Chapter 328: Rats have their own ways, finally found out
Zhou Can looked at the backs of the mother and son as they left, his lips moved, but he finally swallowed his words back into his stomach.
Instead there was a sigh.
The only thing in this world that can be obtained without work is poverty. She and her husband sleep on the card table all day, and they love laziness and hate work, which is destined to the current result. This lazy thinking has been deeply engraved in the bones of the couple. The only way to make them hardworking and motivated is to be whipped by society and persuaded by relatives and friends.
Their children are the hope of saving the family.
If the child's disease is cured and he can go to school and get three good students every year, it will be enough for the couple to see good hope. They think that after they have a goal in life, they will think about finding a job.
Zhou Can sent the names, addresses and other information of the mother and son to Director Tang Fei.
"OK!"
She just replied with an expression.
I guess he is very busy, after all, he is the director of a large department. His workload is much greater than that of an ordinary chief physician.
Zhou Can had just sent a message to Director Tang when a new patient came in for treatment.
He was like a whipped top, and he devoted himself wholeheartedly to the diagnosis and treatment work.
I thought there would be fewer patients in the afternoon, but I didn't expect that there would be an endless stream of patients seeking treatment, one after another.
At around three o'clock, he had already seen sixteen or seventeen new patients.
I really didn't expect that there would be such a large number of patients seeking treatment on the first day of my official clinic.
Fortunately, most of the patients we see are suffering from common diseases. So far, only the little girl whose symptoms are similar to those of a cold but not a cold has not been diagnosed.
After Zhou Can finished seeing the patient in his hand, he stood up and walked to the door.
"Are you busy now?"
He said to the nurse.
"Doctor Zhou, please tell me if you have anything to say. No matter how busy I am, nothing is more important than yours!"
Most of the guide nurses are older and belong to a marginalized group.
Many of them are recruited from society and graduated from technical schools.
Their salaries and status are low, and even the most ordinary resident doctor is someone they need to curry favor with.
The invisible hierarchical relationship in hospitals is actually very similar to that in ancient feudal kingdoms.
People of lower status will try to curry favor with people of higher status to get convenience and care at work. At least, I have a good relationship with you so that you won't make things difficult for me at work.
This is the most real thought of the vast majority of people.
"Can you help me check if the patient who fainted this morning has woken up?"
Zhou Can was still somewhat worried about the grandparents and grandchildren.
"Ward 0, right? I can just call and ask the nurse there for you. What's the patient's name?"
The guiding nurse seemed to be familiar with the nurses in the inpatient department.
Snakes have their own paths, and rats have their own ways.
Even if she is just a nurse guide with a very low status, she has her own network of contacts.
What exists is reasonable.
They are able to survive in the highly competitive hospital and have their own ways of survival.
"I didn't really ask the old lady's name, I only know her granddaughter is called Chen Ziya."
The old lady fainted at that time, and Zhou Can didn't even have the chance to ask her name.
"It's okay. I'll call the nurse over there and I'm sure she'll be able to find out."
The nurse smiled and took out her cell phone and started looking up phone numbers.
"Thank you for your hard work!"
Zhou Can had a good impression of the guiding nurse, who was efficient and had a good attitude.
"Come on, who's next to see the doctor? Come in!"
Zhou Can looked at the patients sitting in the corridor waiting for treatment.
"It's my turn, it's my turn!"
A woman holding a child stood up and followed Zhou Can into the clinic.
"Please take a seat!"
Zhou Can asked the woman to sit down, and his eyes naturally fell on the child she was holding.
The patients who come here for treatment are all children, and occasionally there are babies a few months old, but these patients generally do not seek treatment from young doctors like Zhou Can, and at least they will make an appointment with the deputy director.
Unless there are really no numbers available, we will then give you a regular outpatient number.
The child in the woman's arms looked thin. He buried his head in his mother's arms and didn't move much.
When Zhou Can saw that the little boy's skin on his neck and other parts of his body was turning purple, his pupils shrank slightly.
He was about to sit down, but quickly stood up again.
"What's the problem with this kid?"
"He just doesn't like to move much, and he eats very little." The child's mother seemed very calm.
"Has his skin always been this color?"
The child's skin was somewhat cyanotic. Zhou Can's first impression was that the child was lacking oxygen.
But the child's mother was very calm, which shows that this situation has been going on for some time.
"Yes! My son's skin was a bit reddish purple when he was born. As he grew older, the color seemed to get darker. Many friends and elders joked that my son was born with a noble destiny, as if he was born under the Purple Star!"
The woman replied with a smile.
Zhou Can was speechless for a while. What ignorance is, it is fearless.
The skin has become cyanotic, which is obviously caused by lack of oxygen. How can it be that life is precious?
"His breathing seems a little heavy!"
Zhou Can heard a loud noise when the boy was breathing.
This means that the boy needs to breathe in hard to keep up with the body's oxygen needs. In fact, this is also a manifestation of hypoxia.
When a normal person does some strenuous exercise, the oxygen in the blood is consumed quickly and the body's demand for oxygen increases, so they will instinctively "huff and puff" to breathe heavily.
"My friends say that my son has a strong lung capacity, so his breathing is so heavy. My son is born with something extraordinary!"
The child's mother praised her son with a little pride.
Zhou Can was speechless again after hearing this.
What is mysterious self-confidence?
This woman is probably a typical example.
When her friends see the child, they will definitely say something nice. Will they say there is something wrong with her child? I believe there is no one with such low emotional intelligence.
She took other people's flattery seriously.
"You came to see the doctor this time because your child doesn't like to move and doesn't eat much, right?"
Zhou Can measured the child's vital signs and asked about his condition.
"Yes! There are only these two minor problems. Doctor, do you think my son is born with a noble character, so he is like the emperor on TV, living a life of luxury and not liking to move around every day?"
This woman's logic is really convincing.
It's simply breathtaking.
"Yes, that's possible." Zhou Can actually nodded cooperatively.
You must never argue with this kind of person, otherwise it is easy to get into a quarrel.
According to her, this is a wise approach.
The doctor's goal is to cure the disease, not to correct the family members' views.
In fact, every adult's thinking is extremely stubborn, so don't try to change it. Otherwise, you will not only fail to change the other person, but also turn him or her into an enemy.
"Then tell me, my son doesn't like to eat. Is he born to be an emperor?"
This woman really has a unique imagination.
"Why do you say that?" Zhou Can asked her back.
"Just think about it! The emperor eats delicacies from land and sea every day, so ordinary food can't arouse his appetite at all." The woman answered seriously .
"Yes, you are right. You can get more delicacies for your son in the future. You see, he is too thin. From our doctors' point of view, this is called malnutrition."
Zhou Can persuaded the young mother from the side.
She should be about 30 years old, but why is she still so naive? I really wonder if she has watched too many TV dramas.
After a preliminary physical examination, Zhou Can found that the little boy was stunted, malnourished, had severe cyanosis all over his body, clubbed fingers, a whistling sound between his ribs when breathing, low blood pressure, and a weak pulse...
There is something seriously wrong with this child's health.
“Has the child had a physical examination?”
"I did it once. The young doctor who did the physical examination at the community medical service station talked nonsense and said that my child might have a serious illness. I scolded him. Since then, I have never taken my son for a physical examination again. My son is so good, how could he have a serious illness? Some doctors like to scare people, just to trick patients into buying more medicine."
The woman was still indignant when she mentioned this matter.
Zhou Can couldn't help but wipe the cold sweat from his forehead.
Fortunately, he didn't argue with the woman just now. Otherwise, he would be the next one to quarrel with the woman.
"When I measured your child's heart rate just now, I heard a whistling sound. I will order an echocardiogram for him first, and you can take him to check a two-dimensional echocardiogram."
Zhou Can said to the family members.
"Okay! So do you think my son's problem is serious?"
The woman had a pleasant conversation with Zhou Can before, so she agreed readily.
"It's hard to say, let's see if there's any problem with the heart first!"
Zhou Can felt that there must be something seriously wrong with the child, but the doctor at the community medical service station was scolded for telling the truth. How could Zhou Can dare to tell the truth again?
Let's wait until the test results come out.
By then, with the inspection data to support us, we will be able to speak the truth with confidence, no matter how big the truth is.
After sending the mother and son away, a new patient walked into the clinic.
"Please sit down and wait for a moment. I will check the test results of a patient this morning."
After greeting the family members and the patient, Zhou Can directly looked for the little girl named Chen Ziya in the medical consultation system.
Tuya Hospital has now realized information networking. After the test results come out, the laboratory will transmit them to the hospital intranet, and patients or their family members can print them out with their ID card information.
It is much more convenient than having to search through a large pile of information in the window before.
The attending doctor can directly view all the patient's test results in the system . However, many doctors will wait for the patient to bring the paper test report before checking it.
On the one hand, doctors are very busy and don’t have time to see every patient.
In addition, if the patient is not present, even if the doctor has diagnosed the cause of the disease, he or she still has to wait for the patient to come and talk face to face.
It is definitely not the case that the doctor is aloof and lazy as the family members think.
Zhou Can quickly found Chen Ziya's name.
After clicking it, he found that the biochemical test results of the little girl were finally out.
The data of LDH, CK, AST and ALT were all higher than normal values, and the value of aspartate aminotransferase was even more frighteningly high.
"What disease could this be?"
After reading the biochemical test results, his mind quickly screened out possible matching diseases.
But he racked his brains and still couldn't find a disease that matched these symptoms.
At this moment, he really regretted not having read enough books.
Basic medical knowledge is as vast as the ocean, and it is almost impossible to learn it all. The main reason is that a doctor's energy and time are limited.
Learning is a long process.
He still insists on reading every day and making up for his basic medical knowledge every day.
This can't be rushed, it can only be achieved over time.
Otherwise, why are doctors more popular as they get older? Because some doctors really keep learning until they die. They are knowledgeable and experienced, and their diagnostic efficiency is indeed much higher than that of young doctors.
The chances of misdiagnosis and missed diagnosis are much lower.
"The white blood cells and platelets are decreased, and there is also protein in the urine. Now the aspartate aminotransferase is also frighteningly high. Is it poisoning?"
There is such a possibility.
Because similar symptoms to those of the little girl have also begun to appear in her grandmother.
There is a real possibility that the grandparents and grandchildren ate poisonous food and got poisoned.
At this moment, the door of the clinic was pushed open and the receiving nurse poked her head in.
"Doctor Zhou, I have already asked what you asked me to ask. The old lady has woken up and her symptoms have been relieved. She is worried about her granddaughter's condition and asked to come to see you."
As long as the person has woken up.
"Tell the old lady that she doesn't need to come over yet. I'm diagnosing her granddaughter. When I find out the cause of the disease, I will take the initiative to go find her."
Zhou Can was still a little worried about what infectious disease the grandparents and grandchildren had contracted.
If the virus spreads by then, it will cause serious harm to other patients and their families.
Besides, the cause of the little girl’s illness has not been found out yet, so there is no point in coming to him.
If it is really poisoning, infectious disease can be ruled out.
"If it's not poisoning, then what could be the reason?" After Zhou Can thought hard, his eyes lit up slightly.
How could I forget about this?
If food poisoning is not the cause, another possibility is viral infection.
If one of the grandparents and grandchildren is infected with the virus, they may infect the other.
The more I think about it, the more it makes sense.
Regardless, it’s always a good idea to screen first.
If you want to screen whether you are infected with the virus, serological testing is a relatively efficient method.
He immediately wrote out an application form for examination and then conducted a serological test on the patient.
After that, I continued to see other patients.
Around half past four, he took some time to check whether Sun Ziya's serum test results were out.
Fortunately, the results are out.
Igm and IgG antibodies were positive.
These two data are elevated and the antibody is positive, which means that the patient is likely to be infected with a virus.
Generally speaking, after a patient is infected with pathogenic microorganisms, the body will produce specific antibodies against the pathogens, and IgM and IgG will be positive.
Zhou Can couldn't help but feel excited. Now it could be basically confirmed that the patient was very likely to have been infected with the virus.
Colds are usually caused by influenza virus infection, which is also a viral infection.
But Zhou Can directly ruled out influenza virus infection because the patient's examination data was obviously inconsistent with influenza.
Elevated IgM levels may be seen in macroglobulinemia and primary biliary cholangitis.
A significant increase in IgG is common in autoimmune diseases.
If both monoclonal increases are present and other immune blood proteins decrease significantly, it is likely multiple myeloma.
Zhou Can insisted on his own diagnosis direction, and single-mindedly determined that the patient was most likely infected with a virus, and it was a relatively rare virus.
If it was a common viral infection, it would not be difficult for him at all and he would have diagnosed it eight hundred years ago.
"I'm afraid I need to look up some information!"
When he couldn't figure out what virus the patient was infected with, he decided to learn from his predecessors. When Director Dai first started seeing patients, didn't he also bring a pediatric clinical manual with him and secretly flip through the book when he encountered a disease he couldn't handle?
Now he was facing an extremely difficult case, so there was nothing shameful about looking up the information.
Thanks to the rapid development of smart phones and the Internet, doctors no longer need to secretly carry thick medical books into the outpatient department to look up information.
You can search for relevant information online directly using your mobile phone.
However, for a lot of medical knowledge, it is still faster and more convenient to look up some specialized medical books.
After some searching, the name of a relatively rare disease came into his sight.
New Bunyavirus.
Patients infected with this virus will experience various symptoms, including fever and thrombocytopenia syndrome.
"It must be this disease! If we can do a pathogen test, the diagnosis will be more accurate."
Looking at the time, Zhou Can suppressed his urgency to tell the patient the diagnosis and applied to the laboratory for pathogen testing. In fact, this is also a serum test. However, this time, the new Bunyavirus is directly isolated from the serum.
