Micro-check

After about five or six minutes, the middle-aged woman came back with her son, holding in her hand the spit cup that Zhou Xun had written their names on.

The boy handed the phlegm cup to Zhou Xun. He was tall and thin, with simple eyes and a high nose bridge that seemed to be of Tibetan descent, but looking at his mother, he was pure Han.

Probably because he felt that his mother was too rude just now, he was quite embarrassed, and after handing the sputum cup to Zhou Xun, he asked him in a low voice: "Is this okay this time?"

Zhou Xun wore a mask, leaving only a pair of eyes with heavy eyelids exposed. He checked it again and found that the quality of the sputum sample this time was better, with bloodshot inside. It seems that the patient's condition is not serious, and the previous I heard from the boy's mother that the patient had been diagnosed with tuberculosis a few years ago, but he hasn't recovered after so many years. The situation is definitely not optimistic until now.

He nodded, "It's okay this time."

The woman folded her hands, looked at Zhou Xun vigilantly, and said, "When will I get the report?"

Zhou Xun said, "Just pick it up in an hour."

The other party said suspiciously: "Come and get it so quickly, you can't just write one."

Zhou Xun was about to be laughed at by her. At this time, the older teacher Tan in the laboratory came out. Teacher Tan is a female teacher who is nearly fifty years old. She also heard what the other party said, so she couldn't help scolding this woman: "Why are you like this? If you do it slowly, I will let you get the report tomorrow. Doctor Zhou didn't see that you are in a hurry, so he will do it for you right away. Doctor Zhou is a doctor from the Affiliated Hospital of H University in C City. You Why do people keep yelling here. If you don’t believe me, why do you come to our hospital to see it? You can go to another hospital to see it.”

Tuberculosis is free medical care, from sputum tests to tuberculosis drugs are free.

Moreover, people who get tuberculosis have always been people with poor conditions and poor immunity. It is decided that most of them are poor people, and some rich people also get it, but these rich people often have higher knowledge levels and can standardize treatment. After standardized treatment, they can basically be cured, but the poorer the poorer the less knowledgeable the less they will listen to the doctor's advice, or they have no conditions or psychological preparations, and if they don't receive standardized treatment, they will be cured more and more in the end. This makes tuberculosis basically defined as The poor are sick.

Since it is a disease of the poor, the reimbursement ratio required by the state in this regard is also high.

Therefore, for the hospital, the sputum test and tuberculosis drugs are free, and the information of each patient must be reported to the tuberculosis reporting system according to the requirements of infectious diseases, which increases a lot of workload. Secondly, other drugs such as liver protection or hospitalization Fees and so on, and the reimbursement ratio is very large, so the hospital ends up subsidizing money to treat patients.

In the past, when this disease was treated for disease control, although this was also the case, the disease control has always been done this way, and the staff will not feel unbalanced if they don't compare.Now this work has been transferred to the hospital. Although the state subsidizes part of the money, it is far from enough.Hospitals have to be responsible for their own profits and losses, so naturally they have to pay for this work.For the staff, there is a great risk of infection from doing tuberculosis, and they are exhausted and have no way to make money.It is impossible for the hospital not to give them money. To pay this part of the salary and bonus, it is naturally picked out from the profits of other departments. In the end, the staff working on tuberculosis is thankless, and they are both burdened and other subsidies. Discrimination by money department.Who feels better? !

So Teacher Tan couldn't control his temper and immediately got angry at the patient's family.

She was too angry, but Zhou Xun didn't know how to adjust the situation between her and the patient's family.

Zhou Xun has been in this hospital for half a year, and he has a very clear understanding of the personalities of the people here.

He used to come into contact with world-class national experts, outstanding graduates from prestigious schools, and practitioners in well-known hospitals. The more capable a person is, the more humble he is, because the higher he stands, the farther he sees, the farther he is. Understand your own insignificance, the road ahead is never-ending, every achievement has been made in a down-to-earth manner over the years, and the people around you don't have a few brushes, so few people will be overly proud and violent.

It’s different when it comes to this kind of remote and poor grassroots. Even if it’s just a small staff in a laboratory, some teachers may be staff who have taken over from the past. It’s hard to say whether they are outstanding or not. In front of him, he was very proud.

And patients often accept their arrogance, and their arrogance and fierceness are not enough to shock patients and their families.

Zhou Xun was shocked by this deformity, so far he has no way to adapt.

Of course, there are many doctors and other staff who are good-tempered, but these good-tempered doctors are either well-known doctors or newcomers who have just entered the work. Most of the old fritters have their own pride.

This is almost the same as the comparison between the middle-aged doorman watching the gate and the dean sitting in the dean's office. The doorman must have a much worse temper than the dean.

Sometimes Zhou Xun felt that the doorman had to be so low-minded, otherwise he dealt with all kinds of people all day long, and the talkative people must be the majority, but sometimes there are two or three particularly annoying people, But it can make people use up the good mood for a few days, and it is useless to say good things, you have to drink and scold. Of course, the result of drinking and scolding can have good results most of the time, but sometimes it will Bring the consequences of fighting.

So now Zhou Xun is used to the hospital guards talking softly to him, turning around and scolding the family members of the patients who are running around.

The teacher in the lab used this trick, and he thought he might get used to it in half a year.

Teacher Tan's words made the middle-aged woman stop being picky, but she was still skeptical.

She said sympathetically and with some pity: "If it wasn't for the fact that he started coughing up blood again because he didn't look good at other places, we wouldn't have come here to see it. We came here by car and sat for more than two hours."

Teacher Tan put her hand in the pocket of her white coat, probably feeling that this woman was quite pitiful, so she stopped scolding her, and said in a gentle tone, "Who is looking at tuberculosis?"

The woman said, "It's my guy."

Teacher Tan said: "This disease needs to be treated well, and it can be completely cured. I will ask Dr. Zhou to tell you that he is an expert from a big hospital, a doctor with a doctor, and he is better than us. You can treat him well. Say it."

Teacher Tan is a local boss, and her daughter works as a Chinese teacher abroad. Relying on her status, she usually looks down on these poor farmers who come to see a doctor.In Zhou Xun's eyes, she treats those poor, uneducated people who can't talk to each other with the arrogance of ancient intellectuals who say "summer insects can't speak ice".

But she didn't want to talk to this middle-aged woman at this time, because she didn't do tuberculosis and didn't know much. She was afraid of telling the wrong thing to the patient, and felt that Zhou Xun seemed to be omnipotent, so she asked Zhou Xun to tell the patient's family. .

In fact, this is a matter for the receiving doctors and clinicians, and it has nothing to do with Zhou Xun, but when Teacher Tan called him over, Zhou Xun also came to have a few more conversations with the patient's family.

Zhou Xun asked: "You said that your husband was diagnosed with tuberculosis a few years ago, about a few years ago?"

"It must have been five or six years ago." She folded her hands and said.

Zhou Xun sighed in his heart, "Where was the diagnosis for the first time, and how did you take the medicine afterwards?"

The other party said: "At the beginning, I read it in the disease control department, and it was said that it was tuberculosis, so I started to take medicine, but my family felt that the medicine was uncomfortable, so I didn't take it. We went to see a Chinese medicine doctor. It happened for a while, but two or three years ago, it happened again, so we went to the CDC again, and the CDC prescribed the medicine again. After taking it for a while, my mouth felt very uncomfortable and refused to take it. I have seen Chinese medicine, and I have been taking Chinese medicine, but it is not good to eat Chinese medicine. Recently, I started coughing up blood. There is no way, so we went to the disease control department again. The disease control side said that they were not cured, and that they were transferred to this hospital. It’s over, we’re here.”

She talked about it intermittently, and said a lot, but the main idea was the above paragraph.After Zhou Xun heard this, he was shocked and distressed. He was shocked that he had not been cured after five or six years of intermittent treatment, and felt distressed that they were so tossed. It is likely to turn into drug-resistant tuberculosis.

Commonly susceptible tuberculosis can be cured for a few thousand dollars. With the addition of free examinations and medicines, medical insurance reimbursement and policy subsidies, many places can achieve zero cost.But drug-resistant tuberculosis is very bad. It will cost tens of thousands at least and hundreds of thousands at most, and it may not be cured.In addition, drug-resistant tuberculosis can be reimbursed very little, basically relying on self-funded.

And the people in these places are so poor, how can they have money for treatment.Many patients who develop drug-resistant tuberculosis are actually just waiting to die in pain.

He used to hear from Ke Mei that the patients she encountered in her work were abandoned by her family because they developed drug-resistant tuberculosis, and the tuberculosis patients were too poor to work. They lived in a thatched house in the mountains, raised a few chickens, and barely survived on state relief. , their disease control staff only sent some daily necessities to the patient when they went to care for the patient, and finally got him to participate in a treatment program for drug-resistant tuberculosis, but the man died within a few months.Life is miserable, even if Zhou Xun is used to hearing about life and death in the hospital, he still feels sad.

Zhou Xun couldn't help asking: "I was diagnosed at the beginning, and I went to the disease control and treatment. The doctor over there should have said that I should take the medicine according to the treatment schedule. Why didn't you listen?"

She was so confident that she was even a little arrogant, "That's what the disease control doctors said, and they said they would take the medicine for 8 months. But the medicine is really not good. My family feels very uncomfortable after taking it for two months. , how to eat for eight months, we went to see a doctor of Chinese medicine, and it was better after seeing a doctor of Chinese medicine, and it will be almost fine after that.”

From her posture and words, Zhou Xun finally understood why she didn't trust the doctor.It's just because of the side effects of taking medicine before.Her husband was initially infected with common tuberculosis. After taking quadruple antibiotics for two months, the sputum smear basically turned negative, and the symptoms almost recovered, but some tuberculosis bacteria were not killed. After a while, he switched to dual antibiotics. The medicine can be completely cured after taking half a year to eight months.At this time, he switched to taking traditional Chinese medicine. The symptoms had been eliminated by the previous chemotherapy, and there were no side effects of antibiotics. The patient felt that the disease was cured by the subsequent medicine, but in fact, a small amount of tuberculosis bacteria that were not killed were still in the body. If it grows slowly, it will naturally relapse after two years, and the relapse can easily develop into drug resistance.

These patients are simply unreasonable. Zhou Xun wanted to get angry, but suppressed his temper, and said in a nice way: "Is it important to treat the disease or the side effects and discomfort of the medicine?"

She retorted, "He's cured after taking traditional Chinese medicine. Taking Chinese medicine is much better than taking the medicine for disease control. He just had it again more than two years ago."

Zhou Xun just felt powerless. Of course, it cannot be said that traditional Chinese medicine can’t cure tuberculosis, and there are indeed prescriptions for curing it. However, Mycobacterium tuberculosis is a kind of bacteria. Today’s antibiotic treatment has a history of decades or nearly a hundred years. Yes, how many people have been cured in the process is the most respected method, why are these patients so self-sufficient.

Zhou Xun didn't want to talk to her anymore, turned around to leave, and she said: "Our family is suffering. Since he got sick, he has no way to earn money. I have to work to earn some money. Since I have to treat him, I have to raise two more children. You see, the eldest of my family is already in junior high school, and the younger one is still in elementary school. I thought he was cured, but now it’s happening again and again, our family is having a hard time.”

Zhou Xun had no choice but to turn around again, and said: "He is a tuberculosis patient, and he needs to live in a room by himself. You should not live with him. It is best to spit his sputum in a basin filled with lime. Change the lime frequently and cover it with a lid, otherwise it will be easy to infect you. If you are in good health now, you may not get sick if you are infected, but when you are not healthy, you will easily get his kind of disease."

Both she and her son looked at Zhou Xun, Zhou Xun didn't care whether they would remember or do it, and said with a sullen face: "His tuberculosis is so serious, there must be some side effects from taking medicine, and he is uncomfortable. If so, go to the doctor and make it clear to the doctor. If the doctor thinks there is no problem with this side effect, then stick to it and keep taking the medicine until the doctor says you can stop taking it. Don’t stop taking the medicine halfway to change the treatment plan. This is very bad for the patient. Maybe he should have been cured five or six years ago and would not relapse, but he relapsed after changing the treatment plan."

Regardless of whether they could understand or not, Zhou Xun continued: "I will take his samples now, and I will help with training and drug resistance later. At that time, these results will be given to the doctors who prescribed the drugs. He will take care of them. Treating the sick. That's it."

Zhou Xun stopped talking to them and turned around to enter the laboratory. Teacher Tan came to chase them away, "You guys leave quickly, no one can stand at the door of the laboratory."

Then, the door was closed again.

Teacher Tan and Zhou Xun said: "These patients are all reckless. Sometimes I feel that what the neighbor says is more correct than the doctor. In this world, except for the patients, I am afraid that no one wants to cure the patients more than the doctor. Yeah, but they often feel that doctors just want to get paid and not treat."

Zhou Xun didn't answer, and Teacher Tan continued: "But I don't dare to talk too much with them. Some patients pick out the doctor's random words to find fault. In the future, if someone comes to send samples, Teacher Zhou, you should ignore them. Don't worry about the unqualified samples they sent, anyway, we are just checking the samples sent, if they are unqualified, don't you blame us?"

Zhou Xun thought to himself, could it be that you asked me to help you to say a few words just now, so I went to say a few more words?Otherwise, he didn't want to do such a thankless task.

Even though he thought so, he didn't want to say more, so he went to the nearby laboratory to do experiments.

Moreover, what Teacher Tan said was the most reasonable words for living in the hospital, and Zhou Xun had to listen to them.

When he was still a Ph.D. student, a doctor in their hospital, who was known by his supervisor, cooperated with their laboratory on a project.The patient has pneumoconiosis combined with pulmonary tuberculosis, and needs to be identified for occupational disease compensation. Because the doctor said an ambiguous comforting word to the patient, the patient thought that his medical skills were not good enough. Maybe it was prescribed randomly, so the patient started to make a fuss in the hospital, and they wanted to sue him, and said that the doctor was not meticulous in medical skills, why would he say such comforting words, why the patient is willing to lose money when he makes trouble in the hospital, or the hospital is guilty of guilt, and so on.And their hospital, as a Taishan Beidou-level existence, naturally didn't get compensation for making a fuss.

Zhou Xun felt that it was wrong for him to talk too much when he met poor patients, and these patients were not acquaintances, so it was better to talk less.