A few months ago, through the provincial health department of the selection examination, my German exchange trip finally became a trip. Peer other 9 people also come from the provincial hospital departments, as the first batch of Anhui Province was sent to Germany to participate in the German-Chinese medical exchange program doctors, we have long exceeded the age of “middle-aged” as if regaining their youth, shouldering their respective hospitals of the trust, with ideals, across the ocean. Stranger – Curious – Harvest – Joy After a long flight of more than ten hours, our plane landed at Frankfurt International Airport, and just a few hours later, we were assigned to different cities, and began a three-month internship exchange in the agreed receiving hospitals. I traveled to Greifswald with Dr. Ruobing Qian, a fellow neurosurgeon, and despite the “locomotive ride,” we were curious about what this unfamiliar country had to offer. As it was close to Christmas, the streets of Germany at the end of November were already a little festive – but in the midst of the financial crisis, it was hard to read the festive cheer on the faces of the Germans who flashed past. Only the red Christmas hats and large discount posters in the street windows remind people, if at all, that the New Year is approaching. In the past, Chinese doctors’ exchanges abroad were basically limited to seminars and presentations, and it was a great reward if they were occasionally allowed to observe surgical procedures through the observation window. The German-Chinese medical exchange program organized by the German-Chinese Association for Scientific and Technological Exchanges (GCASTEX), on the other hand, was more oriented towards clinical practice. Dr. Qian and I were assigned to the Clinical Faculty of the University of Greifswald, under the supervision of Prof. Schroeder, the head of neurosurgery, for the exchange of clinical practice. After learning more about our respective specialties, we were allowed to enter the operating room to witness and participate in a rare operation, which was very rewarding and joyful! Although the medical equipment and technology level of many hospitals in China have developed in recent years with the deepening of foreign exchanges, technical training and the introduction of scientific management systems have not been done enough. Therefore, among the doctors who went to Germany for study and exchange, many of them listed these as the main contents of exchange and study. A German professor who takes one small step more than others The Clinical Medical School of the University of Greifswald is one of the oldest and most prestigious medical schools in Germany, and is also the first hospital in Germany to carry out neuroendoscopic surgery. The hospital is divided into two parts: the old part and the new part under construction, which will become the most modern general hospital in Germany when it is completed in 2010. It is said that the completed new area will be highly computerized – the degree of sharing of patient data and information as well as the density of computer access terminals will increase dramatically, and some critical or out-of-town patients can be transported to the hospital by helicopter, which is almost unimaginable in China. Our mentor, 46-year-old Prof. Schroeder, is the youngest director of neurosurgery at this hospital. He is technically versatile and knowledgeable, and is well versed in all kinds of neurosurgery, with a particular specialty in neuroendoscopic surgery and microscopic neurosurgery. This man with a Mexican beard is very enthusiastic and friendly to us. He often took the initiative to book some “interesting” surgeries for us to visit, and even allowed us to take video recordings during the surgeries, which made us very touched. Visiting Prof. Schroeder’s surgeries was a kind of artistic enjoyment, and it also witnessed his rigorous and serious working attitude as well as his skillful microsurgery skills. In an endoscopic-assisted microsurgical operation to remove an acoustic neuroma, he successfully removed the tumor and preserved the facial nerve, but failed to save the acoustic nerve, which was tightly adhered to the tumor. In China, such a result would have been perfect, but Prof. Schroeder did not take credit for it, but rather chagrined: “It is the eternal quest of our neurosurgeons to maximize the preservation of sound sensory and motor functions for our patients.” This made me sweat. This is a kind of professional ethics based on the maximum care for the patient’s health, which is based on the continuous development and improvement of surgical techniques, and only under the guidance of this kind of professional ethics, the surgeon’s level of surgical treatment can be continuously improved, rather than being satisfied with a little bit of so-called achievements in a limited scope. The resection of meningioma in the rocky oblique area is extremely challenging, especially in cases where the tumor is huge and wrapped around multiple arterial vessels! Prof. Schroeder used the “posterior approach of suboccipital sigmoid sinus”, which is unimaginable to domestic doctors, to open a very small bone window under the occipital bone behind the patient’s left ear, and after a fierce battle of nearly 15 hours, the tumor, which was considered to be only removable through the anterior approach of the sigmoid sinus, was completely taken out through the narrow surgical channel, with only a small complication. The surgery was a complete success. The change from anterior approach to the sigmoid sinus to posterior approach to the suboccipital sigmoid sinus, on the surface, only appears to be a change in the choice of surgical access, but in fact it reflects the surgeon’s exceptional courage and superb microsurgical skills, and the real benefit is still the patient, because it reduces surgical by-product injuries to alleviate the patient’s pain, speeds up the postoperative recovery, and improves the quality of patient’s life. Arachnoid cysts in the saddle region are a common condition and usually simple to operate on. It may be hard to believe that such a surgery could be written up and published in the top neurosurgical journals, but Prof. Schroeder wrote an article published in Neurosurgery with just one case and received favorable comments from many experts. Why? The difference from us is that he had to use the endoscope to carefully investigate and observe each case, and “accidentally” he discovered the possible mechanism of arachnoid cyst formation in the saddle region, and proposed a new concept for the treatment of saddle region arachnoid cysts. In addition, he discovered a case in which the interaction between the arachnoid cyst and the anterior cerebral artery in the saddle region damaged the visual crossover through endoscopic observation, which in turn raised new requirements for the timing of surgery. What would happen if we had the same habit? All of his successes were due to the fact that he took one small step forward more than anyone else! This is a kind of professional ethics based on the maximum care for patients’ health, which is based on the continuous development and improvement of surgical techniques, and only under this kind of professional ethics, the doctor’s level of surgical treatment can be continuously improved, instead of being satisfied with a little bit of so-called merits achieved in a limited scope. Due to the schedule of the exchange program, we could only spend the Spring Festival of the Year of the Ox in Germany. Fortunately we were invited by Prof. Schroeder to be his guest, and had dinner in one of the oldest restaurants in Greifswald, and in a piece of wet and cold air from the Baltic Sea in the north, we got a taste of the unfamiliar civilization of this ancient city. A city that has produced two Nobel Prize winners, two German Chancellors (one of whom was Bismarck, the “Iron Chancellor”), and many politicians, writers, and poets, we left the country feeling a little nostalgic. However, we always remembered the purpose and significance of the trip. Here, we felt the harmonious doctor-patient relationship and high social civilization in German society, and the dedication, cooperation and precise control of work planning emanating from every doctor in the hospitals made us feel the great responsibility on our shoulders. As a medical worker, we have the responsibility to let the domestic patients enjoy the most advanced medical and health technology as soon as possible, and for this reason, we will pay more efforts.