Introduction
One spring afternoon, we arrived at Gulou Hospital Affiliated to Nanjing University as scheduled to interview Dr. Pan Jun, deputy chief physician of cardiothoracic surgery and master's supervisor of the hospital.
No one has been seen. I have seen its name - in the cardiothoracic surgery ward on the seventh floor of the main building of the hospital, the handrail on one side of the aisle is covered with brocade banners. Because there are so many layers of brocade banners, Pan Jun is the most frequent name on the brocade banners. There is one side of the banner. The words are very eye-catching. It says "how can a doctor beat Hua Tuo and wield his sword to kill the disease?". A colleague said with a smile, "this banner makes Dr. pan look like a knight in a martial arts film." Everyone laughed. The surgeon doesn't seem to fit in with the chivalrous man?
When we met Pan Jun, we firmly believed that he was more like a refined scholar than a Xiake. But when he talked about his practice and the thrilling operation, we changed our mind: isn't a surgeon a knight?
Swordsman's sword is to save the lives of the people, while surgeon's knife is also to save the lives of the people and relieve the sufferings of the patients.
In those difficult and dangerous surgical operations, if doctors do not have the chivalrous spirit to go forward and dare to bear, how can they concentrate their efforts and cut through thorns and thorns to cut the disease off the horse?
Pan Jun is such a "great Xia".
　　
"We fight like war every day"
During the operation
When we first met Pan Jun, we found his face was tired and his speech was a little laborious.
"You came by chance. The day before yesterday and last night, we had two all night operations, from 8:00 p.m. to 4:00 a.m. the next day. Today, we can't eat any more, so we can only have a rest in the daytime. Or I won't have time to receive you. " Pan Jun said with a smile.
What he called "rest" is just that he can't get on the operating table. From time to time, there is a knock at the door of the office. Doctors, nurses, patients, etc. are one after another, asking for advice, consultation or consultation. The phone is also one by one.
It's no wonder Pan Jun described his work like this: fighting like a war every day.
Pan Jun usually goes to work at 7 o'clock every day, and at the earliest at 7 or 8 o'clock in the evening. In case of emergency surgery, it is common to continue to work after only one or two hours of rest for an overnight operation. Just two days before we interviewed Pan Jun, he had two cases of "aortic dissection" emergency surgery for two days in a row.
"At present, the death rate of cardiovascular disease accounts for more than 40% of the total death rate of residents, and it is the first killer that endangers health. Stroke, aortic dissection and other diseases are particularly dangerous. If they are not rescued in time, a life may be lost. " Pan Jun said. For this reason, they have to fight every minute to save the patients.
A 54 year old patient in Taixing, Northern Jiangsu Province, went to the local hospital for chest pain in the afternoon of April 8. He was found to be "aortic dissection" and was rushed to Gulou Hospital by ambulance.
It was more than 6 p.m. when the patient was admitted. During the day, Pan Jun had performed two operations, but in an emergency, he said nothing and rushed the patient to the operating room for rescue.
Pan Jun gave us a general description of the patient. The human aorta is composed of three layers: intima, media and adventitia. The intima and media of this patient's aorta have been torn, and the blood rushes between the media and the adventitia, propping up the media and the adventitia like a balloon. What's more, the patient's aorta has ruptured all the way - from the heart to the thigh.
The aorta is divided into ascending aorta, aortic arch and descending aorta. This operation requires aortic arch replacement, ascending aorta replacement and descending aorta replacement.
Time is pressing. The rescue team is busy. Operation preparation, anesthesia At about 8 p.m., Pan Jun stood at the operating table.
The operation is very complicated, and deep hypothermia circulatory arrest is needed. The heart is the "engine" of the human body, which is full of flowing blood. In order to operate in the heart and repair the defects of the heart, the first thing is to let the heart empty the blood and stop beating. At normal temperature, if there is no blood supply, the brain and other tissues of the body will be irreversibly damaged. Therefore, Pan Jun's team used deep hypothermia circulatory arrest technology to reduce the patient's temperature to below 22 ℃, so as to protect the patient's brain tissue and other important organs. Of course, deep hypothermia circulatory arrest technology also has risks, such as long time of hypothermia can also cause organ damage. Therefore, the shorter the time to adopt the deep low temperature shutdown technology, the better. Half an hour is the limit. Pan and his colleagues succeeded. They completed key operations such as aortic arch replacement within half an hour, while the whole operation lasted for seven hours.
The difficulty of such an operation is hard for ordinary people to understand. But there's a detail, maybe a glimpse. In this operation, Pan Jun and his two assistants sewed more than 800 stitches on the patient's aorta. Each of the more than 800 stitches needs to be very fine and fast, but each one cannot be loosened or tightened. If it is loose, it will fail to stop bleeding; if it is tight, the blood vessel will be pulled by the needle and thread. Every stitch can't go wrong.
"Everyone's blood vessels and hands are different. Some patients have pathological changes in their blood vessels, or when they are old, the stitches feel like embroidery on tofu. " "So every one of our cardiac surgeons is a craftsman," Pan said
Craftsman? Maybe. However, there is a group of data that shows his high "Craftsmanship"——
Known as the "pearl on the crown" of surgery, cardiovascular surgery has always been very challenging, with great difficulty and risk. Among them, even in Europe and America, the average operative mortality of acute type a "aortic dissection" operation is about 27%, while in Gulou Hospital, the operative mortality has dropped to 6%, which is the best level in China. In the past five years, Pan Jun has performed an average of 400 operations every year, with a success rate of almost 100%. In 2019, for example, he operated on more than 60 cases of "aortic dissection", with a mortality rate of 0.
"Aim for the best and the highest goal"
Visit and study in the UK
A good heart surgeon, generally after 30 years of hard work to "come out". Pan Jun, 41, has been a "full teacher" since he was 36 years old. He can complete all kinds of difficult cardiac surgery on his own, which is very rare in the industry.
But no one can succeed at will, and the pay and the gain are always matched.
Pan Jun, who was born in Fuju natural village, Xushe Town, our city in 1979, has been among the top students since childhood and has become the "child of others" in many parents' mouths. He hoped that he could earn a good future with his intelligence and hard work, but he was at a loss about what kind of future he had.
In 1998, when Pan Jun applied for college entrance examination, one of his uncles suggested that he study medicine. His uncle said that doctors can cure patients and save people, and work steadily. Therefore, he was admitted to Hunan Medical University (now Xiangya Medical College of Central South University) to study clinical medicine.
There is a saying of "South Xiangya, North Xiehe" in Chinese medical circle. It can be imagined how a good medical environment is in Xiangya. It was here that he met many teachers and doctors who "respected life, helped the wounded, was willing to contribute, and loved the boundless". He also saw many kinds of patients. Pan Jun finally found the goal of life - to save people from suffering.
In the eyes of ordinary people, Pan Jun is gentle, introverted, and sometimes even a little shy, but this is only his appearance, but his heart is strong and competitive. "Whether it's reading or choosing a career direction, we should aim at the best and the highest goal, and make unremitting efforts for it," he said During his study in Xiangya Medical College, Pan Jun was arranged to practice in Xiangya No.2 Affiliated Hospital of Xiangya Medical College, whose cardiothoracic surgery is first-class in the country and has a high reputation. For this reason, Pan Jun regards cardiothoracic surgery as his major.
Surgery is a subject of equal importance to practice and theory. Technology, psychological quality and so on are the key factors to decide whether a doctor can go to the operating table or be the main knife.
Pan Jun said that he must thank the university teachers for this, who repeatedly told him and his classmates to practice more in the clinical apprenticeship stage. Therefore, no matter during his undergraduate study, or during his postgraduate study in Nanjing University School of medicine, or during his doctoral study in Shanghai Jiaotong University School of medicine, Pan Jun took every opportunity to study the theoretical knowledge of cardiothoracic surgery with his mentor and predecessors. In 2009, when he entered the cardiothoracic surgery department of Gulou Hospital Affiliated to Nanjing University, he competed for major and minor operations. As long as he had the opportunity to practice, Pan Jun could stay in the hospital for 24 hours. Pan Jun has kept this habit till now. Nowadays, Pan Jun often goes to see his colleagues' surgeries and even study in other departments. He believes that there is always something in common between disciplines, and he can always learn new things.
In 2013 and 2016, Pan Jun went to the University of Pennsylvania Affiliated Hospital for cardiovascular surgery and Hammersmith Hospital Affiliated to Imperial College of technology for further study. After continuous learning and numerous operations, Pan Jun has more and more rich clinical experience, more and more skilled techniques, and gradually stands out in the same industry, becoming the leader in the field of cardiac surgery.
"It's worth every effort a doctor makes"
Follow up for patients
The most important thing on the operating table, of course, is the kindness of the doctor.
Pan Jun said that in his medical career, what he learned most was to keep humility and awe of life. In this regard, he particularly thanked Professor Wang Dongjin, his mentor. In Pan Jun's mind, Professor Wang is a person who will never give up lightly. On several occasions, they rescued a patient for three or four hours. Professor Wang was also very tired and panting. His clothes were wet. Almost everyone felt that the patient was hopeless. But at this time, Professor Wang always said in his usual slow and orderly tone, "let's try again." Pan Jun keeps this scene in mind and sets up such a concept in the bottom of his heart: for the sake of patients, it's worth the efforts of doctors.
Once, an in-patient was suddenly in critical condition. In order to compete with the disease for time, there was no time to send the patient to the operating room. Pan Jun operated on the patient in the ward. But there is a big gap between the ward environment and the operating room. For example, the height of the hospital bed is much shorter than the operating table. During the operation, the doctor's waist is almost 90 degrees. After more than four hours of rescue, Pan Jun pulled the patient back from the edge of death, but he could not stand up.
In May last year, a 28 year old teacher in Taizhou, who was 28 weeks pregnant, had a high fever of about 40 ℃ for a period of time, went to the local hospital for treatment, but did not find the root cause of the disease, and the disease recurred, and finally found the Gulou Hospital.
The female teacher was diagnosed with infective endocarditis. Heart valve infection, unlike skin infection, and her mitral valve has a diameter of 8