Edit note: The original text has been deleted and archived by He Media.
No one has ever said the words "I'm sorry" to me in any situation. But I still feel that this incident further illustrates that everyone should adhere to their independent thoughts, because someone must stand up and speak the truth; there must be different voices in this world...
On December 30, 2019, Ai Fen received a virus test report for a patient with an unknown pneumonia. She circled the words "SARS coronavirus" in red. When a college classmate asked about it, she took a photo of the report and sent it to this fellow doctor. That evening, the report spread throughout the medical community in Wuhan, and those who forwarded it included the eight doctors who were later reprimanded by the police.
This brought trouble to Ai Fen. As the source of the information, she was summoned by the hospital's disciplinary committee and faced "unprecedented and severe reprimands," being accused of spreading rumors as a professional.
In previous reports, Ai Fen was referred to as "another female doctor who was reprimanded," and some called her a "whistleblower." Ai Fen corrected this statement, saying she was not a whistleblower but rather "the one who blew the whistle."
This is the second report in the March issue of "People" magazine featuring "Wuhan Doctors."
Text by Gong Jingqi
Edited by Jin Shi
Photography by Yin Xiyuan
I received a text message from Ai Fen, the director of the emergency department at Wuhan Central Hospital, agreeing to an interview at 5 a.m. on March 1. About half an hour later, at 5:32 a.m. on March 1, her colleague, Jiang Xueqing, the director of the thyroid and breast surgery department, died from COVID-19. Two days later, Mei Zhongming, the deputy director of the ophthalmology department, also passed away; he and Li Wenliang were in the same department.
As of March 9, 2020, four medical staff members from Wuhan Central Hospital had died from COVID-19. Since the outbreak began, this hospital, located just a few kilometers from the Huanan Seafood Market, became one of the hospitals with the highest number of infections among workers in Wuhan. According to media reports, over 200 people in the hospital were infected, including three deputy directors and several department heads, with multiple department directors currently being maintained on ECMO.
The shadow of death looms over this largest tertiary hospital in Wuhan. A doctor told "People" that in the large group chat of the hospital, almost no one spoke; they only mourned and discussed quietly in private.
The tragedy could have been avoided. On December 30, 2019, Ai Fen received a virus test report for a patient with an unknown pneumonia. She circled the words "SARS coronavirus" in red. When a college classmate asked about it, she took a photo of the report and sent it to this fellow doctor. That evening, the report spread throughout the medical community in Wuhan, and those who forwarded it included the eight doctors who were later reprimanded by the police.
This brought trouble to Ai Fen. As the source of the information, she was summoned by the hospital's disciplinary committee and faced "unprecedented and severe reprimands," being accused of spreading rumors as a professional.
On the afternoon of March 2, Ai Fen accepted an exclusive interview with "People" at the Nanjing Road campus of Wuhan Central Hospital. She sat alone in the emergency room office, which used to see over 1,500 patients a day but was now quiet, with only one homeless person lying in the emergency hall.
In previous reports, Ai Fen was referred to as "another female doctor who was reprimanded," and some called her a "whistleblower." Ai Fen corrected this statement, saying she was not a whistleblower but rather "the one who blew the whistle." During the interview, Ai Fen mentioned the word "regret" several times. She regretted not continuing to sound the alarm after being summoned, especially for her deceased colleagues, saying, "If I had known it would come to this, I wouldn't have cared about the criticism; I would have spoken out everywhere, right?"
What exactly did Wuhan Central Hospital and Ai Fen experience in the past two months? Here is Ai Fen's account—
Ai Fen
Unprecedented reprimands
On December 16 last year, our emergency department at the Nanjing Road campus received a patient. They had an inexplicable high fever and were not responding to medication; their temperature remained unchanged. On the 22nd, they were transferred to the respiratory department, where a fiberoptic bronchoscopy was performed to obtain bronchoalveolar lavage fluid, which was sent out for high-throughput sequencing. Later, it was verbally reported as a coronavirus. At that time, the colleague in charge kept repeating in my ear: "Director Ai, that patient tested positive for the coronavirus." Later, we learned that the patient worked at the Huanan Seafood Market.
Then, on December 27, another patient came to the Nanjing Road campus, the nephew of one of our doctors, a man in his 40s with no underlying health conditions. His lungs were in terrible condition, with an oxygen saturation of only 90%. He had already been treated at other hospitals for nearly ten days without any improvement and was admitted to the respiratory department's intensive care unit. He also underwent fiberoptic bronchoscopy to obtain bronchoalveolar lavage fluid for testing.
On December 30, at noon, a classmate working at Tongji Hospital sent me a WeChat screenshot that read: "Don't go to Huanan recently; there are many people with high fevers..." He asked me if it was true. At that time, I was looking at a CT scan of a very typical lung infection patient on my computer, so I recorded an 11-second video of the CT and sent it to him, telling him this was a patient who came to our emergency department that morning, also from the Huanan Seafood Market.
Just after 4 p.m. that day, a colleague showed me a report that stated: SARS coronavirus, Pseudomonas aeruginosa, and 46 types of oral/respiratory colonizing bacteria. I carefully read the report many times, and the note at the bottom stated: "SARS coronavirus is a single-stranded positive-sense RNA virus. The main transmission routes are close-range droplet transmission or contact with the patient's respiratory secretions, which can cause a highly infectious pneumonia that can affect multiple organ systems, also known as atypical pneumonia."
At that moment, I broke out in a cold sweat; this was a very frightening thing. The patient was admitted to the respiratory department, and logically, the respiratory department should report this situation. However, for safety and to take it seriously, I immediately called the hospital's public health department and infection control department to report it. At that time, the director of our hospital's respiratory department happened to pass by my door; he had participated in the SARS outbreak. I grabbed him and said, "We have a patient in your department who has tested positive for this." He looked at me and said, "That's a problem." I knew this was serious.
After calling the hospital, I also sent the report to my classmate, specifically circling the line "SARS coronavirus, Pseudomonas aeruginosa, 46 types of oral/respiratory colonizing bacteria" in red to remind him to pay attention and take it seriously. I also shared the report in the department's doctor group to alert everyone to take precautions.
That evening, the information spread everywhere, and the screenshots circulating were all of the photo I had circled in red, including the version that Li Wenliang later shared in the group. I thought to myself that things might go wrong. At 10:20 p.m., the hospital sent a message, which was a notice to the municipal health committee, stating that regarding the unknown pneumonia, no information should be released to the public to avoid causing panic. If panic arose due to information leaks, accountability would follow.
I felt very scared at that moment and immediately forwarded this information to my classmate. About an hour later, the hospital sent another notice, reiterating that relevant information in the group should not be shared externally. A day later, at 11:46 p.m. on January 1, the head of the hospital's supervision department sent me a message asking me to come in the next morning.
That night, I couldn't sleep, feeling anxious and tossing and turning. But I also thought that everything has two sides; even if it caused adverse effects, reminding medical staff in Wuhan to take precautions might not be a bad thing. The next morning, just after 8 a.m., before I could finish my shift handover, I received a call urging me to come in.
During the subsequent meeting, I faced unprecedented and very severe reprimands.
At that time, the leader conducting the talk said, "We can't hold our heads up when we go out for meetings. So-and-so criticized our hospital's Ai Fen. As the director of the emergency department at Wuhan Central Hospital, you are a professional; how can you spread rumors without principles or organizational discipline?" This was the exact wording. I was told to go back and relay this to over 200 people in my department verbally; I couldn't use WeChat or text messages, only face-to-face conversations or phone calls, and I was not allowed to say anything about this pneumonia, "not even to your husband"...
I was completely stunned. It felt like I was the one who had ruined the great development of Wuhan. I felt a sense of despair; I am someone who usually works diligently and seriously. I believe that what I did was according to the rules and made sense. What wrong did I commit? I saw the report, I reported it to the hospital, and I exchanged information about a patient with my classmates and colleagues without revealing any private information about the patient. It was just like medical students discussing a case. When you, as a clinical doctor, have discovered a significant virus in a patient, how could you not share it when other doctors ask? That's your instinct as a doctor, right? What did I do wrong? I did what any doctor or person should do; I believe anyone would have done the same.
I was very emotional at that time, saying, "This is what I did; it has nothing to do with anyone else. You might as well just throw me in jail." I said that my current state was not suitable for continuing to work in this position, and I wanted to take a break. The leader did not agree, saying that this was a test for me.
That night when I got home, I remember clearly that after entering the door, I told my husband, "If anything happens to me, you take good care of the child." Because my second child was still very young, only a little over a year old. He found it puzzling; I didn't tell him about being reprimanded. On January 20, when Zhong Nanshan announced human-to-human transmission, I finally told him what had happened that day. During that time, I only reminded my family not to go to crowded places and to wear masks when going out.
Peripheral Departments
Many people worried that I was one of the eight who were called in for reprimand. In fact, I was not reprimanded by the police. Later, a good friend asked me if I was a whistleblower. I said I was not a whistleblower; I was the one who blew the whistle.
But that meeting had a significant impact on me. When I returned, I felt completely defeated. I was really forcing myself to stay focused and work diligently. Later, when everyone came to ask me, I couldn't answer them.
What I could do was to make the emergency department pay attention to protection. Our emergency department has over 200 people. Starting from January 1, I told everyone to strengthen protection; everyone must wear masks, hats, and use hand sanitizer. I remember one day during shift handover, a male nurse was not wearing a mask, and I immediately scolded him, saying, "If you don't wear a mask, don't come to work."
On January 9, when I was off work, I saw a patient at the triage desk coughing at everyone. From that day on, I required them to give masks to patients coming for treatment, one mask per person; at that time, we couldn't be stingy. Outside, they were saying there was no human-to-human transmission, yet I had to emphasize wearing masks and strengthening protection, which was very contradictory.
That period was indeed very oppressive and painful. Some doctors suggested wearing isolation gowns on the outside, but the hospital held meetings saying it shouldn't be done, as it would cause panic. I had the department staff wear isolation gowns under their white coats, which was not compliant and very absurd.
We watched as the number of patients increased and the radius of transmission expanded. First, it was related to the area around the Huanan Seafood Market, and then it spread further and further. Many were family transmissions; among the first seven patients, one mother infected her son by bringing him food. A clinic owner also got infected from a patient who came for an injection; the cases were severe. I knew for sure that there was human-to-human transmission. If there wasn't, the Huanan Seafood Market would have closed on January 1; how could the number of patients keep increasing?
Many times I thought, if they hadn't reprimanded me like that, if they had calmly asked about the ins and outs of the situation and consulted other respiratory experts, perhaps the situation would have been better. At least I could have communicated more within the hospital. If everyone had raised the alarm on January 1, there wouldn't have been so many tragedies.
On the afternoon of January 3, at the Nanjing Road campus, urology doctors gathered to review the work history of the former director. Dr. Hu Weifeng, who was 43 years old, was in critical condition; on the afternoon of January 8, Director Jiang Xueqing organized a rehabilitation party for breast cancer patients in Wuhan on the 22nd floor of the Nanjing Road campus; on the morning of January 11, the department reported to me that emergency room nurse Hu Ziwei had been infected; she should have been the first nurse infected at the central hospital. I immediately called the head of the medical department to report it, and then the hospital urgently held a meeting, instructing that the report of "bilateral lung infections, viral pneumonia?" be changed to "bilateral scattered infections." On January 16, at the last weekly meeting, a vice president still said, "Everyone should have a little medical common sense; some senior doctors shouldn't scare themselves." Another leader took the stage and continued, "There is no human-to-human transmission; it can be prevented, treated, and controlled." A day later, on January 17, Jiang Xueqing was hospitalized, and ten days later, he was intubated and placed on ECMO.
The high cost at the central hospital is related to the lack of information transparency among our medical staff. You can see that the emergency and respiratory departments did not suffer as severely because we had a sense of protection and quickly rested and treated ourselves when we fell ill. The serious cases were all from peripheral departments; Li Wenliang was from ophthalmology, and Jiang Xueqing was from the breast and thyroid department.
Jiang Xueqing was a truly great person, an excellent doctor, one of the two Chinese Medical Awards in the hospital. Moreover, we were neighbors; I lived on the 40th floor, and he lived on the 30th floor. We had a good relationship, but due to our busy work schedules, we could only see each other during meetings or hospital activities. He was a workaholic, either in the operating room or seeing patients. No one would specifically go to tell him, "Director Jiang, you need to be careful and wear a mask." He didn't have the time or energy to inquire about these matters, and he must have been careless, thinking, "What does it matter? It's just pneumonia." This is what people from his department told me.
If these doctors had received timely reminders, perhaps this day would not have come. So, as someone involved, I deeply regret it. If I had known it would come to this, I wouldn't have cared about the criticism; I would have spoken out everywhere, right?
Although I was in the same hospital as Li Wenliang, I didn't recognize him until the day before his death because there were over 4,000 people in the hospital, and we were all busy. The night before he passed away, the ICU director called me to borrow the emergency department's cardiac compressor, saying Li Wenliang needed resuscitation. I was shocked to hear this news. I didn't understand the entire process regarding Li Wenliang, but I wonder if his condition was related to his feelings after being reprimanded. I can relate to that feeling of being reprimanded.
Later, as events unfolded, it proved that Li Wenliang was right. I can deeply understand his feelings, which were likely similar to mine—not excitement or happiness, but regret. Regret that I should have continued to sound the alarm and should have kept speaking out when everyone asked us. Many times, I think how wonderful it would be if time could be reversed.
Living is good
On the night before the lockdown on January 23, a friend from a relevant department called me to ask about the real situation of emergency patients in Wuhan. I asked if he was representing a private entity or the government. He said he was representing a private entity. I said, "If it's personal, I'll tell you the truth. On January 21, our emergency department received 1,523 patients, which is three times the usual maximum, of which 655 had fevers."
The situation in the emergency department during that time is something that those who experienced it will never forget, and it can even overturn your entire worldview.
If this is a war, the emergency department is on the front lines. But at that time, the back wards were already saturated; they basically wouldn't admit any patients, and the ICU firmly refused to take in patients, saying there were clean patients inside, and entering would contaminate them. Patients kept flooding into the emergency department, and the back routes were blocked, so they all piled up in the emergency department. Patients waiting for treatment would line up for hours, and we couldn't even finish our shifts. The fever clinic and emergency department were indistinguishable; the hall was filled with patients, and the resuscitation and infusion rooms were crowded with patients.
Some patients' family members would come and say they needed a bed, saying, "My dad can't make it in the car," because at that time, the underground parking lot was closed, and their cars were blocked and couldn't get in. I had no choice but to run with people and equipment to the car, only to find that the person had already died. You can imagine how that feels; it's very painful. This person died in the car without even having a chance to get out.
There was also an elderly woman whose husband had just died at Jinyintan Hospital. Her son and daughter were both infected and receiving injections, and her son-in-law was taking care of her. When I saw her, she was in very serious condition, so I contacted the respiratory department to admit her. Her son-in-law, who seemed to be a cultured and educated person, came over to thank me, and I felt a tightness in my chest, saying, "Hurry up; we can't afford to delay." In the end, she was sent in and passed away. A simple "thank you" took a few seconds, but it also delayed a few seconds. That "thank you" weighed heavily on me.
Many people saw their family members for the last time when they were sent to the ICU; they would never see them again.
I remember on the morning of New Year's Eve, I came to hand over my shift and said, "Let's take a photo to commemorate this New Year's Eve," and I even posted it on social media. That day, no one said anything about blessings; at such times, living is good.
In the past, if you made a small mistake, like not giving an injection on time, patients might still complain, but now there was no one left; no one was there to argue or complain. Everyone had been crushed by this sudden blow and was in a daze.
When patients died, it was rare to see family members crying sadly because there were too many, too many. Some family members wouldn't say, "Doctor, please save my family," but would instead say, "Well, just let them go quickly; it's already come to this." Because at this time, everyone was afraid of being infected themselves.
One day, at the fever clinic, the line to get in took five hours. While waiting, a woman collapsed. She was dressed in leather, carrying a bag, and wearing high heels; she seemed to be a well-dressed middle-aged woman. But no one dared to go up to help her; she lay on the ground for a long time. I had to call the nurses and doctors to come and assist her.
On January 30, when I came to work in the morning, an elderly man's son, aged 32, had died, and he was just staring at the doctor to issue a death certificate. There were no tears; how could he cry? He had no way to express his grief. Without a diagnosis, his son had just become a death certificate.
This is also what I want to call attention to. The patients who died in the emergency department were all undiagnosed cases, and after this epidemic passes, I hope we can provide an explanation for them and some comfort for their families. Our patients are very pitiful, very pitiful.
"Fortunate"
After so many years as a doctor, I have always felt that no difficulty could defeat me, which is also related to my experiences and personality.
When I was nine years old, my father died of stomach cancer. At that time, I thought that when I grew up, I would become a doctor to save others' lives. Later, when filling out college applications, I chose only medical majors and eventually got into Tongji Medical College. I graduated from university in 1997 and went to the central hospital, initially working in cardiology, and became the director of the emergency department in 2010.
I feel that the emergency department is like my child; I built it up to this size, uniting everyone to create this situation, which is not easy, so I cherish it very much, I truly cherish this collective.
A few days ago, one of my nurses posted on social media saying she missed the busy emergency department of the past; that kind of busy was completely different from this kind of busy.
Before this epidemic, myocardial infarction, cerebral infarction, gastrointestinal bleeding, trauma, etc., were all within our emergency department's scope. That kind of busy was fulfilling, with clear objectives and smooth processes for various types of patients, knowing what to do next and where to find help if something went wrong. But this time, there were so many critically ill patients that we couldn't handle or admit, and we medical staff were also at risk. This kind of busy was truly helpless and heartbreaking.
One morning at 8 a.m., a young doctor in our department sent me a WeChat message, also quite characteristically, saying he wouldn't come to work that day because he felt unwell. Because we have rules here, if you're not feeling well, you need to inform me in advance to arrange coverage. When he told me at 8 a.m., I thought, where am I supposed to find someone? He vented his anger at me in the WeChat message, saying, "A large number of highly suspected cases were sent back to society by your emergency department; we are committing sins!" I understood that he was acting out of a doctor's conscience, but I was also anxious, saying, "You can sue me; if you were the director of the emergency department, what would you do?"
Later, after resting for a few days, this doctor still came back to work. It wasn't that he was afraid of dying or getting tired; it was just that facing so many patients at once felt overwhelming.
For doctors, especially many who came to support later, it was psychologically unbearable. When encountering such situations, some doctors and nurses cried. One was crying for others, and the other was crying for themselves, as no one knew when it would be their turn to get infected.
Around mid to late January, the hospital leaders gradually fell ill, including our office director and three vice presidents. The head of the medical department's daughter also fell ill, and he was resting at home. So basically, during that time, no one was in charge; it felt like you were just fighting there.
People around me began to fall ill one after another. On January 18, at 8:30 a.m., the first doctor fell ill. He said, "Director, I've been infected. I don't have a fever; I just did a CT scan, and my lungs have a large area of ground-glass opacity." Before long, a responsible nurse in the isolation ward told me that she had also fallen ill. In the evening, our head nurse also fell ill. My first genuine feeling at that moment was—fortunate, because falling ill early meant I could leave the battlefield sooner.
I had close contact with these three people, and I went to work every day with the belief that I would definitely get infected, yet I never did. Everyone in the hospital thought I was a miracle. I analyzed it myself; perhaps it was because I have asthma and was using some inhaled steroids, which might inhibit the accumulation of these viruses in my lungs.
I always feel that we emergency department staff are sentimental people—in Chinese hospitals, the status of the emergency department is relatively low among all departments because everyone thinks that the emergency department is just a passage to admit patients. This neglect has always existed during this epidemic.
In the early days, there was a shortage of supplies, and sometimes the protective clothing allocated to the emergency department was of very poor quality. Seeing our nurses wearing such clothing to work made me very angry, and I vented my anger in the weekly meeting group. Later, many department heads gave me the protective clothing they had stored in their departments.
There was also the issue of meals. When there were many patients, management was chaotic, and they couldn't even think that the emergency department might be short on food. Many departments had food and drinks laid out after work, but we had nothing. In the WeChat group for the fever clinic, some doctors complained, "We in the emergency department only have diapers..." We were fighting on the front lines, and yet this was the situation; sometimes, I felt really angry.
Our collective is truly great; everyone only leaves the front lines when they are sick. This time, over 40 people in our emergency department were infected. I created a group for all the sick people, originally called the "Emergency Sick Group," but the head nurse said it was inauspicious, so we changed it to "Emergency Cheer Group." Even those who were sick did not have a very sad, desperate, or complaining attitude; they were quite positive, helping each other and getting through tough times together.
These young people are all very good; they have suffered grievances alongside me. I also hope that after this epidemic, the country can increase investment in emergency departments, as emergency medicine is highly valued in the healthcare systems of many countries.
Unattainable happiness
On February 17, I received a WeChat message from that classmate at Tongji Hospital. He told me, "I'm sorry." I said, "Fortunately, you shared it; you timely reminded some people." If he hadn't shared it, perhaps there wouldn't have been Li Wenliang and the other eight; fewer people would have known.
This time, three female doctors and their families were all infected. The fathers, mothers, and husbands of two female doctors were infected, and one female doctor's father, mother, sister, husband, and herself—five people were infected. Everyone felt that discovering this virus so early led to such significant losses; the cost was too heavy.
This cost is reflected in many aspects. Besides the deceased, the sick are also suffering.
In our "Emergency Cheer Group," we often exchange information about our health. Someone asked if a heart rate that stays at 120 beats per minute is serious. Of course, it is serious; feeling anxious with every movement will affect them for life. Will they suffer from heart failure when they get older? It's hard to say. In the future, while others can go hiking or travel, they might not be able to; that's a possibility.
And Wuhan. You say our Wuhan is such a lively place; now the streets are quiet, and many things are unavailable, yet the whole country has come to support us. A few days ago, a nurse from a medical team in Guangxi suddenly fainted while working. She was resuscitated, and later her heartbeat returned, but she remained unconscious. If she hadn't come, she could have lived well at home and wouldn't have encountered such an accident. So, I feel that we owe everyone a debt of gratitude.
Experiencing this epidemic has had a tremendous impact on many people in the hospital. Several medical staff members below me have considered resigning, including some key personnel. Everyone's previous perceptions and common knowledge about this profession have inevitably been shaken—was it right to work so hard? Just like Jiang Xueqing, he worked too diligently and treated patients too well, performing surgeries during every holiday. Today, someone shared a WeChat message from Jiang Xueqing's daughter, saying that her father had given all his time to patients.
I myself have had countless thoughts about whether I should return home and become a housewife. After the epidemic, I basically haven't returned home; my husband and I live outside, and my sister helps take care of the children at home. My second child no longer recognizes me; he shows no feelings when watching videos of me. I feel very lost. It wasn't easy for me to have this second child; he weighed 10 pounds at birth, and I developed gestational diabetes. I had been breastfeeding, but now I've stopped. When I made this decision, I felt a bit sad. My husband told me, "In a person's life, encountering something like this, and not only being a participant but also leading a team to fight this battle, is also a very meaningful thing. When everything returns to normal in the future, everyone will look back on this as a very precious experience."
On the morning of February 21, the leader spoke with me. In fact, I wanted to ask a few questions, such as whether they felt they had criticized me incorrectly that day. I hoped they would apologize to me. But I didn't dare to ask. No one has ever said the words "I'm sorry" to me in any situation. But I still feel that this incident further illustrates that everyone should adhere to their independent thoughts, because someone must stand up and speak the truth; there must be different voices in this world, right?
As a person from Wuhan, who doesn't love their city? Now, when we think back to the most ordinary life we lived before, how luxurious that happiness seems. Now, I feel that holding my baby, taking him out to play on the slide, or going to watch a movie with my husband, which used to be so ordinary, now feels like a kind of happiness—an unattainable happiness.