He Guowei: Doctors are the essence of the civilized world
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(Summary description)He Guowei: Associate Dean of TEDA International Cardiovascular Hospital of Tianjin University, Director of Institute of Cardiovascular Diseases of Tianjin University, Director of TEDA International Cardiovascular Research Institute of Chinese Academy of Medical Sciences and Peking Union Medical College, concurrently serving as clinical department of Oregon Medical Science and Technology University School of Medicine Professor of Science, elected as a member of the French National Academy of Medical Sciences in 2019.
He Guowei: Doctors are the essence of the civilized world
(Summary description)He Guowei: Associate Dean of TEDA International Cardiovascular Hospital of Tianjin University, Director of Institute of Cardiovascular Diseases of Tianjin University, Director of TEDA International Cardiovascular Research Institute of Chinese Academy of Medical Sciences and Peking Union Medical College, concurrently serving as clinical department of Oregon Medical Science and Technology University School of Medicine Professor of Science, elected as a member of the French National Academy of Medical Sciences in 2019.
- Categories:Company News
- Author:
- Origin:
- Time of issue:2021-06-16
- Views:0
He Guowei: Associate Dean of TEDA International Cardiovascular Hospital of Tianjin University, Director of Institute of Cardiovascular Diseases of Tianjin University, Director of TEDA International Cardiovascular Research Institute of Chinese Academy of Medical Sciences and Peking Union Medical College, concurrently serving as clinical department of Oregon Medical Science and Technology University School of Medicine Professor of Science, elected as a member of the French National Academy of Medical Sciences in 2019.
What is a doctor? Who can be a doctor? How to be a doctor? These are questions that often haunt medical students. Professor He Guowei, deputy dean of Taixin Hospital, director of the Institute of Cardiovascular Diseases of Tianjin University, and academician of the French National Academy of Medical Sciences, recently shared his 50-year experience of practicing medicine with the medical students present at the Beiyang Medical Lecture Hall of Tianjin University: OK Doctors must establish a spirit of dedication, adhere to clinical work, cultivate the concept of lifelong learning, maintain a strong body, and strive to improve humanistic quality. --editor
1 What is a doctor
When I was a teenager, the person I admired the most was Einstein, who was extremely obsessed with "theory of relativity" and had determined to be a theoretical physicist. When I was in high school, my favorite courses were mathematics, physics, Chinese and foreign languages. He graduated from high school in 1964 with high scores. He was called the "Science No. 1 Scholar" and accidentally entered a medical school.
Before that, I had never been in contact with medicine, nor did I expect to become a doctor one day. At first I was not willing. But after many years of becoming a clinician and practicing medicine after graduation, I felt that I was one of the luckiest people in the world.
What is a doctor? I want to quote two sentences. The first sentence is what the famous British writer Luo Lu Stevenson said: Doctors are the essence of our civilized world. The second sentence is what the famous American thinker and writer Ralph Waldo Emerson said: As long as life is precious, the profession of doctor will always be admired. It can be seen that the profession of a doctor is very respected.
Why do western developed countries attach great importance to the profession of doctors? I have thought about this question for many years before finally having an answer.
I visited museums in many countries around the world and saw many famous paintings by painters in different periods. What is the difference between Chinese famous paintings and foreign famous paintings? Foreign famous paintings are mainly people, while Chinese paintings are divided into three categories, landscape paintings, figure paintings, and flower and bird paintings. The best paintings in China are landscape paintings. Why is this? Because since the beginning of the Renaissance, the West has emphasized that people are the greatest elves in all things, and the most important thing in all things in the world is human beings. In the history of feudal society in China, the first emphasized the rule of the emperor, and the second emphasized the mind of the literati. The landscape paintings of Chinese literati painting do not completely imitate the scenery, but combine the literati's mind with the landscape. Huang Gongwang's "Living in the Fuchun Mountains" painted not only the landscape, but also the lofty aspirations of the literati. It is the mound in the mind of the literati, and the ideal of the literati for society and the country.
Since the West values people, they must value doctors who treat people. After the Middle Ages, doctors received special attention in the West.
Many western countries implement hierarchical diagnosis and treatment. Large hospitals generally do not receive patients directly, except in emergencies. The patient should first see the doctor in the community clinic. General minor illnesses are diagnosed and treated by community doctors, namely general practitioners. Only complicated ones are recommended by community doctors to see specialists in major hospitals. Even community doctors, Westerners also value and respect them very much.
How important are the general practitioners in community clinics in the hearts of Westerners? If you have a legal document that needs to be notarized, find a lawyer in China and a notary office. However, in some western countries, you can go to the community general practitioner to sign and notarize, which is recognized by law.
In the Yellow Emperor's Internal Classic, there is: "Go to medicine to treat the country, Chinese medicine to treat people, and to go to doctors to treat diseases." Going to medicine is to cure the country, and people who heal people do not count as medicine. This is why Mr. Sun Yat-sen, Mr. Guo Moruo, and Mr. Lu Xun finally gave up studying medicine. But have you heard of a few foreign doctors who gave up studying medicine to go to politics? No, but very few. Because Westerners will take medicine as one of the most important life goals.
Fan Zhongyan, a writer and politician of the Northern Song Dynasty, said: "If you don't be a good minister, you are a good doctor." This sentence has two meanings. The first meaning is that if I can't be a good prime minister, I will be a good doctor; The first level means that doctors are not as good as prime ministers.
Xu Dachun in the Qing Dynasty said in "The Origin of Medicine": "The husband is the most important person in the world, and the life of the person who is tied to the world hangs on the doctor, and the people who are tied to a country and a family do not care about it. It is also important." This sentence still says that governing the country is more important than treating people. I think this may be the difference between Chinese and Western cultures.
The cultural differences in medicine between China and the West are also reflected in the academy system. The national academy systems and academicians in developed countries such as the United States, the United Kingdom, and France are three independent and equal academies: the Academy of Sciences, the Academy of Engineering, and the Academy of Medical Sciences (the Academy of Medical Sciences). The Academy of Medical Sciences is independent of the Academy of Engineering, but there are only two academies in China. Medicine is in the engineering school. This also reflects the West's emphasis on medicine.
But with the progress of society, with the integration of the world and the integration of civilizations, this gap will become smaller and smaller. In the future, we will definitely value people more and more and the profession of doctors.
Xu Tingzuo of the Qing Dynasty said: “To save people, you can study medicine, but you cannot make profit.” This is a sentence that everyone should remember in the future. This sentence is very important.
The second question, I want to talk about what kind of people can be doctors.
"The Yellow Emperor's Internal Classic" says: "If you are not the person, you should not teach, if you are not the truth, don't teach it, it means good way." I was a chair professor at the University of Hong Kong and a research chair professor at the Chinese University of Hong Kong for 15 years. How difficult is the medical examination in Hong Kong? Every year, 60,000 to 70,000 middle school students in Hong Kong graduate and enter the university. Students with all A++ in seven subjects are generally called "champions", with only 3-9 students a year. The entry threshold for general colleges is 22 points, but the entry threshold for medical subjects is 39 points, which is 17 points higher than the entry threshold for ordinary universities! In 2016, 4 "champion" and 3 were studying medicine; in 2017, all 6 "championers" were selected Study medicine. In 2016, I saw such reports in the media that none of the 36 college entrance examination champions in mainland China chose to study medicine. This reflects the different views on the profession of doctors in my country.
In the United States, you have to study for 4 years before going to the medical school. The acceptance rate of a good medical school is 2%~5%. A good student among good students can become a medical student. Dear students, shouldn’t you feel lucky to be a student of the medical school?
When I was assigned to the medical school for the college entrance examination, I once felt that I was the most disappointed middle school student in the world because I could not realize my dream of becoming a theoretical physicist. But when I became a clinician and loved medicine more and more, I felt that I was the luckiest person in the world. I hope that students will value your major, your study, and your opportunities.
The word Doctor refers to doctors before the Middle Ages. The early doctors were doctors from the seminary, and the famous Oxford University was developed from the seminary. PhD, the doctorate degree is awarded to scholars who have in-depth achievements in theological or philosophical research. After the Renaissance, Western society paid special attention to people themselves, and even more to doctors who treated people and prolonged their lives. Therefore, doctors were honored as Doctors, even if doctors did not have doctorates. In general, respect for doctors reflects human respect for life.
2 How to train a good doctor
First of all, I want to emphasize the purpose of training medical students. The most important thing is to train clinicians. Any medical school must first train clinicians. The medical school is not mainly to train scientific research talents, but to train clinical talents who can treat people. This is very important. The medical school of any university should not forget this basic tenet and don't go astray. On the basis of training clinicians, some medical graduate students can be trained in order to improve the level of clinicians. The purpose of cultivating graduate students is to cultivate research talents on the one hand, and on the other hand to cultivate the logical thinking of clinicians, so that doctors can better develop medicine and serve patients.
When I was leading a doctoral student at the University of Hong Kong, I would ask students, what is your purpose for being a doctoral student? Now in Mainland China, if you don’t have a doctorate, there will be problems in the evaluation of professional titles in the future. People who want to find a good job in a large hospital will not want you. That is, the salary is low without a high degree. Everyone thinks about these real problems. In fact, what graduate students cultivate is mainly logical thinking ability. With this ability, no matter what you do in the future, you will have a very solid foundation.
The modern medical education system comes from European and American countries, so we have to learn from the training experience of British and American medical graduate students. In the United States, after graduating from the medical school, he works as an intern and a resident. Then, if you want to be a specialist, you have to do a second specialist resident training. After the completion of the specialist resident doctor, he will also be a Fellow (equivalent to a semi-independent refresher doctor), conduct further training in clinical specialties, and finally become a consultant (that is, an independent attending physician, equivalent to a chief physician in China).
Rough calculations, if you go to university at the age of 18, graduate in 8 years and be 26 years old, 26 years of internship a year and 27 years old, then 3 years as a resident doctor and 30 years old, and then doing specialties such as heart surgery and brain surgery, you will have to take another 3 years. The specialist resident is 33 years old. Can I find a long-term job after graduating at the age of 33? It is usually not found. You must find a good teaching hospital, where a famous expert will teach you, and his patients will give you part of it to further train you. After a few years, if you do very well, someone will hire you. This is the smoothest situation. How old is this time? Statistics show that the average age at which cardiac surgeons in the United States find long-term jobs is 38 years old.
There may only be 5%~10% of people who go smoothly like this. The process for most people to become a specialist is very difficult. They need to go through such a long training and study. During this period, they have to pay the tuition loan for the medical school. Therefore, the high salaries of American doctors are indeed reasonable.
Look at Britain again. The British secondary school is 7 years, the university is 3 years, and the medical science is another 3 years. When I graduated, I got a double bachelor's degree because I went to two universities. The training of clinicians in the United Kingdom is similar to that in the United States. After getting a doctorate at an imperial university, you can also apply for a senior doctorate, such as a doctorate in science. The advanced doctoral degree must be at least 8 years after obtaining the PhD, compile the papers published during this period into a collection of essays, apply to the university's Faculty of Science, and then be reviewed by world-class experts.
What's wrong with Chinese medical education? There are five-year, six-year, seven-year, and eight-year programs, which are very complicated. There are countries in the world that adopt these types of medical education systems, but no country has multiple types of them. We must reform and unify the medical school system. I suggest to follow the British system for 6 years. After 6 years, a double bachelor degree is awarded, which is equivalent to a doctorate degree. As a clinician, you no longer need other degrees. The role of clinicians is not to conduct scientific research, but to be optimistic about the disease, so that patients have the lowest mortality, the highest cure rate, and the lowest incidence of complications. To do this well, sometimes you have to rely on research, but you do not have to do this research yourself. You can learn the latest medical research results through continuing education. A small number of clinicians are interested in scientific research, and only those working in university teaching hospitals need to do research. I think this should be the main direction of China's medical education reform in the future.
The clinical graduate students recruited by the hospital now have to go out to do regular training. In the end, the research was not done well, and Gui Pei did not mind. Now hospitals blindly require high academic qualifications, and good hospitals must have a doctorate to enter. People with a doctorate may have not been in clinical practice for three years and have no clinical experience. This is also a strange thing that violates the laws of medicine. I think it is enough to be a clinician as long as you have a degree from a medical school, but you must go through the above-mentioned strict residency training after graduation.
There are also doctors who want to do research. They want not only to do clinical work, but also to be university professors. Such people, such as myself, need to study a research degree, such as a PhD, to train their research thinking. But such doctors don't need much. In the United States and the United Kingdom, only a few out of 100 clinicians are university professors, and this also requires high competition.
3 How to be a good doctor
First of all, there must be a lifelong dedication to medicine, a complete training of clinical skills, the purpose of patient first, always maintain frontline clinical work, always do a good job in their own continuing education, and have a good body and humanities. Quality.
Dedication is the most important point. I have been a doctor for 50 years, of which at least 35 to 40 years, I have basically never taken leave. I have to check the patient every Sunday morning, and I have never asked for leave because of family matters. Without dedication, you can't do this job. After 30 or 40 years of suffering, I felt happy. I have performed more than 7,000 heart operations and cured many patients. Although I am often woken up in the middle of the night, I think the pain is very worthwhile. Persist in clinical work is critical. During the first three days of today’s lecture, I was undergoing surgery every day.
Another point is to implement the purpose of patient first. As long as the patient needs it, he must put aside other things as much as possible to serve the patient under any circumstances. The patient's life is the most important. The duty of a doctor is to treat diseases and save people. It is the value of the doctor's work that can help the patient get rebirth.
As a doctor, we must constantly sum up clinical experience, improve knowledge reserves, develop new diagnosis and treatment methods, and train our thinking ability.
There is another important point. A good doctor must have good physical fitness. Surgeons often stand for several hours to perform operations. We sometimes do major cardiovascular surgery, without eating, drinking, spitting, coughing, or going to the toilet for seven or eight consecutive hours. It is impossible to persist without good physical fitness. Over a long period of time, cervical and lumbar diseases are common problems for surgeons. You need to improve your physical fitness through proper exercise. Now, I often ride a bicycle on weekends, and I can ride 30 kilometers a day.
Clinicians must also have good humanistic qualities. What are the aspects of humanistic qualities? I have summarized them, including the seven points of personality, IQ, EQ, knowledge, thinking, cleanliness, and diligence.
Let me talk about character first. The profession of doctors is an intersecting field of natural sciences and humanities. Doctors are scientific workers as well as social workers. There are about 150 medical schools in the United States, and each student enrolls in a committee to assess whether you are suitable for being a doctor. There are more than a dozen people in a committee. Let's see how your reaction ability is and whether you can communicate with others, not whether you have a high score in the test. Doctors should be cheerful, good at communication, and good at uniting people around them.
These qualities need to be cultivated. I used to be a nerd, reading books all day, but later discovered that being a doctor requires a good personality. You have to talk to the patient, consider the problem from his point of view, and communicate with him. This is very artistic and needs to be learned and cultivated. This is emotional intelligence. All the students admitted to the medical school have high scores and learn well, and IQ is all right, but more importantly, emotional intelligence.
Also cultivate logical thinking. American universities are generalist education. Undergraduates can be transferred to departments and schools at will. It is to train people, not to train tools. I think the purpose of education should still be to cultivate people, cultivate people's logical thinking ability, and cultivate people who can adapt to and contribute to society.
I have summarized the thinking training by myself
7 balances: the first, the balance of medicine and other scientific knowledge; the second, the balance between natural sciences and the humanities; the third, the balance between science and art; the fourth, the balance of intelligence and physical strength; the fifth One is the balance of left and right brain; the sixth is the balance of intelligence and emotion; the seventh is the balance of large movements and fine movements.
Clinicians should pay special attention to cultivating the balance between the left and right hemispheres of the brain, because the left hemisphere is the logical hemisphere, the right is the emotional hemisphere, the left is the speech and mathematical thinking, and the right is the emotional image thinking.
In terms of logical analysis and judgment, I recommend that everyone must not ignore the study and training of mathematics, because it will benefit you for life. I have been very interested in mathematics since middle school.
Clinicians also need humanistic qualities. As a clinician, the more extensive knowledge you have, the easier it will be to communicate with patients. Your patients may be politicians, lawyers, engineers, mathematicians, and of course workers and farmers. For example, if your patient is a mathematician, you can talk to him about Fermat's theorem; if your patient is a language teacher, if you talk to him about ancient literature and the preface of the King of Teng, he will immediately get close to you in thought. In addition, getting in touch with people with knowledge and learning their spirit of learning will also motivate yourself to make progress. For example, listen to more Nobel science lectures and learn how others learn and think. There are mountains outside the mountains, and there are people outside the people. There are many smart and hardworking people in this world. Never block your own vision.
Non-professional knowledge, such as music, literature, and fine arts, also benefit us. I organized a small band and chorus in the hospital, and I myself acted as the chief violinist and conductor. I am also very fond of ancient Chinese painting and calligraphy. All these have benefited me in terms of thinking, cultural quality, appreciation level and dealing with others.
Another aspect of the humanistic quality of clinicians is to pay attention to clean appearance. When I was working in a foreign university, there were clear requirements for what clothes I would wear every time I participated in an event, generally divided into three categories. The first is casual wear; the second is a general suit with a tie; the third is a black dress with a bow tie.
I think this is respecting the profession of doctors, respecting patients, and respecting oneself. In the United States and some European countries, only four types of people usually wear formal attire. Which four kinds of people? The first is a doctor, the second is a lawyer, the third is a businessman, and the fourth is a politician. I have worked in 8 hospitals in western countries, and all the doctors are neatly dressed like me. Casual clothes are only worn on weekends. This is not my personal habit, but the habit of the mainstream medical profession in the world.
I also want to talk about hard work. I am very hardworking. I haven't taken many vacations for decades, and I often do rounds on weekends. Some doctors in the United States get up at 4 o'clock in the morning to go to the hospital. They are more diligent than me. So don't think you are hardworking, there are more hardworking people. We need to supervise ourselves.
The last point I want to talk about innocence. When you reach a certain age, you still have to stay young and innocent. How to maintain a childlike innocence? Live actively. When I was in middle school, I admired Einstein the most. Last year, I took advantage of the opportunity to cooperate with the New York Hospital and visited Albert Einstein's house in Princeton. At that time, I was very emotional, and wrote a poem, which is also a reflection of childlike innocence: the setting sun is breeze and drizzle, and the white house and yellow flowers reflect the green flat. For more than 50 years, it has been like a dream, and the years have been difficult to grind the youth.
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