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，是警車開道送來的。那是2020年1月24日，除夕。

他跟我這些年見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，頭頂有點禿。除了緊縮的眉頭能讓人感覺出他心事很重，他看上去再普通不過。

他拿著一個背包，自己走下救護車,像是回家路上突然被叫醒，卻發現自己到了一個并不認識的地方。資料上寫他姓萬，比我大一點，我就喊他“老萬”。

和患者做朋友

進到隔離病房，我需要給老萬做一些基礎的檢查。量體溫的時候，護士有些緊張，我說：“我來吧。”

我們用的是紅外線感應的體溫槍，但是戴著兩層手套，手特別不靈活，我一不小心按錯了按鈕，體溫槍關機又開機。我說實在不好意思，操作還不是特別熟練。然后一邊測體溫，一邊趁機和老萬說話：“你感覺怎么樣？”

老萬抬起頭，眼神明顯錯愕了一下，定定地看著我，開口說了第一句話：“你不怕我嗎？”

我指了指防護服，說：“我穿著這些還怕你嗎？倒是你，你看我這樣，不害怕嗎？”

老萬掛著口罩的耳朵動了動，也許是擠出了一個笑：“我很感謝您，被確診以來，您是跟我說話離得最近的人。”

因為得病，老萬沒法跟別人接觸，別人也不敢跟他接觸，這是非常真實、無法逃避的“被隔離”，被關進籠子的感覺。忽然從一個正常人變成因疫情而被追蹤的確診病人，這個角色轉變來得太快了。從老萬的感受來說，他只是有點發熱，卻忽然被隔離在一個小屋子里，不能出去半步，誰都見不到。沒有緩沖，沒有過渡，發現了就被控制了，心里其實很難一下接受。而被隔離的這些天里，可能也沒有人進過老萬的小屋子，跟他說說話。想到這兒，我拍拍他的肩膀說：“老萬，你不用擔心，來到這里咱就是朋友了。”

我問老萬，關于這個病他知道多少。老萬的表情很茫然，說他也不是很了解，只知道這個病的傳染性特別強，跟當年的“非典”很像。

我說：“你說對了，是跟‘非典’很像，但是當年我們面對‘非典’的時候，防護措施是12 層口罩和傳說中的‘板藍根沖劑’，今天和當年可不一樣了。”

“對于這個疾病，你比我了解得多，”我坦率地告訴老萬，“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生著怎樣的變化。而我沒有見過，更沒有得過，你是我的‘第一例’。說實話，現在我沒有什么切實有效的治療方案，請你理解，但是也請你相信我，我會和你一起面對它，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，說出“我也不了解，我們一起面對”這樣的話，其實很冒險，相當于在自己的病人面前袒露自己“不知道”。但從我接診老萬的那一刻起，我就沒有把他當成病人，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，病區籌建的時候，我站在隔離病房那扇窗戶外面無數次設想過：如果我得了這個病，我是什么狀態？我是什么心情？我需要什么？

一個可以說話的朋友，或許在這樣的時刻最能給我安慰。

因為穿著防護服，彼此都看不出樣子，醫護人員會在各自的防護服上做標記。我在胸口左邊寫了自己的名字，又畫上一顆紅色的愛心，右邊寫了一句對老萬說的話：別怕，我跟你在一起。

特殊時期，不光治療手段需要試，連溝通方式，怎樣面對確診病人，怎樣在這樣的環境下和病人建立信任，都需要一點點摸索。

“現在全國對這個疾病都不是特別了解，我關注的可能是藥物、治療手段層面的東西，而你有切實體會，你把你的感受告訴我，我們就可以一起去面對這個事，就沒那么可怕了。”

當我說完這些話的時候，我并沒有在老萬的眼神中看到遺憾或悲傷。老萬反而打開了話匣子，慢慢講他是怎么確診的，說他的感受，他的癥狀。

“老萬，我沒有把你當成一個病人，你能理解這句話的意思嗎？”

老萬定定地看著我，說：“我明白。”

對于這個疾病的進展，誰也不知道明確的階段或者說周期，但是病人的心理狀態每分每秒都在變化，隨著隔離時間的延長，一天一天，恐懼、焦慮都會加重。

治療過程中，老萬會不停地問：“今天我的化驗結果怎么樣？”“我肺的片子拍得怎么樣？”“有沒有什么好的治療方案？”他甚至說：“有沒有新的治療方案，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題，就是像老萬這樣的確診患者的心理問題。他們的壓力主要來自對家人的愧疚，一人確診，全家都要被隔離。這個過程中，他們見不到家人，我們就是他們每天能夠見到的唯一對象。

每次跟老萬聊天，我都會格外留意老萬的反應，從他的反應判斷他的狀態。我需要的并不是他聽我的，或是信我的，我需要他參與進來。我教老萬看他的化驗結果，給他講解CT 影像怎樣看：“你看你原有的病灶現在都已經縮小一部分了，這說明，我們在一步一步走向勝利！”

CT 影像的前后對比，一點點細微的變化，我都指給他看。只有他動起來了，把精力放在我說的話上，他才不那么容易胡思亂想，心理壓力也會小些。

其實，感染性疾病的康復主要得靠病人自身的免疫系統，用藥只是抑制病毒的繁殖，并不能將其殺滅。所以說人很重要，自己很重要。而對這些被隔離的人來說，最重要的莫過于希望。

互相支撐

有一天，我發現老萬特別煩躁，一見到我就像是抓到了救命稻草，著急地說：“您能幫我個忙嗎？”

我趕緊問怎么了。他說：“現在我確診了，我父親也被強制隔離了，我父親80 多歲的人了，生活不能自理，脾氣又倔，我這實在是沒辦法了……”

老萬聽說父親一直抗拒隔離，特別不配合，因此非常擔心。

我抱著試試看的心態打電話給疾控中心，說明了情況。疾控中心很重視老萬的情況，答應盡量協調。第二天，老萬的家人就過去照顧老萬的父親。當天下午，老萬父親的咽拭子核酸檢測顯示陰性，被獲準居家隔離。

我把這個好消息告訴老萬。老萬的臉被口罩遮蓋，但露在外面的那雙眼睛熱切地看著我，眼圈漸漸紅了。老萬沒說話，卻主動握了握我的手。

當天晚上，同事們都去清潔區吃飯了，病區里的病人都睡覺了，我一個人在隔離病區值班。只是值班而已，卻幾乎是我人生中最難熬的一個小時。

白天，我在病人、同事面前是“小太陽”，是帶來希望和光亮的人。但夜晚，在隔離病區的走廊里，待眼前的一切都安靜下來的時候，我終于能面對我自己，才發現原來自己也有撐不住的時候。

大年初一，老萬的哥哥來給老萬送餃子。他哥哥一見到我就拉住我，說帶了兩份餃子來，一份給老萬，一份給我。“您不用擔心，這個肯定是干凈的。”

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)

但是我確實不能吃他的餃子，因為我們的病區里，所有物品都是單向流動，病人的物品是從病源通道進來的，一旦進來只能剎住，不能再往清潔區走。

他哥哥轉而給我拜年：“您辛苦了。我弟打電話都說了，我知道您很勇敢，但是您要保護好自己。今天是大年初一，我給您拜個年吧。”

說完給我深深鞠了一躬。

那一刻，我真的差點繃不住。我突然意識到，我們和病人之間其實是互相支撐的。

我一直把自己想象成戰士，在戰場上堅決不能退縮，不能有任何思想波動。但其實我也清楚，自己就是個穿著白大褂的普通人。沒有晝夜、不知陰晴、連續不斷地工作，聽見老萬哥哥那句話的時候，我特別想家，想往家打個電話。

我想告訴老萬，也告訴那一晚的自己：別怕，有很多人跟我們在一起。

（摘自《呼吸在一米之外》湖南文藝出版社）