早上交班，周末病区来了两个心包积液的病人。
突然想起我学心包穿刺的过程。心包穿刺是二级操作，在各种穿刺里危险度最大。我第一次做是升主治后，上级医生带着我在肿瘤科穿，穿了六七针都没有出来，满头大汗…若干次后，我去他科会诊，不用助手，独自一人，随手就把心包穿刺给做了。当时，能独立做心包穿刺的医生，还是有点少。

可是，时代变了

超声越来越普及，超声下穿刺的技术也越来越成熟。超声下心包穿刺的难度较传统降低，安全性也大大增加。
我也设想过，退休后有时间，去学学国画。从这一年AI的进化来看，自己画似乎意义也不大了。
站在新时代的大门，马车夫不去学驾驶的话，那么就会被抛弃。

In the Morning Handover, Two Patients with Pericardial Effusion Were Admitted to the Ward over the Weekend

Suddenly, I recalled my experience of learning pericardiocentesis. Pericardiocentesis is a second-level procedure and is the most dangerous among various punctures. The first time I performed it was after I became an attending physician, with a senior doctor guiding me in the oncology department. After six or seven attempts without success, I was sweating profusely... After several attempts, I went to another department for a consultation, and without an assistant, I performed the pericardiocentesis alone with ease. At that time, there were still quite a few doctors who could perform pericardiocentesis independently.

However, Times Have Changed

Ultrasound has become increasingly popular, and the technique of ultrasound-guided puncture has become more refined. The difficulty of ultrasound-guided pericardiocentesis is much lower than the traditional method, and the safety has greatly increased.
I also thought that after retirement, I would have time to learn Chinese painting. But seeing the evolution of AI this year, it seems that drawing by oneself is not very meaningful anymore.
Standing at the gate of the new era, if a coachman doesn't learn to drive, he will be left behind.