Chapter 303: The poor will shake their clothes when they get ten cents. This is the real effective treatment
“Thank you for your encouragement!”
Zhou Can smiled at her gratefully.
Today's consultation made him realize once again the importance of fame.
Even the best wine needs to be hidden in a remote alley.
He does not have outstanding academic qualifications, has little experience, is too young, and has low visibility, which are all obstacles he currently needs to overcome.
Today should be the happiest day for Du Leng in the past few days.
He had long regarded Zhou Can as his competitor. He was particularly anxious when he saw Zhou Can repeatedly making great contributions in diagnosing difficult diseases, while he, a returned overseas doctor, had a lot of medical knowledge but made no achievements.
I really want to change this situation where I am beaten by a domestic undergraduate.
Fortunately, God is very fair.
Zhou Can had been so proud and successful for three consecutive days, but today he suffered the worst defeat in his history.
During the whole day, I only saw two patients.
One of them even stood Zhou Can up and ran away with the application form. This kind of thing is quite rare in the hospital.
If this wasn't bad enough, another patient took the prescription and went directly to Director Dai to make an appointment without paying. He also asked Director Dai to treat him again.
This clearly shows a lack of trust in Zhou Can's medical skills.
Although the medicine prescribed by Director Dai and the diagnosis were the same as Zhou Can's, who knows if Director Dai did this deliberately to save Zhou Can's face?
Zhou Can was in a miserable state, while Du Leng Leng's bad luck was gone and good luck came to him.
He saw a total of fourteen patients today. Except for two difficult patients who were referred to other specialists, the rest were all solved by Du Leng.
Compared with Zhou Can, he has achieved great results.
No wonder he was so happy.
Anyone would be happy to see their strongest competitor in trouble.
Du Leng finally had a chance to feel proud, but now he just kept silent. That was definitely not his style.
When a poor man suddenly becomes rich, if he gets ten cents, he will shake his clothes and make a noise.
For three days in a row he was either criticized or made no progress, and he was already feeling very depressed.
Today was a great start with outstanding results. Zhou Can happened to be experiencing an unprecedented "cold winter". If he didn't run to Zhou Can to show off, he would definitely not be able to sleep when he returned to the hotel at night.
Du Leng was seen walking towards me briskly, carrying a plate of food.
"Doctor Zhou is popular with women! Every beautiful lady, whether a doctor or a nurse, likes to be close to you. It's really enviable."
Du Leng and Zhou Can usually don't get along well and they rarely have any formal conversations.
At this moment, I am just making small talk.
In his opinion, Zhou Can's popularity with women is indeed enviable. The beauties who appear around Zhou Can are not only good-looking, but also have good looks and inner qualities.
"Oh! Different people will see different results when seeing one thing. In the eyes of people who only care about work, when they see me communicating and staying with female nurses and female doctors, they see that we are working hard and trying our best to save patients. In the eyes of a romantic and talented man like Dr. Du, he sees that I am very popular with women and they envy me for having the opportunity to stay with so many beauties."
Zhou Can did not answer him directly.
Instead, he gave an example to fight back.
If you think differently, you will see completely different problems.
Some people always see ghosts, that's because they have a guilty conscience. The ancients said that if you don't do bad things in your life, you won't be afraid of ghosts knocking on your door in the middle of the night.
The true interpretation of this sentence is that different people come to completely different conclusions about the same thing.
The blind men see the elephant in different ways.
"We are all mortals, and we all have our own natures. Doctor Zhou doesn't need to pretend to be a gentleman. It is normal for young people to fall in love and try to have several girlfriends abroad. Only those who are incompetent will only have one girlfriend in their entire life, or even no girlfriend at all!"
Du Leng has a very high IQ and his ability in bickering is no worse than Zhou Can.
After replying, he changed the subject.
"When I was seeing Dr. Zhou today, he was sitting there bored. I felt bad. Dr. Zhou's medical skills are so good, but few people are interested in him. It's really pitiful."
Isn't this obviously false sympathy?
Zhou Can's eyelids fluttered and he felt nauseous.
"If necessary, I can assign a few patients to Dr. Zhou tomorrow. Oh! You don't know, when they see that I am a doctor of medicine who studied abroad, they all rush to make an appointment with me, and some even prefer to wait in line. I'm really a little overwhelmed!"
Du Leng's purpose was to show off in front of Zhou Can.
If he really wants him to help and care about Zhou Can, he wouldn't be that kind.
When did Zhou Can fall to the point where he needed charity from others? It was simply a joke.
Is a silver wax spear head worthy of barking in front of him?
"Thank you for your kindness, Dr. Du. You have given quite a few patients to other specialists. Didn't you give me the little boy who ate a live fish yesterday? When I went to make rounds today, the patient's family was still complaining about you, saying how could a returned doctor not be able to diagnose his child's illness? I was quite angry when I heard that. The family member's words were too much. Returned doctors are also human beings. They just went abroad to study for two more years. Why should they be able to diagnose every disease?"
Zhou Can’s greatest pleasure is to choke such shameless people to death.
A piece of rubbish, and you have the nerve to show off to him. Don't you like to show off? Then just talk about the fact that you always pass difficult patients to other doctors.
Hit the snake at its most vulnerable part; step on people in the face.
If Du Leng didn't come to provoke Zhou Can, nothing would happen.
If you provoke someone, you will only be asking for trouble.
After hearing these words, Du Leng's face turned blue little by little, and his smile completely froze.
Look at this expression, it's more uncomfortable than swallowing a dead fly.
"Xiao Zhou, come here! I have good news for you. The laboratory at Tuya Hospital called me just now and told me good news. The boy's ANA test was weakly positive. It is really as you boldly assumed. The patient is very likely to have systemic lupus erythematosus."
Director Zhang had just received a phone call and excitedly told Zhou Can the good news across several tables.
Because she was so excited.
The cause of the boy's illness was extremely complex and obscure.
Now that the diagnosis was successful, she was extremely excited. She couldn't wait to tell Zhou Can the news.
Because it was Zhou Can who first put forward the bold hypothesis.
"Great, we found the cause of the disease, and the child can be saved." Zhou Can's depressed mood during the daytime consultation was completely swept away after hearing this. "This disease is very scary. Although it cannot be cured, as long as it is discovered early and the disease is controlled in time, the child's life can be saved."
Tuya Hospital successfully detected that the patient's ANA was weakly positive, which shows that the testing capabilities of each hospital are different.
Xinxiang Women's and Children's Hospital, even the Provincial Children's Hospital and the County Women's and Children's Hospital, have all done this test, but the results have always been negative.
This undoubtedly seriously misled the doctors who were treating the patient, causing them to rule out the possibility of systemic lupus erythematosus at the first opportunity.
There are many such examples in clinical practice.
It is true that success and failure are both due to Xiao He.
Some gold standards for diagnosing a certain disease not only help doctors to boldly diagnose the disease, but also because the test results of this gold standard are normal, doctors will instinctively rule out the disease under fixed thinking.
This ultimately leads to missed diagnosis and misdiagnosis, delaying the best time for treatment for patients.
There are not just one or two such cases, but many.
"Doctor Zhou, that's great!"
Yang Chan smiled sweetly and gave him a thumbs up.
Praising him in front of so many people was probably because he saw that Du Leng, this villain, was showing off in front of Zhou Can and humiliating Zhou Can, so he deliberately exaggerated Zhou Can's strengths and achievements.
Class monitor Yang can't stand seeing his classmates being bullied.
Even if someone like Vice Dean Bai or Director Xie of the General Surgery Department bullied Zhou Can, she would never hesitate and directly ask Director Zhang for help to support Zhou Can.
"Didn't the squad leader also boldly assume the same diagnosis result at that time? How about we praise each other?" Zhou Can smiled and winked at her.
"Hate!"
She glared at Zhou Can, and it sounded like she was acting like a spoiled child.
It's completely different from the attitude towards other men.
Du Leng was jealous, he had pursued Yang Chan many times but failed. Unexpectedly, Zhou Can didn't need to pursue her at all, Yang Chan maintained a very close relationship with Zhou Can directly.
Even a fool could see that Yang Chan treated Zhou Can as a good friend, and Du Leng as a 'guest'.
The so-called 'guest' does not refer to a guest, but a polite stranger.
"Dr. Zhou is really popular with women! Dr. Yang Chan is the most beautiful and coldest flower in our obstetrics and gynecology department. She never speaks to men in a pretentious way, but only takes special care of Dr. Zhou."
Ji You teased Zhou Can with a smile.
"She is my college classmate and also my class monitor. How can she treat me the same way?"
After Zhou Can answered, he ignored Du Leng, whose face had turned pale, and walked quickly towards Zhang Bihua's table.
"Director Zhang, now that we've found the cause of the disease, should we give the child medication overnight?"
He couldn't wait to see the child's condition improve significantly after treatment.
Because the ANA test result is only weakly positive, it is still not certain whether it is systemic lupus erythematosus. The only way to test the truth is to take medication.
"Yang Chan, can you and Xiao Zhou talk about how to treat this disease?"
While Director Zhang was testing Zhou Can, he also did not forget to cultivate his beloved disciple.
Her training of Yang Chan was truly through teaching by example.
"Well... considering that he has always had 3+ proteinuria, restrict his protein diet, give him angiotensin 2 receptor antagonist medication, and avoid ultraviolet radiation!"
Yang Chan answered first.
The treatment plan given is relatively appropriate to the boy's actual situation.
"Xiao Zhou, what is your opinion on treatment?"
Although Director Zhang did not express his opinion, it was obvious that he was not very satisfied with the treatment plan given by Yang Chan.
"I think estrogen-containing drugs should be avoided. According to the patient's current symptoms and the organs and tissue systems affected, anti-infection treatment should be difficult to be effective. If methylprednisolone pulse treatment and intravenous immunoglobulin treatment can be used, it should be better."
Zhou Can's pharmacological differentiation is currently only at the lower level of main treatment, and the treatment suggestions he gives may not be perfect.
However, compared with Yang Chan, he is obviously not on the same level.
The treatment method Yang Chan gave was textbook-style, almost equivalent to reading from a book. The treatment plan Zhou Can gave was already integrated with valuable experience from clinical practice.
There is still a big difference between the two.
"Well, both of your treatment plans are feasible. According to the actual situation, the shock treatment proposed by Xiao Zhou is the preferred treatment plan. As for medication, it is fine to use methylprednisolone and immunoglobulin first, but after five to seven days of treatment, the medication must be changed according to the patient's actual situation."
Director Zhang made a summary speech.
He gave Yang Chan some face. The final treatment plan was basically the same as the one given by Zhou Can.
Director Zhang Bihua is also a decisive person. He found out the cause of the disease, determined the treatment plan, rushed to the ward to check on the child's condition, and prescribed medication.
It is worth mentioning that she does not take away Zhou Can’s functions.
The writing of medical prescriptions was given to Zhou Can, who only provided guidance and supervision from behind.
This is to give young people the opportunity to show their .
Many veteran comrades try to take all the benefits and credit for themselves. Director Zhang's selfless behavior in cultivating new people has also made her image particularly tall.
Zhou Can didn't say it, but he was full of respect for her in his heart.
Especially after experiencing the daytime experience of "Even good wine needs no bush", Zhou Can became much more motivated in accumulating fame than before.
He will not take the glory that does not belong to him.
But he was the one who treated the patient, and he made a great contribution to the diagnosis. Basically, he was the attending physician, and Zhang Bihua was just providing guidance.
It is reasonable to let him prescribe this treatment.
After the doctor's order is issued, what I look forward to is the result after taking the medicine. I have to wait until tomorrow to get the result feedback.
Any treatment takes time.
The treatment of systemic lupus erythematosus is a long process and usually requires lifelong medication like hypertension, diabetes, and chronic obstructive pulmonary disease. It cannot be cured.
Coming out of the ward, Zhou Can knew that Zhang Bihua would work overtime tonight to perform surgery on two patients.
He volunteered to participate and perform the operation together.
The pregnant woman had been successfully weaned off the ventilator during lunch, and after an afternoon of monitoring, her vital signs were normal and her spontaneous breathing had also recovered quite well.
He can now be transferred to a general ward for care.
With his hands freed up, Zhou Can can focus his energy and time on other studies.
Surgery has always been his strong point and it is also the medical path he intends to stick to.
Even the current internal medicine regular training is only to lay the foundation for future surgical career.
Director Zhang liked him very much, so he readily agreed to such a small matter.
However, it was almost impossible for Zhou Can to get an important surgical task as soon as he entered the operating room.
Every time you follow a chief physician, if you want to gain their recognition and trust, you must prove yourself little by little.
When senior doctors delegate authority to lower-level doctors for all treatments that require actual patient care, they are extremely cautious. Operating on the surgeon is considered a high-risk operation.
Not to mention the interns, it is normal for many residents to have not touched a knife in the operating room for two or three years.
…
The next day, Zhou Can had breakfast at the hotel and rushed to Xinxiang Maternity and Child Health Hospital with the experts.
The seven-day specialist clinic activity is already more than halfway through. Today is the fifth day and it is drawing to a close.
Zhou Can felt that the total gains from the previous four days were greater than what he gained from the one-month training at Tuya Hospital. This time, Director Shang of the Department of Gastroenterology forced him to attend the expert clinic, which was a good decision.
Life is like this. If you don’t go out and explore, you will never know how wonderful tomorrow will be.
If he didn't see patients alone, he would never understand how important fame is to a doctor. Yesterday, he saw other experts seeing many patients one by one. There was a long queue in front of Zhang Bihua's desk, but Zhou Can's desk was deserted. He felt very upset.
It was this experience that made him know what to strive for in the future.
Just like many second-generation rich people, when their parents were still around, they didn’t feel bad at all because they were spending their parents’ money. They also never knew the hard work of making money.
It was not until my family fell into poverty and had no food to eat that I realized the importance of money.
If I had understood this truth earlier, I wouldn't have been so willful and squandering money when I had it. Even if I had kept only a few hundred thousand, I wouldn't have had to starve to death.
The importance of cognition sometimes surpasses everything.
The first thing Zhou Can did when he arrived at the hospital was to rush to the ward to check on the child's condition.
After taking the medicine, the patient's body temperature dropped further and was close to normal. Symptoms such as cough, vomiting, and abdominal pain were greatly alleviated, and the stool changed from watery to yellow-brown loose stool.
Diarrhea decreased from more than ten to twenty times a day to five times.
In addition, the child’s father happily told Zhou Can that the child ate two buns and drank a cup of porridge in the morning, which showed that the child’s appetite had increased significantly.
All signs indicate that the boy has systemic lupus erythematosus, and everything is moving in the right direction.
The improvement in his condition this time is completely different from the improvement in his condition the day before after treatments such as fasting and drinking, gastrointestinal decompression, fluid replacement, and acid suppression.
Now that we have found the cause of the disease, we can get truly effective treatment.
The slight improvement in the condition the day before yesterday was just an illusion and temporary.
