By Bo Shining

People often encounter problems while making decisions:incomplete information,inadequate time,and intimidating,life-or-death consequences may influence their decisions.

These types of problems are especially commonplace in hospitals.

Doctors can never wait until they have all the information about the disease before diagnosis and treatment.Instead,they have to decide on a treatment within a short period of time.Therefore,only those who can make quick decisions on the basis of limited information can be regarded as qualified doctors.This ability is not easy to come by;it stems from one’s analytical skills and clinical experience,both of which can only be acquired over time.

When it comes to analytical skills,doctors usually follow four rules in their decision-making while processing incomplete information.

Rule Number 1:The Law of Tang Sanzang (a master monk in the 16th century novel Journey to the West)

On their journey to the West,Tang Sanzang was often captured by demons and monsters.In most cases,his three disciples didn’t know what superpower the captor had or who they were.As long as Tang Sanzang was alive,Monkey King would find a way to rescue him;when Monkey King’s powers failed,he could turn to Guan Yin (Chinese translation of the Avalokiteśvara) for help;when Guan Yin was powerless,there was still Tathagata who could offer help.So long as Tang Sanzang was alive,there was surely a way.Similarly,in hospitals,as long as the patient is alive,there is hope.This is the Law of Tang Sanzang.

For example,I have had many patients in the ICU suffering from cardiac arrest,which could be caused by a number of things.However,in those few golden minutes when the patient’s life is at stake,the most important thing is not looking for the cause of cardiac arrest,but keeping them alive.Therefore,I focus on three critical indicators in the patient:heart rate,blood pressure,and respiration.If the patient’s heartbeat is unstable,I use medicine to keep it stable to avoid fatal arrhythmia;if the patient’s blood pressure is low,I use medicine to raise it to ensure that every organ is getting blood flow;if the patient has breathing problems,I immediately have the patient’s trachea intubated with a ventilator so as to provide them enough oxygen.

我们在做决策时，经常会遇到一些问题：首先，需要的辅助决策的信息不全面；其次，留给决策的时间往往有限；最后，决策带来的后果时常性命攸关。

在医院里，这种问题尤为常见。

医生永远都不可能等掌握了疾病的全部信息后再开始诊断和治疗，而必须在短时间内决定治疗方案。所以，只有具备了在信息不完备的情况下快速决策的能力，才算合格的医生，但具备这种能力非常不容易，因为它是建立在长期养成的思维逻辑和大量临床经验的基础上的。

思维逻辑方面，医生在信息不完备的情况下做决策，会遵循下面四条法则。

第一条：唐僧法则

在西天取经的路上，唐僧经常会被妖怪抓走。大多数情况下，他的几个徒弟都不知道这个妖怪有什么法力，是什么来头。但是只要唐僧不死，孙悟空就总有办法把他救回来。就算孙悟空救不了，还可以求助观世音；观世音不行，还有如来。所以只要唐僧活着，就有办法。

同样的道理，在医学上，只要先保证病人活着，就有希望。这就是唐僧法则。

比如，在ICU，我经常会遇到心搏骤停的病人，原因可能有无数个，但是，在病人生死攸关的那几分钟里，寻找心跳停止的原因不是最重要的，最重要的是先救命。所以，我最先关注的一定是病人的三个指标：心律、血压和呼吸。心律不稳，就用药物把心律维持在一个稳定的水平，处理致命性的心律失常；血压低，就用升压药物把血压升起来，从而保证身体每个器官都有血流；……