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my name is liu chuang. i studied international trade in college. after graduation, it was difficult to find a job, so i borrowed money from my relatives and started a company with my classmates.

after two years, the harsh reality taught us a lesson. in the end, the classmate who cooperated with me inherited the family business, while my parents were tightening their belts to help me pay off the debt.

as a human being, you still need to have some dignity. i desperately needed a job that could save money. so, i went to work as a male nurse in a tertiary hospital in beijing, with food and accommodation provided.

there is no threshold for this job. i am strong and can adapt quickly. however, the various stories i experienced were also eye-opening.

rich people outside icu: money is not a problem

everyone knows that the icu is like a money-eating machine. at that time, a patient i was caring for had just been transferred out of the icu. i was sitting on a waiting chair at the door of the icu, sorting out my belongings, and before i was ready to leave, there was a commotion.

a medical bed with an led dynamic display screen was pushed by three or four people from the emergency passage to the icu. four narrow infusion pumps were fixed on the metal pole at the head of the bed. some people were pushing a ventilator and some were pushing a monitor.

this is not uncommon in the icu, but what is uncommon is that there are more than a dozen people following behind, turning the originally spacious corridor into a dark place.

the man pulling the bed was a young man wearing trendy brand clothes, probably a family member. he rushed up and punched the icu door. the one pushing the ventilator was an emergency doctor from our hospital. he raised his head in panic and said, "don't smash it! there's a doorbell, there's a doorbell next to it!"

the doctor inside opened the door angrily, but was also a little confused when he saw the situation. he was stunned for a moment, then he straightened his face and said to the emergency doctor, "how come the person arrived just after the call came in?"

the emergency doctor pulled the icu doctor's sleeve and walked in: "go in and talk, go in and talk..."

the treatment bed, ventilator, monitor, ambulance doctor, nurse, and two people pushing the bed entered the door one after another, and the people behind were stopped outside the door by the nurse. this wave of people squeezed forward, as if eggs were being delivered in front, and the air was squeezed thin.

at this moment, my vision went dark, and when i looked up, my nose almost touched a big belly. it turned out that a pregnant woman had squeezed in front of me.

i quickly stood up and offered her my seat, but she still pushed forward.

the nurse said, "are you all family members? then please spread out a little bit. you are blocking the door. when the x-ray workers come, they won't be able to enter the passage."

she glanced at the pregnant woman and was a little surprised: "she's about to give birth, what are you doing here? the family members should take the pregnant woman out first, leaving two people in charge, and everyone else can go away."

however, no one listened to her. the pregnant woman continued to push forward: "i am carrying my eldest grandson in my belly. he is the first person grandpa wants to see when he wakes up!"

a middle-aged woman next to him snorted and muttered quietly: "he hasn't even got the certificate, and he's still the eldest grandson..."

the pregnant woman replied with full energy: "second aunt, you brought a lot of things home on the day of the wedding! the doctor asked my husband to push his father to the icu, why didn't he let you in?"

the nurse looked at the group of people making a fuss and was obviously angry: "i'll say it one last time, only two or three family members are allowed in the waiting area. in addition, the icu only has one hour of visiting time per day, so you have to hire a nurse."

she saw me from the gap between the crowd and pointed at me: "he is good, he has experience."

just like that, before i could squeeze out, i was hired by this family. i turned around and walked into the icu door, watching a scene of "rich people spending money to buy life".

this family came from a famous and wealthy coastal town. at that time, there was no emergency helipad, so they found a super luxurious ambulance and took the people directly from their hometown to beijing. the rest of the people drove luxury cars and followed the ambulance all the way. it must have been quite spectacular to think about.

the patient was the head of a family with two sons and two daughters, and the eldest son had a daughter. after confirming that his youngest son's girlfriend was pregnant with a boy, the old man held a banquet with great fanfare, but he fell into a coma before his grandson was born.

the two sons and a son-in-law were the ones pushing the bed in, so the doctor didn't call anyone else in, and just talked to the three of them at the nurses' station about the situation. basically, the patient had been in a deep coma for a long time, and the functions of all organs were very poor. it might be a matter of minutes, and the family members were expected to be mentally prepared.

the younger son was quite emotional: "isn't your icu the best? no matter what, my dad has to see his grandson being born!"

the eldest son was very impatient and took out a cigarette from his jacket pocket. when the doctor stopped him, he tapped the table at the nurses' station with his fingers. "money is not a problem. we will use whatever means we can. we can borrow the equipment we don't have. even if we have to buy it, we can accept it."

under the "no shortage of money" treatment plan and the strong request of the family members, the expensive treatment of emco plus bedside hemofiltration was started.

bedside hemofiltration is a blood filtration process that drains the blood, purifies it, and then transfuses it back; ecmo is extracorporeal respiratory and circulatory support, which costs 60,000 to 70,000 yuan to start up, and the treatment cost is less than 10,000 yuan per day thereafter.

from the conversation among this family, it can be seen that they tried their best to delay the old man's life, not out of family affection, but because of "their own ulterior motives" - the old man promised before his death that as long as he saw the youngest son give birth to the eldest grandson, he would get more inheritance. naturally, the other children did not agree, and they all wanted to gain more family property for themselves while the old man was still alive.

unfortunately, the expensive equipment was only used for one day before the patient could no longer endure.

after accepting this reality, they refused to accept another one - if the patient died, according to beijing's epidemic prevention regulations at the time, the body could not leave beijing and had to be cremated locally.

the family members unanimously requested that the patient be allowed to go home alive, but the doctor could not guarantee that, and could only tell them: "if the patient leaves these treatments, his life will most likely be counted on minutes."

but no one cares about it.

finally, the immediate family members all signed a waiver of discharge, and a top-of-the-line ambulance was called to take the patient away. because they left in such a hurry, the treatment bed knocked a large dent in the icu door and cracked the glass.

after they left, the nurse whispered, "this patient can't leave beijing, right?"

the doctor shook his head: "it would be good if you can survive 5 kilometers."

look, no matter how rich and powerful a person is, he has no privileges when it comes to life.

retired dean: raising children does not prevent old age

there are always patients who give up treatment in the hospital, but most of them are unconscious after falling into a coma, and the only way to do this is to get the signature of all their family members to agree.

the patient i want to talk about is the retired director of this hospital. it is said that he participated in the establishment of the hospital and has been working as a doctor here ever since.

even though the old director is in his eighties and has retired for many years, he is still visited one by one by the hospital leaders every time he is hospitalized, and the new medical staff are always educated about the old director's outstanding achievements.

the old director suffers from cor pulmonale, the most common disease among the elderly. he rarely stays in the hospital. if he has a minor problem, the hospital will send doctors and nurses to his home for diagnosis and infusion. the old director lives in the family building in the hospital, with only him and the nanny. his children are doing scientific research abroad, and his grandchildren are also studying abroad.

when i was taking care of him, i seldom heard his children calling me. when visitors mentioned his two very successful children with envy, the old dean’s attitude was not very good: “it would be fine if they just went abroad, but they sent such young children abroad to study. is there no room for them in the country? we were so excited when we came back from abroad to help build the hospital…”

due to the special status of the old director, when he is hospitalized, the hospital will generally vacate a single room in the respiratory department and arrange for a caregiver and a special nurse to provide one-on-one service.

i was young and looked smart, so the head nurse specifically asked me to take care of the old director. his nanny prepared meals and brought them to me every day, so that i could eat with the old director.

the old director was a very kind person. he always asked the nanny to take out high-quality fruits and share them with the medical staff and other patients who passed by to look in. he was mostly reading books, large professional books, magazines and newspapers. sometimes when he was exhausted, he asked me to read to him.

there was an influenza outbreak that year, and many elderly people died that winter.

the old director was hospitalized several times from the fall to the following spring. he probably felt that his condition had become much worse, and he always told me the same thing, as well as the directors and deans who made rounds during the ward rounds.

he said: "i have been a doctor all my life, even though i am a surgeon, but i know very well what the consequences of cor pulmonale are. if one day i get sick, i won't be rescued, i won't be intubated, i won't be given invasive treatments like tracheotomy, and i won't even have a ventilator blowing my lungs. i don't want to lie there like a living dead and turn myself into a dried corpse."

the old dean once got tired of reading a book, and he closed his eyes and said, "i have seen a lot of death processes, and i know what it is like. i am not afraid at all, but i still don't understand what it is like after death. i don't believe in ghosts and gods, nor do i believe in religion, but i believe that there is a space after death. i really hope to go there with dignity."

after that, he opened his eyes and looked at me. i could actually see a hint of mischief in his eyes, as if he was teasing me, or as if he was asking me: "i'll have to trouble you to help me dress nicely. an ordinary suit will do. don't dress me up like an old landlord."

i couldn't help but laugh out loud, but when i lowered my head, my throat felt a little tight.

it seems that in one’s life, one has no control over birth, and most of the time one also has no control over death.

the old dean was later admitted to the icu and took me with him.

one night, the "moment" that the old dean had been waiting for came. his heart stopped beating. i was waiting outside the glass door of the icu ward. the doctors took turns kneeling on the bed to perform external cardiac compressions. the nurses injected rescue drugs and pushed in a ventilator...

the incumbent dean came and issued a death order, "you can only live, not die, no matter what." the dean said that he had contacted the former dean's children overseas, who said they could only return to china in a week, and that they must see their father for the last time.

that was the longest rescue operation i have ever seen. it lasted the entire night, and when the shift was changed the next morning, several people had to be assigned to prepare for any possible rescue operation.

the heart started beating again, then stopped, and external cardiac massage and electric shocks were repeated in cycles.

the old director finally inserted a tracheal tube, connected the patient to a ventilator, and inserted a nasogastric tube and a urinary catheter. he also punctured the femoral vein at the base of the thigh for infusion.

at the morning meeting, the director told the doctors and nurses that whoever's shift the old dean was in would not receive this month's bonus, and they had to hold the old dean back.

no one dared to mention that the old dean himself had emphasized many times that no resuscitation or invasive treatment was needed in the hope of maintaining dignity.

it turns out that such a prominent and special patient cannot decide his own life or death.

in order to keep the old director as clean and respectable as possible, the nanny and i would turn him over every two hours to prevent bedsores. while turning him over, we would also wipe his body.

when people reach the terminal stage, their anal sphincters are relaxed and they can defecate at any time, making a new bed every time. in better cases, they need to change the urine pad. in serious cases, three or five medical staff will need to help change the sheets, quilt covers, and wipe the whole body.

the dignity and respect that the old dean hoped for were actually gone, but he didn't know it either.

the doctor said that he was actually brain dead and his physiological circulation was only maintained by a ventilator.

i know there is no extra red envelope for taking care of the old dean, but i still do my best.

finally, the old dean's children returned to china. they were a pair of gentle brothers and sisters, both wearing gold-rimmed glasses. the son was older, and the daughter looked tough.

when she entered the icu, she did not follow her brother into the ward. instead, she looked around first. her sharp eyes made everyone a little hesitant to look at her.

when they arrived at the bedside, the daughter just took a towel and symbolically wiped the old dean's face, and the son said a few words to his father, "the grandchildren are all doing well, they are too busy with their studies to come back." the farewell scene was similar to that of an ordinary family, and maybe even not as neat as others.

a few minutes later, they signed a consent form to give up treatment.

as soon as they turned around, they regained their elite appearance and asked the accompanying hospital leaders about financial issues such as the ownership of the dormitory and the funeral expenses of the old dean in the icu as if they were discussing business.

after such a long delay, the old dean can finally leave. looking at his two children, i feel that they have everything, but i always feel that something is missing...

crazy bridegroom: a fever that changed destiny

the word "arrest" is usually used for prisoners, but in hospitals, patients occasionally need to be arrested.

the patient came in with a high fever and was suspected of having pneumonia. he was a very young guy who had just been married two months. he was tall and handsome, and his new wife was also very beautiful.

because of persistent high fever and exhaustion, he was pushed in on a stretcher. the person pushing the stretcher was his eldest brother-in-law. his newly-married wife, who was smaller in stature, followed closely beside him, and from time to time she reached out to wipe the sweat off his face with a tissue.

the young man's sister also rushed over and was called away by the doctor for questioning. his elder brother-in-law ran around to buy things, leaving the young couple alone in the ward.

when his young wife was about to get some water from his thermos, he quickly stopped her and told her not to work any harder. he moved to the side of the bed with difficulty, wanting her to lie down beside him and take a nap, but his wife blushed and refused, after all, everyone in the ward was looking at the couple.

after a day of intravenous drip, the young man's fever subsided and he started to walk around the ward. as he was walking, something seemed wrong. he walked faster and faster, his eyes became more and more focused, and suddenly he rushed into a women's ward next door.

there happened to be a female doctor who was seeing patients. the doctor asked him why he came here. he pushed the doctor away, pointed at a young female patient in the ward and said something inexplicable, such as "i have known you for a long time" and "you are a monster"...

several patients and their families gathered at the door of the ward. the young man pushed and shoved, and the scene began to get chaotic. the nurse called the security department and organized several nurses and male doctors, including me, to chase him.

an experienced old doctor called the young man's relatives and asked about his medical history again.

we followed him down the stairs, but he was much more agile than an ordinary person. he immediately ran into the orthopedic nurses' station and held the nurse hostage with a bench.

when he was about to enter the elevator with the nurse by the neck, the orthopedic surgeon quickly stepped forward, grabbed his arm, and dislocated his arm. his arm was dislocated and he was in pain and powerless, so he let go of the nurse and ran away.

finally, the security department intercepted him on the first floor, and the emergency doctor gave him an injection of tranquilizer.

how could a healthy patient go crazy after receiving intravenous drip for a day? the answer is - concealing the medical history.

the young man had only one direct relative besides his new wife, his sister. his sister was much older than him and raised his younger brother alone. she concealed the family history of mental illness on his mother's side, which even the young man himself did not know, because he did not remember when his mother died. his sister took him away from home and the maternal relatives also stopped communicating with him.

this high fever became the trigger, causing the first attack of mental illness, and he had to be transferred to anding hospital for subsequent treatment.

everyone around was sighing, thinking it was a pity to lose such a handsome guy.

the old doctor sighed. the young man’s newlywed wife was really pitiful. a high fever changed the fate of both of them.

the 60-year-old "novel hero": from shrimp to eggplant

most of the time, i am employed by patients in the respiratory department, because there are many elderly patients who are repeatedly hospitalized there. some even have to stay three or four times a year. they have become regular customers, and it is hard to bear to stay by the bedside for a long time, so this department has one of the most nurses stationed there.

rhett butler is such a person. he has the same name as the protagonist in the novel "gone with the wind", so he is easily remembered.

when i first met him, i was employed by his roommate. rhett butler was less than 60 years old at the time, very energetic, with a loud voice unique to northerners, and did not hire a private nurse. he often helped his fellow patients. in addition to delivering three meals a day, his wife only stayed with him all day when he was undergoing alveolar lavage.

all the staff liked this enthusiastic and cheerful patient, especially the young medical staff. he always took the initiative to ask the trainee nurses to examine him and give him injections. "i'm not afraid of pain, use me as a training tool" was his common saying.

mr. white's disease is pulmonary alveolar proteinosis. the doctor said that this disease is irreversible and will only get worse. the technology at that time could only delay the progression of the disease. he needed to do alveolar lavage regularly - a very painful treatment.

he went from being hospitalized two or three times a year to once every two months. his wife and children took turns taking care of him, and now he has to hire a nurse. he used to walk around the ward with his back straight, but gradually became a "big shrimp" who stays in bed almost all day and gasps for breath at the slightest movement.

his temper gradually became more and more irritable. the more he couldn't breathe, the angrier he became. he gasped and scolded everyone as if he was about to spit fire.

the family members all said that it was due to illness. later, some caregivers refused to take care of him. his wife came to me and said that i had seen his past and knew that lao bai was not a bad person. she begged me to take care of him. i agreed. from then on, whenever he was hospitalized, i would take care of him as long as i was free.

due to financial pressure, i dare not be picky about work, and i try to be considerate and patient. sometimes i receive bonus red envelopes from family members. lao bai's family gives more than others, so i have to endure more anger.

when other patients were at the end of their infusion and their family members were not around, i would just help them ring the bell. but lao bai was different. he would throw whatever he had at hand at me. when things went well, it was toilet paper. when things went bad, it was cups and fruits. he would even deliberately say loudly, "i paid you to do this. why do you want to work part-time? then don't eat my food anymore..."

later, he had more and more difficulty holding his breath, and kept asking me to call the doctor to prescribe medicine for him. i knew he was in pain, but the doctors and nurses couldn't do anything, so they just asked me to tell him to calm down.

the result of such a reply was that i was cursed and accused of being inhumane and taking pleasure in seeing him suffer. i could only continue to rub his back to help him breathe and prevent him from gasping for breath again.

when lao bai started to breathe heavily, his face turned purple and red, and he was trying hard with his whole body to make the breath flow smoothly. at first he just grabbed the bed railing, but later he grabbed my wrist out of habit.

when my arm became as purple and red as his face, he probably felt better because he thought someone was like him. later, i got smart and held his palm with my palm, so that i could use my strength to fight back, otherwise i would really be disabled.

when sleeping, lao bai's bed could not be laid flat, and he had to sleep sitting up all night. there were a few times when i couldn't sleep, and i saw him wake up in the night, under the moonlight, with his eyes half open, his emotions were rare and stable, but his face was full of pain.

maybe he felt that his end was near, but lao bai called his wife to chat: "my children are all good children, but i am not a good father. i have caused them trouble. i have to go to the hospital every few days..." as he spoke, he became excited again: "i might as well die early!"

i hurried to calm him down and snatched the phone to comfort the old lady.

mr. bai was upset and asked me to find the doctors and nurses to apologize to them. i said the doctors were resting. then the nurse came to check on the ward. she was an old nurse and she said, "don't let your imagination run wild. we all know that you are a long-term patient and an excellent patient. you are the most considerate and cooperative with us. go to bed early. your wife will come tomorrow and will be worried if she sees that you are not in good spirits."

later, every time lao bai had a bronchial alveolar lavage, he was tortured. in his last days, his face turned as purple as an eggplant.

on an ordinary afternoon, lao bai passed away.

some days later, when i was taking care of others, i heard the doctor say that lao bai's alveoli had almost no tension in the later stage, like a piece of inelastic glass candy wrapper - he was suffocated to death.

the reason why he suffered to the end was that he was sober from beginning to end.

patients like lao bai are the most common in hospitals. they are not rich or famous, nor have they achieved great success. they fight against illness and finally leave this world.

someone would bring it up occasionally, but after a while, no one would remember it.