Chapter 302: A newborn calf is bold, the importance of fame to doctors
Zhou Can and Director Zhang were also very happy to hear that the family member had finally thought it through and let his wife undergo radiotherapy.
Many people are afraid of the word radiotherapy, and hearing it is like a death warrant.
Little do people know that radiotherapy is still one of the most effective means to combat cancer.
Chemotherapy has the strongest side effects. While using chemical drugs to kill cancer cells, it also damages normal cells. It is a typical case of killing 800 enemies but injuring 1,000 of your own.
"After receiving radiotherapy, the patient's urination was reduced from more than 100 times a day to more than 30 times. The amount of water he drank was also reduced from 17,000 ml to about 7,000 ml."
The attending physician was reporting the patient's condition to Director Zhang.
It seems that Zhou Can's diagnosis was correct, and the real cause of this female patient's illness was thalamus-pituitary lesions.
It is very good that only one radiotherapy treatment had a very significant effect.
I believe that if I continue with radiotherapy for a few more times and a full course of treatment, I should be able to achieve satisfactory results.
After listening to the report from the attending physician, Director Zhang nodded with satisfaction.
She personally checked the patient's recent nursing records, including physical signs, frequency and time interval of urination, etc. Zhou Can stood by and secretly learned from her carefulness and meticulousness.
Ward rounds are not just a formality, but should be put into practice like Director Zhang does.
"I see that her condition has improved significantly in all aspects. She should continue with two aspects of treatment: one is controlling blood sugar, and the other is radiotherapy." Director Zhang gave guidance.
They continued to check other beds.
When Zhou Can found out about the little boy who ate live fish, he was full of anticipation.
The boy has been given fasting, fluid replacement, and gastrointestinal decompression.
"Doctor Zhou, Director Zhang!"
When the family members saw Zhou Can and Director Zhang, they immediately greeted them warmly.
At this moment, only the boy's father was by his bedside.
Yesterday, I saw them bringing their families to the hospital for treatment. It is very likely that they have purchased a property in the provincial capital, or have relatives in the provincial capital who can provide them with accommodation.
"How is the child doing today?"
"It has improved. The vomiting and diarrhea symptoms have been significantly alleviated."
The child's father was very satisfied to see that the treatment had achieved certain results.
Ordinary people do not understand medical expertise. For them, as long as they see the symptoms alleviated, they think there is hope for recovery. However, they do not know that this is just a test method adopted by doctors and cannot be implemented in the long run.
It is like when a car is out of gas. You can still drive the car by opening the auxiliary tank's gas, but if the problem of the main tank running out of gas is not solved, this problem will always exist.
In order to cure a disease, the real cause must be found.
In fact, many hospitals now have vague treatment plans. Sometimes, if the cause of the disease cannot be found, then they simply do not bother to find out the truth. Instead, they treat the symptoms, control the progression of the patient's disease, and improve the patient's symptoms, so that the patient can live with the disease for a long time.
This lazy diagnostic and treatment thinking has almost become the mainstream in clinical practice in the medical community.
As the saying goes, a good death is worse than a miserable life.
Trying to alleviate patients' pain and prolong their lives through medication or other treatments is also a compromise.
At least doctors from top to bottom recognize this model.
Saving lives first, then curing diseases, is the first principle Zhou Can learned after engaging in clinical training.
"The body temperature has also dropped a little, the highest level is 7.1 degrees."
Zhou Can looked through the hospitalization records and found that the patient's temperature had dropped significantly compared to yesterday's 38 degrees.
Just then, the sound of a plastic bag being torn open .
The child looked towards the bed next to him.
Family members are feeding biscuits to the patient.
The little boy had been fasting for more than 12 hours and must be very hungry. Seeing others eating, the little boy couldn't help but look envious.
He swallowed quietly.
“Ahem…”
As if choked by his saliva, he suddenly started coughing violently. The boy's father quickly patted his son's back gently.
Under normal circumstances, the only way to choke is by drinking water.
Choking when swallowing saliva rarely occurs.
Accidents may happen occasionally.
After the child stopped coughing, his face had turned red due to the violent coughing.
Originally, this matter would not have attracted Zhou Can's attention.
Unexpectedly, after a while, the little boy started coughing violently again.
This time, Zhou Can took it more seriously.
After the boy stopped coughing, Zhou Can asked the family, "Has your son always been so easily choked?"
"No! Even since this morning, I have been telling him to be careful when swallowing his saliva." The boy's father was helpless and puzzled.
Why am I suddenly choking on my saliva so easily?
Director Zhang obviously noticed this problem as well and was also thinking about it.
"Could his choking be related to gastrointestinal decompression?" Yang Chan asked bluntly.
“It’s possible.”
Zhang Bihua nodded slightly.
"The patient's gastrointestinal tract, urinary system, heart, lungs and other parts are affected. There are not many diseases that can cause so many systemic involvements at the same time. After excluding malignant tumors, there seem to be only a few known diseases left. The ANA test was negative, so lupus can basically be ruled out."
Director Zhang's diagnosis was the same as Zhou Can's, and he was also in a dilemma.
Zhou Can stared at the sick child for a while and made a bold inference, "Do you think his systemic lupus erythematosus is latent? If we don't take the negative ANA as the gold standard for rejection, his disease progression and all his symptoms are highly consistent with systemic lupus erythematosus."
The bolder the man, the more fertile the land.
A novice doctor like Zhou Can is not as cautious as an experienced doctor like Director Zhang.
In diagnosis, he dared to boldly overturn some iron laws.
"Teacher, I also think this child's symptoms are too similar to systemic lupus erythematosus. When I was doing my internship in pediatrics, I met a six-year-old patient, a little girl who was very cute and sensible. At the beginning, she also had cold-like symptoms. She was treated in many hospitals but to no avail. Instead, her condition got worse. Various symptoms popped up like mushrooms after rain."
"After diagnosis, it was confirmed to be systemic lupus erythematosus. However, the ANA test result of the patient was positive."
Yang Chan also supported Zhou Can's diagnostic speculation.
She thought she could at least give it a try.
"You young people are all so inexperienced! How can we make a diagnosis of a disease so hastily? However, you are not bound by some so-called gold standards and are bold in doubting and making assumptions. This is very commendable. Let's check his ANA again, both in the laboratory of Xinxiang Women's and Children's Hospital and the laboratory of Tuya General Hospital."
Director Zhang made this decision with deep meaning.
There are some things that cannot be said in front of the doctors and nurses of Xinxiang Maternity and Child Health Hospital.
In terms of laboratory construction, Tuya Hospital is currently recognized as the best in the province. In terms of various biochemical tests and specimen inspections, Tuya's technical strength is significantly higher than that of other hospitals.
ANA, also known as antinuclear antibody spectrum, checks a series of autoantibodies in serum components. Under normal circumstances, if the antinuclear antibody is positive in high titers, it often indicates the presence of connective tissue disease.
It is not a particularly advanced laboratory test in itself, but the ANA test of this patient has been checked several times, and all results were negative.
It is a very wise choice to send another blood sample to Tuya Hospital for examination.
The possibility of missed detection due to inadequate instruments, equipment and technology can be largely eliminated.
The family members now have great trust in Zhou Can and Director Zhang, and readily accept all the examination plans they proposed.
In the first three days, a total of eleven patients were admitted, two of whom were undergoing surgery, which made Zhou Can envious. Since he entered the internal medicine training program, he has rarely had the opportunity to practice surgery.
One is a uterine fibroid removal surgery, and the other is a chest granuloma removal surgery, both of which are quite challenging operations.
If Zhou Can could perform the operation, it would be very helpful for him to gain more surgical experience.
Most importantly, his surgical skills need to be practiced regularly, otherwise they will regress if they are neglected for too long.
According to Director Zhang, the surgeries for these two patients may need to be scheduled for the evening. Director Zhang will personally perform the surgeries on the patients and work overtime at night. This way, he will not delay his daytime consultations.
After the rounds, Zhou Can and Director Zhang went back to the outpatient hall to continue seeing patients.
Although Zhou Can had shown his skills in his first consultation yesterday, showing his face twice, and the patients who came to see him also achieved satisfactory treatment results, but accumulating and improving fame was much more difficult than he imagined.
I am seeing patients again today and almost have to start from scratch.
His desk was deserted, with no patients coming to see him.
Compared with yesterday, the number of patients seeking treatment today has obviously increased a lot.
The number of patients visiting the hospital has increased, but the number of patients registering for his appointment has not increased at all. This is an awkward period that every novice doctor has to go through.
Some young doctors rely on the large hospitals behind them, which is equivalent to having a traffic platform and credibility endorsement guarantee, so they can attract some patients to seek treatment.
After all, many patients and their families don’t go to see doctors, but come to famous large hospitals.
When all the specialist appointments are taken, they are willing to accept an ordinary consultation number.
The situation is different when Zhou Can is seeing patients at this moment.
Xinxiang Maternity and Child Health Hospital itself has encountered a serious credibility crisis and is unable to endorse him.
Although he could use the reputation of Tuya Hospital to some extent and was supported by the expert group, he was still too young and the patients had a lot of choices.
It is natural that they are reluctant to entrust their lives to a young doctor who seems to have no experience.
Du Leng's situation is much better than his.
The identity of a doctor of medicine who graduated from a prestigious overseas university is the best sign. Patients and their families who come to see the doctor do not know the details, but when they see that the doctor is a doctor of medicine who returned from overseas, their trust in him will increase rapidly.
There are quite a few people who come to Du Leng for medical treatment.
Who says academic qualifications are not important?
Academic qualifications are not only a stepping stone for job hunting, but also a golden signboard in your resume, which can make your starting point much higher than others.
In this way, Zhou Can spent the whole day seeing patients in a deserted manner.
He received a total of seven patients yesterday, but today only two patients came to see him.
And he also had a look of disgust and distrust on his face.
One patient left cursing after seeing Zhou Can prescribe a CT scan for him. Another patient only had a common cold, but his parents were extremely distressed. They kept calling him "darling" and "precious child" on the left and right, which gave Zhou Can goose bumps.
I endured the discomfort and treated their child and got him prescribed medicine.
As a result, he didn't trust it and went to Director Dai at the next table to look at it again.
Today is the most hurtful day in Zhou Can's history.
Although they have a lot of skills, they are unknown and not trusted or recognized by patients and their families because they lack fame, education and achievements.
At dinner time, Ji You diligently prepared food for him.
"Doctor Zhou, I don't know if it suits your taste?"
"With the meals you prepare for me personally, even the rice tastes delicious. These dishes are all to my taste! Thank you!" It was hard to refuse such a kind invitation. Zhou Can was not used to being served like an emperor.
"Haha, as long as you like it. I didn't expect that Dr. Zhou is so serious at work. He is very good at saying things to please girls!" She glanced at Zhou Can with a little embarrassment, quickly lowered her head and ate the food on the plate.
Zhou Can didn't react at first.
But as someone who has been in love before, he is already an experienced person.
The way Ji You looked at him just now clearly made her feel as if her heart was being pried open.
Thinking carefully about what he had just said, he pinched himself.
It seems that I was not paying attention when I spoke, which caused her misunderstanding.
"Haha, I'm probably forced to talk in a way that girls like me. I practiced a lot when I was pursuing my current girlfriend." Zhou Can didn't want this misunderstanding to continue to ferment.
The best way is to make things clear and resolve this misunderstanding.
The best way is to let Jiyou know that he has a girlfriend.
When Qiao Yu first learned that he had a girlfriend, her sad expression and lonely eyes left a deep impression on him.
So, now he has learned to be smart. When he finds any sign of trouble, he quickly points out that he is already taken, thus putting an end to the girl's thoughts.
“Giggle~!”
She laughed a little exaggeratedly, covering her mouth and shaking her body.
After learning that Zhou Can had a girlfriend, a hint of loss could be clearly seen deep in her eyes.
However, she still only had a crush on Zhou Can and was far from being in love, so she was not hurt. At most, she was just a little disappointed.
"I know that a man as outstanding as you must have a girlfriend! They say that love can make people mature. The skill that Dr. Zhou has learned from love is to make girls happy!"
She teased Zhou Can.
"I have to develop this ability, otherwise I'm afraid my girlfriend will be taken away by other men." Zhou Can touched his nose and replied.
"You are so outstanding that other men are no match for you! But if you practice your talking skills, you will be more competitive. All creatures on the earth are striving to evolve, and we humans are the fastest evolving species. Our evolution is not in the body, but in the brain, thinking, and consciousness."
She has a very high opinion of Zhou Can.
"I didn't expect Miss Ji to speak so philosophically. You are beautiful, talented, and have inner qualities. You are truly outstanding."
After Zhou Can chatted with her for a few words, his mood, which had been bad due to the cold reception during the day's consultation, gradually improved.
The two of them ate and chatted.
"I noticed that you were in a very low mood when I got off work just now. Are you feeling better now?" Ji You asked him in a low voice when they were almost done eating.
"With a beautiful lady like you to cheer me up, I'm no longer depressed. You're quite observant." Zhou Can was slightly touched. It's a kind of happiness to be cared for by others.
"I have been with you in your consultations, so I can empathize with you. In fact, I think gold will shine sooner or later. You are so capable, all you lack is opportunity and fame. As long as you accumulate slowly, more and more people will come to you for treatment. Your fame will gradually rise."
She gently guided Zhou Can.
Give him encouragement.
