My Medical Skills Give Me Experiences Chapter 229

【My medical skills can add experience points】【】

"Of course, there are no absolutes in the world, and we can't give up eating because of choking. Sometimes the cause is clear, but the pathological mechanism is not clear, or there are only superficial symptoms, and the cause cannot be found for the time being. At this time, symptomatic treatment is also an expedient measure. The patient is in pain, and the patient's life can be saved as much as possible. In the process of practicing medicine, dogmatism should not be avoided."

Director Shang might be worried about teaching Zhou Can to be an elm bump, so he added another sentence.

Diagnosis and treatment is an extremely complex process that must be learned and used flexibly.

People who can only be formulaic and rote are not suitable to be doctors.

Etiology, pathogenesis, syndrome, and symptoms are the understanding and reflection of a disease from different angles. This requires doctors to flexibly use several treatment modes such as examination of causes and treatment, disease differentiation and treatment, syndrome differentiation and treatment, and symptomatic treatment.

"clear!"

Zhou Can nodded to show that he knew.

He's never been the type to do things rote, either.

"Being Pearson under me, there are no special requirements. You just need to maintain a serious and responsible attitude. It would be even better if you can be more active and diligent on the basis of being serious and responsible."

Director Shang's request may not seem high, but it is actually quite high.

It is very difficult to do well in the four words of being serious and responsible. Coupled with an initiative and hard work, it is even more difficult. It is equivalent to not only doing a good job as a regular trainee, but also taking care of the director.

"I will open a department login account for you later, and you can check the patient information of this group at any time. If you have time, you can even check the patient information of other groups in the department. If you have any questions, you can ask me at any time."

This treatment has basically become the standard equipment that Zhou Can can enjoy when entering a new department.

For ordinary regular trainees, being able to catch up with the chief physician for a few words is enough to be happy for a long time.

However, Zhou Can can consult the chief physician at any time.

"Then tell me about your daily work schedule. For the time being, it is basically normal operations such as checking nursing records, checking test results, writing medical records, issuing doctor's orders, and rounding the ward. You are now a Guipei student. Interns can't compare, you need to take on more work tasks. For example, if a new patient is admitted in the group, it will be randomly assigned to you regular trainees or excellent interns to manage alone.”

Interns generally don't take on much work.

The superiors will not let them take care of patients alone casually, mainly because they are afraid of accidents.

After all, most of the interns are undergraduate seniors who have just studied medical theory for four years at school. Medical undergraduate students usually enter the hospital for internship in the fifth year.

Tuya College of Medical Sciences is a relatively top medical university, and Tuya Hospital itself is interdependent.

Some of its outstanding senior students will be eligible to enter Tuya General Institute for internship.

Those who are slightly worse may get an internship in Tuya Attached Second or other hospitals. Basically, the school arranges internship units for students.

The interns are basically noobs when they first enter the hospital.

The teaching teacher usually doesn't care much about the interns under him. Some people have been intern for a year, and they don't even know what the chief physician looks like. This is really not nonsense, but the truth.

Most of the people in charge of interns are resident doctors, and the total number of inpatients.

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【My medical skills can add experience points】【】

A few excellent big thick legs that can hold the attending doctor may also be covered by the attending doctor.

In short, interns will never take care of patients alone as soon as they enter the hospital.

Since when?

The superior started to let you write the medical records alone, which basically indicates that you are going to manage the patients alone.

Zhou Can is Gui Peisheng, and has already obtained a medical license, so it is necessary to take care of patients alone.

But he has just entered the gastroenterology department, at least he needs to get used to it for two days!

Being famous also has its downsides.

Director Shang didn't even ask him if he could take care of the patients, and arranged for him directly.

And from the tone of voice, managing patients alone is only the most basic operation.

"I have a number of trainees, interns, residents, and attending physicians under my command. If you want to get more advanced training opportunities, you need to work hard for yourself. Whoever performs well, I will give them more growth opportunities, fair and just If you want to get the opportunity to perform interventional surgery, attend clinics with you, or even participate in research projects, you need to perform well.”

Fair competition is Zhou Can's favorite.

Ordinary interns, regular trainees, would basically lose out if they competed with him.

It is also difficult for a resident doctor to compete with him.

An excellent attending physician might be able to fight against him.

At least in surgery, almost all departments are like this. Now that he's in the internal medicine department, he doesn't dare to say anything big.

After opening the login account of the department, Zhou Can began to honestly check the case information in the group.

By looking at the course of disease written by others, you can basically infer the level of the doctor.

"Doctor Zhou, a patient who underwent radical total gastrectomy has come to bed 71. Director Shang said that you are in charge of the management."

The nurse who greeted him was quite beautiful, with extremely fair skin and a sweet smile on her face.

"Okay, I'll be there right away."

On the first day of work, the patients were assigned to him for separate management, and Director Shang probably also had the intention of testing him.

These chief physicians are all veterans.

It is not an easy task to gain their appreciation.

No matter how great Zhou Can's reputation in other departments is, if he moves to a new department or changes the chief physician, if he wants to gain trust and recognition, he must work hard.

He already has a very high status in the minds of Director Jia, Liu Lao and others.

But at Director Shang's place, the treatment is a little better than that of ordinary regular trainees.

Quickly coming to bed No. 71, Zhou Can saw three family members surrounding the bed. A gray-haired old lady, a middle-aged woman who looks somewhat similar to the old lady, and a middle-aged man with an ordinary appearance and extraordinary momentum.

The clothes of the three family members are all of class and taste.

It shows that the family circumstances of the patient should be very good.

But when it comes to the hospital, no matter how good the family is, it doesn't matter. In the face of disease, everyone is equal.

If it is a malignant tumor, as long as it spreads, even a wealthy country cannot buy it.

"Hi, I'm the doctor in charge of bed 71. My surname is Zhou. If the patient has any problems during the hospitalization, you can come to the doctor's office to find me at any time. If you have any needs or new progress, you can report to me at any time."

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【My medical skills can add experience points】【】

When Zhou Can was just an intern before, he was somewhat apprehensive when he saw his family members.

It's all right now, generous and confident, completely no different from those doctors who have worked for many years.

The more unconfident you are, the less confident you are, the more your family will look down on you. This is unfavorable for the management and communication of patients during hospitalization.

The family members believe that you are an intern doctor and will not tell you anything.

Because he didn't think it would work to talk to an intern.

Therefore, they usually bypass you and directly ask the superior doctors to report the situation during their ward rounds.

The superior doctor would think in his heart, what did the doctor in charge of the bed do? I can't handle such a trivial matter well, and I have to make a fuss when the family members come to report to me during the ward rounds.

In this way, the superior doctor will have a bad impression of the intern or trainee in charge of the bed.

Zhou Can also suffered many losses, and slowly figured it out, and then learned how to deal with family members and patients.

"Doctor Zhou, when will your hospital arrange for my dad to be treated?"

the woman asked politely.

"From the moment our hospital admitted the patient, we have already treated the patient. The examinations, the measurement of the basic signs during the hospitalization, and the selection of various medication options are all preparations that must be made before treatment."

Zhou Can answered the woman's questions one after another, picking up the patient's information to check at any time.

In order to be aware of it.

"Did he have a total gastrectomy half a year ago?"

"That's right! It was discovered that my dad had stomach cancer unfortunately. After evaluation, the entire stomach had to be cut off to save his life."

The woman replied.

"Unexpectedly, after the operation, after my dad ate, the food would turn into liquid and flow out directly from the drainage tube in the abdominal cavity. My dad couldn't eat at all, so he could only make nutritional infusions to maintain his life."

This patient is really unfortunate.

Total gastrectomy itself will bring some adverse effects. After the operation, food will flow out from the abdominal drainage tube, most of which is due to a problem with the anastomosis between the esophagus and the jejunum.

"Is the patient having an anastomotic leak of the esophagus and jejunum after the operation?"

Zhou Can made inferences based on his own experience.

"Yes, yes, after the doctor's examination, it was said that there was a fistula, and we don't understand these medical terms. The general meaning is that there is a problem with the connection between the esophagus and the jejunum. Let's observe for a while at the beginning and then take a look. After two months, there was still no improvement. We were actually very angry at the time, which meant that the operation was not done well. We also no longer trusted the technology of that hospital, so we took my dad to another famous university. The hospital did a second operation."

When the woman mentioned this matter, she was quite sad and indignant.

However, Zhou Can's ability to tell her father's illness at that time gave her a little more confidence in the medical skills of Tuya Hospital.

Any young doctor in charge of a hospital bed can have such a high level, how can the medical level of Tuya Hospital be poor?

But she didn't know that the doctor in charge of the bed in front of her was one of the best among all the doctors in charge of the bed.

Under normal circumstances, a doctor with many surgical skills has reached the level of deputy director, and his pathological diagnosis has reached the fourth level. However, it is impossible for a doctor with this kind of strength to stay in the ward and do behind-the-scenes management work.

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【My medical skills can add experience points】【】

Instead, they will be arranged by the hospital to be on the front line to engage in surgical work and consultation work.

Any hospital is willing to push excellent doctors to the forefront, let them directly face the diseases of various patients, and use their hands to diagnose the etiology and pathological mechanism. For patients who need surgery, doctors with excellent surgical skills will be arranged to operate on the patients.

Those doctors who are relatively ordinary in all aspects, as well as rookies with short working years, will be arranged to do management work in the ward.

Bed check, dressing change, surgery, medical record writing, etc.

"After the second operation, has the problem been solved? This kind of esophagus-jejunum anastomotic leakage is actually very difficult, even if it is performed a second time, it is not easy to solve."

Zhou Can's surgical experience was learned in digestive surgery.

At that time, Director Jia told him that total gastrectomy is not difficult, but the difficulty is the anastomosis from the esophagus to the jejunum. Whenever something goes wrong it's going to be tricky.

Moreover, the more open abdominal or thoracic cavities are performed, the more severe the internal adhesions will be.

These valuable surgical experiences are hard to learn in books.

After Zhou Can got the guidance, he kept it firmly in his heart.

Since then, he has had a new concept of surgery. If you can do without surgery, try not to do surgery, and if you can not open the chest and abdominal cavity, you will resolutely not open it.

After the operation, the organs and tissues in the thoracic cavity or abdominal cavity will be seriously adhered, which will definitely have a considerable impact on the patient.

It's not just as simple as increasing the difficulty of surgery in the future.

"Oh! You're right! After my dad's operation, not only did the anastomotic leak still exist, but he still couldn't eat. He also had new problems. It became very difficult to swallow food. He even had to spit out his own saliva. Even I couldn't even drink water. We were about to collapse. What kind of hospitals are these? How can an operation be so difficult? The results are getting worse every time.”

When the woman talked about what happened after the second operation, her tone and eyes were full of despair.

Although the other two family members did not speak, their expressions were similar.

With the development of medicine to this day, many technical problems have been overcome, and even kidney transplantation, liver, lung, heart and other important organs can be transplanted.

Even head transplants have been successfully experimented abroad.

But there are still many things that medicine cannot solve.

The doctors were helpless about this.

Zhou Can has seen too many medical cases that could not be solved during the nearly two years in Tuyaguipei.

Some patients really can only watch them die, there is nothing they can do.

What impressed him most was a very young female patient. Her child was only six months old, but she was already in the advanced stage of breast cancer. In the ward of the intensive care unit, she tearfully begged the doctors to let her live for a few more months because she wanted to hear her child call her mother.

But the doctors tried their best, but they still couldn't stop the crazy spread of cancer cells and the damage to her body.

When cancer cells develop to the late stage, in addition to destroying the body's immune system, it will also cause damage and failure of organs.

In the end, the young mother could not wait for the day when her child learned to call mother. On a gloomy morning, she left this beautiful but suffering world with endless regrets.

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【My medical skills can add experience points】【】

At that time, Zhou Can, a big man, felt very uncomfortable when he saw that scene.

If medicine can improve a little bit, I believe that the mother of that child must want to live longer. She wants to hear the child call her mother, and she wants to see what the child will look like when he grows up.

If possible, I even hope to watch the children get married and have children.

But she could no longer see it, and closed her eyes forever.

The patient in front of him was already in his sixties, so he was not short-lived.

At least his children are grown and married.

But ants are greedy for life, let alone human beings who are the spirits of all things!

No one wants to die easily if they can live.

"After the patient's second operation, did the anastomotic stenosis from the esophagus to the jejunum appear?" Zhou Can actually couldn't bear to ask when he saw her sad expression.

"Well! You are quite right."

She bit her lip and nodded vigorously.

"Doctor, do you think my father's illness can still be cured?"

After two failed operations, each of which became more serious, she has lost confidence in the operation.

Just looking at her father's painful appearance, she was like a moth to a flame, and wanted to try again.

"This depends on the results of the examination. I estimate that the operation will be very difficult. Because after such a long time, the patient's anastomosis is likely to have formed. He can't even drink water now. I just speculate, I was wrong. You don't mind. I guess the patient's anastomotic stoma may be completely blocked. It's like two hollow steel pipes. Hollow becomes solid."

In order to help the family members understand better, Zhou Can also made a metaphor.

"It was right again. After the examination at the local hospital, the doctor said so. It was originally planned to undergo esophageal dilation surgery to solve the problem of inability to eat, but after the examination, it was found that the anastomosis was completely blocked. The doctor at the local hospital shook his head Sighing and telling us that there is no way to have another operation.”

The woman's face was full of bitterness, more of helplessness and deep despair.

Sometimes family members do not take the initiative to tell the doctor the whole story, including which hospital they visited, what the result was, and so on.

They have all kinds of ideas.

For example, I am worried that telling the doctor that I have seen it in other hospitals and then coming here for treatment will make the doctor unhappy. Or you want to hear what the new doctor at the hospital has to say.

It can also be used to understand the strength of this hospital.

Zhou Can was right every time, which made the confidence of the woman and the other two family members in Tuya Hospital soar. Will definitely try it out. You don't have to be too desperate, as long as there is a glimmer of hope, there will be endless possibilities. "

Zhou Can reassured family members and patients so that they would not lose confidence in treatment.

this point is very important.

"His examination data is very little, and his medical history is not as comprehensive as you described. Are the examination and operation materials in other hospitals still available?"

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【My medical skills can add experience points】【】

Zhou Can took a rough look at the patient's examination data and felt that it was far from enough.

Because the patient's current condition is very complicated.

There is both esophagus-jejunum anastomotic leakage and anastomotic occlusion.

The local hospital that the woman mentioned is definitely not a small hospital, at least it is a medium-sized tertiary hospital.

It can make the doctors in that hospital dare not even perform surgery, which shows that the problem is very serious.

Surgery can also be surprisingly difficult.

The risks of surgery are also very high.

"All the inspection materials are kept there. I was worried that I would need those materials for seeing a doctor here, so I happened to bring them all and put them in the car. If necessary, I will go to the underground garage to get them right away."

She asked for Zhou Can's opinion.

"Bring them all! I think Director Shang will use them when discussing your father's illness in the department."

Zhou Can knew in his heart that Director Shang probably wanted him to be the main force in diagnosing and treating this patient.

(/novel/)

Chapter end