立委NLP频道

by Hanyang Yijiangshui

Let me share a few anecdotes about my father to provide a glimpse into his professional life.

One

During one Lunar New Year, Hanyang and I went back to our hometown to celebrate with our father.

After the New Year's Eve dinner, we all sat together watching TV and chatting. Around eleven, a call came in for my father. It was from the hospital where he served. They had an emergency and wanted him to consult. Without hesitation, my father got ready and asked Hanyang to drive him to the hospital.

He worked throughout the night and only called Hanyang to pick him up the next morning. On the way home, Hanyang inquired about the emergency. My father, visibly exhausted, simply said, "Doctors often face such situations. Emergencies don’t care about holidays. It's been this way since I was young." He then closed his eyes to rest.

Days later, my father recounted the event with pride. That night, an emergency case was admitted with a suspected acute appendicitis. Two on-duty surgeons began the surgery, but upon opening the patient, they were puzzled to find no inflammation. As they debated the next steps, one suggested consulting my father.

Upon arrival, my father swiftly diagnosed a stomach perforation with gastric contents spilling into the abdominal cavity. He then skillfully performed the surgery, saving the patient from potential complications. This type of condition, where the symptoms are hidden, often goes undiagnosed, requiring both experience and theoretical knowledge to identify.

He later said that had they not properly diagnosed the issue, the patient would've faced further surgeries, and if the acidic gastric content had remained in the abdomen for too long, it could've been life-threatening.

Two

During the Cultural Revolution, my father had a close friend, Uncle Gui, from a neighboring county. His 16-year-old son had a neck condition, which was misdiagnosed as a recurrent malignant tumor. The family was advised amputation, a heartbreaking prognosis. Desperate, they turned to my father. After a careful examination, my father determined it was another type of benign tumor. He successfully performed surgery, saving both the boy's arm and his life. The boy went on to have a successful international career, and they still visit my father in gratitude.

In the 1970s, a 35-year-old female patient came in with a vertebral issue. She was emaciated, weighing only 40 kilograms, and suffered from paraplegia. With a challenging surgery involving careful removal of the necrotic material and grafting, my father successfully treated her. The husband, a blacksmith, gifted my father with handmade stainless steel kitchen tools, which are still in use today.

Among his notable achievements in orthopedics, my father performed hundreds of surgeries for lumbar disc herniation. Many patients, immobilized by pain, found instant relief post-surgery and went on to live healthy lives.

Three

My father practiced medicine for over sixty years, performing surgeries on more than ten thousand patients. Were there any medical accidents? None at all! However, he did have a few surgical failures in his career. One particular case deeply pained him, reminding him that intentions don't always match outcomes, leading to self-reproach. My father's surgical mentor, the former head of surgery at Wannan Medical College's Second Affiliated Hospital, Mr. Min Mei, once consoled him with a story from his time at Beijing Fuwai Hospital, a renowned cardiology institution. Many patients entered the hospital walking but were carried out after unsuccessful surgeries. Leading Chinese medical authorities had once advised Min Mei that while some patients might die without surgery, there's still a glimmer of hope with surgery. Science comes with its costs, and doctors often work on the front lines of life and death, carrying the weight of their successes and failures.

A particularly heartbreaking case for my father involved surgery on a middle school teacher who came to him by reputation. The 64-year-old teacher was diagnosed with gallstones based on his medical history and an ultrasound. My father had successfully performed over a thousand such surgeries. On October 16, 1984, my father removed the teacher's gallbladder, discovering 23 cholesterol gallstones inside. The surgery seemed to proceed "smoothly," lasting 75 minutes. However, the patient's unique anatomy presented a congenital variation that wasn't detected until complications arose post-surgery. Three days post-operation, jaundice appeared and worsened. Subsequent surgeries on November 9, 1984, and February 10, 1985, failed to save the teacher, who succumbed to multi-organ failure five days after the last operation. My father was deeply affected and often cited this tragic case as a cautionary tale. He penned a medical paper based on these experiences to remind himself and others to be diligent and continuously learn.

Four

A 29-year-old male patient, after colliding with a stationary cart while riding his bicycle, experienced intense pain, difficulty breathing, and palpitations. He was admitted to my father's hospital an hour later. Preliminary examinations showed no internal organ injuries or fluid accumulation in the abdominal cavity. However, after 16 hours of observation, the patient complained of pain in the right flank and testicle. A diagnosis of posterior peritoneal duodenal injury was made, leading to an exploratory laparotomy 28 hours post-injury. During the procedure, some bile-like fluid was found in the abdominal cavity. No injuries were detected in the gallbladder, extrahepatic bile duct, or liver. Swelling and green discoloration were observed in the posterior peritoneum. Upon further examination, a 1.5 cm rupture was found in the descending part of the duodenum, causing leakage of intestinal fluid and tissue necrosis. After thorough cleaning and repair, intestinal motility was restored within 48 hours. The patient fully recovered after three weeks, with no complications or aftereffects. Such posterior peritoneal duodenal injuries are rare and severe, often presenting subtle early symptoms that can lead to misdiagnosis. The surgery itself is intricate and demanding. Surgical precision and adaptability are crucial as a slight oversight can be life-threatening. Fortunately, my father's skillful hands saved this patient, who now leads a normal life.

Five

The patient, a male, suffered from melanin spots and gastrointestinal polyposis syndrome. Over fourteen years, he underwent three surgeries, all of which were performed by my father. Particularly challenging was the patient's extremely rare intestinal and biliary obstruction, a condition possibly unparalleled worldwide! Complications were the primary reason for his medical consultations, typically manifesting during his youth. Being a congenital condition with no complete cure, its prognosis can be favorable with proper management, even though it necessitates multiple surgeries. It doesn't necessarily shorten the lifespan. With my father's meticulous treatment, the patient was given a new lease on life. Throughout his career, my father encountered many such critically ill patients. Practically self-taught and working in a basic grassroots hospital, he took saving lives as his mission, creating miracles one after another.

Six

In 1968, in a remote mountainous village called Hewan in southern Anhui, a 13-year-old boy fell off a bull's back. My father, upon examining him, found a ruptured right liver and significant internal bleeding, requiring a thoracotomy to be treated. Even in big cities, liver surgeries were major procedures at the time, and my father had never performed one before. Especially in such a remote village, ensuring an adequate blood supply for the operation was a challenge. With the boy's life hanging by a thread and time running out, my father, in a moment of quick thinking and audacity, decided to draw accumulated blood from the abdominal cavity and re-transfuse it. This innovative approach of re-transfusing abdominal blood mixed with bile was a first in China. (From a theoretical standpoint, the idea of re-transfusing liver blood, especially contaminated with bile, was barely mentioned in medical literature then. Only a decade later was it reported and subsequently confirmed in various studies.) Relying on his previous experience with blood transfusion (without bile) and given the urgent situation, my father performed this transfusion technique throughout the night, extracting, filtering, and re-transfusing a total of 1700 ml of blood, buying precious time. Operating under a kerosene lamp in a rural health center, with rudimentary anesthesia, my father proceeded to carry out both a thoracotomy and laparotomy. The surgery was a triumphant first attempt, successfully repairing the liver. In a tiny village with no electricity, limited assistance, basic equipment, scarce medicine and blood supplies, and without the guidance of a senior surgeon, my father's successful completion of his first-ever liver surgery was nothing short of miraculous. The postoperative recovery was also "smooth," and the patient's life was saved. Given the conditions and technical expertise of that era, it was a remarkable achievement.

The procedure represented the pinnacle of surgical expertise in county hospitals of China at that time, truly cutting-edge. Accomplishing such a surgery in a small village operating room, lacking electricity and running water, is unprecedented in China.

Seven

In October 1965, following the “6.26” directive, my father led a medical team of seven, including one internist, five nurses/midwives, and himself, a surgeon, to the Yandun Commune in southern Anhui. Although he held the position of deputy leader, the actual leader was Dr. Tian, an internist in his fifties with poor health, who often stayed home for recuperation and rarely spent time in the countryside. This effectively put my father, who was not yet thirty, in charge of the entire operation for three straight months.

During the last 100 days of 1965, without electricity, an anesthetist, assistants, or adequate equipment and medicine, my father, on his own, set up a makeshift “operating room.” With cloth overhead as a ceiling, the ground wetted to keep dust down, and lit by a kerosene lamp and flashlight, this “room” was where he performed 612 surgeries of various sizes without a single mishap. All patients recovered, a testament to the miracles he performed in the rural setting. Of these, 121 were major open surgeries ranging across general surgery, gynecology, orthopedics, and otorhinolaryngology. Surgeries included stomach, gall bladder, intestine, and uterus removals, bile-intestine internal drainage, vaginal total hysterectomies, bladder-vaginal fistula repairs, and many others. In an era when even basic medicines like penicillin were rare, to perform such a diverse range of surgeries in 100 days was a feat – a testament to my father's exceptional surgical skills and innovation.

At the same time, the medical team organized training for health workers from all six production brigades in the commune, established a health-conscious village, and dug two wells, forever changing the village's history of consuming muddy water.

My father, always on duty, never took a single day off during these intense three-plus months. Although he was only an hour's drive from home, where both the elderly and children awaited, he didn't return even once in over 100 days. This unparalleled dedication to work, without any financial incentive, would be unimaginable today.

On one particular afternoon during this medical outreach, with the assistance of the only anesthetist from the county hospital who had temporarily come over, my father single-handedly performed three vaginal total hysterectomies with pelvic floor repair and reconstruction. This was in the aftermath of China’s infamous famine, which left many with malnutrition-related conditions. On the same day, he continued to operate until 3 am, performing over ten other surgeries and working continuously for nearly 18 hours. Such a work rate is unmatched even today.

For these achievements, the medical team was recognized and rewarded by the county and district (city) governments. My father was specially invited to give a presentation at the commendation meeting, where he displayed all the surgical instruments he used. His methods were promoted throughout the Wuhu region, a grand acknowledgment and reward for his efforts.

During this period, several unforgettable cases stood out:

1. A patient with heavy bleeding due to incomplete miscarriage was treated with an emergency dilation and curettage, along with rapid fluid resuscitation, ultimately saving her life.
2. A bladder-vaginal fistula patient underwent successful surgical repair and recovered in 12 days, pioneering such surgery in the region.
3. A middle-aged woman suffering from typhoid with an intestinal perforation and peritonitis underwent intestinal resection. Treated for free due to her financial situation, my father later visited her home in Qingyang Mud Town to ensure her well-being.
4. An emergency cesarean section was performed on an office desk for a woman with a threatened uterine rupture due to fetal malposition.
5. A patient with a ruptured spleen underwent a splenectomy on the same office desk, where 800 ml of abdominal blood was re-transfused, a groundbreaking procedure at the time.

The adage goes: necessity is the mother of invention. In this case, dire circumstances crafted the hero. Theoretical support and recognition for some of these groundbreaking procedures would only emerge in the literature later on.

Dad, second from right on the front row

Eight

On July 28, 1976, the historic Tangshan earthquake occurred, and my father had a deep connection to it. On August 2, he was summoned to join a three-person medical team from Wuhu district (city) to aid in the earthquake-stricken areas. Upon their arrival in Nanjing, they received a call from Beijing, advising that the injured were being sent south and that medical teams from various locations should prepare to treat them locally, eliminating the need to go directly to the disaster site. Consequently, my father was stationed at a treatment center in E'Qiao, Fanchang. Leading a 25-person medical team, with another 25 locals supporting logistics, they received 100 injured individuals. As the team leader overseeing all operations, my father had three deputy leaders and two instructors with him — an impressively robust leadership team. All the selected members were the "elites", directly under city and county leadership. The national government covered all expenses for the injured, prioritizing this as a top-tier political task.

My father, along with a few doctors, went to the Nanjing railway station to inspect and receive the injured from a medical-special train. When the train reached E'Qiao, a team awaited to carry the patients into the "wards". Most of the injured had non-life-threatening injuries, mainly bone and muscle injuries. Fortunately, my father was well-versed in orthopedics. Switching from administrative duties to focus on clinical medical care, over the subsequent months, they worked tirelessly to ensure the recovery of every individual and even sent doctors to accompany the injured back to their hometowns. In this catastrophic event that shocked the world and claimed 240,000 lives, my father contributed his bit, accomplishing this historical mission.

That year, China faced multiple calamities. After the deaths of prominent national leaders Zhou and Zhu, during this national disaster caused by the earthquake, on September 9th, Mao — China's paramount leader, also passed away. This cast a shadow over the entire nation, with the populace uncertain and apprehensive about China's future.

During this tumultuous period, my father, away from home, bore the significant responsibility of managing 100 injured individuals and 50 staff members. With the local region also experiencing aftershocks and given the concerns of staff about their own safety and their families, coupled with the successive deaths of national "parental" figures, it's easy to imagine the pervasive sense of despair and hopelessness. However, my father, leveraging his skills and leading by example, accomplished the task brilliantly, once again submitting a perfect report card.

Dad, 5th from left in the middle row

Nine

During the violent confrontations of the Cultural Revolution, different factions armed themselves, leading to disrupted transportation and hospital shutdowns. However, bullets don't discriminate, and gunshot wounds were rampant, affecting vital organs like the liver, lungs, blood vessels, kidneys, and the gastrointestinal tract. This often necessitated on-the-spot surgeries. It was under these dire circumstances that my father was forced to self-learn and master the techniques for repairing organs, particularly in cases of brain injuries.

Despite the challenging environment and conditions, my father managed to save many lives. While he undoubtedly had his share of successes, even in the instances where he couldn't save a life, there was minimal blame attributed to him (given the circumstances). These experiences significantly honed his technical skills and expertise.

The confrontations resulted in hospitals operating at limited capacities, granting my father ample free time. He used this period to systematically read medical textbooks and study English, thereby solidifying his foundational knowledge in medical theories. This self-learning phase marked a significant leap in his theoretical understanding, which, when applied practically, further solidified his expertise. The synergy of theory guiding practice, and practice leading to real insights, elevated my father's knowledge and application to new heights.

Ironically, the violent confrontations of the Cultural Revolution ended up cultivating surgical talent. This can be seen as a peculiar silver lining — a dark kind of humor in the midst of chaos.

Ten

Throughout my father's medical career, which spanned over 60 years, he performed countless surgeries. In his practice, he often introduced minor improvements, innovations, and breakthroughs that yielded highly effective results.

a. Except for special requirements, my father abandoned the convention of pre-inserting gastric tubes in the thousands of gastrectomy procedures he performed (a procedure recommended in textbooks). He had no failures with this approach. This demanded meticulous suturing, impeccable hemostasis, intraoperative emptying of gastric residues, and rigorous post-operative observation, which greatly enhanced patient comfort.

b. In cases of diffuse peritonitis, after removing the lesions and infectious materials, he discarded intraperitoneal drainage, thus reducing post-operative adhesions. The key was thorough intraoperative washing and cleaning. He believed that drain fluid in the peritoneal cavity would quickly get clogged by fibrin, which only added to the patient's discomfort. Certainly, in cases like pancreatitis or abdominal abscesses where ongoing leakage is expected, negative pressure drainage with double tubes is necessary.

c. In circumcision, standard procedures often led to misalignments, hematomas, edemas, and difficulties in removing stitches, causing distress to both doctors and patients. My father modified the procedure, using local venous anesthesia, precise cutting under tourniquet control, impeccable hemostasis, and meticulous suturing with human hair or absorbable sutures, resulting in a pain-free procedure with excellent alignment, quick healing, and no stitch removal.

d. Fistulectomy for anal fistulas traditionally involved threading or open excision, causing significant post-operative pain and a lengthy recovery. My father adopted long-acting local anesthesia (with a diluted methylene blue injection) for a one-stage excision and suturing, usually resulting in a single-phase healing and a shorter treatment duration.

e. Controlling wound infections, especially traumatic ones, hinges on the thorough cleaning during the initial treatment, rather than relying on drainage or antibiotics. Extensive washing with water to remove foreign bodies and dead tissue, meticulous disinfection, tension-free sutures, and, if post-operative inflammation occurs, supplemental alcohol compresses – with or without antibiotics – ensured infections were largely eliminated in wounds treated within 6 hours.

f. In inguinal hernia repairs, the focus was on the transverse abdominal fascia. My father used a modified Madden technique instead of the traditional Bassini method, greatly alleviating the post-operative pain from tensioned sutures. This also promoted healing and significantly reduced the recurrence rate.

Eleven

My father was brilliant. Not only was he adept in surgery, but he also had a knack for writing articles effortlessly. Although he only received a vocational education, his surgical skills, prolific writing, and fluency in English allowed him to smoothly acquire mid-level, associate, and full professional titles without any disputes.

However, many of his colleagues (excluding the leadership) weren't as fortunate. Some lacked the necessary skills, others didn't have enough research articles. Even though many had higher educational qualifications than my father, they struggled to achieve the highest professional titles.

My father had strong reservations about this system. He believed that several of his friends, who were competent in clinical surgeries, were hindered due to their inability to write articles. Without publications, they couldn't ascend the professional ladder.

He argued that clinical work is practical, especially in surgery. It requires dexterity and intuition. Improvement comes from experience and observation, not from writing research papers. Clinical work is not about research. Considering the massive patient load and back-to-back surgeries and shifts, it's already taxing. Being in a non-academic hospital, who has the time to sit, apply for research topics, conduct studies, and write articles?

Clinical doctors need extensive training and a wealth of experience. Combining research tasks with clinical duties and judging doctors based on their research publications rather than their clinical expertise is unfair. It's absurd for a profession that's fundamentally about clinical skills to prioritize publications over actual patient care proficiency.

Being kind-hearted and always eager to help, on one occasion, he told two friends, both highly skilled surgeons who were held back in their professional advancements due to a lack of publications: "I'll write several articles for you both. You can revise them, provide feedback, and then publish them under your names."

True to his word, my father promptly wrote several medical articles and handed them over to his two friends.

Twelve

Despite being 88 years old, my father has an insatiable curiosity about new technology. He's deeply interested in emerging knowledge and science and is adept at adapting to novel concepts. He's a progressive thinker, always reflecting on novel ideas and not just sticking to traditional views. He's always driven to achieve excellence and delves into unknown territories. From computers, mobile phones, and the internet to intelligent AI applications, he has been at the forefront, keen to experience the latest technological advancements and to understand their innovation. He often says that to avoid being left behind in this world, one must be open to new things. This way, life doesn't stagnate, and we can continually enhance our lives and improve our quality of living. Staying updated and keeping pace with the times has always been his life's norm.

When OpenAI's ChatGPT was introduced, he was immediately intrigued. Almost daily, he would inquire about it with his son, my younger brother Li Wei, who works in natural language processing, eager to understand ChatGPT's applications, its current status, and future direction. Recently, Wei managed to set up ChatGPT for him to work via VPN, having made father one of the most senior users of ChatGPT in China.

Of course, as LLM applications are being rapidly deployed, we'll see a seamless integration with smart home functionalities in the future. People will increasingly rely on artificial intelligence, which often determines the quality of life. While domestic AI research might be a step behind Western countries, its practical application is not lacking, and the adoption rate in China exceeds that of the West. This allows the public to experience the convenience of the latest tech products, providing my father ample opportunities to try out various AI products and software at home. He thoroughly enjoys it, making him a genuine AI application enthusiast.

My father is witnessing the AI boom of the 2020s and certainly won't miss out on this magnificent era. He currently uses an Apple 15 Pro, the latest model with three-nanometer technology. Paired with the newest VPN software on his iPad and ChatGPT, he has the latest tech tools at his disposal. It's rare to find an elderly individual with such a tech setup in the entire country. At 88, my 'fully-equipped' father remains ahead of the curve, always staying at the forefront of technological advancements.

Dad's passion and pursuit of technology are not only to satisfy his own curiosity but also to maintain competitiveness and adaptability in an ever-changing era. In this age where technology evolves rapidly, Dad shows us through his actions what it truly means to 'learn as long as you live'. His positive attitude and curiosity about new things are worth learning and passing on by each of us.

Closing Words: In the quiet depths of night, the familiar silhouette, a symbol of tireless dedication, invariably emerges before my eyes, invoking clear and heartfelt memories. It brings back scenes of my father's hard work and life from yesteryears. Though many of those moments have faded into the annals of time, spanning over half a century, they remain ever-present in my mind, etching deep imprints in my heart, evoking emotions, instilling strength, and radiating warmth.

Dad, you stand as my beacon, my source of pride. I love you.

【李名杰从医67年论文专辑】（电子版）

【李名杰从医67年论文专辑（英语电子版）】

这是我的老家，我长大的地方。山水还是那个山水，但建筑不再是那个建筑。不认识了，但的确很美。城建超出想象。

中国的经济起飞，不仅仅有一线（如上海北京）二线（如南京、武汉）三线（如 芜湖）城市的巨变，四线县城也是换了人间。这个成就还是值得称道的。江南是个好地方，感觉真要生活在三线四线，应该很容易适应。生活的便利、烟火味儿，啥也不缺。并不是只有大城市才宜居。且不说生活成本的差异。

"Though turtles live long, they meet their end. Though dragons ride the mist, they eventually turn to dust. Aged but still full of fire, ambitious till the very end. The natural order isn't the only clock; contentment brings longevity. How fortunate indeed, to express these sentiments through song."
— "Though Turtles Live Long" by Cao Cao of the Eastern Han Dynasty

My father was born on November 3rd, 1936, or September 20th according to the lunar calendar. He's a Rat in the Chinese Zodiac. Following our local tradition, which counts one extra year, he is currently 88 years old.

Father's name is Li, Mingjie, his courtesy name Hao, and his art name is Cuisheng. Born into a struggling intellectual family, his youth was filled with hardship and adversity. Lack of finances kept him from attending university, a lifelong regret.

In March 1956, my dad graduated from the Wuhu Health School and has been involved in medical work for 67 years. After a stint in schistosomiasis prevention and two years in public health administration, he shifted his focus to surgical clinical work in 1961. He has been practicing for over six decades now. He served in Nanling County Hospital for 25 years, Wuhu Changhang Hospital for 22 years, and China Railway Wuhu Hospital for 16 years. Approaching his nineties, he still hasn't fully retired. His vision remains clear, his hearing sharp, and his hands steady. He conducts research, reads literature,  remains engrossed in his profession, and stays updated with the latest surgical developments.  His thoughts are coherent, and he still performs surgeries. Moreover, as the medical industry transitioned to digital documentation, he adapted seamlessly, never falling behind. His age hasn't dampened his spirit; he continues to contribute to society with undiminished vigor. Truly, he is a tireless father.

My father has dedicated his life to medicine and saving lives. Over the course of more than half a century, he has understood the emotional states of patients, and monitored their health conditions, and with his exceptional intellect, energy, and skilled hands, he has tailored treatments to individual needs. He has brought health to countless patients, saved numerous lives from the brink of death, and restored joy to many families clouded with sorrow.

My father worked diligently at the grassroots level. Despite only having a diploma from a technical health school, he had no formal professor or mentor to guide him. He was self-taught. His medical skills came from personal insights and countless hours spent studying medical books. His natural talent, intelligence, diligence, and unwavering passion paved the way for his medical aspirations. Even in remote and impoverished regions, and in an era when intellectuals were often marginalized, he carved out his own success. As my father often says, 'My surgical career has been one of the longest, with numerous surgeries across a wide spectrum of specialties.' He also notes that many of the surgeries he performed at the grassroots level were highly challenging. Some of these procedures are still considered cutting-edge in the world of surgery. For instance, liver and lung surgeries, removal of cervical spine tuberculosis lesions, and repairs of injuries to the duodenum behind the peritoneum – such surgeries were rarely conducted even in the provincial hospitals during the 1960s. Yet, my father took the initiative to perform these complex operations in a modest county hospital and achieved success. He often proudly asserts: 'In surgery, sometimes, you have to pull a tooth from a tiger's mouth. It's not about blind risk-taking! It's about taking calculated risks, having advanced skills, and providing high-level treatment. Being brave yet cautious, breaking the norm, and always prioritizing scientific and pragmatic approaches are essential.

My father has practiced across a broad spectrum of medical specialties, from abdominal surgery, thoracic surgery, orthopedics, obstetrics and gynecology, neurosurgery, urology, otolaryngology, ophthalmology, radiology to anesthesiology. He has successfully performed many high-difficulty level-4 surgeries in each specialty, which is truly an astounding achievement. These surgeries range from operations for acute pancreatitis in abdominal surgery, carotid artery aneurysm resections in head and neck surgery, spinal tumors in neurosurgery, lung malignancies and esophageal cancer in thoracic surgery, clearing lesions of various osteomyelitis and tuberculosis of the cervical, thoracic, lumbar, and sacral vertebrae, and other fractures in orthopedics. Additionally, he has conducted lymph node stripping in urology, hysterectomy and ovariectomy in gynecology, nasolacrimal duct anastomosis in otolaryngology, cataract surgeries, and artificial pupil operations in ophthalmology. He's also proficient in different forms of anesthesia, including epidural blocks, brachial plexus blocks, spinal anesthesia, intubation general anesthesia, and intravenous composite anesthesia. The breadth of medical categories my father has mastered is unparalleled and unmatched, both domestically and internationally.

The unique circumstances of that era provided my father with a rare opportunity to showcase his talents and capabilities. Facing a continuous influx of impoverished rural patients, the stakes were high. To not treat was to let die. Treating them was always better than leaving them to their fates. He had significant autonomy. With an endless drive to work hard, he performed surgeries almost daily for decades. With exceptional professional skills, noble medical ethics, passion for medicine, dedication to his patients, persistence, diligence, and unwavering perseverance, he emerged as an outstanding major surgery doctor. My father seized fleeting opportunities, often breaking barriers and shining in his field. His achievements made him stand out, eventually reaching the pinnacle of clinical practice in grassroots hospitals.

For decades, when not performing surgeries, he would immerse himself in medical books, often sacrificing sleep and meals. Rarely did we see him rest; he was a true workaholic. We've always felt that my father is the modern-day Hua Tuo, crafted by his era. Considering the breadth of his medical practice, the number of patients he's aided, and the length of his service, he stands almost unparalleled in history—perhaps with the exception of Hua Tuo—and likely unmatched in the future.

Surgical practitioners need intuition. The stability and flexibility of one's fingers and wrists are incredibly crucial. My father seemed to be naturally made for surgery. He had an insatiable thirst for knowledge, a bold yet meticulous approach, an innate intelligence, and an innovative spirit. His expertise in surgery enabled him to comprehend concepts instantly and perform operations with exceptional precision. Especially during his younger years, he honed exceptional skills. Additionally, his team spirit was exemplary. Every subordinate doctor trained under him developed rigor, dedication, and a relentless pursuit of excellence, shaping a generation of medical leaders and experts.

As soon as he stepped onto the operating table, it was as if my father became a different person—calm, confident, and masterfully executing each surgical procedure. His surgical precision and speed earned him accolades from peers, patients, and their families. Over the years, his reputation spread far and wide, attracting a steady stream of patients seeking his expertise. Even the relatives of the chief surgeons from top-tier hospitals would seek my father for surgeries, trusting only in his magic hands. The renowned Director of the Surgery Department from the original Yijishan Hospital, Dr. Chen, entrusted my father with the surgery of his wife, Madam Xie, who was the head of the Nursing Department in Changhang Hospital. Despite her being in her eighties and diagnosed with breast cancer, my father's successful surgery ensured her well-being well into her nineties. She considered my father her lifetime "personal physician". Similarly, Wang Ping, the Head of the ENT department at Nanling County Hospital, trusted my father to operate on his daughter, Dong Wei, who had breast cancer. Years later, the Chief of the Obstetrics and Gynecology Department of the same hospital entrusted the care of her daughter in the same manner to my father.

The director of the surgery department at Changhang Hospital, Mr. Shen, had an elderly father-in-law in Shanghai, a distinguished professor, who was diagnosed with stomach cancer and pyloric obstruction. After being unable to eat or drink for several days and his body deteriorating, his family had almost given up hope. Yet, my father undertook the "risky" direct radical surgery, having saved his life. The patient lived for another five years before succumbing to other illnesses. Conventionally, patients of this age and condition would first undergo a bypass surgery to relieve the obstruction, and only later would they have the surgery to remove the lesion. In reality, few would get the chance for this second operation.

Back in 1970, my elder uncle, Pan Yaoyi, had hepatic and biliary stones along with obstructive jaundice. Refused by a renowned hospital in Hefei, he turned to my father in desperation. At the Nanling County Hospital, my father personally performed the surgery to remove the stones, excise the gallbladder, and establish an internal biliary-duodenal drainage, ensuring his full recovery. In 1986, another uncle of ours, Pan Yaotong, was diagnosed with rectal cancer and similarly turned away by the provincial hospital. Once again, my father stepped in, performing the radical surgery that lasted over seven hours.

Back in the 1980s, numerous patients would report their symptoms over the phone, and my father could make a diagnosis then and there. For instance, his colleague Cheng Daben had a perforated stomach. The young doctors at Yijishan Hospital misdiagnosed it as renal colic and treated it by administering laxatives to clean the intestines. The urinary system imaging examination the next day proved them all wrong! This not only delayed the crucial time for life-saving treatment but also exacerbated the perforation and leakage, pushing the patient into critical condition! The patient, in excruciating abdominal pain, desperately called my father and urged a return to our hospital, where an emergency surgery to cut into the stomach cured him. The husband of the head nurse Gao at the undergraduate department, Tao, experienced a similar ordeal. Nowadays, it's more common for patients to seek medical advice remotely through mobile "WeChat" at any time and place, resolving many medical issues this way.  What's particularly remarkable is that all the surgeries for our immediate family members were personally performed by my father. This demanded immense confidence, determination, and mental fortitude.

We once knew a young rural doctor who, feeling constrained in his medical career, chose to pursue an English teaching degree instead.  When discussing my father's medical skills, he expressed deep admiration: "Do you know? Your father is one of the most incredible doctors in the world. He can perform complex surgeries that many top-tier hospitals have yet to introduce or popularize." He shared several cases with us, and even though we might not have understood all the medical intricacies, one thing was clear: my father consistently pushed boundaries, always striving for surgical excellence.

Later, when we asked my father about any complicated surgeries he wished to perform but couldn't, he mentioned microsurgery, limb reattachment, and other surgeries requiring advanced equipment that were beyond the reach of the county hospital at the time. He also expressed admiration for the fields of stem cell regenerative medicine, gene-editing techniques, genetic engineering to reverse aging cells, and precision medicine, recognizing them as the frontiers of medical research, while humbly admitting that as a grassroots clinician, he could only admire them from afar.

After the Cultural Revolution, with the resumption of professional promotions, my father climbed the ranks seamlessly, from Medical Practitioner, Physician, Attending Physician, Associate Chief Physician to Chief Physician. His progress was smooth, never missing a step. In all three secondary hospitals, each with over a hundred staff where he served throughout his life, he was the sole Chief Surgeon. In fact, in the entirety of these institutions, there were only one or two with such a distinguished title. Compared to his peers who graduated from technical health schools like him, almost none had the chance to rise to such a senior position. Even graduates from medical colleges in his generation, the majority in secondary hospitals couldn't attain such a high-ranking title. The criteria for grassroots hospitals were even more stringent. One needed to excel in clinical practice, publish academic papers, and be proficient in English. Typically, only one chief position each was reserved for internal medicine and surgery specialties. They preferred having a vacancy rather than compromising on quality. This emphasizes how my father was truly a rare gem among his contemporaries, standing head and shoulders above the rest.

The era shapes individuals. My father never attended elementary school, high school, undergraduate, or postgraduate courses. His formal education consisted of only middle school and a medical diploma from a technical health school. Yet, he relied primarily on countless hours of medical practice, learning through hands-on experiences. With sheer skill and determination, he ascended the ranks to become a Chief Surgeon in general surgery, ultimately earning a reputation as a renowned all-around physician.

While doctors are respected, many lead modest lives. A bit of hardship in life didn't bother my father, but the challenge he faced was how to save up money to buy medical books. Those thick professional volumes like "Surgery" and "Orthopedics" were expensive, yet indispensable for his work. Who could have imagined that many of these medical books were acquired by my father secretly selling his own blood? Each time he would donate 300cc of fresh blood and receive 30 yuan – an amount that would typically take him half a year to save. My father would brush it off, saying: "humans have a hematopoietic system, so losing a little blood doesn't matter. There are often stories of doctors donating their own blood in emergencies to save patients, and I've experienced this myself several times during my medical career".  But acquiring professional books by selling one's blood, such instances are probably rare across all of history and around the world and perhaps only characteristic of that particular era in China. Perhaps only in that specific era could a reputed doctor resort to such means to own medical books.

On June 3, 2007, my father faced the greatest ordeal of his life. Suddenly, he began vomiting blood and developed an inexplicable fever reaching 40°C. The once indomitable spirit, who often claimed to be "forever young and vital", was suddenly brought to his knees. He lost over 2000ml of blood, putting him in grave danger. He was rushed to the hospital and was diagnosed with 'low-differentiated gastric adenocarcinoma.' On June 21, he underwent major surgery in Wuhan, having his entire stomach and gallbladder (due to pre-existing gallstones) removed. He narrowly escaped the clutches of death. Having worked tirelessly throughout his life, he always took pride in his robust health and positive attitude.  Who would've thought? A man so rarely ill could be brought down so severely. This incident was the most significant challenge he had ever faced and marked a turning point in his health journey.

My father has always been the backbone of our family, typically appearing youthful and vigorous, especially for his age, without a hint of any vices and never having stayed in a hospital before. Despite the hardships, life was always vibrant for him. Thankfully, his sudden illness led to an early diagnosis and timely treatment. Being under the best medical care and surrounded by family during his recovery gave everyone peace of mind. After the surgery, he aged noticeably, and it took him over six months to regain his strength. Now, he speaks with such vigor and frequently performs surgeries, which is a huge relief for our entire family.

Now semi-retired, my father, at the age of 88, is astonishingly spry for his age. Despite his modest living, he keeps an orderly life and continues to be eager to learn new things. Although he no longer drives, his curiosity about the latest tech developments remains. Just this February, he was asking me about the etymology and background of OpenAI and ChatGPT. He's more tech-savvy with smartphones and computers than many youngsters I know, ordering food from Meituan, hailing cars from DiDi, and shopping on Taobao. He also frequently consults English professional materials, absorbing new knowledge, proving the adage true: you're never too old to learn. He even outpaces English-major graduate Wei in English technical vocabulary, truly an exemplary lifelong learner.

Before his major illness, he was a whirlwind of energy, performing surgeries, driving, browsing the internet, writing memoirs, and enjoying chess games. In the decade since his surgery, even with a decline in his physical condition, he hasn't given up his lifelong passion for clinical medicine. He may have set aside other specialties, such as orthopedics, gynecology, and urology, but he remains steadfast in his dedication to general surgery, continuously contributing to the field and aiding patients. Medicine is an eternal bond he could never sever.

Gentle in nature and kind to all, my father has always been upright and warm-hearted. His patience and attentiveness when diagnosing patients, regardless of their socio-economic status, genuinely exemplify the benevolent spirit and humanistic essence of a doctor.

With progressive thoughts and a modern mindset, he always treated his children as equals, never reprimanding them, let alone resorting to physical punishment. He has always gently guided us, both through his words and his actions. Our individual successes are his greatest solace, and the growth and antics of his grandchildren bring him immense joy and satisfaction.

This book is a compilation of some of the medical papers my father published after the Cultural Revolution. Although it's not exhaustive, it preserves many invaluable experiences and theoretical summations from his medical career, standing as an enduring testament to his dedication. These papers encapsulate how a doctor from a grassroots hospital refined himself through challenges, continuously pushing his boundaries. They embody a physician's fundamental principles, conscience, responsibility, commitment, and mission, spotlighting the gallantry of medical professionals in their efforts to save lives and epitomizing the profound essence of "healing the world."

Recently, as we were compiling some of these medical papers, my father reflected on his journey spanning over 60 years, filled with both pride and nostalgia. While his papers primarily encapsulate his clinical experiences and might not be heavily research-oriented, their practical utility is undeniable. They are meticulously crafted, adhering to strict academic standards, and represent the crystallization and theoretical evolution of his medical practice, holding a certain legacy value. The excellence he has demonstrated throughout his life, his unwavering dedication to medicine, his relentless pursuit of knowledge, and his humble, upright, and benevolent character serve as a priceless heritage for our generation.

Given the vast timeline, locating all his papers was challenging, and unfortunately, many have been lost over the years. We've done our best to gather as many of his past medical writings as possible, compiling them into this volume as a birthday gift for our 88-year-old father, who has been practicing medicine for 67 years non-stop. We wish him a happy birthday, good health, and a peaceful twilight year!

《李名杰医学论文集影印版》

【李名杰从医67年论文专辑】（电子版）

【李名杰从医67年论文专辑（英语电子版）】

提示词：a detailed artistic photograph as portrait of a beautiful Chinese young girl next door, beautiful lighting

老哥问： 能否用 ChatGTP4 给这几张照片取个名字？汉江边，琴台公园旁

It all starts with this piece of AIGC original about 2 years ago (2021):

Then:

小雅高清 8.3 MB

2.5MB

2 MB

1.9 MB

2.4MB

1.8MB

2.3MB

2MB

1.8MB

1.8MB

309KB

220KB

317 KB

1.8MB

596KB

179KB

285 KB

262 KB

汉阳一江水

这里讲一讲老爸的几则小故事，就能一窥老爸业务全貌。

一

有一年春节，我回老家陪老爸过年。

大年三十吃完年饭，大家一起看着电视， 聊着家常。大约十一点左右， 老爸电话响了，是老爸服务的医院打来的。说医院有个急诊，希望老爸过来会诊指导一下。老爸二话没说，稍加收拾，叫我开车把他送往医院。

老爸一直工作到第二天，大年初一的早晨，才叫我接他回家。路上我询问老爸，什么急诊，大年三十都过不安稳？老爸很疲劳，眯着眼疲惫地淡淡说：医生吗，常会有这种事，急诊才不管假日不假日。年轻时年年如此，你们小记不得了。说着，就闭眼休息去了。

过了几天，老爸才骄傲地告诉我，那天幸亏他去了。原来大年三十医院来了个急诊病人，初步诊断为急性阑尾炎。两位值班外科医生连夜开刀动手术。打开肚皮后，两位医生懵了，阑尾没有炎症。在手术台上两位医生发生争论，一位提出关腹缝肚，看情况转高一级医院。另一位提出让老爸过来看看，再决定下一步方案。

两位争论一下，最后一致决定请老爸过来一趟。老爸一过来，一边听他们介绍，一边消毒换衣上手术台检查。姜是老的辣，老爸上台一探查，就发现问题。病人是胃穿孔，大量胃中物流出。随后老爸亲自动手，缝合胃孔，清理腹腔，用时二小时，顺利关腹，解决问题。这例胃穿孔，穿孔渗出被包裹，隐匿很深，难以查出，因而易被手术医生漏诊。这需要临床医生先判断，再寻找，没有一定临床经验和理论基础，是很难发现的。

老爸说，如果当时不查明病因就关腹，误诊误治，再次手术是必然的。如果拖久一点，腹部被胃液等物浸蚀，感染扩散，会危及生命。老爸说，这个手术最需要仔细，必须非常细心地清理腹腔残留物，确保术后不被感染，不然，后面麻烦事很多。老爸很兴奋，自己又救人一命。

要知道老爸那时已过八十高龄，虽眼不花手不抖，但五年前他因胃癌做了胃全切手术，因胆结石做了胆全切手术，身体已大不如从前。但老爸一上手术台，就生龙活虎，一站就二小时，也不叫累，下手术台后，也迟迟不回家，继续观察病人病情。

老爸对自己职业，热爱深入骨髓。救人救命，是他一生的追求。直到今天他仍然离不开他的岗位，不是为了收入，而是为了他那份对自己职业的热爱和执着。

二

故事发生在文革期间，老爸有一世交老朋友桂叔，家在邻县，我 们两家当年走动频繁，我们也很熟悉他们一家人。桂叔他有一个16岁 的儿子，患颈椎5结核并寒性脓肿，压迫了食道和气管，不能进食，呼 吸困难，声嘶、脱水、缺氧，生命危急。他们家先去芜湖最大医院弋 矶山医院，骨科陈主任拒收，说，几天前，类似一例，手术，未下得 了台。嘱转合肥省级医院，要备800元。可是，他月工资52元，要养活 一家六口，哪能成行？况且，也不知合肥又如何打发他？火急的他听 说南陵城郊的解放军127医院有位全国骨科权威许竟斌主任（也是老爸 的骨科恩师），怀一线希望，他带着儿子来到127医院。不巧的是，许 军医出差南京，他旗下几位，都不敢接受这例高危病人。无奈，老友 找到老爸，老爸过去一看，发现过去从未接触过此类病人，感觉有些 心有余而力不足，不太敢接受。于是老爸找到127医院的骨科和外科军 医们（老爸与他们都很熟，老爸在127医院许教授门下进修过半年）， 做他们工作，与他们一起讨论方案细则，商讨救治方法，希望能在这 所医院救治。但对方院领导仍不愿接受病人，领导建议转合肥或南京 救治，并答应免费派车送行。病情紧迫，病人随时有生命之虞，远水 不救近火，127医院做手术的路堵死了。没办法，老爸毅然决然，决定 自己接手这疑难重症。老爸和老友交底，谈到转院风险和手术风险， 两人决定共担此责，病人送回县医院。老爸临时抱佛脚，复习文献， 重温解剖。半小时后，病人送手术室，局麻下手术。细心解剖，进入 脓腔，放出大量脓汁，解除压迫，患者立即发声，进水，呼吸通畅， 立即脱险。手术继续深入下去，显露颈椎5椎体病灶，祛除死骨，刮除 结核肉芽，冲洗脓腔，置入链霉素、异烟肼，放引流片，缝合，术毕 返回病房。手术顺利、有效，术后3天退烧，病人自己去理发，进食正 常，恢复良好。术后12天出院，医药费仅32元，继续抗痨治疗半年， 病愈。这40多年了，病人一直正常劳动、生活，儿孙满堂。这颈椎结 核病灶清除手术，除了颈前密集血管、神经以及甲状腺、气管、食管 等复杂解剖，更因颈椎脆弱，加之结核破坏，其后的颈髓，稍有闪 失，就会高位截瘫，甚至死亡！是骨科铁4级手术。这类手术就是在北 京、上海大医院做，主任们也都谨小慎微，如履薄冰！难得老爸救人 之心迫切，知道转院那基本上是死路一条。为朋友之子，虽颤颤巍 巍，如临深渊，但靠着自己多年的颈部甲状腺手术经验和熟悉解剖， 又有骨科专科知识的积累，加上深思善谋，胆大心细，勇于实践，终于圆满完成了这基层医院罕见的难题。既治标又治本，病灶根除，终身治愈。

80年代末，芜湖一中初二学生小魏，14岁，曾患右肱骨颈肿瘤。弋矶山医院和上海中山医院两次手术。这次右肩胛骨再发病。市某院骨科主任发话：恶性肿瘤复发、转移，要截肢，难保命！病家投医无门，身处绝境。患者外祖父吴老师是老爸当年初中老师。吴老师知道前述桂老师儿子治颈椎结核病事例，于是，来找老爸商讨。老爸审视前后病历和片子，诊断为另一临界肿瘤，不是原病的复发，也不是转移。在老爸的医院，老爸亲自给他做了右肩胛骨半切除，顺利完事、痊愈。2 0多年过去了，小魏身体健全，一路成了洋博士，游弋于全球，是高端人才。至今，他和他父亲总找机会登门拜望，令人欣慰。

1975年秋，一35岁女性病人，消瘦40公斤，胸椎6、7椎体结核并截瘫入院。全麻下经胸前入路，病灶清除，祛除死骨，坏死椎间盘，椎管内结核肉芽长达8cm压迫胸髓，导致椎管梗阻截瘫。掏刮后，可见此段脊髓恢复搏动，彻底冲洗病灶区，放入抗痨药。以开胸时切下的肋骨，修剪后嵌植于椎间缺损区，完成前路植骨。术后恢复良好，治愈。病家丈夫是一铁匠，他送老爸他亲自打造的不锈钢菜刀和锅铲，至今还在使用，医患之间情深意重。骨科手术中，这也是顶级4级手术。胸椎结核并截瘫，经胸前路一次病灶清除并植骨，在县级医院，当属巅峰。

骨科特例中，值得一提的是腰椎间盘突出症手术，老爸做过几百例，常见奇效。病人大多为中壮年，行动寸步难移，疼痛日夜不宁，抬来医院手术，当日见效，终身恢复！老爸农民表弟骆本炎，老爸同事弟弟开车司机汪锡龙，中壮年均患此症，直视下确保被压神经根及脊膜囊的松解，收到立竿见影的效果，事过二十多年，一直重回健康和劳力！这些病例，在此领域，至今仍居前沿！

三

老爸行医六十多年，手术万例以上，有没有发生过医疗事故呢？

没有，那还真没有！但他一生中也确有几次手术失败的案例，其中一个案例让老爸痛心许久。初衷与效果有时很难一致，为此老爸常常自责。老爸的外科恩师，皖医二附院外科老主任闵梅先老先生就曾开导过老爸，他给老爸讲他当年在北京阜外医院心胸外科进修时故事。在这个中国心胸外科堪称老大的医院里，当年病人不少都是走着进去，然后抬着出来！屡屡手术失败。中国顶尖权威大拿们就曾告诫过老爸恩师，不动手术就是死，动手术还有一线希望。这条血路，我们不走，谁来闯！科学是要付代价的！医生工作，本就在风头浪尖上生活，一医成功有前人的辛酸。

让老爸深刻教训，终身难忘病例是一位老师的手术。老师是慕名来找我老爸医治的。老师64岁，依据病史及B超诊断为胆囊结石，这种病老爸开过千例以上，从未失手。1984年10月16日老爸在本院给老师行胆囊切除手术，术中发现胆囊内胆固醇结石23枚。手术进行很“顺利”，切除胆囊，解剖清楚，历时75分钟，无异常，符合B超报告，术后无渗胆，切口甲级愈合。但病人特别之处在于解剖先天变异，肝肠之间正常通道缺如，代之以胆囊及胆囊管，教科书上及医学文献，亦从未见报，B超也未发现此先天异常，故迟至术中仍全然不知。术后第3天，发现黄疸并进行性加深，1984年11月9日行第二次手术，85年2月10日上级医院作第三次手术，未能挽救。为此老爸十分难受自省，医道充斥甚多未知和意外，遇此任何医生都难以避险。老爸常拿这少数几个痛心案例告诫自己，训诫前后同行，并写成医学论文《胆道手术中几个特殊问题的诊治体会》，用来总结经验、吸取教训，同时鞭策自己今后工作认真，认真，再认真。学习，学习，再学习！化未知为已知。

四

患者，男，2 9岁，骑自行车时，右季肋部撞击于停放的板车手把，当即剧痛、感呼吸困难，心慌，一小时后送入老爸医院。经查，肝脾胰肾均正常，腹腔无积液。胸腹透视无异常。住院观察16小时出现右侧腰背胀痛及睾丸痛，提示为腹膜后十二指肠损伤，于伤后28小时剖腹探查。进腹后见腹腔内有少量胆汁样液、胆囊、肝外胆管及肝脏无损伤，右侧后腹膜广泛水肿、绿染。作Kocher切口游离翻转十二指肠，发现其降部于乳头前上1.5cm处破裂∅1.5cm，肠液外溢，局部 及右肾周围水肿，组织坏死。彻底清除坏死组织、漏出肠液，修补肠 破裂口，毕氏Ⅱ式结肠后胃空肠吻合，48小时肠蠕动恢复，进流汁。 三周后两造瘘管造影正常，先后拔除两管，一期愈合。随访一年，无 并发症及后遗症。这例腹膜后十二指肠损伤是一种严重的、少见的腹 部损伤，早期因症状隐蔽，极易延误诊断。且手术复杂，高大上，考 验医生临床技术。要精准设计，一生难遇二例。手术台上，善思应 变，无规范可循，稍一闪失，危及生命，抢救成功率不高！本例是老 爸亲自手术，现患者还健在，生活正常。

五

患者，男，患黑色素斑点~胃肠道多发性息肉症候群病，十四年三次手术，老爸一人完成的。尤其是患者患极罕见的肠道、胆道双梗阻，十分难治。可能全球独一，世界无双！并发症是使患者就诊的主要原因，往往要到青年时期。因系先天性疾患，又无根治办法，此病的预后，若处理得当，可以长期生存，唯需多次手术。并不妨碍寿命。在老爸细心多次治疗下，病人获得新生。老爸一生中，碰到的这样疑难危重病人很多。在简陋的基层医院里，几乎是自学的他，把挽救患者生命当作使命，创造一个又一个奇迹。

六

1968年，在皖南一个深山小乡镇何湾，一个13岁男孩从牛背上摔 下，老爸出诊，发现该小孩右肝破裂，腹内大出血，要开胸才能完成 手术。肝手术，当年在大城市都是大手术，老爸之前从未做过。何况 在偏僻山村，连手术需要大量血液都无法保障。这时小孩已生命垂 危，时间不等人，救命第一，老爸艺高胆大。一方面老爸急中生智， 当时病人腹内在大出血，老爸大胆决定从腹腔抽取积血回输，首创混 有胆汁的腹血回输。而混有胆汁的腹血安全回输，他创造国内第一 例。（这里也有一个理论问题：肝血回输当时医学上尚极少论及，因 有胆汁污染，10年后，文献才有报道混有胆汁的血能安全回输，并在 后来的文献上陆续得到肯定的。）当时是形势所迫，也是老爸曾有过 一次腹血回输经验，（没有混有胆汁。另外宫外孕破裂的腹腔出血， 虽混有羊水，但也可回输，老爸经历多次。）那一夜，老爸立在病人 身旁，“车水战术”，从腹内把出血抽出来，过滤后再静脉输入，共 回输1 7 0 0毫升，赢得了时间。接着就在汽油灯下，老爸在山村卫生 院，就地全麻开胸开腹。手术，初战告捷，顺利完成肝修补手术。在 一个小山村，没有电、缺乏助手、设备简陋、药品不济、血品又少、 又无指导老师的情况下，老爸胆大心细成功完成他第一例肝脏修补手 术，这应算是一个少见奇迹。术后恢复顺利，终于救回了患者一命。 在那个时代，那样条件，那种技术，是个了不起的成绩。 这是当时中国的县医院，腹部外科水平的最高峰了，绝对前沿！ 而在山村小镇简陋无电无自来水的手术室里完成这一手术，在中 国也是绝无仅有的。

七

1965年10月，遵循“6.26”指示，老爸带队带领7（含内科一人， 护士、助产士五人和外科老爸一人）人组成巡回医疗队，去皖南烟墩 公社。虽然老爸是副队长，但队长是位年过半百的内科田医生，他当 年心脏不是太好，多半在家休养，在乡下时间不多，实际是不到三十 的老爸主持全盘，一连干了三个月。 在1965年最后100天里，没有电，没有麻醉师，没有助手，缺器材 少医药。老爸光杆司令一人，带着手术包、手提高压消毒锅，自己搭 建“手术室”。上面蒙块布，就是天花板，下面洒水，?避尘土飞 扬，汽油灯水电筒照明，就是一个“手术室”。以老爸为主角在此做 了大小手术612例次，无一事故，全部痊愈，创造乡村手术的奇迹。其 中开腹手术是121例次，手术遍及普外、妇科、骨科、五官等，手术有 胃、胆、肠、子宫切除，胆肠内引流，阴式全子宫摘除，膀胱阴道瘘 修补 …… 疝、痔、眼球摘除，不全流产急诊清宫等。这在当时医疗卫 生尚处落后，青毒素都奇缺的年代，100天多如此多不同类型手术，是 一项记录，也是老爸外科一次特别展示，创造。

与此同时，医疗队组织全公社6个大队卫生员分批脱产培训一遍，创建卫生村一个，为这个村建了两口水井，改变此地世代饮用“泥水”的历史。

对于老爸，忙，是属当然，三个多月工作，昼夜不分。老爸没离岗一天。虽离家也就几十里地，1个多小时车程，家中有老、有小，百日时间里老爸竟未回家一次。这么卖命工作，其实收入并不增分文，这种对工作投入精神，是现今不可思量的例外。

巡回医疗的某一天下午，在一位临时赶来的县医院唯一麻醉医生的帮忙下，老爸一人连台做了三例阴式全子宫切除术加盆底修补重建术（那是中国著名的大饥荒后，留下营养不良后遗症——三度子宫脱垂（实为盆底疝）的高发病例），也就是这同一天，老爸一直手术到凌晨三点，一人主刀做了十多例其他手术，在临时性“手术室”手术台上连续工作十七、八小时。直到如今，在中国也再不可能再有人单独有如此高的工作效率。

为此，医疗队受到县、地区（市）表彰和奖励，在褒奖会上还专门安排老爸上台作了专题报告， 展览了老爸所用的“ 全部手术器械”，发了专文通告，并在全芜湖地区推广，这是对老爸最大肯定和奖赏。

老爸为前右2

在那段时间里，有很多难以忘怀的病例。

第一例为不全流产大出血，血流如注，分秒面临危局，老爸出诊救急时，与一位助产士在三星大队她农舍家中给紧急清宫并快速补液，回天有术，救回一命。第二例为膀胱阴道瘘，手术修补，12天康复出院，填补空白，开创这一手术本地区的先例。

第三例是一中年妇人，患伤寒病肠穿孔并发腹膜炎（那时此类传染病盛行，近年来罕见），做了肠切除手术。她身无分文，给予免费。出院后老爸骑着自行车，携带由我们医生自掏腰包购得的礼品，再去青阳木镇她农村家中随访和慰问，是体现了“白衣天使”圣洁原味。

第四例是一个剖腹产，横位，子宫先兆破裂，不敢再转运，只得就地行剖宫产，办公桌上当手术台，顶上拉布挡灰，地面洒消毒水，吊上水，局麻下手术，成功救了两条人命。

当年医疗条件特别简陋，遇上急出诊，单枪匹马，就地手术，真是俗话说的好：艺高人胆大。

第五例是一病人脾脏破裂，老爸去出诊，也是在办公桌上为其就地成功作了脾切除手术。称奇的是腹血回输8 0 0毫升，克服无血源难题。这血，无须抗凝亦无法抗凝，是可输入病人的。但这是第一次、国内首创。路是逼出来的，“时势造英雄”，理论支持和认可，是后来才逐渐见诸文献。（ 脾出血回输， 过去文献有记载， 但须“ 抗凝”，不“抗凝”是首创。不“抗凝”，是后来才逐渐见诸文献。）

八

76年7月28日那场旷世唐山大地震与老爸也有渊缘。8月2日，老爸被召参加芜湖地区（市）三人医疗队赴震区救援。三人到南京后，接到北京来电：伤员南下，各地准备，就地接纳医治，不用去受灾现场救助。于是，老爸被安在繁昌峨桥治疗点，带25人医疗队，当地再配25人后勤，接收100位伤员。老爸是队长，通管全盘，还有三个副队长和二位指导员（可谓一个强悍的领导班子），人员挑选也都是“精英”，直接受市县领导，一切为伤员的开支由国家包下来，是当时国家的头等政治任务。

老爸带几位医生到南京车站，上卫生专列检查、接收伤员，车至峨桥，大队人马在迎候，担架抬入“病房”，来的大多已无生命危险，主要是骨伤、筋伤，好在老爸还算得上是骨科医生，此时，从行政安排转而重点临床医疗，几个月下来，逐一使之恢复，并派医生全程护送回原籍。这是对这场震惊世界、付出24万人生命、罕见的自然大灾害的做了自己一丁点贡献，老爸完成这一历史性任务。

这一年，中国多灾多难，国家主要领导人，继周、朱作古之后，就在这全国闹地震的国难当口，9月9日，毛——中国一号人物，也溘然去世，给全国人民撒下了阴云，中国前景如何？人们茫然！

老爸当时身在客地，担负这一重任，管理100个伤员和50个工作人员，本地也在闹地震，工作人员自己和家人安危和牵挂，加上国家的“家长”们相继辞世，可以想见，人们心头，抑郁、无望！老爸发挥全身解素，以身作则，出色地完成了任务，又交了一份完满答卷。

老爸为中左五

九

文革武斗期间，各派武装割据，交通中断，医院停诊。但子弹是不长眼的，枪伤是乱来的，穿肝、伤肺、伤血管以及肾、肠胃等，也只得就地手术。肝、肺修补术，尤其是脑外伤，老爸也就是那时被逼上路自学成才实施的。

在各方面环境条件极差状况下，老爸倒也救了不少人的命。好歹有功无过（ 真的救不过来， 也少有问责的。当然， 多数还是成功的），这让老爸长技术、练手艺，成就一身本领。

由于武斗，医院半瘫痪，空时多，老爸系统地阅读学习医学专著、英语，并补全了大学医学基础理论，使老爸在医学理论上也有了一次飞跃，理论指导实践，而实践又出真知，老爸无论理论还是实际应用以及经验都达到一个新的高度。

文革武斗造就外科人才，算是一奇迹，这也是另类的黑色幽默。

十

老爸从医六十余年来，手术无数，在实践中他常有些小改进、小

创新、小突破，都取得十分好的效果。

a．除特殊需要外，老爸所做的上千例以上胃切除基本废除预置胃管（书本上要求预置），无失败病例。这就要求精良吻合，完善止血，术中排空胃残物以及术后严密观察，极大地提高了病人治疗的舒适度。

b．泛发性腹膜炎，在除去病灶及感染物之后，废弃腹腔引流，减少术后粘连。关键是术中彻底冲洗拭净。因引流物在腹腔内很快被纤维蛋白粘堵失效，徒增病人痛苦。诚然如胰腺炎、腹腔脓肿等，预计有持续溢漏者，则需双套管负压引流。

c．包皮环切术，常规术式，内外板对合不良，血肿、水肿和拆线困难等，都困扰医患双方。老爸予以改良，局部静脉麻醉，止血带下整齐切割，完善止血，人发或可吸收缝线缜密缝合，可获术中无痛、对合良好、愈合快、免除拆线等优点。

d．肛瘘挂线疗法或切除敞开，均令病人蒙受术后痛苦，且恢复期长。老爸用长效麻醉（局部注入稀释的亚甲蓝），一期切除缝合，大都一期愈合，缩短疗程。

e．控制外伤感染，关键是首诊的彻底清创，而不是依赖引流和抗生素。大量清水冲洗，消除异物及失活组织，认真消毒，无张缝合，若术后炎症反应，局部辅以酒精湿敷，用或不用抗生素，按此，6小时内的外伤，几可消除感染。

f．腹股沟疝修补，重点在腹横筋膜，以改良的Madden术式代替传统的Bassini法，大大减轻病人术后张力缝合的痛苦，也有利于愈合，且复发率大降。

十一

老爸聪慧，不但手术做得好，文章也写得得心应手。

老爸虽是中专生，但因手术高超，论文丰产，英语熟练，虽无官职，但中级职称、副高、正高都评的很顺利，没有疑义。

但不少同事（不包括领导）就没有他那么幸运了，有的水平不行，有的论文不够，虽然大多学历比老爸高，但就是评不上正高。

老爸对此很有异议，他认为有几个朋友，临床手术水平很不错，但不太会写文章，没有论文，就被卡着评不上。

老爸认为临床工作是实践性东西，尤其是外科，需要手巧有悟性，要多做多看，才能提高业务水平。临床不是搞科研，而且病人那么多，那么忙，值班接着值班，手术接着手术，大家都忙得喘不过气来，又不是教学医院，哪有时间坐下来申请课题、搞科研、写文章？

临床医师需要大量病例的训练和临床经验的积累，把科研任务和临床工作混为一谈，让许多临床经验丰富和技术精湛的医生被论文卡住而评不上职称，这是很不公平的。

一个以临床技能为核心的实践性职业，要求论文而不要求临床治病水平，有点荒唐。

老爸是个热心肠，急公好义的人。

有一次他对两位外科水平很高，评职称卡在论文上的朋友说：我替你们写几篇文章，你们拿去修改指正后，再以你们名字去刊物发表吧。老爸说干就干，很快把几篇新写的医学文章给了两位。

果然，经两人修改的文章发表后，很快评上正高，后来他们都成为医院的台柱子，是手术台上一把好手。

这是好多年前的事，老爸每每谈起，没有后悔老爸虽然有违规，但他只是怜惜人才。

助人为乐，成人之美，尽量为他认为值得人才，铺铺路，搭搭桥，这都是他很乐意做的。

他们每一次进步，老爸都要和我唠叨好几天，兴奋之意溢于言表，十分骄傲。

十二

我们曾经的邻居慧姐是这样描述老爸和我们一家：

我是小慧，少儿时曾与汉阳一江水一家是邻居。我父亲是黄埔军校后期学员，五十年代因历史反革命进了大狱并迫害至死，母亲是师范生，但剥夺了做教师的权利。我们是典型的黑五类家属，妈妈不断遭到批斗，子女按规定不能上中学。我算幸运的，因是女生缘故，还能上中学，总算高中毕业。大哥根生是跑到偏僻乡下才勉强读了初中，二哥根宝小学毕业时，政审把他刷下来，连初中也不让上。在那艰辛苦难严酷无助年代里，我的邻居李叔叔一家一直很关爱我们，外婆潘奶奶还认我母亲为干女儿，没有一丝歧视，让我一家倍感温暖。

有病找他们家，没得吃找他们家，有困难找他们家，凡事都找他们家来帮忙。李叔叔串门时经常看我家米罐子有没有米，没有了他就送来了米，有好吃也会给我们送来，需要帮忙时总是尽力帮忙，我们两家小孩也像亲兄妹一样相处，这些我是永远也忘不了。

李叔叔，是我们这个皖南县城医院的一名外科医生。李叔叔五官周正，一表人才，长相清秀，很有古时秀才风韵。他爱读书肯钻研，天赋极强。腹外，胸外，骨科，眼科，五官科都涉略精通，自学成才。那个年代，年纪不大，李叔叔就是当地外科手术一把刀，在那片天下声誉日隆。我现在时常回想过去的岁月，很想念李叔叔他们一家，想到那个年代我们的生活。在李叔叔夫妇身上，真正体现到人类最珍贵的友爱和仁慈，他们就是我妈和我们的精神支柱，是我们全家的大救星，我终身难忘。青少年时期的我，有时真的感到李叔叔就是我的父亲，他对我及我一家关心备至，我从小就看在眼里，喜在心里。遇到李叔叔一家是我妈的福分，更是我一家人的福分，有这样的邻居，我心里充满幸福。感恩上苍派来李叔叔潘阿姨这样的神灵，一直护佑着我们家全体人员。我小时候体弱多病，那是由于营养不良贫困造成的，在缺食少粮，无钱治病的年代，几次大难不死，活到今天，是我的邻居李叔叔和潘阿姨救过来。

有一年，我得了急性肝炎，很重。妈妈带我找李叔叔诊治，李医生通过检查和询问，得出结论，急性甲型肝炎。李叔叔说：保肝治疗，不要吃任何药，因为吃药给肝脏再次伤害。肝脏已经生病不能正常解毒了，再吃药的话会火上浇油的。不要乱花钱，现在猪肝便宜，我给你弄点猪肝吃，增加营养多休息就会好的。我按照医生的嘱咐，没多久甲肝真的好了。这件事，在我少年时代留下了很美好的记忆。

李叔叔妙手回春，手到病除，对症食疗，可敬可佩。几年后我下乡，因为穷，也不太注意卫生，不知道如何保护自己，也不带手套。我们用框子将奇臭无比、经过发酵后的杂草肥料挑到田间，然后用手抓着散开，就这样不干不净的生活。其实当地农村很多人面黄肌瘦，不知道何原因？估计大都可能得了肠虫症，寄生虫虫卵进入寄生于身体，久而久之大量繁殖，总有一天要爆发的，这都是愚昧落后和无知以及生活极度贫困造成的。我也不例外得了肠虫症，期初主要症状肚子隐痛，两条腿上布满红血点，农村医生说是过敏，吃了大量的抗过敏药，一直不好，一拖就是一个月。没多久我极度消瘦又没力气，生命垂危，眼看就要归西天了。妈妈赶过来一看，吓坏了。我肚子上还起包块，人也完全变了形，妈妈很着急了，流着泪立刻找来她的好友和曾经的邻居李叔叔和潘阿姨，两个经验丰富的医生。他们在我肚子上一摸，说是蛔虫，用现代医学名词解释我那个病叫做“蛔虫过敏性紫癜”，上帝又饶了我一次小狗命。我像小猫咪一样有九条命奥！赶快吃了两片驱虫净，第二天我妈倒马桶时惊呆了，里面全是蛔虫夹着血液。第三天我肚子不痛了，身上的血点逐渐消退，立马又是一个活泼可爱的大姑娘了。李叔叔和潘阿姨诊断正确，药到病除。由于他们的高超医学，我的生命得以挽救。李叔叔一家对我家的恩情，我永远无法报答。

祝李叔叔身体健康，永远年轻。

小慧母女与汉阳一家水一家合影

十三

老爸虽然已经8 8岁高龄，但他对新科技的好奇心和兴趣从未减退。他对新知识、新科学有着浓厚的兴趣，接受新事物的能力也非常强。老爸思想开明，勤于思考，不墨守成规，追求卓越，总是喜欢探索未知的领域。从电脑、手机、互联网到智能化应用，老爸总是敢于尝试和应用最新的科技成果。他常说，要想不被这个世界抛弃，就必须具备接受新事物的能力。只有这样，人生才不会停滞不前，才能不断提升自己和提高个人生活质量。紧跟时代步伐，不断更新观念，这是老爸一生的追求。

自从O p e n A I公司的C h a t G P T问世以来，老爸就一直对它充满兴趣。他几乎每天都会向从事自然语言处理的老弟立委询问ChatGPT的使用范围、应用现状和发展方向。为了让老爸能够更深入地了解和使用ChatGPT，不久前立委给他试装了一个。在试装过程中，老爸头脑清晰，能够准确无误地键入各种复杂的口令和操作。与其他同龄人相比，老爸的精神状态和思维能力都非常出色。

随着LLM各家应用落地的加速，未来各种智慧家居功能也将无缝对接，人们的生活将越来越依赖人工智能。很多时候，人工智能甚至能够决定一个人的生活质量和人生高度。虽然国内人工智能在研究领域上落后于欧美国家，但在应用落地方面却一点也不差。而且，国内的人工智能普及率远远高于欧美国家，这让老爸有了更多机会尝试和应用各种最新的科技产品。他在家中试用各种人工智能产品和软件，兴趣盎然，乐在其中。

老爸在使用chatGPT

除了对最新科技的关注和应用，老爸还是一个货真价实的AI应用追随者。他热衷于尝试各种人工智能产品和软件，从中获取便利和乐趣。无论是智能家居、智能助手还是自然语言处理软件，老爸都有浓厚兴辆。他的这种积极态度和学习能力让我们这些下一代人也自愧不如。

老爸赶上了一个科技大爆炸的时代，自然不会错过这个伟大的时代。他现在使用的是苹果15pro手机，这是当代最新的产品之一。他还拥有iPad上的最新翻墙软件以及ChatGPT等最新的科技软硬件。全国也找不到几个这样配置的老人了。“顶配”的老爸，88岁依然不掉队，依然走在最新科技的最前面。

老爸的这种对科技的热爱和追求不仅仅是为了满足自己的好奇心，更是为了在日新月异的时代中保持竞争力和适应力。在这个科技日新月异的时代，老爸用自己的行动向我们展示了什么是真正的活到老学到老。他的这种积极向上的态度和对新事物的好奇心值得我们每个人学习和传承。

结语

每当夜深人静的时候，那伴着我少儿时成长的劳累疲乏背影，总在眼

前呈现，历历在目。这常让我回想起老爸当年工作生活的情景，许多事已

过去半个世纪，却时时萦绕于脑海，烙印在心里，让我感动，赋我力量，

给我温暖。

老爸，您是我的榜样，您是我的骄傲，我爱您!

祝老爸八十八岁生日快乐！

作者与父亲合影

      汉阳一江水、立委

    神龟虽寿，犹有竟时。螣蛇乘雾，终为土灰。老骥伏枥，志在千里。烈士暮年，壮心不已。盈缩之期，不但在天。养怡之福，可得永年。幸甚至哉，歌以咏志。

          ——东汉曹操的《龟虽寿》

    老爸生于一九三六年十一月三日，农历九月二十日，属鼠，按照我们当地习俗“虚”一岁计，今年正是八十八岁。

    老爸姓李，名名杰，字豪，号翠生。出身在家道中落的知识分子家庭，从小生活贫困，苦难与艰辛一直伴随他青少年成长过程。因为贫困，没有进入大学学习，成了他的终身遗憾。

    一九五六年三月老爸从芜湖卫校医士班毕业，一直从事医务工作达六十七年之久，在经历了三年血吸虫病防治和两年卫生行政工作之后，一九六一年老爸开始从事外科临床工作，至今也已超过一甲子。其中南陵县医院供职25年，芜湖长航医院22年，中铁芜湖医院16年。老爸年近九十，仍退而不休，没有完全放下工作。他眼不花、耳不聋、手不抖，干起专业扎扎实实、做起事来认认真真、走起路来风风火火。查资料，看文献，始终关注外科最新进展。思路清晰，条理分明，至今仍上台手术。并且赶上电子化处理医疗文书时代，他也能游刃有余，毫不落伍。人老不失戎马志，老有所为，尽职尽责，为社会奉献余热，是个永不知倦的老爸。

    老爸以行医为生，以救人为本。在半个多世纪救死扶伤的工作中，了解患者心理状态，关注患者病情变化，凭着他过人的才智、精力和手巧，因地制宜，胆大心细，给无数患者带去健康，从死神手中夺回众多生命，让许多笼罩愁云的家庭重拾欢笑。

    老爸在基层默默工作，一个中专毕业生，没老师教，没导师带， 自学成才。医技来自个人领悟，“ 老师” 就是医学书籍， 天资、聪颖、勤奋， 一腔热血成就了自己的医学理想。在穷乡僻壤之地， 在知识分子受排斥的年代， 创造了他自己辉煌。诚如老爸所说：

    “ 我的外科生命，堪称最长，手术数量亦多，手术科目也广。”老爸还说，当年他在基层做的不少手术，难度很高，这些手术至今还站在外科前沿，很是不易。比如肝、肺手术，比如颈椎结核病灶清除手术，比如腹膜后十二指肠损伤修补手术等，这些手术在上个世纪六十年代，省内都很少有医院开展。而老爸在简陋的基层县医院就独自开展这类手术，并全获成功。老爸常自豪地说：外科，有时，要虎口拔牙，绝非盲目冒险！担风险，高技艺，高配治疗。胆大心细，打破常规，当然科学，求实，是前提。 

    老爸从事过腹外、胸外、骨科、妇产、神外、泌外、五官、眼科、放射和麻醉等各科工作，完成各科不少高难度的四级手术，这是个非常了不起的成绩。腹外的急性胰腺炎等手术，头颈外科的颈内动脉瘤切除吻合等手术，神外的脊髄瘤等手术，胸外的肺部恶性肿瘤、食管癌等手术，骨科的各种骨髓炎的病灶清除，颈、胸、腰、骶椎结核的病灶清除和各类骨折等手术。泌外的肾蒂淋巴结剥脱等手术，妇产的子宫、卵巢切除等手术，五官的鼻泪管吻合等手术，眼科的白内障、人造瞳等手术以及各段硬膜外阻滞麻醉，颈丛、臂丛阻滞麻醉，脊髓麻醉，插管全麻及静脉复合麻醉，老爸都能熟练掌握，游刃有余。老爸所掌握的医学门类之多，是常人难以企及的，在现今国内，乃至国外，也难有其二。

    那个特定的时代特定的条件下，给老爸一个难得的施展空间，并提供充分展示他的才能和天赋的机会。面对源源不断，农村各类经济匮乏的农民兄弟患者。不救治就是死，治疗总比自生自灭、听天由命好许多，老爸有充分自主权。有多大精力就有多少工作，几十年来他几乎每天都有几台手术，凭着出众的专业技能和高尚的医德，凭着对医学的热衷和对患者的关爱，凭着毅力恒心、勤奋刻苦、执着坚持，老爸成为出色的大外科医生！老爸把握一瞬即逝的机遇，常常突破禁区，在一亩三分地崭露头角，屡屡取得不凡的成绩，终于登上了基层医院普通临床医生的顶峰。

    几十年，除手术外，老爸回家就是一头扎到医书里，废寝忘食，很少见他休息，是个标准的工作狂。我们一直觉得，老爸就是时代造就的现代华佗，就医疗面之广、救助病人之多、服务时间之长，基本是前无古人（maybe 除了华佗），后无来者。

    外科医生需要悟性，手指手腕的稳定性和灵活性相当重要，老爸仿佛是天生做外科医生的料。老爸特别好学，胆大心细，慧根极高，勇于创新，有学外科的天赋，一看就懂，一点就通，手术做得赏心悦目。中青年时期尤为特出，练就一身绝技。另外，他的团队精神极佳，他带教的下级医生，无不严谨、敬业、精益求精，培养了一批医疗骨干和专家。

    一上了手术台， 老爸似换了一个人，从容不迫，施展自如，飞速下刀、稳准剥离、显露宽敞、术野清晰。老爸手术做得漂亮利索明快，深得同行、病人及家属的好评。多年下来，老爸名震四方，求医者络绎不绝。甚至上一级医院外科主任的亲属需要手术，也来找老爸“这把刀”主刀才觉得放心。外科老辈原弋矶山医院外科陈主任，其夫人，长航医院护理部谢主任，八十高龄，患乳腺癌，经老爸手术根治，现在九十有三，并从此成了他们的终身“保健”医生。南陵县医院五官科主任王平，其大女儿董薇患乳腺癌，这是他家头等大事，心急无耐，托付于老爸，老爸亲自为之手术，终身治愈；几年后，该院妇产科主任席德华女儿，同样如此。长航医院外科主任沈某岳父，上海高龄教授，胃癌并幽门梗阻，多日不进饮食，全身衰竭，家属绝望地准备后事，终于是老爸为之“冒险”直接做了根治手术，五年后终老于其他疾病！然而通常，如此年迈体衰恶性患者，一般均先予短路手术，解除梗阻救命，尔后择期再手术切除病灶。实际，很少能争到“择期手术”机会，衰竭，病灶转移，噩耗，指日可待，后果堪忧！早在一九七零年，我的大舅潘耀毅，肝胆管结石并梗阻性黄疸，合肥安医拒收，无奈之下，从家乡三河寻老爸求医，在南陵县医院，老爸亲自为之手术取石、切除胆囊、再加胆管十二指肠内引流，顺利恢复，两周出院，终身治愈。一九八六年，五舅潘耀童，直肠癌，同样被省医拒收，再來芜湖，老爸在江东船厂医院，手术台上奋战七个多小时，行根治术。早在上世纪八十年代，不少病人电话报告病情，老爸即可确诊，比如同事成大本，胃穿孔，弋矶山医院青年医生误诊肾绞痛处理，给予泻药清洁肠道，次日泌尿系造影检查，全错了！如此，不仅耽误救命的宝贵时间，更加重穿孔外漏，推向病危！患者此时撕心裂肺地腹部绞痛，扒地抓了电话报告老爸，嘱急回本院，急诊手术切胃治愈。本科护士长高某丈夫陶某，也是如此。如今，更多的是手机“微信”远程看病，任何时候任何地点，众多病情，就此解决。尤其称奇的是我们家至亲的所有手术，都是老爸亲自包揽主刀的，这需要很强的自信、果敢和心理素质。立委当年认识一位农村青年医生，由于难能施展，而厌倦行医，转报英文师专，当谈起老爸的医术，却充满钦佩：“你知道么？你爸爸是世界上最了不起的医生。许多省立大医院尚未开展或普及的大手术，你爸爸也能做。”他给立委讲解一些案例，立委也不懂，但是我们心里明白， 老爸一直在超越自己， 向越来越复杂的手术攀登。后来，跟老爸谈话时，我们问他还有哪些疑难手术，想做而做不成。老爸说， 能做的差不多都做了， 但是有些手术，比如显微外科，断肢再植等，对于器械要求太高，当年县医院没有这种条件， 只好遗憾了。另外， 干细胞再生医学，基因编辑技术，基因工程减少或逆转老化细胞，精准医学与个性化医学，这些属于医学研究范畴，我这个基层临床医生只能望洋兴叹。

    文革后，职称晋升恢复，老爸从医士、医师、主治医师、副主任医师、主任医师一路走过来，从来都没拉下，总是一路顺风。老爸，在他一生前后任职的三家百人以上的二级医院里，是唯一外科主任医师，就是全院，正高职称，难有一、两位而已！而他的中专同学，几乎没有升正高的机会，即便同时代的医学院本科毕业生，在二级医院绝大多数也无缘斩获正高职称，基层医院，要求更苛刻，论文、临床、英语一样不能少，还有指标限制，一般只有内、外科各一指标，没有过硬的条件，宁缺勿滥！可见，老爸，在同辈人中，凤毛麟角，出类拔萃！”

    时代造就人，老爸没上过小学、没上过高中、没上过本科、更没上过研究生，正式教育只有初中和医士中专这两张文凭，主要还是靠无数的医学实践，摸滚爬打拼出来，凭实力顺利晋升普外主任医师，终成一代全科名医。

    医生受人尊敬，但却是清贫的。生活苦点，倒也无所谓， 老爸的难题是，到哪里去攒买书的钱呢？那些大厚本的专业书 籍《外科学》、《骨科学》等，定价不菲，却是工作必不可少 的。谁能想到，许多医书是爸爸瞒着家人卖血换来的。一次抽 300cc 鲜血，当时的价格30元，这可是平时半年也难攒下的钱 啊。老爸总是轻松说：人有造血机制，失点血无碍。医生常有 紧急情况下自己输血救病人的例子，我在行医过程中也曾有过 多次。但靠卖血去购专业用书，古今中外应不多见。一个时 代，一种活法，一个享有盛誉、对医术精益求精的医生非卖血 不能拥有医书，这样的事，从古到今，大概也只有那个特定时 代才有。 2007年6月3日，老爸经历一生最大一劫。老爸突然吐血， 那莫名的高烧竟达摄氏40度，自诩“不老不衰”的老爸，一下 被击垮了，出血量2000毫升以上，当即病情十分凶险。急症送 医，诊断为“胃腺癌，低分化”，21日在武汉行大手术，作了 全胃加胆囊切除（原有胆结石），终于闯过这一生死关。他操 劳一辈子，一直退而不休，仗的就是身体好和心态好。没想到 平时不生病，一病吓死人，这次是他一生中遇到的最大挑战， 也是他健康的拐点。 老爸是我们全家的主心骨，平素身体清瘦健康，无不良嗜 好，更没住过一次医院，一直比同龄人显得年轻。很多大风大 浪闯过来，人生很精彩。总算坏事变好事，老爸这次急病倒 下，对病情的早期诊断和及时治疗有利。得以宽心的是，老爸 得到了最好的医疗条件，家人也多在身边照顾。老爸术后恢复 很快，但人比手术前明显苍老，经过大半年休养，才慢慢恢复 底气。现在说话很有力气，精神仍很旺盛，还常常上台做手 术，我们全家人这才终于松了口气。 老爸现在半退休在家， 身体健康， 一点不像8 8 岁的老 人。虽依旧清贫，但生活有条不紊，仍保持对新事物的好学之 心。虽不再开车，但对于科技最新动态好奇心不减，今年二月 还在问立委 open AI 和 chatGPT 的词源和背景。手机电脑玩得 比许 多年轻人还熟，淘宝网购，滴滴叫车，美团订餐。同时 经常查阅英文专业资料，吸收新知识，不断进取。长年的博闻 强识，他的英语专业词汇量比立委这英语“科班”出身高出许 多，普通词汇也有一比，真正是活到老、学到老的楷模。 老爸大病之前，退而未休，青春不减，宝刀不老，手术、 开车、上网、写回忆，还有下棋对弈，乐此不疲。大病开刀后 这十多年来，虽体质下降，老爸终究丢不开他从事一辈子的至 爱——临床医学，他丢不下他的本行，仍然没有最终选择下 课，颐享天年，还是在临床一线工作，发挥余热。 现在老爸基本上放弃普外以外的其他相关专业工作，如骨 科、妇产科、泌尿外科等。老爸坚守这个普外阵地，希望自己 在有生之年，永不落伍，永葆“青春”，而他的多学科的临床 经验，一直能为社会奉献，能为病人解忧。

    医学，这是老爸终身无法割舍的情结。

    老爸性情温和，与人为善，为人正直，待人热情。问病十分认真，不烦不躁，回答耐心细致，亲切和气。无论病人贫富贵贱，一视同仁，倾尽全力给予医治，真正体现医者仁心和人道主义精神。

    老爸思想开明，观念前卫，对子女平等交流，从无训斥，更无打骂，也不给委屈！总是疏而不堵，循循善诱，身教言教并举。子女各自发展，是他最大的安慰，孙儿辈的成长花絮，更给他带来许多欢乐和满足。

    本书是老爸文革后公开发表的部分医学论文，虽挂一漏万，还是留下了许多珍贵的从医经验和理论总结，是为不朽的丰碑！老爸这些论文诠释了一位基层医院的医生如何百炼成钢，不断自我超越的过程，表达一位医者的底线、良知、责任、担当和使命，彰显白衣战士救死扶伤的风采和“悬壶济世”的深刻内涵。

    最近在整理集结部分医学论文时，老爸回顾60 多年所走过的路程，不胜感慨和自豪。虽然他的论文都是他临床上经验总结，科研成分含量不大，但实用性极强。论文文风严谨，格式规范，是老爸医疗实践的结晶和理论升华，具备一定的传承价值。老爸一生展示出的追求卓越、精诚为医的风范，勤学不辍、孜孜不倦的精神，谦和为人、正直仁善的情怀，更是我们后辈一笔不可多得的宝贵财富。

    由于时间跨度太久，论文寻找难度极大，遗失不少，我们尽可能收集老爸过去的医学论文，汇编成册，作为生日礼物，献给八十八岁生日、从医六十七年的老爸。祝老爸生日快乐，身体健康，安享晚年！

老爸与作者汉阳一江水和立委

立委的中文视频

The Tireless Father (Preface)

            Hanyang Yijiangshui, Li Wei

"Though turtles live long, they meet their end. Though dragons ride the mist, they eventually turn to dust. Aged but still full of fire, ambitious till the very end. The natural order isn't the only clock; contentment brings longevity. How fortunate indeed, to express these sentiments through song."
— "Though Turtles Live Long" by Cao Cao of the Eastern Han Dynasty

My father was born on November 3rd, 1936, or September 20th according to the lunar calendar. He's a Rat in the Chinese Zodiac. Following our local tradition, which counts one extra year, he is currently 88 years old.

Father's name is Li, Mingjie, his courtesy name Hao, and his art name is Cuisheng. Born into a struggling intellectual family, his youth was filled with hardship and adversity. Lack of finances kept him from attending university, a lifelong regret.

In March 1956, my dad graduated from the Wuhu Health School and has been involved in medical work for 67 years. After a stint in schistosomiasis prevention and two years in public health administration, he shifted his focus to surgical clinical work in 1961. He has been practicing for over six decades now. He served in Nanling County Hospital for 25 years, Wuhu Changhang Hospital for 22 years, and China Railway Wuhu Hospital for 16 years. Approaching his nineties, he still hasn't fully retired. His vision remains clear, his hearing sharp, and his hands steady. He conducts research, reads literature,  remains engrossed in his profession, and stays updated with the latest surgical developments.  His thoughts are coherent, and he still performs surgeries. Moreover, as the medical industry transitioned to digital documentation, he adapted seamlessly, never falling behind. His age hasn't dampened his spirit; he continues to contribute to society with undiminished vigor. Truly, he is a tireless father.

My father has dedicated his life to medicine and saving lives. Over the course of more than half a century, he has understood the emotional states of patients, and monitored their health conditions, and with his exceptional intellect, energy, and skilled hands, he has tailored treatments to individual needs. He has brought health to countless patients, saved numerous lives from the brink of death, and restored joy to many families clouded with sorrow.

My father worked diligently at the grassroots level. Despite only having a diploma from a technical health school, he had no formal professor or mentor to guide him. He was self-taught. His medical skills came from personal insights and countless hours spent studying medical books. His natural talent, intelligence, diligence, and unwavering passion paved the way for his medical aspirations. Even in remote and impoverished regions, and in an era when intellectuals were often marginalized, he carved out his own success. As my father often says, 'My surgical career has been one of the longest, with numerous surgeries across a wide spectrum of specialties.' He also notes that many of the surgeries he performed at the grassroots level were highly challenging. Some of these procedures are still considered cutting-edge in the world of surgery. For instance, liver and lung surgeries, removal of cervical spine tuberculosis lesions, and repairs of injuries to the duodenum behind the peritoneum – such surgeries were rarely conducted even in the provincial hospitals during the 1960s. Yet, my father took the initiative to perform these complex operations in a modest county hospital and achieved success. He often proudly asserts: 'In surgery, sometimes, you have to pull a tooth from a tiger's mouth. It's not about blind risk-taking! It's about taking calculated risks, having advanced skills, and providing high-level treatment. Being brave yet cautious, breaking the norm, and always prioritizing scientific and pragmatic approaches are essential.

My father has practiced across a broad spectrum of medical specialties, from abdominal surgery, thoracic surgery, orthopedics, obstetrics and gynecology, neurosurgery, urology, otolaryngology, ophthalmology, radiology to anesthesiology. He has successfully performed many high-difficulty level-4 surgeries in each specialty, which is truly an astounding achievement. These surgeries range from operations for acute pancreatitis in abdominal surgery, carotid artery aneurysm resections in head and neck surgery, spinal tumors in neurosurgery, lung malignancies and esophageal cancer in thoracic surgery, clearing lesions of various osteomyelitis and tuberculosis of the cervical, thoracic, lumbar, and sacral vertebrae, and other fractures in orthopedics. Additionally, he has conducted lymph node stripping in urology, hysterectomy and ovariectomy in gynecology, nasolacrimal duct anastomosis in otolaryngology, cataract surgeries, and artificial pupil operations in ophthalmology. He's also proficient in different forms of anesthesia, including epidural blocks, brachial plexus blocks, spinal anesthesia, intubation general anesthesia, and intravenous composite anesthesia. The breadth of medical categories my father has mastered is unparalleled and unmatched, both domestically and internationally.

The unique circumstances of that era provided my father with a rare opportunity to showcase his talents and capabilities. Facing a continuous influx of impoverished rural patients, the stakes were high. To not treat was to let die. Treating them was always better than leaving them to their fates. He had significant autonomy. With an endless drive to work hard, he performed surgeries almost daily for decades. With exceptional professional skills, noble medical ethics, passion for medicine, dedication to his patients, persistence, diligence, and unwavering perseverance, he emerged as an outstanding major surgery doctor. My father seized fleeting opportunities, often breaking barriers and shining in his field. His achievements made him stand out, eventually reaching the pinnacle of clinical practice in grassroots hospitals.

For decades, when not performing surgeries, he would immerse himself in medical books, often sacrificing sleep and meals. Rarely did we see him rest; he was a true workaholic. We've always felt that my father is the modern-day Hua Tuo, crafted by his era. Considering the breadth of his medical practice, the number of patients he's aided, and the length of his service, he stands almost unparalleled in history—perhaps with the exception of Hua Tuo—and likely unmatched in the future.

Surgical practitioners need intuition. The stability and flexibility of one's fingers and wrists are incredibly crucial. My father seemed to be naturally made for surgery. He had an insatiable thirst for knowledge, a bold yet meticulous approach, an innate intelligence, and an innovative spirit. His expertise in surgery enabled him to comprehend concepts instantly and perform operations with exceptional precision. Especially during his younger years, he honed exceptional skills. Additionally, his team spirit was exemplary. Every subordinate doctor trained under him developed rigor, dedication, and a relentless pursuit of excellence, shaping a generation of medical leaders and experts.

As soon as he stepped onto the operating table, it was as if my father became a different person—calm, confident, and masterfully executing each surgical procedure. His surgical precision and speed earned him accolades from peers, patients, and their families. Over the years, his reputation spread far and wide, attracting a steady stream of patients seeking his expertise. Even the relatives of the chief surgeons from top-tier hospitals would seek my father for surgeries, trusting only in his magic hands. The renowned Director of the Surgery Department from the original Yijishan Hospital, Dr. Chen, entrusted my father with the surgery of his wife, Madam Xie, who was the head of the Nursing Department in Changhang Hospital. Despite her being in her eighties and diagnosed with breast cancer, my father's successful surgery ensured her well-being well into her nineties. She considered my father her lifetime "personal physician". Similarly, Wang Ping, the Head of the ENT department at Nanling County Hospital, trusted my father to operate on his daughter, Dong Wei, who had breast cancer. Years later, the Chief of the Obstetrics and Gynecology Department of the same hospital entrusted the care of her daughter in the same manner to my father.

The director of the surgery department at Changhang Hospital, Mr. Shen, had an elderly father-in-law in Shanghai, a distinguished professor, who was diagnosed with stomach cancer and pyloric obstruction. After being unable to eat or drink for several days and his body deteriorating, his family had almost given up hope. Yet, my father undertook the "risky" direct radical surgery, having saved his life. The patient lived for another five years before succumbing to other illnesses. Conventionally, patients of this age and condition would first undergo a bypass surgery to relieve the obstruction, and only later would they have the surgery to remove the lesion. In reality, few would get the chance for this second operation.

Back in 1970, my elder uncle, Pan Yaoyi, had hepatic and biliary stones along with obstructive jaundice. Refused by a renowned hospital in Hefei, he turned to my father in desperation. At the Nanling County Hospital, my father personally performed the surgery to remove the stones, excise the gallbladder, and establish an internal biliary-duodenal drainage, ensuring his full recovery. In 1986, another uncle of ours, Pan Yaotong, was diagnosed with rectal cancer and similarly turned away by the provincial hospital. Once again, my father stepped in, performing the radical surgery that lasted over seven hours.

Back in the 1980s, numerous patients would report their symptoms over the phone, and my father could make a diagnosis then and there. For instance, his colleague Cheng Daben had a perforated stomach. The young doctors at Yijishan Hospital misdiagnosed it as renal colic and treated it by administering laxatives to clean the intestines. The urinary system imaging examination the next day proved them all wrong! This not only delayed the crucial time for life-saving treatment but also exacerbated the perforation and leakage, pushing the patient into critical condition! The patient, in excruciating abdominal pain, desperately called my father and urged a return to our hospital, where an emergency surgery to cut into the stomach cured him. The husband of the head nurse Gao at the undergraduate department, Tao, experienced a similar ordeal. Nowadays, it's more common for patients to seek medical advice remotely through mobile "WeChat" at any time and place, resolving many medical issues this way.  What's particularly remarkable is that all the surgeries for our immediate family members were personally performed by my father. This demanded immense confidence, determination, and mental fortitude.

We once knew a young rural doctor who, feeling constrained in his medical career, chose to pursue an English teaching degree instead.  When discussing my father's medical skills, he expressed deep admiration: "Do you know? Your father is one of the most incredible doctors in the world. He can perform complex surgeries that many top-tier hospitals have yet to introduce or popularize." He shared several cases with us, and even though we might not have understood all the medical intricacies, one thing was clear: my father consistently pushed boundaries, always striving for surgical excellence.

Later, when we asked my father about any complicated surgeries he wished to perform but couldn't, he mentioned microsurgery, limb reattachment, and other surgeries requiring advanced equipment that were beyond the reach of the county hospital at the time. He also expressed admiration for the fields of stem cell regenerative medicine, gene-editing techniques, genetic engineering to reverse aging cells, and precision medicine, recognizing them as the frontiers of medical research, while humbly admitting that as a grassroots clinician, he could only admire them from afar.

After the Cultural Revolution, with the resumption of professional promotions, my father climbed the ranks seamlessly, from Medical Practitioner, Physician, Attending Physician, Associate Chief Physician to Chief Physician. His progress was smooth, never missing a step. In all three secondary hospitals, each with over a hundred staff where he served throughout his life, he was the sole Chief Surgeon. In fact, in the entirety of these institutions, there were only one or two with such a distinguished title. Compared to his peers who graduated from technical health schools like him, almost none had the chance to rise to such a senior position. Even graduates from medical colleges in his generation, the majority in secondary hospitals couldn't attain such a high-ranking title. The criteria for grassroots hospitals were even more stringent. One needed to excel in clinical practice, publish academic papers, and be proficient in English. Typically, only one chief position each was reserved for internal medicine and surgery specialties. They preferred having a vacancy rather than compromising on quality. This emphasizes how my father was truly a rare gem among his contemporaries, standing head and shoulders above the rest.

The era shapes individuals. My father never attended elementary school, high school, undergraduate, or postgraduate courses. His formal education consisted of only middle school and a medical diploma from a technical health school. Yet, he relied primarily on countless hours of medical practice, learning through hands-on experiences. With sheer skill and determination, he ascended the ranks to become a Chief Surgeon in general surgery, ultimately earning a reputation as a renowned all-around physician.

While doctors are respected, many lead modest lives. A bit of hardship in life didn't bother my father, but the challenge he faced was how to save up money to buy medical books. Those thick professional volumes like "Surgery" and "Orthopedics" were expensive, yet indispensable for his work. Who could have imagined that many of these medical books were acquired by my father secretly selling his own blood? Each time he would donate 300cc of fresh blood and receive 30 yuan – an amount that would typically take him half a year to save. My father would brush it off, saying: "humans have a hematopoietic system, so losing a little blood doesn't matter. There are often stories of doctors donating their own blood in emergencies to save patients, and I've experienced this myself several times during my medical career".  But acquiring professional books by selling one's blood, such instances are probably rare across all of history and around the world and perhaps only characteristic of that particular era in China. Perhaps only in that specific era could a reputed doctor resort to such means to own medical books.

On June 3, 2007, my father faced the greatest ordeal of his life. Suddenly, he began vomiting blood and developed an inexplicable fever reaching 40°C. The once indomitable spirit, who often claimed to be "forever young and vital", was suddenly brought to his knees. He lost over 2000ml of blood, putting him in grave danger. He was rushed to the hospital and was diagnosed with 'low-differentiated gastric adenocarcinoma.' On June 21, he underwent major surgery in Wuhan, having his entire stomach and gallbladder (due to pre-existing gallstones) removed. He narrowly escaped the clutches of death. Having worked tirelessly throughout his life, he always took pride in his robust health and positive attitude.  Who would've thought? A man so rarely ill could be brought down so severely. This incident was the most significant challenge he had ever faced and marked a turning point in his health journey.

My father has always been the backbone of our family, typically appearing youthful and vigorous, especially for his age, without a hint of any vices and never having stayed in a hospital before. Despite the hardships, life was always vibrant for him. Thankfully, his sudden illness led to an early diagnosis and timely treatment. Being under the best medical care and surrounded by family during his recovery gave everyone peace of mind. After the surgery, he aged noticeably, and it took him over six months to regain his strength. Now, he speaks with such vigor and frequently performs surgeries, which is a huge relief for our entire family.

Now semi-retired, my father, at the age of 88, is astonishingly spry for his age. Despite his modest living, he keeps an orderly life and continues to be eager to learn new things. Although he no longer drives, his curiosity about the latest tech developments remains. Just this February, he was asking me about the etymology and background of OpenAI and ChatGPT. He's more tech-savvy with smartphones and computers than many youngsters I know, ordering food from Meituan, hailing cars from DiDi, and shopping on Taobao. He also frequently consults English professional materials, absorbing new knowledge, proving the adage true: you're never too old to learn. He even outpaces English-major graduate Wei in English technical vocabulary, truly an exemplary lifelong learner.

Before his major illness, he was a whirlwind of energy, performing surgeries, driving, browsing the internet, writing memoirs, and enjoying chess games. In the decade since his surgery, even with a decline in his physical condition, he hasn't given up his lifelong passion for clinical medicine. He may have set aside other specialties, such as orthopedics, gynecology, and urology, but he remains steadfast in his dedication to general surgery, continuously contributing to the field and aiding patients. Medicine is an eternal bond he could never sever.

Gentle in nature and kind to all, my father has always been upright and warm-hearted. His patience and attentiveness when diagnosing patients, regardless of their socio-economic status, genuinely exemplify the benevolent spirit and humanistic essence of a doctor.

With progressive thoughts and a modern mindset, he always treated his children as equals, never reprimanding them, let alone resorting to physical punishment. He has always gently guided us, both through his words and his actions. Our individual successes are his greatest solace, and the growth and antics of his grandchildren bring him immense joy and satisfaction.

This book is a compilation of some of the medical papers my father published after the Cultural Revolution. Although it's not exhaustive, it preserves many invaluable experiences and theoretical summations from his medical career, standing as an enduring testament to his dedication. These papers encapsulate how a doctor from a grassroots hospital refined himself through challenges, continuously pushing his boundaries. They embody a physician's fundamental principles, conscience, responsibility, commitment, and mission, spotlighting the gallantry of medical professionals in their efforts to save lives and epitomizing the profound essence of "healing the world."

Recently, as we were compiling some of these medical papers, my father reflected on his journey spanning over 60 years, filled with both pride and nostalgia. While his papers primarily encapsulate his clinical experiences and might not be heavily research-oriented, their practical utility is undeniable. They are meticulously crafted, adhering to strict academic standards, and represent the crystallization and theoretical evolution of his medical practice, holding a certain legacy value. The excellence he has demonstrated throughout his life, his unwavering dedication to medicine, his relentless pursuit of knowledge, and his humble, upright, and benevolent character serve as a priceless heritage for our generation.

Given the vast timeline, locating all his papers was challenging, and unfortunately, many have been lost over the years. We've done our best to gather as many of his past medical writings as possible, compiling them into this volume as a birthday gift for our 88-year-old father, who has been practicing medicine for 67 years non-stop. We wish him a happy birthday, good health, and a peaceful twilight year!

立委的英文视频

《李名杰医学论文集影印版》

【李名杰从医67年论文专辑】（电子版）

【李名杰从医67年论文专辑（英语电子版）】

李名杰：医学论文集电子版（内部刊印2023）

 https://liweinlp.com/?p=9312

李名杰：医学论文集英语电子板

https://liweinlp.com/?p=11456

咸昇、名杰、汉阳一江水、立委：《李家大院》电子版（内部刊 印 2022）

https://liweinlp.com/?p=8524

汉阳一江水:《小城青葱生活》电子版（内部刊印 2022）

https://liweinlp.com/?p=10798

汉阳一江水:《江城记事》电子版（内部刊印 2022）

https://liweinlp.com/?p=11221

立委：《朝华午拾》电子版（内部刊印 2022）

《朝华午拾》电子版