A Vaccine for the Soul

On January 24,2020,Chinese New Year’s Eve,I had my first COVID-19 patient,who was delivered by an ambulance escorted by a police car.

He looked utterly different from any of my previous patients.He wore a mask,so I couldn’t see his face entirely,but a pair of glasses hanging at the end of his nose,and a slightly bald head.Besides the furrowed brow,which showed that something had been weighing on his mind,there was nothing special about him.

He grabbed his backpack and got off the ambulance in a daze,as if being woken up during sleep on the way home,yet found out himself end up in a place he didn’t know.Reading through his file,his surname,Wan caught my eye,along with his seniority over me,age-wise,so I called him “Old Wan.”

Friend rather than patient

At the isolation ward,I had to run some routine examinations on Old Wan.When taking his temperature the nurse was visibly shaken,so I offered to do it for her.

I tried to take his temperature with an infrared thermometer,but it was difficult to move my hands in the double-layer gloves we were wearing.It made me hit the wrong button by accident,causing the thermometer to switch off and on again.I apologized for my clumsiness,and chatted with him while taking his temperature,“How do you feel?” I asked.

Old Wan looked up at me with an expression of bewilderment.There was a bloated,uncomfortable pause before he finally answered,“You’re not scared of me?”

I pointed at my protective suit and said,“Look what I’m wearing.Why would I be scared of you? But what about you? You’re not scared of me dressed this way?”

Old Wan’s ears twitched and he managed a faint smile.“I really appreciate this.Since I was diagnosed with the disease,you’re the first person who has come this close to me.”

Because of his infection,Old Wan became devoid of contact with the outside world,and no one dared to be around him.This was true,inescapable isolation,like being locked up in a cage.In the blink of an eye he went from being a normal,healthy person to a confirmed COVID-19 case,tracked down and isolated in a tiny room just after a small fever.From then on,he couldn’t step outside the door or see anyone.Such sudden isolation without any buffering or transitional period was hard for anyone to be mentally prepared and accept.During the quarantine,no one had ever entered Old Wan’s room or talked to him.Thinking of it,I patted him on the shoulder and said,“Listen,don’t worry.Now you’re here,just regard me as your friend.”

我接診的第一位新冠肺炎患者，是警車開(kāi)道送來(lái)的。那是2020年1月24日，除夕。

他跟我這些年見(jiàn)到的病人完全不一樣：他戴著口罩，看不清面容，我只能看到他口罩上方的鼻梁上架著一副眼鏡，頭頂有點(diǎn)禿。除了緊縮的眉頭能讓人感覺(jué)出他心事很重，他看上去再普通不過(guò)。

他拿著一個(gè)背包，自己走下救護(hù)車,像是回家路上突然被叫醒，卻發(fā)現(xiàn)自己到了一個(gè)并不認(rèn)識(shí)的地方。資料上寫(xiě)他姓萬(wàn)，比我大一點(diǎn)，我就喊他“老萬(wàn)”。

和患者做朋友

進(jìn)到隔離病房，我需要給老萬(wàn)做一些基礎(chǔ)的檢查。量體溫的時(shí)候，護(hù)士有些緊張，我說(shuō)：“我來(lái)吧?！?/p>

我們用的是紅外線感應(yīng)的體溫槍，但是戴著兩層手套，手特別不靈活，我一不小心按錯(cuò)了按鈕，體溫槍關(guān)機(jī)又開(kāi)機(jī)。我說(shuō)實(shí)在不好意思，操作還不是特別熟練。然后一邊測(cè)體溫，一邊趁機(jī)和老萬(wàn)說(shuō)話：“你感覺(jué)怎么樣？”

老萬(wàn)抬起頭，眼神明顯錯(cuò)愕了一下，定定地看著我，開(kāi)口說(shuō)了第一句話：“你不怕我嗎？”

我指了指防護(hù)服，說(shuō)：“我穿著這些還怕你嗎？倒是你，你看我這樣，不害怕嗎？”

老萬(wàn)掛著口罩的耳朵動(dòng)了動(dòng)，也許是擠出了一個(gè)笑：“我很感謝您，被確診以來(lái)，您是跟我說(shuō)話離得最近的人?！?/p>

因?yàn)榈貌?，老萬(wàn)沒(méi)法跟別人接觸，別人也不敢跟他接觸，這是非常真實(shí)、無(wú)法逃避的“被隔離”，被關(guān)進(jìn)籠子的感覺(jué)。忽然從一個(gè)正常人變成因疫情而被追蹤的確診病人，這個(gè)角色轉(zhuǎn)變來(lái)得太快了。從老萬(wàn)的感受來(lái)說(shuō)，他只是有點(diǎn)發(fā)熱，卻忽然被隔離在一個(gè)小屋子里，不能出去半步，誰(shuí)都見(jiàn)不到。沒(méi)有緩沖，沒(méi)有過(guò)渡，發(fā)現(xiàn)了就被控制了，心里其實(shí)很難一下接受。而被隔離的這些天里，可能也沒(méi)有人進(jìn)過(guò)老萬(wàn)的小屋子，跟他說(shuō)說(shuō)話。想到這兒，我拍拍他的肩膀說(shuō)：“老萬(wàn)，你不用擔(dān)心，來(lái)到這里咱就是朋友了?！?/p>

我問(wèn)老萬(wàn)，關(guān)于這個(gè)病他知道多少。老萬(wàn)的表情很茫然，說(shuō)他也不是很了解，只知道這個(gè)病的傳染性特別強(qiáng)，跟當(dāng)年的“非典”很像。

我說(shuō)：“你說(shuō)對(duì)了，是跟‘非典’很像，但是當(dāng)年我們面對(duì)‘非典’的時(shí)候，防護(hù)措施是12 層口罩和傳說(shuō)中的‘板藍(lán)根沖劑’，今天和當(dāng)年可不一樣了。”

“對(duì)于這個(gè)疾病，你比我了解得多，”我坦率地告訴老萬(wàn)，“你知道它有什么癥狀，知道自己是什么感受，你知道你的身體里發(fā)生著怎樣的變化。而我沒(méi)有見(jiàn)過(guò)，更沒(méi)有得過(guò)，你是我的‘第一例’。說(shuō)實(shí)話，現(xiàn)在我沒(méi)有什么切實(shí)有效的治療方案，請(qǐng)你理解，但是也請(qǐng)你相信我，我會(huì)和你一起面對(duì)它，好嗎？”

When I asked Old Wan how much he knew about the novel coronavirus,he looked very puzzled,saying that he only knew it was highly infectious,just like SARS years ago.

“You’re right.They’re similar.But when SARS was around back in the day,wearing a 12-layer surgical mask and drinking liquid radix isatidis could provide pretty good protection.But this disease is much tougher,” I said.

“You know more about it than me,” I told Old Wan frankly,“because you know what symptoms it can cause,and you know how it feels and what kind of changes have taken place inside your body.But I’ve never seen the disease before,and I’ve never had it before.You’re my first COVID-19 patient.To be honest,I don’t have any practical treatment plan at the moment.Please try to understand,but trust me,I’ll fight it with you,okay?”

I knew that it was risky for a doctor to say something like this to a patient,as it was like admitting his “ignorance.” But from the moment I took on Old Wan’s case,I didn’t want to treat him as a patient,but as a friend.And I intended to keep it that way.

Never give up hope

Ten days ago,when the infectious disease ward was under construction,I would stand outside the window of the isolation ward,pondering: What if it were me who had the disease?How would I feel? And what would I need?

At times like this,the most comforting thing would be to have a friend to talk to.

It was difficult to tell each other apart under the heavy protective suits,so we all marked our suits as a means of identification.I wrote my name on the left position of my chest,with a red heart drawn outside,and on the right,I wrote a message for Old Wan that read:“Don’t be afraid! I’m with you!”

Such an unprecedented event left us scrambling for the right treatments.But that didn’t stop us from communicating with confirmed patients every step of the way,and working to build trust with them under the extremely trying conditions.We had no choice but to just feel our way through it and take what came one day at a time.

“At this point,no one in China knows much about the disease.My focus is on the medications and treatments,and you have first-hand experience,so if you tell me about your feelings,we can work together to deal with the disease.And then you won’t feel like you’re going through hell all alone,” I told Old Wan reassuringly.

When I finished,I didn’t see any sorrow or sadness in Old Wan’s eyes.Instead,he began to talk about how he was diagnosed,how he felt,and his symptoms.

“Old Wan,you can see that I don’t regard you as just a patient.Right?”

“Yes,” Old Wan said,staring at me.

No one knew the definite stages or developmental cycles of the disease at that point,so the patients’ state of mind kept changing every minute,and their fear and anxiety would increase with each passing day in the isolation ward.

Old Wan kept asking as treatments progressed,“How is my test result today?” “How is my chest x-ray?” or “Any good treatment plan?” And once he even said,“If there are any new treatments that you’re afraid to use,try them on me!”

The mental health of confirmed cases like Old Wan’s was most likely to be neglected in the prevention and control of the epidemic.The primary source of their mental and emotional stress came from the sorrow they felt towards their families.If anyone in the household was diagnosed with the disease,the whole family would have to be quarantined.They had been separated from their families from the moment their disease was discovered and we health practitioners became the only people they could see from day to day.

我也知道，說(shuō)出“我也不了解，我們一起面對(duì)”這樣的話，其實(shí)很冒險(xiǎn)，相當(dāng)于在自己的病人面前袒露自己“不知道”。但從我接診老萬(wàn)的那一刻起，我就沒(méi)有把他當(dāng)成病人，而是想和他做朋友。這是我有意為之的。

最重要的是希望

10 天前，病區(qū)籌建的時(shí)候，我站在隔離病房那扇窗戶外面無(wú)數(shù)次設(shè)想過(guò)：如果我得了這個(gè)病，我是什么狀態(tài)？我是什么心情？我需要什么？

一個(gè)可以說(shuō)話的朋友，或許在這樣的時(shí)刻最能給我安慰。

因?yàn)榇┲雷o(hù)服，彼此都看不出樣子，醫(yī)護(hù)人員會(huì)在各自的防護(hù)服上做標(biāo)記。我在胸口左邊寫(xiě)了自己的名字，又畫(huà)上一顆紅色的愛(ài)心，右邊寫(xiě)了一句對(duì)老萬(wàn)說(shuō)的話：別怕，我跟你在一起。

特殊時(shí)期，不光治療手段需要試，連溝通方式，怎樣面對(duì)確診病人，怎樣在這樣的環(huán)境下和病人建立信任，都需要一點(diǎn)點(diǎn)摸索。

“現(xiàn)在全國(guó)對(duì)這個(gè)疾病都不是特別了解，我關(guān)注的可能是藥物、治療手段層面的東西，而你有切實(shí)體會(huì)，你把你的感受告訴我，我們就可以一起去面對(duì)這個(gè)事，就沒(méi)那么可怕了。”

當(dāng)我說(shuō)完這些話的時(shí)候，我并沒(méi)有在老萬(wàn)的眼神中看到遺憾或悲傷。老萬(wàn)反而打開(kāi)了話匣子，慢慢講他是怎么確診的，說(shuō)他的感受，他的癥狀。

“老萬(wàn)，我沒(méi)有把你當(dāng)成一個(gè)病人，你能理解這句話的意思嗎？”

老萬(wàn)定定地看著我，說(shuō)：“我明白。”

對(duì)于這個(gè)疾病的進(jìn)展，誰(shuí)也不知道明確的階段或者說(shuō)周期，但是病人的心理狀態(tài)每分每秒都在變化，隨著隔離時(shí)間的延長(zhǎng)，一天一天，恐懼、焦慮都會(huì)加重。

治療過(guò)程中，老萬(wàn)會(huì)不停地問(wèn)：“今天我的化驗(yàn)結(jié)果怎么樣？”“我肺的片子拍得怎么樣？”“有沒(méi)有什么好的治療方案？”他甚至說(shuō)：“有沒(méi)有新的治療方案，你不敢在別人身上用的，可以給我試試！”

疫情防控中最容易被忽視的問(wèn)題，就是像老萬(wàn)這樣的確診患者的心理問(wèn)題。他們的壓力主要來(lái)自對(duì)家人的愧疚，一人確診，全家都要被隔離。這個(gè)過(guò)程中，他們見(jiàn)不到家人，我們就是他們每天能夠見(jiàn)到的唯一對(duì)象。

每次跟老萬(wàn)聊天，我都會(huì)格外留意老萬(wàn)的反應(yīng)，從他的反應(yīng)判斷他的狀態(tài)。我需要的并不是他聽(tīng)我的，或是信我的，我需要他參與進(jìn)來(lái)。我教老萬(wàn)看他的化驗(yàn)結(jié)果，給他講解CT 影像怎樣看：“你看你原有的病灶現(xiàn)在都已經(jīng)縮小一部分了，這說(shuō)明，我們?cè)谝徊揭徊阶呦騽倮?！?/p>

CT 影像的前后對(duì)比，一點(diǎn)點(diǎn)細(xì)微的變化，我都指給他看。只有他動(dòng)起來(lái)了，把精力放在我說(shuō)的話上，他才不那么容易胡思亂想，心理壓力也會(huì)小些。

其實(shí)，感染性疾病的康復(fù)主要得靠病人自身的免疫系統(tǒng)，用藥只是抑制病毒的繁殖，并不能將其殺滅。所以說(shuō)人很重要，自己很重要。而對(duì)這些被隔離的人來(lái)說(shuō)，最重要的莫過(guò)于希望。

互相支撐

有一天，我發(fā)現(xiàn)老萬(wàn)特別煩躁，一見(jiàn)到我就像是抓到了救命稻草，著急地說(shuō)：“您能幫我個(gè)忙嗎？”

我趕緊問(wèn)怎么了。他說(shuō)：“現(xiàn)在我確診了，我父親也被強(qiáng)制隔離了，我父親80 多歲的人了，生活不能自理，脾氣又倔，我這實(shí)在是沒(méi)辦法了……”

老萬(wàn)聽(tīng)說(shuō)父親一直抗拒隔離，特別不配合，因此非常擔(dān)心。

我抱著試試看的心態(tài)打電話給疾控中心，說(shuō)明了情況。疾控中心很重視老萬(wàn)的情況，答應(yīng)盡量協(xié)調(diào)。第二天，老萬(wàn)的家人就過(guò)去照顧老萬(wàn)的父親。當(dāng)天下午，老萬(wàn)父親的咽拭子核酸檢測(cè)顯示陰性，被獲準(zhǔn)居家隔離。

我把這個(gè)好消息告訴老萬(wàn)。老萬(wàn)的臉被口罩遮蓋，但露在外面的那雙眼睛熱切地看著我，眼圈漸漸紅了。老萬(wàn)沒(méi)說(shuō)話，卻主動(dòng)握了握我的手。

當(dāng)天晚上，同事們都去清潔區(qū)吃飯了，病區(qū)里的病人都睡覺(jué)了，我一個(gè)人在隔離病區(qū)值班。只是值班而已，卻幾乎是我人生中最難熬的一個(gè)小時(shí)。

白天，我在病人、同事面前是“小太陽(yáng)”，是帶來(lái)希望和光亮的人。但夜晚，在隔離病區(qū)的走廊里，待眼前的一切都安靜下來(lái)的時(shí)候，我終于能面對(duì)我自己，才發(fā)現(xiàn)原來(lái)自己也有撐不住的時(shí)候。

大年初一，老萬(wàn)的哥哥來(lái)給老萬(wàn)送餃子。他哥哥一見(jiàn)到我就拉住我，說(shuō)帶了兩份餃子來(lái)，一份給老萬(wàn)，一份給我。“您不用擔(dān)心，這個(gè)肯定是干凈的?！?/p>

When chatting with Old Wan,I would pay close attention to his feelings,and thereby judge his state of mind.I didn’t need his blind obedience or trust,just his cooperation.I taught Old Wan how to read his test results,and explained his CT images to him,“Look! The lesion is getting smaller.It means that we’re getting one step closer to beating the disease!”

I would also point out every nuance on the CT images to him.If he just did as I asked,and followed the treatments faithfully,his imagination wouldn’t run wild so easily,and this would alleviate some of his mental anguish.

As a matter of fact,the treatment of any contagious disease is largely dependent on the patient’s own immune system.Medication can only delay the growth of the viruses,rather than eliminating them.Therefore,the patient himself holds the key to his own recovery.For any patient in quarantine,the most important thing is to never lose hope.

Mutual support

One day,I found Old Wan in a horrible mood.When he saw me,it was like he has found his last straw of hope.“Could you do me a favor?” He said anxiously.

I asked him what the matter was,and he told me,“Since I’ve been diagnosed with the disease they’ve quarantined my dad too.But he’s over 80,and can’t take care of himself,and he’s also real stubborn.I’m at my wit’s end…”

Old Wan was worried because he heard that his father was so resistant to quarantine and refused to cooperate.

I tried to call the Center for Disease Control,and explained the situation to them.Doctors in the CDC took account of Old Wan’s situation,and promised that they would try to help him.The next day,Old Wan’s family was allowed to look after his father,and in the afternoon,the nucleic acid test they gave his father turned out to be negative,so he was allowed for home quarantine.

When I shared the good news with Old Wan,I could see a hopeful look play over the visible parts of his face,and tears began welling up in his eyes.Old Wan didn’t say a word,but shook my hand warmly.

That night,when my colleagues went to eat in the sterile area,and all the patients in the ward zone had fallen asleep,I was the lone doctor on duty in the isolation ward.Although it was just a routine task,I felt that onehour stint seemed the darkest time in my life.

During the day,my colleagues and patients regarded me as someone who could bring hope and light to them,just like “a little ray of sunshine.” But at night,when I was alone in the quiet hallway of the isolation ward,I would be confronted by the terrible truth that I wasn’t always as strong as I let on.

On the first day of the Chinese Lunar New Year,Old Wan’s elder brother brought dumplings to him.When he saw me,he grabbed my hands,and said that he brought two bowls of dumplings,and one of them was for me.“Don’t worry.It’s definitely clean,” he reassured me.

The problem was,I couldn’t accept it,as in the ward zone after all,there was a one-way flow for all items,and the goods for the patients came from restricted channels.Once being sent to the isolation ward,the goods had to be stopped there,and couldn’t proceed to the sterile area.

His brother then gave me New Year’s greetings instead,“Thank you for your hard work.I’ve heard from my brother that you’re a brave doctor.Please take good care of yourself.Today is the first day of the Lunar New Year.I’d like to wish you a happy New Year.”

Then he bowed down in front of me in a show of deep gratitude.

At that moment,I tried my best to hold back the tears.It suddenly dawned on me that doctors and patients actually supported each other.

I’ve always thought of myself as a soldier who couldn’t retreat or ever lose morale on the battlefield,but now I know that I’m just an ordinary doctor.After working around the clock for so many days in a row,when I received the New Year’s greetings from Old Wan’s brother,it made me miss my own family all the more,and so eager to call home and talk to my wife and kids.I just really needed to hear their sweet voices.

What I wanted to tell Old Wan and myself that night was: Don’t be afraid! There are many people standing behind us!

(FromTake a Breath at One Meter Away,Hunan Literature and Art Publishing House.Translation: Zhu Yaguang)

但是我確實(shí)不能吃他的餃子，因?yàn)槲覀兊牟^(qū)里，所有物品都是單向流動(dòng)，病人的物品是從病源通道進(jìn)來(lái)的，一旦進(jìn)來(lái)只能剎住，不能再往清潔區(qū)走。

他哥哥轉(zhuǎn)而給我拜年：“您辛苦了。我弟打電話都說(shuō)了，我知道您很勇敢，但是您要保護(hù)好自己。今天是大年初一，我給您拜個(gè)年吧?！?/p>

說(shuō)完給我深深鞠了一躬。

那一刻，我真的差點(diǎn)繃不住。我突然意識(shí)到，我們和病人之間其實(shí)是互相支撐的。

我一直把自己想象成戰(zhàn)士，在戰(zhàn)場(chǎng)上堅(jiān)決不能退縮，不能有任何思想波動(dòng)。但其實(shí)我也清楚，自己就是個(gè)穿著白大褂的普通人。沒(méi)有晝夜、不知陰晴、連續(xù)不斷地工作，聽(tīng)見(jiàn)老萬(wàn)哥哥那句話的時(shí)候，我特別想家，想往家打個(gè)電話。

我想告訴老萬(wàn)，也告訴那一晚的自己：別怕，有很多人跟我們?cè)谝黄稹?/p>

（摘自《呼吸在一米之外》湖南文藝出版社）