Military Review

For those who see the horizon. Part of 2

11
In the first part of the article I wrote about the patients of the oncologic dispensary. The fact that we care about. How we look at the world and about what happened to us. And now it's time to talk about those who help us fight the disease. About those who, day and night trying to help their knowledge, skills, medicines, hands.


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.

Nurses

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."

Doctors

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 ...
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  1. EFA
    EFA 30 October 2015 05: 51 New
    +6
    I am glad that I was lucky with the doctors, even somewhat unexpectedly. I hope they will bring their work to victory over the disease.

    Unfortunately, it also happens that doctors brazenly earn money for illness. So it was with my sister who was lying in the tube dispensary, and who had surgery. In the suburbs of the epidemic of tuberculosis if anyone does not know.

    Медицина вроде (пока) бесплатная, но за операцию в качестве благодарности 40 000 вынь и положь. При наводящих вопросах о том что будет если не заплатить следует снисходительная улыбка и многозначительное: "А как вы думаете".

    Moreover, with all that the hospital is quite famous in Moscow.

    But still, be that as it may - we will live!
    1. EvgNik
      EvgNik 30 October 2015 08: 55 New
      +2
      Quote: EFA
      Unfortunately, it also happens that doctors brazenly earn on illness

      Unfortunately it happens. Last year I was at a surgeon's appointment in Berezniki. They were so naughty that they received the first call from a stroke (with a stroke I got to the hospital after 4 months). I don’t remember how I got to the bus station, only there I came to my senses a little.
  2. EvgNik
    EvgNik 30 October 2015 06: 14 New
    +4
    A very familiar picture .. In his youth he was in the hospital for 9 months with complex leg fractures. 4 months - on the hood, and operations, operations. I still remember the doctors and sisters, the doctors parted, some for promotion, some already. With sisters still in good relations, some still work, albeit retired for a long time.
    1. smershxnumx
      smershxnumx 30 October 2015 07: 25 New
      +4
      Повторюсь (в 1-ой части я уже писал в это в комментариях)... Хирург получает деньги за проведенную операцию и отдавать "свои" деньги химиотерапевту или радиологу не хочет. А так как на первичном приеме "сидят" ТОЛЬКО хирурги, то все пациенты - прямиком "под нож"! Мотивация дается хирургом жесткая: "Или завтра операция или я не буду оперировать, потому что уже всё будет бесполезно (меня вот так "развели" на абсолютно ненужную и весьма опасную операцию, но это выяснилось в другой клинике и в другой стране). А там пусть уже и "химики" и "радисты" свои "копейки отбивают". Но и у них "разводов" тоже хватает hi
    2. The comment was deleted.
  3. Reptiloid
    Reptiloid 30 October 2015 06: 50 New
    +2
    For some reason, there is always a mess in polyclinics, at all levels, one is not there, then the other. About hospital doctors, sisters, nannies --- only good. Also different characters, different fates. Everything always follows the rules in hospitals. The fact that doctors and sisters are military-liable is felt in hospitals. And I often met staff in hospitals, who went through modern wars.
    Unfortunately, a white coat does not guarantee health for doctors and sisters. I saw this.
  4. RU-Officer
    RU-Officer 30 October 2015 07: 06 New
    +8
    "Завтра" - будет. Обязательно - будет. Знаю по себе: как только остановился, позволил отчаянию взять верх - всё, кранты, можно дальше не трепыхаться. Только вперёд. Обязательно помнить то, что было "вчера" и всеми своими чувствами ощущать "сейчас". Только так можно ощутить всю полноту бытия (как бы ни высокопарно это звучало). Искренне всем желаю - никогда не терять бодрости духа.
  5. Tatar 174
    Tatar 174 30 October 2015 07: 31 New
    +5
    In the country's medical institutions there is a huge shortage of doctors, not to mention the average and junior staff. Lack of specialists means an increase in the number of patients whose diseases were not detected in the early stages and therefore no measures were taken for early treatment or for their prevention. This is a huge disaster. It is necessary to increase the number of doctors, to encourage this profession in every possible way, which, unfortunately, can either be done or not seen, for something else is clearly visible, reduction in beds, low salaries and not only for a novice doctor, meager supplies of hospitals and clinics .. Based on the foregoing, I state the dream of the average Russian: Ehhh, to live to retire without serious illness and then at least 20 years to live ...
  6. Indifferent
    Indifferent 30 October 2015 08: 28 New
    +2
    Patience, will and health! I am sure everything will be fine, although not immediately.
  7. Rus2012
    Rus2012 30 October 2015 11: 02 New
    +5
    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.


    ...it happens.
    Только не нужно когда предоставлен сам-себе заниматься - "самокопанием" по сотому, тысячному разу и кругу! Круг этот бесконечен и замкнут на себя...

    It flooded over. From the experience ...
    In this position, he tried to entertain himself by reading prayers. Various...
    не только церковные, "Отче наш", но и другие...светские.
    Мне по жизни попалась, точнее встретилась давняя подруга. С которой до того не виделись - лет 15-ть. Она к этому времени увлеклась вещами типа "Кармической психологии"... На мне стала использовать набранные навыки. Мне помогало...
    For example, she wrote me a whole set of modern Orthodox and secular prayers.
    Типа - "Все будет хорошо!", есть такая песня Верки-Сердючки, можно даже его петь со смыслом, вникая в каждое слово...Ведь для нас главное-чтобы тягость и депрессии покинули душу и тело! Читал молитвы со словами - "Всё что плохое уже произошло, дальше будет - только хорошое"...И представлял себе что по прошествии Н-дней своими ногами выхожу с этого заведения...
    And so dozens and hundreds of times I read, imagined in reality these prayers ...
    Somewhere after a couple of hundred times, a MIRACLE happens, you start to BELIEVE THIS and you can inspire and adjust yourself that the pain goes away, the pressure normalizes ... and painful thoughts disappear ...

    It is also especially useful if you are lying next to a window and you can observe what is happening outside the window: whether snow is flying, leaves are falling or the sun is shining or clouds are floating ...
    It is important to try to observe each leaflet - each one spins and falls in its own way, as a person passes, lives his life ... It is especially piercing when you hear the birds singing ... Especially in the fall ...
    В такое тягостное время бывает полезно вспомнить диалог Абдуллы и Сухова с "Белого Солнца пустыни".
    На вопрос Абдулы - "Тебя как, убить - сразу или помучить?" Сухов отвечает - "А нам помучится..."
    So it was - when I found out the diagnosis, it happens - when the ill-wishers are pressing ...

    The Lord and Time will put everything in its place ...
    We’ll all be there when the time comes ... Let it come itself, do not rush ...
    My best friend, a colonel in the ward, said in such cases - let the enemy take your life from you, then why ease his task ...

    The main thing is never to despair -
    healthy indifference, optimistic outlook on things, more positive - and everything will be fine!


    Мне и моим коллегам книга Свияша "РАЗУМНЫЙ МИР или КАК ЖИТЬ БЕЗ ЛИШНИХ ПЕРЕЖИВАНИЙ" очень помогла изменить взгляды на жизнь и настроиться на позитивное отношение к себе, к жизни, окружающему миру...

    Full title -
    REASONABLE WORLD or HOW TO LIVE WITHOUT EXTRA EXPERIENCES. Second edition, supplemented. Publishing house of ROO “Reasonable Way” “Prime-EUROZNAK” “OLMA-PRESS” 2001. BBK 86.426. UDC 159.96. Alexander Grigorievich Sviyash.
  8. The comment was deleted.
  9. Reptiloid
    Reptiloid 31 October 2015 00: 37 New
    0
    There are serious, but not fatal, diseases that make life very difficult. I have been able to see improvements that are impossible. And the joy of it.
    I also happened to see something very strange - to see that the time for the disease seemed to stop at a completely unthinkable moment, when the forecast is a month or two. And 5 years have passed.
    Therefore, I think - for all the will of God