Chapter 243: Wrong Diagnosis and Prescription
Hearing the interview questions, it was actually the on-site case analysis, and some people in the audience couldn't hold their breath and let out a continuous exclamation. Pen | fun | pavilion www. biquge。 info
It is no wonder that they are shocked, under normal circumstances, ordinary interviews are only a test of a person's communication skills, whether the conversation is appropriate, whether the thinking is agile, but the case analysis is an inherent test question in the professional physician examination, which is very difficult.
Under normal circumstances, even doctors with rich clinical experience are very afraid of this kind of exam questions, let alone two young doctors who come for an interview?
However, after thinking about it, it is also reasonable, after all, the person who is the judge next to him today is the "Golden Needle" Wang Yueting, if you follow the ordinary interview process, it will be too boring, of course, you have to play some high-end atmospheric and high-grade tests.
Individual doctors looked at Su Ye and Zheng Yichen on the stage with a look that looked at the grill on the livestock, and sighed in their hearts: "The luck of these two people is really not ordinary. The difficulty of this interview is no less than passing five levels and killing six generals! ”
There are some doctors who think more deeply, but their hearts are bright: "Director Gu, I love Su Ye very much on weekdays, and it is impossible for Su Ye to lose face in front of Wang Yueting." specially came up with such an exam question, which was intended to take advantage of the situation to make him stand up, and the young man next to him was just used as a foil. ”
Gu Minggao looked at Su Ye and Zheng Yichen with sharp eyes, and announced the rules of the interview: "Wait a minute, I will call a patient to enter the venue, you have to take turns to consult the patient, and then write the content of the consultation in the medical record book, as well as the diagnosis, and the prescription for acupuncture, and finally in front of me and Wang Lao, give the patient acupuncture treatment, test the practical ability, and see if your acupuncture can be effective." ”
After handing out a medical record book to each of them, he said seriously: "I hope you two will remember that the patient is the center, and the doctor is the standard." My judgment and that of Mr. Wang are still secondary, and the most important thing is the patient's feelings after you apply the needle. Is this clear to you? ”
Zheng Yichen and Su Ye glanced at each other and said in unison: "It's clear!" ”
"Okay, let's start the formal interview next, give you five minutes to ask for a consultation, five minutes to write the medical records, come one by one, Zheng Yichen, you avoid it for the time being, and when Su Ye's interview is over, you will come in again."
Hearing that the time was so harsh, the doctors in the audience were not calm anymore, and they exchanged heads and whispers, agreeing that it would be an impossible task to complete this series of steps within ten minutes!
Zheng Yichen answered, walked outside the conference room, and waited patiently for Su Ye's interview to be completed.
After more than ten hours, a doctor with a flat head opened the door and beckoned to Zheng Yichen: "It's your turn to interview." ”
Zheng Yichen walked into the conference room, only to find that there was a middle-aged man in a gray and black suit sitting in the vacated space in the middle, and it seemed that it was the patient Gu Minggao had found.
Su Ye had already written the medical records, and was respectfully handing them over to Wang Yueting, and then with a confident smile, he found a seat in the audience, and sat down steadily, looking like he was winning.
Wang Yueting and Gu Minggao read the medical records together, and while looking at it, they smiled lightly on the other hand, and seemed to be very satisfied.
The demeanor and demeanor of these three people invisibly formed a huge pressure, which weighed heavily on Zheng Yichen's heart, and he couldn't help but feel a little nervous, sweating in his palms.
This is also the reason why Gu Minggao deliberately asked him to line up at the back for the interview, just to create psychological pressure on Zheng Yichen.
When a person is under heavy pressure, it is inevitable that he will perform abnormally.
However, Zheng Yichen's adaptability is very amazing, he has gone through countless life-and-death situations, and he has turned the tide on his own, which time is not burdened with huge psychological pressure?
After a short period of panic, Zheng Yichen regrouped and regained his calm look.
Wang Yueting was a little impressed by Zheng Yichen, this kind of anti-high pressure psychological quality is an important prerequisite for becoming a famous doctor, just imagine, a doctor decides the life and death of the patient, the conversion of life and death, just between thoughts, if there is no strong psychological quality, it will definitely not be competent!
Gu Minggao's face was indifferent, and he said lightly: "Zheng Yichen, you can start the consultation." ”
"Yes."
Zheng Yichen turned his head and carefully looked at the patient sitting in the chair.
It was a middle-aged man, nearly fifty years old, with a haggard face and a pained look, and he held his left cheek with his left hand, and the yellowed knuckles could be seen.
Zheng Yichen asked, "Uncle, may I ask what is your name?" ”
"Hongzhuang."
"What's wrong?"
Hong Zhuang pointed to his cheeks: "It hurts here." ”
"How long has it hurt?"
"It's been three months, when I got up in the morning to brush my teeth, I suddenly felt a kind of electric shock-like pain, and it was like being burned by someone, which was very uncomfortable, and I have never been so painful in my life!" Hong Zhuang remembered the feeling of pain for the first time, and Wu Zi felt palpitations.
Zheng Yichen's heart was bright: This is a very typical neuralgia.
Of the many types of pain, neuralgia is the most unbearable.
There are some people who call themselves tough guys, and after being cut a few times with a watermelon knife, they can not change their faces, and if they have neuralgia, they will still cry in pain.
Zheng Yichen asked again, "How long does the pain last each time?" ”
"The time and cycle are not fixed, sometimes a few minutes, sometimes a dozen minutes."
After the consultation, Zheng Yichen had no doubts, from the action of Hong Zhuang's cheek support and the content of the description, it can be confirmed that Hong Zhuang suffered from trigeminal neuralgia on the left side, which belongs to the category of facial pain in traditional Chinese medicine.
"But......" Zheng Yichen frowned, encountering a big problem.
The common syndrome types of trigeminal neuralgia mainly include blood stasis and obstruction, lack of qi and blood, and liver and gallbladder fire.
Although Hongzhuang is nearly 50 years old, he has a strong physique and sufficient qi and blood, which can rule out the syndrome type of insufficient qi and blood.
He did not have yellow urine, dry mouth and bitter mouth, and it can also be ruled out that trigeminal neuralgia is caused by liver and gallbladder fire.
Judging from Hongzhuang's tongue, it is a tongue with blood in the body.
It seems that it is the syndrome type of blood stasis and obstruction.
However, Zheng Yichen still had a lot of doubts in his heart, and the reason was that with his hope, Hongzhuang's face was clearly a symptom of water drinking that had stopped gathering from dampness!
I have never heard of water drinking, which can cause trigeminal neuralgia, could it be that the record of "Wangqi Chapter" is wrong?
"Nope! There can be no mistake in "Wangqi Chapter", there must be something that I overlooked! ”
Zheng Yichen frowned and thought hard, Su Ye saw his appearance, and he was very proud in his heart: "I just took three and a half minutes to complete the consultation process, you have been more than four minutes now, and there is no conclusion yet, in the first link, you will lose!" ”
Wang Yueting coughed lightly and kindly reminded Zheng Yichen: "Young man, you only have less than thirty seconds, hurry up and ask questions!" ”
Zheng Yichen's mind wavered, and he hesitated between the two syndrome types of dampness and blood stasis.
"Which one should you choose? Or choose blood stasis and blockage, insurance point...... Hey! ”
Zheng Yichen's eyes shone brightly, stopped on Hong Zhuang's yellowed knuckles, looked excited, and asked quickly, "Uncle, do you smoke often?" ”
Hong Zhuang was stunned when he heard this, and replied honestly: "Yes, I am an old smoker, I have been smoking since the sixth grade of primary school, and I have been smoking for more than 30 years. ”
"Do you cough and phlegm a lot?"
"Yes, I used to cough up a mouthful of phlegm when I got up every day, but recently, I don't cough anymore, and I don't have phlegm to spit out......"
"Thank you, uncle." Zheng Yichen's eyes were clear, and he bowed slightly to the two judges on the stage: "My consultation is over." ”
While he was writing down the medical records carefully, the acupuncturist, as a bystander, sighed at Zheng Yichen's dizziness at the last minute.
"The most important thing in TCM consultation is to be concise and concise."
"His initial consultation was very standardized, in line with procedures, and in some details, he was even better than Su Ye."
"The bad thing is that the last-minute consultation is simply adding to the snake."
"That's right! At the beginning of a series of questions, it has been determined that Hong Zhuang is a trigeminal neuralgia patient, why do you have to ask him about smoking and coughing and phlegm, this question is too powerful. ”
"Just the time spent on him, as well as the content of the consultation, it seems that some points will be deducted."
Wang Yueting, as a judge, was also a little confused, and did not understand the significance of Zheng Yichen's final consultation.
Gu Minggao exchanged glances with Su Ye, and said secretly in his heart: "Hmph! I really overestimated this stinky boy, it seems that the layout I worked so hard to put in was using anti-aircraft guns to fight mosquitoes! ”
Three minutes later, Zheng Yichen finished writing the medical records, browsed them, nodded with satisfaction, handed the medical records to the judges, returned to his original seat, and waited for the results.
According to Su Ye's medical records, the diagnosis of Hongzhuang was the pattern of blood stasis and obstruction of facial pain, and the prescription for the acupoints selected was to take the local sun, Shangguan, Xiaguan, cheek car and other acupuncture points on the affected side, and cooperate with the Hegu acupoint at the distal end of the limb.
The prescription is rigorous, far and near, and it is a standard prescription that can be used as a textbook version of acupuncture trigeminal neuralgia, and there is nothing wrong with it.
The uniqueness and sophistication in the selection of acupoints made Wang Yueting look at it and praise it, and even wondered if it was Gu Minggao's acupuncture prescription specially matched for Su Ye.
And Zheng Yichen's medical records, compared with Su Ye's, can be described as very different.
The diagnosis of his disease name is also facial pain, but the syndrome type diagnosis is impressively written "water and dampness stop gathering"!
What's even more outrageous is that Zheng Yichen's acupuncture prescription has only one acupuncture point: Tiantu acupoint!
Located in the center of the neck and suprasternal fossa, the Tiantu acupoint is mainly used to treat cough, vomiting, sore throat and other conditions, and is used to treat trigeminal neuralgia, which is simply unheard of.
Even in order to show his maverick, he added a few local acupuncture points on the affected side, and he dared to treat the disease with a single acupoint, which is too arrogant!
No! This is simply an idiot's act, and anyone who has studied the meridians and acupoints can see that the prescription is inappropriate.
After Gu Minggao read the content of Zheng Yichen's medical records, he secretly sneered in his heart: Sure enough, I really overestimated him, so I don't have to use my next move at all! ”
He pretended to be angry and slapped the table hard: "Zheng Yichen, on such a serious interview occasion, there are also acupuncturists in charge, are you joking?" Actually wrote such a diagnosis and prescription? ”
Zheng Yichen said loudly: "I think my diagnosis and prescription are 100% correct. ”
Gu Minggao sneered: "Are you embarrassed to say that you are right?" Listen, he diagnosed Hongzhuang's illness as facial pain caused by the accumulation of water and moisture......"
As soon as these words came out, the people in the audience burst out a series of ridicules, which was very lively.
"I'm laughing to death, the facial pain caused by the dampness stopping, is your Chinese medicine taught by a physical education teacher?"
"It's no wonder that he, I heard that he is a college student, and it is normal for this kind of mistake to occur."
"Hurry back to school, study for a few more years, and then come out to practice medicine."
"A doctor like you, when it comes to clinical practice, must be an executioner who cares about human life!"
The look of mockery on Gu Minggao's face was even heavier: "His prescription for acupuncture points has only one acupuncture point: Tiantu acupoint!" ”
In this way, even a few old and steady acupuncture doctors couldn't help it, some held their stomachs, leaned forward and backward with laughter, and some knocked on the table with their hearts, and couldn't help laughing.
The treatment of trigeminal neuralgia by Tiantu acupoint is simply a big fallacy in the world!
From ancient times to the present, I have never heard of a famous acupuncture expert who has used this acupuncture point to treat trigeminal neuralgia.
As long as you are a beginner, you will not make such a low-level mistake.
And Zheng Yichen's choice of the occasion for making a mistake was too wrong, the people in front of him were Gu Minggao, the "King of Acupuncture", and Wang Yueting, the "Golden Needle", two famous acupuncture experts.
It can be expected that Zheng Yichen's ridiculous and generous low-level mistake will definitely spread all over the country and become a joke, which is enough to make him completely removed from the acupuncture world!
The ridicule and ridicule of everyone did not make Zheng Yichen lose his position, he still smiled calmly, looked at Gu Minggao without blinking, and said leisurely: "Director Gu, what you just said, is it considered a fart?" ”
Gu Ming shouted in a deep voice: "What do you mean by this? ”
Zheng Yichen said: "You just said that the patient is the first, the doctor is the standard, you and Wang Lao's judgment is secondary, the important thing is the patient's feelings after treatment." You also said that this case analysis is divided into three parts: consultation, writing medical records, and practical treatment. Now that the third part has not started, you are going to deny my diagnosis, you are too anxious, right? ”
Gu Minggao said with a smile: "Your diagnosis and prescription are full of errors and omissions, and I don't need to wait for the third link to start, I can judge that you have lost, so there is no need to compare." ”
Zheng Yichen restrained his relaxed expression, and said solemnly: "It's not the last moment, you are not qualified to make a judgment, I, no, serve!" ”