Wei Chen さん
National Taiwan University
Thank for offering me the chance to study at ER&ICU for this two weeks!
First of all, I want to thank everyone I met at ER&ICU, I had an excellent two weeks here! Prof. Matsuda leads a great team that not only focuses on clinical treatment, but also basic research and medical education. Besides, I am surprised that there are so many people in NUH speaks good English, my Japanese is not so well, thus it helped me a lot! And if the doctors are not so good at English, they are all willing to say Japanese slower and easier (sometimes through writing) so that I could understand what's going on, its very kind indeed! Though 14 days might be short, I learned a lot! Thank you very much!
I must say, the ER&ICU here are totally different from our hospital. To tell the truth, I like how things work here better. Let's talk about ER department first. ER in NUH is always quiet and tidy. Quiet doesn't mean totally silent, it means that ER in NUH is not a noisy place, people may talk louder but never shout, there are no one yelling at each other, too. And tidy is that the family just stay outside the working zone waiting, doctors and nurses do things in order, ER will never be in a mess even a second. Sadly, It's just the opposite in our hospital. I think the decisive reason may be that ER team in NUH only accept a limited patient number at a time. They do so in order to keep the quality. Doctors can make full investigation of the patient and don't have to make diagnosis in a rush. Back in Taiwan, we just let patients come continuously, so there are always full of people at our ER. When there're too many patients, it's hard to maintain the treatment quality, also, the place will definitely in a mess, just like battlefield. Our hospital receives more than 300 patients a day at ER, our staff may be 4 times more compared to NUH, it's still overloading. Hope we have the same medical environment as NUH!
Secondly, the ICU. What impressed me most is the morning meeting and evening meeting every day. All the available doctors gather to discuss the patient. When it comes to pediatric patient, doctors might even be over 20 totally! I think this is great, every one in the ICU knows exactly each patient's condition, it's easier to react when emergency happens. Another thing catch my eyes is that there are TVs for patient in ICU! I've asked the doctor on duty, he told me that the TV may have benefit to patient's rehabilitation, it can offer some stimulations to unconscious patients. I think the goods of TV is more than that, ICU is often thought as a deadly silent space that there're only the beeping sounds of machines, thus it makes people nervous and very stressful. With the sound of TV, even doctors and nurses may get ease! Maybe not evidence-based, it's still a good try.
Finally, I want to share a case I saw at ER. The patient was a 83-year-old male, he was sent into ER by ambulance, CPA. He was talking to his wife at about 16:30, suddenly he complained about short of breath and lost of consciousness soon. 119 was called, patient received CPR immediately, yet when the ambulance arrived at about 17:00, patient was still unconscious and remained CPA. After a few CPR circles and medication treatment, spontaneous heart beat and breath resumed. But shortly after, CPA again. After CPR for 5 minutes, patient's wife came in, she said it was enough, just let him go. She walked to bedside, gently stroked patient's head and said "おじーさんーお疲れ様でした。" That was the most moving scene I have ever seen.
Medicine is a lesson about life and death, and ER&ICU is the place you can see the light of humanity. I am very to lucky to have the chance to visit ER&ICU at NUH, I feel grateful for that. At last, I want to offer special thanks to Dr. Matsuda, Dr. Murase, Dr. Hinoshita Dr. Numaguchi and Dr. Umino. Without you, I can't have such a wonderful learning experience!
to be continued