What happened on Monday is also the way for every doctor.

In the face of the results of failed treatment, it is unforgettable for a long time, but if you want to engage in this profession, you must learn to be rational and learn to let go. Because throughout your career, you are dealing with not just one patient, but thousands more.

The appearance of the old man was like uncovering a scar, and it hurt hotly.

Although I am uncomfortable, I also know that I am numb when I hurt, but the human heart is always long, and the uncomfortable emotions are not controlled, and the process from sensibility to rationality is not to abandon sensibility, but to learn to control sensibility, but self-control is a difficult thing to cultivate, which is a difficult journey.

The only direction that can comfort oneself on Monday is to 'experience it early and finish it early', and the long pain is better than the short pain.

Before the free clinic.

Zhou Shouming felt that his grandson's state was fine, and then he relieved himself and continued to diagnose and treat.

And on Monday, I want to avoid the sight as much as possible, but I can't help but want to look at the elderly, and the psychological contradiction is very subtle, which is probably what people often call an occupational disease. My girlfriend, who is a nurse, always likes to rub the back of her boyfriend's hand to find blood vessels, and my girlfriend's slender collarbone is protruding, which has a great temptation for her orthopedic surgeon boyfriend, and I can't help but think, 'If such a beautiful collarbone is broken, I must do it myself'.

When a patient with superficial pathological features appears, it is undoubtedly a great temptation for the doctor -

I'll have to see what's wrong with you!

In fact, even if the elderly do not have tracheal intubation, it is enough to be eye-catching for ordinary people.

The electric wheelchair he is riding in is very high-end, it should be the same model as the deceased Mr. Huo, the right armrest has a rocker forward operation device, and the left side is fixed with the latest ipad tablet.

In the eyes of wheelchair users, this wheelchair is a proper 'luxury car'.

The function of the iPad is obviously not to play, after hearing the conversation between the old man and the old man around him, the old man will click his finger on the iPad to make a sound response. Tracheostomy patients have an open airway in the neck, and cannot make a sound when the nasal cavity and throat are not ventilated, and even if they want to speak, it is only a 'snort' sound.

If you are a long-term 'endotracheal intubation wearer', you can actually figure out a way to make a sound, squeeze the airway intubation with body movements to form a blockage, so that the air can be transmitted to the throat again, and it is feasible to make a short vocalization.

The old man in front of him obviously didn't learn how to speak, so he could only use the 'money ability' to replace it with technological products.

In addition, if you don't mention the trachea, the old man's hair is groomed and shiny, and he wears a white shirt inside the upper body, with a snow-white collar and a gold collar badge decoration, and a cardigan woolen vest on the outside, and the woolen combination pattern is LV.

The lower body of the velvet trousers should only be cropped, the exposed ankles are matched with pure wool stockings, deliberately pulled down to form folds, and the slender round-toe black and white leather shoes are matched.

The intern nurses on the side couldn't help but sigh: "Uncle is so luxurious, why did he come to the park to play mahjong?"

Zhou Zhou was not affected, and no matter how gorgeous his appearance was, he could not stop his curiosity about the disease. The use of the detection system is an inevitable result, but before using it, he has already developed the habit of self-diagnosis, so as to improve his dialectical ability.

Patients who require tracheostomy and are intubated for breathing have pathological limitations and can be delineated to a very small extent.

First of all, a hard condition is that the condition obstructs the normal breathing, and the lower tracheal breathing obstruction is obviously not established, if it is after thoracic and abdominal surgery in order to place secretion retention and facilitate sputum suction to keep the respiratory tract unobstructed, then it is also certain that the condition is too serious to support the old man to dress up so foreign and come out to wave.

Then you can only look upwards to find the cause, laryngeal inflammation, tumors, trauma and other factors will cause difficulties and obstruction of respiratory function.

After the incision of the tube, the traumatic knot can no longer be seen, and there is no clue about inflammation and tumor.

Zhou Zhou kept looking at it, and finally found some small clues, the old man's left nasal cavity is obviously more swollen than the right side, and the nasal wings are due to long-term swelling, and the skin tissue has metabolized and cracked sebum.

"Unilateral nasal tumor?!cancer?"

It's quite possible.

Nasal tumors and cancer are two different diseases, but even if it is a benign tumor in the nasal cavity, the probability of cancerous transformation is very high, so in order to prevent cancer, the surgical department definitely recommends excision and treatment to avoid cancer.

It is important to know that nasopharyngeal cancer is the malignant tumor with the highest incidence of ear, nose and throat cancer.

Since the elderly have not undergone resection, they must have suffered cancer, otherwise the tumor will disappear after resection and treatment, and there is no need to use tracheal assisted breathing for a long time.

Of course, the doctor's recommendation of 'tumor survival' treatment is not ruled out, because the nasal cavity is rich in blood vessels and nerves, and considering the location of the tumor and the patient's age and physical condition, it will also be recommended not to remove the tumor.

For example, the elderly are already very old, and the risk of resection is higher than the risk of cancer and death, and the advice given by doctors is definitely the most rational and scientific judgment.

At this stage, unless you witness the state of the tumor, you will not be able to give a diagnosis by a powerful doctor.

This situation is like a quiz game for Monday, and when the time is up to reveal the results, it is time for the system to give a standard answer for scoring......

B. The special detection with the body scanning detection function was set in the nasopharyngeal area on Monday.

The scan frame in the field of vision flashes, and the results are instantly arranged.

The data of various human body indicators were temporarily ignored by Zhou Zhou, and his eyes instantly fell on the special test report-

"Nasopharyngeal carcinoma stage II (status: stable), the tumor on the side wall of the left nasal cavity is descending, seriously obstructing the respiratory trachea, and there is a tracheostomy intubation to assist breathing (effective), no metastasis and distant metastasis of lymph nodes (symptom rating B+), the effectiveness of radiotherapy is 63% (stable and decreasing), although there is a trend of cancer cell clearance, but in view of the patient's signs and age factors, surgical local dissection is not recommended, and radiotherapy and traditional Chinese medicine assisted conservative treatment can be considered. ”

Note, symptom rating: C is the passing line, the lesion rate is less than 40%, B is good, the lesion rate is less than 30%, A is excellent, the lesion rate is less than 20%, plus or minus items are referred to as appropriate. ”

Sure enough, nasopharyngeal cancer.

No matter what kind of cancer it is, it is scary and deadly.

The old man's condition is already a blessing in misfortune, and the condition of nasopharyngeal cancer is stabilized in the second stage.

The most feared thing about cancer is lymph node metastasis...... The metastases of nasopharyngeal carcinoma are located in the neck.

Most patients only need eight months to go from stage 1 to stage 4, and the most frightening thing is that the lymph nodes on both sides of the neck are swollen like two apples, and the neck is thicker than the head.

And distant metastasis is even worse, bone metastasis, lung metastasis, liver metastasis, and the evolution of this situation is basically waiting for death.

As for the moment, even the system has given a symptom rating, the lesion rate is low and 30%, if you are lucky, you will not relapse in your lifetime, and you can enjoy your old age with endotracheal intubation.

Just like now, play mahjong with friends and enjoy the lazy afternoon sun.

Zhou Yi silently prayed for the old man in his heart, but he temporarily put his previous unpleasant emotions behind him.

Soon.

The free clinic team lined up with the elderly, but the nurse behind him didn't interject, and let the 'Mayou' next to him introduce: "Doctor Zhou, right? You show Lao Chen, his problem is serious, he has to go to the hospital every once in a while for radiotherapy, and he has to take Chinese medicine. ”

Grandpa smiled, looked at the old man in the wheelchair and couldn't grasp his age, so he could only say, "Old brother, can you still talk?"

The old man smiled and pointed to the iPad, clicked it, and the voice played naturally: "Yes." ”

Zhou Zhou got up and glanced at it, there were some simple words fixed on it, and there was also a handwriting board, so that the old man took the initiative to say that the condition must not work, and he could only guide the inquiry, or just ask the nurse.

Grandpa thought the same thing, so he looked at the nurse again: "Can you give me a general description of the condition?"

The nurse said: "I only know that it is nasopharyngeal cancer, and it hasn't been long since Uncle Chen came to our Qinzhong, so I just came to take care of him." ”

In this way, you can only ask the old man to guide and ask......