The most enlightened doctor

After working until 6:30 in the evening, Yu Zhiming finished diagnosing the last patient assigned to him.

Fifty!

For a whole day, Yu Zhiming treated a total of fifty patients, and he felt like he was going to be exhausted.

This deep feeling of fatigue does not come from the body, but mainly from the spirit.

Not only must he maintain a high degree of physical and mental attention during auscultation and percussion, he must also work hard to mobilize what he knows and learn and conduct detailed verification with the patient's symptoms.

The goal is to make diagnostic conclusions as accurate as possible.

Unlike the outpatient clinics of county hospitals, most of the patients suffering from minor illnesses such as headaches and fever do not require much effort.

But the patients here are different. Yu Zhiming needs careful examination, and he is afraid of misdiagnosis or missed diagnosis due to negligence.

After working continuously for a day with such high intensity, Yu Zhiming was really almost exhausted.

Even though he worked so hard, he started work nearly half an hour early at noon, and only fifty patients could be diagnosed on that day.

Yu Zhiming learned about it from childhood nurse Wang Li.

Most of the outpatient visits completed by other outpatient clinics today were 80+, 90+, and even more than 100.

His outpatient volume is considered to be at the bottom.

"But the quality of my work is high." Yu Zhiming, who was slightly shocked, encouraged himself.

He did not dare to say that there would be no errors or omissions in his diagnosis, but the error rate would definitely be very small.

A doctor who has more than 100 outpatient clinics needs to spend a lot of time reviewing the examination results or imaging pictures of outpatients.

Sometimes, the same patient is reviewed more than once.

In this case, the average time spent on each patient is only three to five minutes?

In such a short diagnosis time, unless he has a keen eye, superb medical skills, a sense of responsibility and a high degree of concentration, the chance of making mistakes will not be low.

From time to time, misdiagnosed cases in large hospitals appear on the Internet and make many people laugh...

As a participant, Yu Zhiming understands, but he is also a little helpless. Sometimes such problems are unavoidable.

Doctors are humans too, not machines.

It is difficult for a doctor to maintain a high level of physical and mental concentration throughout the day, facing a revolving door of patients.

Quantity and quality are always contradictory...

Among the patients that Yu Zhiming received in the afternoon, another patient was transferred to the center.

The patient is a 16-year-old boy. His symptoms are drowsiness and he can fall asleep anytime and anywhere.

Not only did the teenager fall asleep unknowingly during class, he even fell asleep without paying attention while eating.

This ability to fall asleep quickly makes people with difficulty falling asleep like Yu Zhiming envious.

For a teenager, his narcolepsy seriously affects his studies, especially when he is in his second year of high school after the summer vacation.

Yu Zhiming judged his symptoms to be neurological problems, which fell within the scope of Teacher Qi's treatment.

Yu Zhiming took the initiative and took the young man into the center...

He dragged his heavy body back to the central office and unexpectedly found that Teacher Qi had not left yet.

Yu Zhiming knocked on the door and entered the director's office, where he saw Teacher Qi looking through a stack of heart examination information.

"Teacher, who is the patient this morning?"

"Confirmed?"

Qi Yue nodded and said, "In the afternoon, Dr. Wang and I did a stress test on him."

"He was asked to do overloaded and high-intensity exercise. Within two or three minutes of exercise, we found signs of ventricular fibrillation and ventricular tachycardia in his heart."

Qi Yue sighed: "If we hadn't called a halt immediately and started treatment, we would have suffered a cardiac arrest on the spot."

"His condition is indeed serious."

Yu Zhiming snorted and asked with concern: "The cause?"

Qi Yue shook his head and said, "It's difficult to find out for sure."

"We have dissected the hearts of more than one deceased person who suffered cardiac arrest, and found that the hearts of several deceased people were obviously healthy, but they stopped beating for no reason."

"Many sudden cardiac deaths are actually caused by systemic causes, and the heart is just a stress-induced organ."

Qi Yue said jokingly: "It's as if the brain has received alarm messages from all over the body, saying that I am too tired and need to take a rest."

"The brain synthesizes the information and decides to stop working, so it notifies the heart as the power source."

"Stop it, me."

Yu Zhiming laughed a few times and said, "If we can't find the exact cause, we can only do maintenance and prevention?"

Qi Yue nodded and said: "The first is to adjust work and life conditions, reduce stress and tension, and change the way of life."

"The second is to implant an ICD as a precaution."

An ICD is a small pacemaker, and its technical name is an implantable cardioverter-defibrillator.

Its working principle is just like what you see in movies and TV shows. Medical workers use a defibrillator to put brick-sized electrodes on the patient's chest and deliver an electric shock with a bang.

The ICD is small and can be implanted under the skin of the patient's chest and abdomen.

The electrode leads placed in the heart can automatically sense the patient's ventricular fibrillation and ventricular tachycardia at any time, and the pulse generator quickly charges and generates electric shock energy.

The whole process only takes about 15 seconds, which can terminate ventricular fibrillation in time and save lives.

Its advantage is that the success rate of electric shock is almost 100%, and it can also monitor the patient's heart rate around the clock.

If the patient develops a fatal arrhythmia, it can automatically identify and perform discharge therapy to restore the heart to normal state.

Yu Zhiming thought of another question and asked with concern: "Teacher, what is the total cost of ICD implantation?"

Qi Yue said casually: "Using the best ICD and minimally invasive implantation surgery, the total cost is about 150,000."

"It's really not cheap." Yu Zhiming sighed lightly.

Qi Yue chuckled and said: "This is something that can save lives at critical moments. Besides, once implanted, it can be used for ten years. On average, fifteen thousand a year is not too high."

After a moment of pause, Qi Yue turned around and said, "The boy who was transferred here this afternoon is not suffering from narcolepsy, but from narcolepsy."

"This is a genetic mutation disease that causes the hypothalamus to secrete too many neuropeptides, causing the patient's sleep switch to malfunction and produce irresistible short-term sleep."

"This disease cannot be treated, it can only be controlled."

When Yu Zhiming heard that this was a genetic mutation disease, he knew that this disease was difficult to cure.

I heard Teacher Qi continue: "I have treated dozens of cases of this disease, and I have rich treatment experience."

"Observe for two days, do a few medication tests, let the boy do willpower resistance sleep training, and then take the medicine I prescribed for a long time to maintain a normal life."

Yu Zhiming said with deep emotion: "This disease in teenagers will cause many inconveniences in life and work."

"At least driving is out of the question, and I can't think of a way to turn a bad thing into a good thing."

Qi Yue nodded and said: "Not only driving, but all high-altitude operations and dangerous work are prohibited."

Yu Zhiming suddenly felt something in his heart and asked: "Teacher, is there any equipment similar to ICD?"

"When this kind of sleeping sickness occurs, just give him an electric shock and it will immediately make him energetic."

Qi Yue was slightly startled and said, "I have never seen any similar equipment."

He pondered for a moment and said: "Although this kind of narcolepsy is a rare disease, there are 600,000 to 700,000 patients in our country, and there are many new cases every year."

"If there was such a device..."

Qi Yue thought thoughtfully and said, "I can ask the domestic medical equipment companies whether there is such a thing in the world and whether it has any research and development value."

"Maybe it's worth doing."

Qi Yue looked at Yu Zhiming, hesitated for a moment, and asked, "Zhiming, did you have lunch with Zhou Mo?"

Yu Zhiming felt a thump in his heart and hurriedly explained: "She brought her lunch as a thank you for giving her mother a physical examination. I wanted to refuse it."

"It's just that Zhou Mo is too enthusiastic..."

Qi Yue said oh, and then said: "I know Zhou Mo is very good, so it is inevitable that you have some ideas."

"It's just that Zhou Mo's mother had something to say beforehand, and she was determined not to allow Zhou Mo to associate with the doctor..."

Yu Zhiming thought to himself, if she doesn't care about doctors, why let her work in the hospital? It's a typical contradiction.

Teacher Qi said this because there was no three hundred taels of silver here, so he used Zhou Mo's mother's words as a shield.

Yu Zhiming was very sensible and quickly expressed his position.

"Teacher, don't worry, I will never have any thoughts about Zhou Mo."

"I am concentrating on improving my medical skills. I will never consider personal issues for at least a year!"

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