My Medical Skills Give Me Experiences

My medical skills can add experience points Chapter 109 Director Yin's excitement, entrusted by others, and loyalty

The relationship between blood and body is equivalent to gasoline and cars.

When a car leaves gasoline, it loses its source of power. When the body's blood is not flowing, nutrients and oxygen cannot be supplied to the body's cells.

Paralysis is often accompanied by problems with the blood supply.

For example, patients with half body paralysis will feel that the paralyzed side is particularly afraid of cold, poor blood flow, numbness and so on.

"Her blood supply to her lower extremities has not been seriously affected!"

Director Yin said affirmatively.

So many famous doctors have seen it. If such a simple problem can't be found, wouldn't those famous doctors have lost their reputation?

"No, no, I'm not referring to the blood supply of the lower limbs, but the blood supply of the upper limbs."

Zhou Can's eyes were firm, revealing a kind of excited light of finding the truth.

"Is there a problem with the blood supply to the upper limbs?"

Director Yin frowned. If he hadn't seen Zhou Can's ability, he would have scolded "You have to go to school for a few more years!", then turned his head and left.

At this moment, he is maintaining great patience, and even has a little expectation.

This difficult case was a case that he failed to solve three years ago, and today, three years later, he still cannot make a clear diagnosis.

The more difficult it is, the more interested he is.

Because at his level, cases of ordinary difficulty no longer challenge him.

"Paralyzed patients will naturally have insufficient blood supply due to muscle atrophy, especially in the extremities. To be honest, I shook hands with the patient, and her hands were very cold, indicating that there must be a problem with the blood supply to her upper limbs. At that time, I also Just a little curious. After listening to your advice just now, I got some inspiration."

"Since her electrocardiogram is not too abnormal, it means that the whole body's blood supply should be relatively balanced. So I suspect that she is suffering from systemic blood supply insufficiency caused by motor neuron damage."

Zhou Can boldly made a series of inferences and dialectics.

"Well, there is indeed such a possibility. But it doesn't mean anything. Paralyzed patients generally have this kind of blood supply that is weaker than normal."

Director Yin Hua didn't care much about Zhou Can's discovery.

It can even be said that I am a little disappointed.

The blood supply to the whole body is weakened, which is just a common phenomenon that occurs in most paralyzed patients.

In the words of traditional Chinese medicine, it is the profit and loss of blood and qi, and the deficiency of qi and weak blood.

"I checked the cause of the patient's miscarriage that year. The patient said that he first lifted a heavy object upstairs, then felt unwell. Finally, he fainted at home. But the diagnosis on admission showed a virus infection in the blood? Abnormal brain nerves?"

Zhou Can clicked on a diagnosis sheet when she was first admitted to the hospital.

This is a very original medical record.

Back then, after she fainted, she was sent to the No. 3 City Hospital for treatment by the 120 ambulance according to the principle of nearest rescue.

Paralysis of the lower limbs occurred after the miscarriage, and the third city hospital could not diagnose the cause, so the family members sent her to the provincial people's hospital with higher medical standards. Later, the Provincial People's Hospital also failed to find out the cause, and the patient was severely depressed.

His family members transferred him to Tuya Hospital for further diagnosis and treatment.

Many patients will have such an experience. They thought it was a minor illness, but it was ineffective after being treated in a general hospital.

Three years ago, the reputation of the Provincial People's Hospital was similar to that of Tuya, or even slightly better.

Today, Tuya Hospital has left it behind.

It has become the hospital with the highest medical level and diagnosis and treatment ability in the province.

"Do you think the patient has symptoms of paralysis of the lower limbs before being admitted to the hospital?" Zhou Can made another extremely bold speculation.

"It should be unlikely. Before admission, the receiving doctor will definitely do a series of examinations on her. The medical level and diagnosis and treatment capabilities of the Third City Hospital are not bad, and their medical quality control has always been extremely strict. If the patient was at that time If there is paralysis of the lower limbs, it will definitely be recorded in the admission records. But they clearly stated in the medical records that they were paralyzed after abortion.”

Director Yin is well aware of the strength and medical style of various hospitals in the city.

At his level, he should often be invited to major hospitals to participate in some exchanges, guidance or lectures.

After contacting the doctors in those hospitals, I naturally had the opportunity to learn about that hospital.

"Could it be that when the patient was admitted to the hospital, the paralysis of the lower limbs was not obvious, so it was ignored? The 120 admission record stated that the pregnant woman fainted in the toilet at home."

Zhou Can persevered in insisting on this determination.

"That's a possibility."

Director Yin agreed with Zhou Can's point of view this time.

"It's a pity that the Third City Hospital lacks high-level doctors who can support the pillars. It would be great if I could measure the myoelectricity for this patient at that time."

If the EMG test was done when the pregnant woman was admitted to the hospital that year, it could provide a strong basis for the subsequent diagnosis.

It has been more than three years now, and the meaning of doing the inspection that has not been done is very different.

"Director Yin, please read these inspection reports again. These are the electromyography tests performed by Renhe Hospital in the Imperial City. I compared them with the electromyography reports of many normal people yesterday. Qiu Jie's nerve conduction velocity is not Slow, but from the neck down, the strength of the EMG signal is constantly attenuating. Like climbing a hill, the closer to the lower limbs, the weaker the attenuation."

"Then her evoked potential EMG test, as well as her motor unit count, were unremarkably abnormal."

Director Yin had already discovered what Zhou Can said.

"What do you want to say?"

Director Yin didn't know that he had provided so many evidences, what exactly was he trying to prove?

Pathological diagnosis is extremely complicated, especially in this kind of difficult case, the difficulty of syndrome differentiation is even more frighteningly high.

Check the profile everyone will read.

To find a clue out of thousands of clues, and then sort them out, this is the level of diagnosis.

"I think the patient's cause is a problem with the source of motor neurons in the lower extremities. Her lesion is in the brain, and postpartum infection should only be an illusion of the cause."

What Zhou Can is doing now is to turn the clouds to see the sun and find the real lesion.

"It may be that there is a problem with the motor neuron hub in the brain, or it may be that there is a problem with the nerve center or the brainstem." Zhou Can further added.

[Pathological diagnosis experience value +0.9.]

Seeing the sudden increase in experience points, his heart beat faster for a while, and he was even more convinced that his diagnosis was correct.

His diagnosis method, which is almost blind guessing, would not be recognized by senior residents who have undergone standardized training, let alone famous doctors.

However, pathological diagnosis must sometimes dare to jump out of the shackles of the framework and not stick to the rules.

One of the biggest shortcomings of Western medicine is that it is not flexible enough.

It all speaks by checking the data.

Even with the inspection data, there is still a question mark behind the diagnosis result.

Why?

Because I am afraid of being overthrown, afraid of being slapped in the face!

Under China's current medical system, what doctors are most afraid of is misdiagnosis and medical accidents. The question marks behind the diagnostic results reflect many real problems.

In the final analysis, it is also a kind of lack of self-confidence in Western medicine.

Looking at the old Chinese doctors in the past, there were very few ambiguous moments. Or it's your illness that I can't see, so please be smart. Either clearly identify the lesion, write down the pathology, and then prescribe a prescription.

"Why only increased 0.9 diagnostic experience points?"

This was the first time Zhou Can encountered such a situation.

I have also encountered the situation of increasing 0.2 experience points before. That's because the patient had multiple lesions at the same time, and he only diagnosed one.

The experience value obtained this time is already very close to 1, and the difference of 0.1 is probably because the specific location of the lesion has not been clarified yet.

Director Yin fell into deep thought after hearing Zhou Can's diagnosis opinion.

One minute passed, two minutes, three minutes...

This time it was his turn to fall into a 'dementia' like Zhou Can.

In fact, many famous doctors have their characteristics.

In order to overcome a certain disease, one can forget about eating and sleeping, even eating, going to the toilet, and even sleeping and dreaming, all thinking about diagnosis and treatment.

After nearly six minutes, Director Yin followed Zhou Can's diagnostic opinion and rearranged his thoughts.

There was excitement in his eyes.

That is the excitement and excitement that comes after a major breakthrough in diagnosis.

"Xiao Zhou, the situation you mentioned is entirely possible. After repeated demonstrations, I think that the paralysis of this female patient is likely to be due to changes in the environment of the cranial cavity or compression of the cranial nerves. Hemangiomas, neuromas, and osteomas can basically be treated. exclude."

After all, a lot of inspections have been done.

There is a tumor in the brain, it must be found out.

"If the patient is willing, you can ask her to come to the hospital to see me for another diagnosis. My opinion is to give her another head MRI examination. There is a high probability that the exact lesion can be found."

Director Yin said to Zhou Can.

If the patient is unwilling to trust Director Yin, or has no hope for Tuya Hospital and refuses to come, then there is nothing to do.

"Okay, I'll notify her now."

"If she is willing to come, there is no need to register again. I will explain to the hospital then."

Director Yin gave some convenience.

You know, his special needs expert account is very difficult to get.

800 yuan is a lot of money for ordinary people.

"Okay, thank you! I missed you today, so go get busy!"

Zhou Can got up to say goodbye.

"Don't say that. If you have any questions in the future, you can ask me for advice at any time. Today's patient's diagnosis has made a major breakthrough, and your contribution is no less than mine. Your talent in pathological diagnosis is really mine. I have only seen it in my life. It is no exaggeration to say that this kind of alternative diagnostic thinking that does not follow common sense is unique in the world.”

Director Yin's attitude towards Zhou Can became more and more polite.

This kid is indeed a rare talent.

"Xiao Zhou, if you are willing to come to our neurology department, I can come forward and transfer you here. Although the emergency department can train people, it is enough to stay there for three months. A lot of advanced medical knowledge is important in the emergency department. It is difficult to learn. Our human lifespan is very short, and it is difficult to work for more than fifty years."

"The current field of medicine is becoming more and more subdivided. It is not easy to spend a lifetime studying and thoroughly studying a subject. A talent like you, in internal medicine, will definitely not have low achievements in the future. In addition, it is easier to improve your academic qualifications in internal medicine. Director Tan is a first-level professor, academician level, and you can choose his teaching subjects when you apply for the exam."

Although he didn't speak clearly, he basically hinted at Zhou Can.

As long as they enter the internal medicine department, the matter of improving their academic qualifications is on them.

The evaluation standards for first-level professors are extremely strict, and basically only academicians can meet them.

I really didn't expect Director Tan of Internal Medicine to be so awesome.

However, in terms of academics, internal medicine is indeed easier to achieve.

Director Yin now invites Zhou Can to develop in the Department of Neurology, and promises a lot of benefits, which is enough to show how much he values ​​Zhou Can.

"Thank you for putting yourself in my shoes and thinking so much for me. I'd better mix it up in the emergency department first." Zhou Can made up his mind at the beginning that he wanted to look like a normal person in the emergency department.

Let those directors who did not choose him understand that academic qualifications are not the only ones.

"Well, when you change your mind, you can come to me at any time. You can even go to Director Tan directly. He also appreciates you very much." Yin Hua nodded helplessly.

If people don't want to develop in internal medicine, he can't help it.

"By the way, have you chosen your regular training direction?"

Even for general trainees, after being divided into departments, they still need to choose the direction of compensation.

"I used to want to choose general surgery, but now it seems that I can only choose emergency medicine?"

Zhou Can is also not very clear about the hospital's arrangements for these general practitioners.

Both he and Jin Mingxi were assigned to the emergency department, and they chose the direction of training, which he thought must be emergency.

"It's not bad to choose emergency department as the direction of regular training, and you can transfer to another department in the future. As for the general surgery you mentioned, I suggest not to consider it. The road is too narrow. The development prospect of general surgery is far inferior to that of neurosurgery and cardiothoracic surgery. As for internal medicine , and it is also the most promising for the development of neurology and cardiothoracic medicine.”

Director Yin actually guided his choice of training direction, so much attention was paid to him, so he spent so much effort.

"Thank you for giving me such thoughtful guidance. I am very touched."

Zhou Can and Director Yin Hua didn't even know each other.

The first time they met each other, Yin Hua even scolded him in public. At that time, my impression of Zhou Can was also very bad.

Later, with Zhou Can's excellent performance and humility, Yin Hua's impression of him gradually became better and better.

…

After coming out of Shennei, Zhou Can called Li Luo directly.

"Brother Luo, it's me, yesterday..."

"I know, Zhou Can! Do you want to come to my house today?"

Li Luo chatted with him yesterday and hit it off very well.

As soon as he opened his mouth, he directly invited Zhou Can to play.

It is estimated that he is boring enough to be alone at home with his wife.

"I won't go today, I'm still in the regular training stage, and I need to practice my surgical skills! Alas, studying medicine is really hard!"

Zhou Can sighed.

"Haha, who told you to choose this line of work? Regret it!"

Li Luo laughed.

"It's not too much to regret. After all, I like this job. Brother Luo, let me tell you something. Didn't you send me the inspection materials of my sister-in-law yesterday? I asked a few teachers to read it today. , with a major diagnostic discovery. His opinion is that if you and your sister-in-law are willing, you can go to him again for a diagnosis, maybe a head MRI."

Zhou Can didn't dare to continue chatting with Li Lao.

Instead, hurry up and talk about business.

Otherwise, he will be able to talk about some topics of common interest later, and the chat will last for an hour.

Zhou Can also likes to chat with him, and he can gain a lot of knowledge and learn a lot.

It's just that he still focuses on hard training in medical skills.

Anyway, there will still be time to cook wine and talk together in the future.

"Really wow! That's great!"

Li Luo was very excited when he heard the good news.

Zhou Can even suspected that he jumped up happily like a child.

"I know you are a sincere person. I just didn't expect you to take my wife's illness so seriously. Brother, don't say too much, brother will keep this feeling in mind. Even if your sister-in-law goes to check up tomorrow, Still can't find out the cause, I still thank you for your kindness."

Li Luo, who almost became the president of Tianyu Interactive, has a strong ability to know people.

Don't look at him as a bit unrestrained, but his talent and ability are extremely strong.

When dealing with people, I don't like to play tricks.

This can be felt when the two sides chat.

When he chatted with Zhou Can, he never played tricks.

"Hey, is Director Yin's name Yin Hua?" Li Luo asked again as if remembering something.

"Yes! It seems that you still remember him! When I showed him the information about my sister-in-law today, he was also very impressed with her. He said that he couldn't find out the disease of my sister-in-law three years ago~www.readwn.com ~I am very sorry."

"It's really him. I'll take my wife to him tomorrow."

Li Lao is extremely concerned about his wife's illness.

When he heard that there was a new discovery in the diagnosis, he was very happy.

Although every time I seek medical treatment, I always go with hope, and finally return with disappointment.

But as long as there is a glimmer of hope, he never gives up.

indomitable.

"Director Yin said yes, so you don't need to register. It's just that I think it's better to register out of respect."

Zhou Can has his own principles of life.

He believed that Li Luo would not care about the 800 yuan registration fee.

"It must be registered. I understand this. Brother, don't worry. It's just that Director Yin's account is more difficult to get, and I'm afraid it will be cheaper for those vicious scalpers."

Over the past few years, Li Luo often took his wife to seek medical advice.

I am afraid that it is suffering from scalpers.

So I hate scalpers very much.

"There's no need to buy an account from scalpers. Anyway, it's already agreed, you just ask Director Yin to add an account." Zhou Can gave them an idea.

He has a very sense of justice in his bones.

Unless it is absolutely necessary, it will never encourage unhealthy trends.

If patients do not buy numbers from scalpers, the profession of scalpers will naturally disappear.

After the call, Zhou Can was very happy.

Loyalty to friends entrusted, this is the show of credit. If there is no accident in this matter, there will be a good result soon.

He also wanted to see, where exactly was Qiu Jie's disease? What is the specific cause?

I believe that after the examination tomorrow, Director Yin will be able to diagnose the specific cause. +Bookmark+