Chapter 292: You Dare to Take a Step, Director Zhang's Request for Help
"Doctor Zhou, can you share the basis for your diagnosis?"
Yang Chan still found it a little unbelievable.
The patient's symptoms clearly indicated colorectal cancer, and experts had previously determined that the patient might have gastrointestinal cancer. She could accept these conclusions.
Because one of the biggest characteristics of digestive tract tumors is that they easily metastasize downward.
For example, if esophageal cancer is not discovered in time, it is likely to metastasize and the patient may develop gastric cancer, intestinal cancer, etc.
The ovaries are not part of the digestive system and are located in the female pelvic cavity, approximately behind the anterior superior iliac spine.
Although it is adjacent to the rectum, the pathologies of the two are not similar.
Even if the patient's primary lesion is an ovarian tumor, if it metastasizes, the uterus is most likely to be affected.
"Well... the diagnosis of this case is mainly based on the combination of symptoms and clinical experience! The test data only plays a supporting role in the diagnosis. For example, the patient reported abdominal distension for nearly five months, and had difficulty defecating, as well as abdominal effusion and other symptoms. These symptoms all indicate that one or more organs have lesions."
"Abdominal distension and difficulty in defecation. After ruling out the possibility of colonic lesions, I made a two-way inference based on my clinical experience. Tumors in the rectum can cause difficulty in defecation and may also cause abdominal distension. But when I learned that signet ring cells were found in the abdominal effusion, I immediately suspected that it was not just the rectum that was affected, but that the stomach must have had lesions as well."
"After the examination, it was confirmed that there was a tumor in the greater curvature of the stomach. According to conventional diagnostic thinking, gastric cancer metastasizes to the rectum and develops rectal cancer, which is feasible. However, if you are more careful, you will find that the rectal tumor is quite large, while the tumor in the greater curvature of the stomach is relatively small. In addition, the patient reported that he had stomach discomfort in the last one or two months. I boldly concluded that the occurrence of gastric tumors is later than that of rectal tumors."
Zhou Can analyzed the diagnostic ideas for her in detail.
Hearing this, the other experts all nodded.
The look in Yang Chan's eyes when she looked at him was also sparkling with a hint of brilliance.
She had never thought that she could make a diagnosis by working backwards in this way.
"It is common for gastric cancer to metastasize to the rectum, but it is relatively rare for rectal cancer to metastasize to the stomach. Therefore, I determined that the gastric tumor was still not the primary lesion. As for why I suspected it was an ovarian tumor, it was based on my personal clinical experience and some clues of pathological evidence. The risk of ovarian lesions in women over the age of 40 increases significantly. It happened that I had treated three cases of ovarian cancer metastasis, so I made this bold determination."
Zhou Can then went on to explain some of the basis for his diagnosis.
Not to mention the experts and Yang Chan present, even the family members nodded in agreement.
"Teacher, do you think that this patient's ovarian tumor can be detected through abdominal and pelvic tomography and tomography imaging?" Yang Chan no longer had any doubts about Zhou Can's diagnostic ideas, but she still had some doubts about the diagnosis results.
"The ovary is a sex gland organ. When a tumor occurs in it, it is more difficult to diagnose than pancreatic cancer. CT scans have a certain probability of finding lesions, but there is also the possibility that the lesions are not obvious. Not to mention CT, even MRIs have the possibility of missed diagnosis or misdiagnosis. Directly taking suspicious tissue for pathological examination is the gold standard for diagnosing this disease. Dr. Zhou Can is right. We can take some tissue for pathological biopsy through surgery."
Zhang Bihua has so much experience in diagnosis that she says it is difficult to diagnose through ordinary examinations.
This is enough to show how difficult it is to detect ovarian cancer.
After communicating with the patient and his family, they agreed to undergo surgery to remove some tissue for biopsy.
There is no need for Tuya's experts to perform the operation personally, as the operating room of Xinxiang Maternity and Child Health Hospital is fully capable of performing this operation.
If it doesn't have this surgical capability, it can't become a strong tertiary specialized hospital.
Zhou Can performed extremely well many times in a row, and his status in the experts' minds rose sharply. Experts who didn't know him before began to look at him with new eyes.
Xinxiang Maternal and Child Health Hospital has also begun to focus on this outstanding resident doctor.
The reporters had already discovered that this young doctor was extraordinary and much more impressive than the overseas returnee doctor. They all began to stare at Zhou Can intentionally or unintentionally.
Mu Ming was the first reporter to discover that Zhou Can was a big fish.
What she was worried about at the moment was how to quickly establish a good relationship with Zhou Can and make him willing to be interviewed by her.
Unfortunately, her beauty and coquettishness, which always worked in front of other men, seemed to have no effect on Zhou Can.
This bothered her a lot.
Zhou Can ignored the envious or admiring looks. After helping to diagnose the patient, he returned to the emergency room.
The pregnant woman, who was carrying a five-month-old baby, touched his heart deeply.
After the patient's vital signs stabilize, the first six hours are the critical period.
"Doctor Pang, is there anything unusual about her condition?"
Zhou Can asked politely.
He was not familiar with Doctor Pang, so naturally he could not speak as casually as he did with Deputy Director Shi.
"good!"
Doctor Pang's tone was a little cold, and there was no smile on his face.
Zhou Can had long noticed that something was wrong with her mood.
For example, when rescuing the pregnant woman in the morning, she was also a member of the crisis management team and should have followed Zhou Can as an assistant, but she didn't. During the rescue, she did her own thing and didn't take Zhou Can as the main person at all.
After the pregnant woman's vital signs stabilized, Doctor Pang did not stay with Deputy Director Shi and Zhou Can to guard the pregnant woman, but directly followed Director Zhang and others to evacuate.
It was not until later that the patient with rectal cancer that Director Zhang saw had a complex cause of illness that was difficult to diagnose, and Zhou Can needed to rush over to participate in the consultation.
It was only then that Deputy Director Shi stepped in to invite Dr. Pang over.
After Dr. Pang came, when Zhou Can took over from her, her attitude was as cold as it is now.
There was no open confrontation with Zhou Can.
It's a lukewarm and indifferent attitude.
Although Zhou Can felt a little unhappy, he didn't say much.
She is the attending physician in the obstetrics and gynecology department. Compared with Zhou Can, a young resident doctor, she is considered to be a veteran.
"If there's nothing else, I'll leave first."
Doctor Pang threw down a few words and walked straight out of the emergency room.
The two nurses looked at them with strange expressions, but did not say anything.
Nurses never get involved in conflicts between doctors.
The two have different statuses and cannot be mixed.
"Wait! Director Shi, please stay in the outpatient hall. I am the only doctor here to look after this pregnant woman. If an emergency occurs, we will be caught off guard. Doctor Pang, if there is nothing urgent, please stay and help me look after this pregnant woman. The first six hours of fat embolism are an extremely dangerous period, and accidents may happen at any time."
Zhou Can had spent several months in the intensive care unit and knew how fragile human life was.
It's gone just like that.
"They also need my help at the outpatient department! I don't think there's anything to do here. Doctor Zhou, you can handle it anyway."
Even though Zhou Can asked her to stay, she still refused.
And he spoke in a sarcastic tone.
Zhou Can is not stupid either. Does he know why she has this attitude?
It was nothing more than that she was not chosen as deputy team leader, and Zhou Can, a newcomer whose rank was lower than hers, was appointed as the deputy team leader. Now it was like she, an old comrade with a higher rank, had to obey Zhou Can's orders, and she felt unhappy.
"If Dr. Pang insists on going to the clinic and something happens to the pregnant woman, who will bear the consequences?"
The smile on Zhou Can's face disappeared.
If he is shameless even when given the chance, then you can't blame him for using his status to bully others.
Having high emotional intelligence does not mean not offending people.
To rescue the patient the entire medical team must work together. If Dr. Pang is not subdued, and if she gets angry during the rescue process, it will be no joke.
"Ha, Doctor Zhou is here with people trying to save lives, but should others bear the consequences? Besides, as long as the doctor has fulfilled his duty to save lives, where does the responsibility come from?"
Doctor Pang smiled with a forced smile.
"In the case of this pregnant woman, she is already relying on a ventilator to maintain her life. If something dangerous happens, do you think Dr. Pang can handle it alone?"
Zhou Can stared at her and asked.
This time, the tone was no longer polite, but rather the tone of a superior questioning his subordinates.
This will definitely make Doctor Pang unhappy, there's nothing we can do about it.
She was happy, but Zhou Can couldn't be happy.
"If the rescue is ineffective due to your absence and the higher-ups hold them accountable, who do you think should be held responsible? That's all I have to say. If you think your future is not important to you, Doctor Pang, you can leave. If you dare to step out of the emergency room without the permission of the deputy team leader, I will tell you how to be a doctor."
Zhou Can directly used harsh words to pressure her.
I don't believe it today, let's see if she has the courage to do it?
There is an old saying that evil cannot prevail over good, but there is a prerequisite, that is, the side of justice must be brave and fearless.
Otherwise, the more honest you are, the more the evil side will think you are easy to bully.
Dr. Pang was threatened by a junior doctor. In addition to Tuya’s two nurses, there were also doctors and nurses from Xinxiang Maternity and Child Health Hospital at the scene.
Her face turned red with anger and her eyes became extremely fierce.
Zhou Can just looked at her with cold eyes, but his expression was calm.
The two men stared at each other and confronted each other.
"Go if you have the guts, don't hesitate!"
Zhou Can had already seen the retreat deep in her eyes.
For a woman approaching 40, a stable job is very important to her. She saw strong self-confidence and fearlessness in Zhou Can's eyes.
"What will you do if I leave?"
She was still somewhat unwilling to give in, and tried to test Zhou Can's strengths and weaknesses in the end.
Having openly conflicted with Zhou Can today, it is definitely embarrassing.
If she could win, she would not only be able to vent her anger, but also be able to save her so-called face.
So, she was testing.
"As the deputy team leader, I ask you to stay at the scene and be ready to rescue the pregnant woman at any time. If you insist on leaving, it means you are not listening to the order from your superiors. I will immediately report your work attitude to Director Zhang. It is up to Director Zhang to decide how to deal with it. Maybe you think you are an old comrade and have some connections in Tuya Hospital, but this is not enough to save you. You may even lose your job."
Zhou Can said it very bluntly.
He really wasn't trying to scare her, but he really had the ability to do so.
The attending physician, who was nearly 40 years old, had limited potential no matter how strong it was. Compared with a monster like Zhou Can, he was not even a little bit inferior.
"Is it not okay for me to go to the bathroom? Haha, I was just joking with Dr. Zhou just now!"
After struggling with her conscience for a few seconds, she forced a smile and decisively admitted defeat.
Just as Zhou Can determined, she couldn't afford the gamble.
And she was totally unreasonable.
"Of course there's no problem with going to the toilet. I know Dr. Pang was joking, and I didn't take it seriously."
Zhou Can speaks the truth to different people and lies to different ghosts.
The originally tense atmosphere suddenly warmed up. The two of them made peace as if they had never had a quarrel.
Of course, this is just the surface.
It's easy to reconcile, but too difficult to go back to the way it was before.
After this quarrel and confrontation, Dr. Pang probably held a grudge against Zhou Can.
So what?
Just like when Zhou Can first worked in the emergency department, he had Dr. Lu under his control. Finally, when he became powerful enough, Dr. Lu took the initiative to lower his head and repair their relationship.
Zhou Can is now countless times stronger than he was before. Doctor Pang bowed to him and took the initiative to find him to repair the relationship, which would only be faster.
For adults, what does face mean? Profits are the most important.
If she offends Zhou Can, it will affect her promotion in Tuya, her evaluation, and even her review for associate professor. Can she bear it?
After Dr. Pang left, the older nurse Chen Qingling didn't say anything.
Ji You was younger after all, so she lowered her voice and said to Zhou Can, "Doctor Zhou is really amazing. She intimidated her. She is usually very powerful in the obstetrics and gynecology department." Ji You was about to continue speaking, but Chen Qingling quietly pushed her away.
The worst thing to do at work is to speak ill of your colleagues behind their backs.
It's very easy to get into trouble.
She subconsciously glanced at Chen Qingling, who winked at her, and she didn't say anything else.
It is not difficult to hear from Ji You's words that Doctor Pang must be overbearing in his daily behavior.
"Aren't you afraid that she will hear you saying bad things about her?"
Zhou Can asked Ji You with a smile.
"I'm not afraid! Doctors and nurses are two different systems. She can't control me."
She said she was not afraid, but there was a hint of fear in her eyes.
A chief doctor is fully capable of punishing any young nurse if he wants to.
Not long after, Dr. Pang came back from going to the toilet.
His complexion looked much better than before.
It is no longer the same as before, the eyes are not eyes, the nose is not a nose.
A 40-year-old woman is much more capable than a 20-year-old girl. She can control her temper or let it go.
…
Around three o'clock in the afternoon, Zhou Can's cell phone rang.
This time it was Director Zhang Bihua who called personally.
"Hello, Director Zhang. Do you have any instructions?"
Zhou Can greeted respectfully.
When Doctor Pang heard that it was Director Zhang calling, he immediately pricked up his ears to eavesdrop.
You can tell that she is somewhat nervous.
She was afraid that Zhou Can would report her.
"Xiao Zhou, how are things going over there?"
"The pregnant woman's vital signs have been stable, but her blood pressure still fluctuates a bit. I dare not take it lightly." Zhou Can answered truthfully.
"Can you draw for a while? The diabetic patient who drank a lot yesterday has improved after treatment. But this is only a temporary treatment. To cure her disease, I'm afraid we have to call all the experts to have a consultation with her, sort out her condition, and find out the real cause."
Director Zhang relies on Zhou Can so much because he has witnessed his abilities.
"Shall I come to you now?"
Zhou Can asked.
"Yes, the family member is in the outpatient hall now. He told me that the patient's condition has improved and he is very happy. He also told me that his family is in a difficult situation and he hopes to use this opportunity of expert consultation to completely cure his wife's illness."
Director Zhang Bihua has a kind heart and, like most chief physicians, cares about her patients from the bottom of her heart.
