。不过为了向认为学工科才有出息的老爸证明,违抗父命也可以成功,我硬生生熬过来了。我心中默想,最多听他唠叨一个月就可以逃离了。那时的我并没想到这个寒假竟然会有4个月之久。
在这之后,武汉封城、小区封闭、出入要证、假期延长、开学渺茫。我们一家本来计划过年要回贵州看望多年未见的爷爷,也不能成行了。爷爷在电话里还宽慰地说,明年回也一样。谁也不曾想过这个决定的后果。
疫情发展迅速,无数位白衣天使舍小家为大家,在除夕之夜前往武汉支援。为了激励人民同白衣天使一起抗疫,春晚临时添加了诗朗诵《爱是桥梁》。看完这个节目,老爸突然问我:“武汉缺医护人员,医学生可以顶替吗?”
我回答:“不行,没有执业医师资格证。”
“特殊时期,医学生经过简单培训后应该可以搭把手了吧,毕竟医学生比普通人更专业。”
我懒得多解释,心里却盘算着这两者之间的差距。如果医生可以那么快被培养出来的话,为什么还要学习至少十年呢?
2月12日,我的小区封闭了。出入小区的过程变得繁琐——消毒,测温,发通行证。小区一封闭,父亲的第一反应不是赶紧去买米买肉,而是要求我去社区服务站帮忙,负责在小区出入口给大家测温消毒,理由是:我是一名医学生。
我愣了一下,不仅是害怕还有慌乱,这是我第一次感受到了那个隐秘的角落的存在。
“我不去!一天需要接触那么多人,感染几率得多大啊?医学生的免疫力就比别人强吗?”
2月16日,隔壁小区出现确诊病例和我们小区出现疑似病例的消息在微信群传开,老爸再次要求我去当社区服务志愿者,说身为一名医学生,我应当担起这份责任,不应该害怕。
我想,“这分明就是道德绑架!医学生就不能害怕了吗?凭什么要我们冲锋在前为大家消灾消难?我是医学生,又不是医生。” 我被来自隐秘角落的力量说服,以学校开始组织上网课为由搪塞了过去。老爸依然隔三差五的提当志愿者的事,却不再唠叨转专业的事情了。
3月1日,各地疫情逐渐稳定,教育部允许医学院校或医学专业的学生先返校。我迟疑了,都是大学生,为什么我们开学就没有危险呢?作为医学生真的要承担更多的责任吗?
3月28日凌晨,噩耗传来,一向身体很好的爷爷于凌晨4:00去世了。爷爷十几天前,已出现腹水,呕吐等症状,但由于害怕会因去医院而感染新冠,就一直在家坚持着。最后实在扛不住去到医院,被确诊为胰腺癌晚期。爷爷从确诊到离世只有三天。
我们一家买了最早班的高铁票赶回贵州,一路上只有静默。
两天后,爷爷下葬。由于疫情期间的管控,殡仪馆和墓地都只允许十人进入,很多亲戚朋友只能送到殡仪馆门口。殡仪馆里没有告别仪式,墓地里没有哀嚎,安静而克制,悲伤但隐忍。墓地的安葬仪式压缩到最简,按风俗要做的扶三和头七也由于不能去祭扫而直接取消。从头到尾,不管是来自乡村还是城市,不管是耄耋老人还是黄发垂髫,没有人埋怨,只有遵守和理解。
3月31日,我执意先单独返回家中。当初,我宣誓时昂首挺胸,坚信我将来一定会成为一位好医生。但当疫情来临时,我既没能做到“为大我而舍小我”,也没能守护自己的亲人。如果我能多关注爷爷奶奶的身体健康,也许就能提早发现病情,而不是让父亲悔恨于前年的那顿除夕饭竟是与爷爷的最后一面。
回到家,电视上播着各大医院的救治情况,各小区志愿者的工作情况……许多人都在奉献自身。我那隐秘的角落里是什么,为什么可以一次又一次地阻拦我?
呆坐,思考……
从宿舍走到白求恩广场不过800米,我走的欢快轻松;可从家中到小区门口的80米,我却一步也不曾迈出。
隐秘角落里的怯懦、畏惧、恐慌,我有,奋斗在一线的医护人员也有,只是他们能将誓言牢记在心中并学会了克服这种种情绪。而我却只是将誓言说出而已。学医十年寒窗,不仅要习得知识,还要修得心境。北京朝阳医院陶勇医生虽然被恶意砍伤,但现在依旧坐诊看病。钟南山前辈已是八旬老人却依旧冲锋陷阵。奉献与博爱这两个词语需要我用一生去学习。
如今,阳光明媚,暖风依旧,菜市场里熙熙攘攘,饭店里人来人往,角落依然在,生活却也在继续……END

Do you also have a hidden corner? 

Qian Wei

As I write about the hidden corner that has been revealed in myself, 400 days have passed since my father slammed the door in my face. 400 days ago, I declared my undergraduate major on the National College Entrance Examination form; all of my choices were clinical medicine, and not a single one was related to engineering. My father, a robotics engineering expert, was full of despair that his daughter had no interest in following his line of work.

Sept 12, 2019, was the first time I stood opposite the main gate of the Medical College of Nanchang University, in Norman Bethune Square, where the college motto— high morality and medical expertise—was carved out in huge Chinese characters. At 7 AM on that sunny day, looking up at the national flag and holding my right hand in a fist, I took the oath to enter medical school: I will dedicate myself to medicine, be loyal to the people, abide by medical ethics... I was officially a medical student. Without the COVID-19 pandemic, I would have naively thought that the journey to becoming a doctor is not a difficult one. Yet, the past few months have shone a light on a hidden corner in my heart.

On Jan 13, 2020, I went home for the winter holidays. Looking back now, that day was not far from the start of the COVID-19 outbreak. At the time, I was mostly preoccupied with fending off my father’s various tactics to convince me to change my major. I had expected the hard work and exhaustion that come with studying medicine, especially as I was studying for a dual Chinese and English degree. Not long after I started my freshman year, I already felt the burden from my demanding course. But determined to prove to my father that I could succeed against his wishes, I worked hard and made it through my first semester at medical school. I went home thinking that I only had to put up with his nagging for a month at most, before I could escape again. I had not anticipated that the winter break would last for 4 months.

Soon after, Wuhan went into a city-wide lockdown, my neighbourhood was also in lockdown and required permits for entries and exits, the holidays were extended, and a second semester on campus was looking less and less likely. My family had planned to go to Guizhou during Chinese New Year to visit my grandfather, whom I had not seen for many years, but that trip had to be cancelled. On the phone, my grandfather comforted me, saying that it would be just as nice if we visit him next year. None of us could have foreseen the consequences of that decision.

The outbreak spread rapidly. On Chinese New Year’s Eve (Jan 24), many health workers travelled to Wuhan to support the epidemic response. A poetry recitation of Love is a Bridge was added to the annual Spring Festival Gala on TV to inspire solidarity during this time of crisis. After watching the programme, my father suddenly asked me, “Wuhan has a shortage of medical staff; can you medical students help?”

I said, “No, because we do not have the medical licence yet.”

“During this exceptional period, can’t medical students help after some basic training? After all, you are more knowledgeable than ordinary citizens”, my father said.

I could not be bothered to explain further, but thought about the enormous gap between medical students and doctors. If doctors could be trained so quickly, why do I need to study for at least 10 years to become one?

On Feb 12, our residential compound was closed off. The process of entering and leaving became cumbersome, involving disinfection, temperature checks, and the issuance of permits. When the lockdown began, my father’s first reaction was not to rush to buy groceries, but to ask me to volunteer as a community worker in our neighbourhood, helping with temperature checks and disinfection at the entrance of our residential compound. His reason was again—you are a medical student.

I froze for a second. Fear and panic arose in me—for the first time, I saw that hidden corner in myself.

“I’m not going! Being exposed to so many people every day, how high is the probability of getting infected? Do medical students have a stronger immune system than others?”, I retorted.

On Feb 16, news began spreading about a confirmed case in the neighbourhood and a suspected case in the residential compound where we lived. My father asked me again to volunteer as a community worker, telling me that, as a medical student, I should take up this responsibility and not be afraid. I thought, “This is clearly moral coercion! Are medical students not allowed to be afraid? Why should we go to the frontlines? I am a medical student—not a doctor.” I was convinced by a voice from that hidden corner and used online classes as an excuse to put off volunteering. As the days passed, my father kept asking me to volunteer, but he no longer mentioned anything about switching majors.

By March 1, the epidemic was under control in most cities in China. The Ministry of Education allowed medical students to resume classes on campus earlier. I began to doubt myself—“Why are medical students going back to university ahead of other students? Do medical students really have to take on more responsibility than others?”

In the early morning of March 28, we received the unexpected news that my grandfather, who had always been in good health, had passed away at 4 AM. For the past 2 weeks, he had been experiencing symptoms such as ascites and vomiting, but insisted on staying at homebecause he was afraid of getting COVID-19 if he went to the hospital. When he finally sought medical help, he was diagnosed with late-stage pancreatic cancer, and died after only 3 days.

My family bought tickets for the first high-speed train and rushed to Guizhou. No one spoke during the entire journey. My grandfather was buried 2 days later. Infection control measures dictated that only ten people could enter the funeral home and the cemetery. Many relatives and friends could only accompany us to the entrance of the funeral home. No proper funeral could be held; no one wailed in the cemetery. The atmosphere was quiet, restrained, and sad. The burial ceremony was reduced to the bare minimum, and the customs of visiting the grave on the third day and seventh day after burial also had to be cancelled. During the entire process, no one complained about the restrictions. From city dwellers to villagers, the youngest to the oldest, everyone showed compliance and understanding.

On March 31, I insisted on returning home on my own. When I took my oath to enter medical school, I firmly believed that I would become a good doctor. But when the outbreak hit, not only was I unable to make sacrifices for the greater good, but I could not even take care of my own family. If I had paid more attention to my grandparents’ health, perhaps my grandfather’s illness would have been discovered earlier and my father would not have the regret of not being able to visit him at all the year before his passing.

When I arrived home, the TV channels broadcasted the various pandemic response efforts across the country— from doctors and nurses working in the major hospitals to community volunteers scattered across neighbourhoods, many people have made sacrifices. What is in my hidden corner? Why did it stop me from stepping out time and time again?

I had happily walked the 800 m between my dormitory and Norman Bethune Square at medical school. Yet, I had not even taken a single step to walk the 80 m between my home and the entrance of my residential compound. I realised that the cowardice, fear, and panic in my hidden corner are not unique to me. The frontline health workers probably have the same feelings too, but they have learnt to overcome these struggles to fulfil their responsibilities. Yet, although I had taken the same oath as they did, I have not lived it out. The 10 years of medical training is not just about acquiring clinical knowledge, but also about developing this state of mind. Although Dr Yong Tao at Beijing Chaoyang Hospital was attacked and stabbed by an angry patient, he returned to the clinic as soon as he could. Although Dr Nanshan Zhong is already in his eighties, he was one of the first to go to Wuhan at the beginning of the outbreak. Cultivating selfsacrifice and the love for humanity will be a lifelong lesson for me.

Today, the sun is shining, and the warm breeze is the same as ever. Markets and restaurants are bustling again. That corner in me is still there, but life goes on too…

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