An excellent complex of buildings, the most modern equipment, the availability of the best instruments and equipment do not guarantee cure at all if incompetent people use all this. Omsk Clinical Oncologic Dispensary is an institution of not only regional significance. He is an international institution. And he treats not only his regional patients. People from all regions of Russia and Kazakhstan are treated there.
As in the army, the most important teacher and educator of ordinary soldiers are sergeants, so in medicine the closest thing to a sick nurse. The doctor is an officer. It makes decisions, determines the tactics of treatment, carries out operations, controls the whole process. But the sergeant-nurse just fulfills most of the appointments of the doctor. She makes injections, distributes medicines, bandages wounds. She is everywhere. Even enemas and preparation for surgery on her shoulders. And also transportation of patients to the operating room, for treatment and examinations, for other procedures.
Some people think that this is a trifling matter. As a patient who was rolled on such a "taxi", I will say: not every man can do this. The distance from the chamber to the operating a few hundred meters. Including elevator, turns, suddenly open doors and other obstacles. Yes, and the patients themselves are often of a decent size. I, for example, have 97 kilograms of live weight. And after the operation (in a state of anesthesia), my weight could only be called alive by convention. Body weight in an unconscious, "liquid", state increases.
And girls not only carry these bodies, but also move them to the tables and beds, and then back. And so on 10 and more times in a day. Just today I saw a nurse who could not unbend after one of these trips.
The best information is the one that comes to the journalist from the original source. I naturally talked. With several women who are engaged in this hard work.
So where do nurses come from? Where is that "anthill" that supplies such tireless and calmly benevolent laborers?
Someone came to oncology, because the thesis was on this topic. Someone for the company of a friend. Absolutely not delving into the profile of the medical institution. Someone because of a slightly higher salary. And someone simply because it is convenient to get. Simply put, nurses appear exactly the same as in other enterprises and institutions. There is a profession, and there is a list of places where such a profession is required.
And then come into force the laws of natural selection. Serious and even sometimes cruel. But through these tests are all. Experiencing newbies is not only doctors. The main testers are us patients. Some people think that sores are the main test. Not. The main thing is our suspiciousness and "education." It always seems that the medicine is not right, because I read somewhere that there is better. Neighbor ward pay more attention. We teach them everything. How to put an injection, how to apply a bandage, how to give medicine. And they, professional doctors, tolerate this. Pretend to take into account our opinion.
Another serious challenge is our “scourge of state employees”. Low wages. 15-20 thousand rubles for such work. Particularly offensive is the fact that literally several hundred kilometers it costs several times more expensive.
And many at different stages go. No one blames them. Well, not her this thing. You can work with other patients, in other hospitals and clinics.
Very interesting relationship between nurses and doctors. Doctors sometimes indulgently refer to paramedical staff. Attitude of creators and performers. It is very difficult to get rid of it. But in the oncologic dispensary, I did not notice this. I can not say on 100% that it is not. But did not notice. On the contrary. Willingness to prompt, willingness to teach ... Exactly the work of an officer with a non-commissioned staff.
This is achieved, it seems to me, not by administrative efforts, not by orders and upbringing. Not even the personal desire of people. Blame, again, natural selection. Doctors also pass it. And no less than nurses. That’s why people gather here in the end in something similar. With the same outlook on life. With the same aspirations. With the same obsession. Each clearly performs its task. And together they make up a team.
That is why Olga Alexandrovna, Natalya Petrovna, Dina, Svetlana Viktorovna are constantly heard in the department ... Somebody always needs something from them. They do not have time to just sit down and relax. They are in oncology.
And at the end of this part - very little about those whom no one sees and does not know by name. About those who are not, but they are. Otherwise, the branch will simply close. They do not take part in saving the lives of the sick. Do not make injections. Do not do operations. You know, like engine oil. When it is and works, it is not remembered. But when it is not ...
Nurse and cook. This they clean, wash, disinfect. They create the gloss that often influences a person’s choice of hospital. The selection factor if you want. Same as having good medical staff.
Likewise, good food is important. With the meager funding that now exists. And we have every meal ends with numerous "thank you."
The hardest thing to write about doctors. Not because the medical caste is more closed. Or doctors are not inclined to communicate. I wrote above that the doctors - the officers. Both literally and figuratively. The doctor does the main work. He is responsible for the result. Not only the further life of the patient, but also his fate depends on him.
Global conclusions will not do. I can not simply because I spoke with a limited number of doctors.
The first doctor who met me at the dispensary was a thoracic surgeon. Do you understand the hope of a person who first came to such an institution? The most cherished desire is to hear laughter or swearing towards colleagues from other hospitals. Something like - yes, what are they, really forgot how to look at the pictures? There was no oncology here and there! However ... Maybe it happens like this, but only in dreams.
The procedure for the inspection of documents, pictures, analyzes did not take much time. The horror in the eyes of the doctor, I also did not notice. He busily examined me in the section on a computer picture. Not sure of the correctness of the diagnosis. We must look at us. Next, for a bronchoscopy, then we'll talk.
I will not describe the details of this very bronchoscopy. The procedure is just for not very advanced sadomasochists. The same probe as when checking the esophagus. Just check the lungs. And injected through the nose. To be honest, I was impressed. To tears. Literally.
There also worked a doctor. Same businesslike. The same collected. The same terse. And next to a nurse. A sort of young mother. And you know, the calm doctor reassures the patient. After a few minutes, the procedure itself is perceived more as a ridiculous incident. And the diagnosis ... Not oncology, but some kind of bronchitis similar to oncology. With a bunch of other titles. Straight back itched. Wings like steel began to cut through.
However, the wings "cut" the surgeon. Straight Stanislavsky - I do not believe! And I believe! But his opinion is more important. And on 100% there is no certainty. Need a consultation. Not doctors, and Snakes Gorynychi. One head is good, but four is better.
Honestly, struck somewhere inside. Therefore he agreed to come the next day.
Why did I talk in detail about the work of doctors at the reception? Because this is the first reception. The time when the "blow to the nerves and the heart" for any patient. And the main feature of the doctors at the reception - calm confidence. Confidence of a person who knows what and how to treat. Such confidence gives strength to patients for further struggle. As the appearance of Kutuzov in the First World War or Zhukov in the second repeatedly raised the morale of the soldiers, so it is here. Only this "Kutuzov" harder. We see them for the first time.
Consilium. Four surgeons. Snapshots, analyzes. Minimum questions to me. Need to cut. There is no complete confidence without operation. Chance to use.
Every surgeon has his own graveyard. I do not remember who discovered this truth. But that is true, I agree. And oncologists have the biggest graveyards. They are at war every day. The specifics of the disease, most often the neglected form of the disease, the need for intervention, even with one chance in a thousand, contribute to the rapid growth of such graveyards.
But next to this gloomy cemetery there is always a village, a village, and even a town of those whom the surgeon helped to survive. And the dream of any of these doctors to turn such a village into a city. Big-very big.
For a long time I could not understand why the work of thoracic surgeons was to my liking. What distinguishes them from the rest? The same patients. The same equipment. The same operating. The same medicines. Why do some surgeons stay, others leave?
The main difference between an oncologist surgeon, in my opinion, is the need to make a decision often already during the operation. Delete what was not noticed before and leave what was planned, but not affected by the disease. It is this doctor who assumes full responsibility for all others. By his decision, recognizing or denying the diagnoses of others.
So, the result. The main difference between local doctors is self-confidence, calm, benevolent perseverance and teamwork. A sort of competition cooperation.
The article was written almost a week. During this time I went through all stages of treatment. From examination and surgery to the period of postoperative rehabilitation. And I am writing the last lines on the most hated day for cancer patients. On Sunday.
Weekend as if take off the mask, even with the most reckless fun-loving, the biggest optimists. In the department is oppressive atmosphere. Even meetings with relatives are not encouraging. Eyes grow dim. Time stops.
Tomorrow is a big round. Tomorrow may decide the fate of some of us. Tomorrow someone will again be taken to the operating room, and someone to intensive care. Someone will go "dolekivatsya" home.
Everything will be tomorrow. And I am also waiting for this tomorrow ...