A. Černauskas, author of “Pragar Ambulatorijas”: the flow of night-time worriers has increased in the reception area | Culture

The book, which was published 8 years ago, tells the story of even the most complicated events and decisions in the hospital reception without embellishment and with a large dose of humor. “The Infirmary of Hell” has received a lot of attention from readers, so today the book is back – the fourth edition of the book is published.

Hell’s Infirmary or Emergency Department (ED), a place where no one wants to be, but still curious regarding what life is like around the clock. Andrius talks regarding it very openly. At the same time, this book is a collection of calm and wise advice on what to expect when you arrive at the SPS, how to behave and, finally, when you should go there, and when the problem is not so serious and you can go to the family doctor.

Photo of Tyto alba/Hell’s Dispensary

The author of “Hell Clinic”, today the senior doctor of the Republican Vilnius University Hospital SPS, was one of the first to speak publicly and courageously regarding doctors’ wages, and openly wrote regarding other important medical problems in his blog. So today, following the return of “Hell’s Infirmary”, Andrius and I talk regarding what has changed in the reception during those 8 years.

– You said that the first time you were in the reception area, you felt like you were on a war field. What has changed the most in Hell’s Infirmary in the 8 years since the book came out?

– Perhaps the biggest change is that the SPS in my sights are finally well-stocked with emergency medicine doctors (EMS). Finally, this department has its own real doctor, who understands very well what to do with any patient who comes to the department.

Along with these doctors, the entire team is also changing: nurses’ horizons and knowledge are deepening, their assistants are also improving, and consultant doctors, when they no longer have to be on duty at the SPS, can specialize more in their fields. Of course, we will have to wait until we “displace” (the vast majority of them are not at all opposed to it) doctors of other specialties from SPS.

– Would you write a different book today? You write regarding the fact that reception is perceived by many as hell on earth. Maybe the hell dispensary is gone today?

– Would I write a different book now – definitely yes. SPS has definitely remained the same place, my vision has changed. I wrote as I felt at the time, using humor that was funny at the time. True, there were people who took my jokes at face value and didn’t seem to question for a second what a cynical superhuman I was and that I really wasn’t fit to be a doctor. I’m glad they didn’t meet me (so nothing bad happened to them and they didn’t have to visit SPS). And those who met me knew, understood and were not disappointed.

– Have the working conditions of doctors changed? The society was constantly shaken by the extremely painful stories of doctors leaving their lives, and then there are discussions regarding the working conditions and earnings of medical specialists. You were one of the first to publish your salary on social media, and then it caused a lot of discussion. How does everything look following 8 years?

– The working conditions of doctors and other healthcare professionals have definitely changed. At least as far as I know. Of course, there are differences between treatment facilities. Today, no one shows their payslips in public anymore, apparently they understand that such reactions as before would not arise. In addition, the same residents currently earn significantly more.

– During those 8 years, your career has also developed successfully – you are the senior doctor of the Republican Vilnius University Hospital SPS. When the book came out, you said that despite the hellish moments, you never wanted to run away. Were there really no such moments during those years?

– As I said then, I will confidently repeat it now – there has never been such a moment. I am where I want to be. Even during the most difficult vigils or when collapses a million other jobs and problems, I have no intention of running away from here.

– What helps you the most to maintain such internal and professional motivation, not to get overworked and not become a cynic?

– Moderation and balance. Even if you are the best in your field, there is no need to work 2 or 3 jobs and burn out in a few years. There are no irreplaceable ones. You need to take breaks, rest, know when to back off and not become a fanatic. If you like to be in the city, you like its pace and rush, you still have to break away and go to nature or the countryside, to be somewhere else. Then there will be no need for radical changes, which we hear so much regarding today.

Being in nature, observing, exploring, fresh air helps. Physical exertion. It can be sports, training, running, cycling or just physical work that disconnects the brain and rational thinking. Also communication and being with people, observing their abilities, creativity, art. All this is important so that during the vigils I do not doubt for a second what I am working for, what I am striving for. And what can a person do – following contributing to the patient’s recovery, I will help him continue to live and create.

– Do those who come to the reception change?

– Changing. Medical literacy is growing. This has various consequences. If 10 years ago, it was not so rare to meet a patient who talked regarding his body, illnesses, and health no boom boom didn’t understand, now we talk much more often and much more deeply with patients.

Patients choose which radiological examination they would or would not like, which drugs to take and which not to. If earlier we complained the only 3 a.m. patient who came in for an anxiety disorder, now there are 3-5 of them, and most nights the flow of those worriers doesn’t stop at all. It is true that patients are less eager to go to the hospital, because they understand that if they are seriously ill, there will be nothing to do in the hospital.

– You wrote “Infirmary of Hell” with great humor. It may seem like there is no time or place for laughter in the hospital waiting room. But is humor an important companion for you at work?

– Humor saves. Our patients didn’t study medicine, they didn’t learn all that incomprehensible nonsense that we doctors know, but they live and suffer injuries, get sick and worry regarding it. They are afraid because they don’t know. And I know if it is SERIOUS or NOT SERIOUS. And if the doctor can and knows how to make a joke or calm down, then the patients who accept the laugh perfectly get the point: there is nothing to be afraid of or what to do regarding it. Sometimes I don’t hit the mark with that humor, then I wind up the rods and choose another path.