He worked until half past six in the evening, when Yu Zhiming finished diagnosing the last patient assigned to him.

Fifty!

For a whole day, Yu Zhiming received a total of 50 patients, and he felt that he was going to be tired and paralyzed.

This deep feeling of tiredness does not come from the body, but mainly from the spirit.

Not to mention that he has to maintain a high level of physical and mental attention during auscultation and percussion, he also strives to mobilize what he knows and learn, and carefully corroborate with the patient's symptoms.

The aim is to make the diagnosis as accurate as possible.

Unlike in the outpatient clinic of the county hospital, most of the patients who visit the clinic have minor diseases such as headache and brain fever, and it takes little effort.

But the patients here can be different, Yu Zhiming needs to be carefully examined, for fear of an inadvertent misdiagnosis and missed diagnosis.

After working for such a high-intensity day, Yu Zhiming was really tired and stupid.

Even with his efforts, he started work nearly half an hour early at noon, and it took him 50 patients to complete the diagnosis on this day.

Yu Zhiming learned from the little nurse Wang Li.

Most of the outpatient volumes completed by other outpatient clinics today are eighty+, ninety+, and even more than a hundred.

His outpatient volume can be regarded as the bottom existence.

"However, the quality of my work is high." Yu Zhiming, who was slightly hit, cheered himself up like this.

He didn't dare to say that there would be no errors or omissions in his diagnosis, but the error rate would be very small.

Doctors like those who have more than 100 outpatient visits still need to spend a lot of time reviewing the results of the examinations or imaging images that the outpatients have just done.

Sometimes, the same patient is re-examined more than once.

In this case, the average time spent on each patient is only three to five minutes?

With such a short diagnosis time, unless he is sharp-eyed, with superb medical skills, plus a sense of responsibility and high concentration, the probability of mistakes and omissions will not be low.

From time to time, some misdiagnosis cases that have appeared in big hospitals have made many people feel ridiculous......

As a participant, Yu Zhiming understands in his heart, but he is also a little helpless, and sometimes such problems are inevitable.

Doctors are also people, not machines.

It's hard for a doctor to stay focused all day long in front of a steady stream of patients.

Quantity and quality are always contradictory......

Among the patients Yu Zhiming received in the afternoon, another patient was transferred to the center.

The patient, a 16-year-old teenager, is drowsy and can fall asleep whenever and wherever he wants.

Not only do teenagers fall asleep unconsciously during class, but they can even fall asleep without paying attention during meals.

This ability to fall asleep quickly makes people like Yu Zhiming, who have difficulty falling asleep, a little envious.

For teenagers, his narcolepsy has seriously affected his studies, especially when he is in his second year of high school after the summer vacation.

His symptoms, Yu Zhiming judged to be neurological problems, and it also happened to belong to the scope of Teacher Qi's treatment.

Yu Zhiming made the decision and put the teenager into the center......

He dragged his heavy body back to the large office of the center, and unexpectedly found that Teacher Qi had not left yet.

Yu Zhiming knocked on the door and entered the director's office, and saw Teacher Qi looking through a stack of cardiac examination materials.

"Teacher, the patient in the morning?"

"Confirmed?"

Qi Yue nodded and said, "In the afternoon, Dr. Wang and I gave him a stress test. ”

"Let him do an overloaded high-intensity exercise, and after two or three minutes of exercise, he found that his heart showed signs of ventricular fibrillation and ventricular tachycardia."

Qi Yue sighed: "If we hadn't stopped and treated it quickly, it is estimated that there would have been a cardiac arrest on the spot." ”

"His situation is indeed very serious."

Yu Zhiming sighed and asked with concern: "The cause?" ”

Qi Yue shook his head and said, "It's hard to find out exactly. ”

"We have dissected the hearts of more than one person who died in cardiac arrest, and found that the hearts of several deceased people were obviously healthy, but they just stopped beating for no reason."

"Many sudden cardiac deaths are actually caused by systemic causes, and the heart is just a stress attack organ."

Qi Yue said with a smile: "It's as if the brain has received alarm messages from all over the body, saying that it is too tired and needs to rest." ”

"The brain synthesized the information and decided not to go on strike, so it notified the heart as a power source."

"You stopped Lao Tzu."

Yu Zhiming laughed a few times and said, "If you can't find the exact cause, you can only maintain and prevent it?" ”

Qi Yue said: "First, adjust the work and life conditions, reduce pressure and tension, and change the way of life. ”

"The second is to implant an ICD to prevent accidents."

An ICD is a small pacemaker, technically known as an implantable cardioverter-defibrillator.

It works just like what you can see in movies and TV dramas, medical workers use defibrillators to put brick-sized electrodes on the patient's chest and slam them to rescue them with an electric shock.

ICDs are small in size and can be implanted subcutaneously in the patient's chest and abdomen.

It is placed in the heart of the electrode leads, which can automatically sense the occurrence of ventricular fibrillation and ventricular tachycardia at any time, and the pulse generator quickly recharges and generates the energy of the shock.

The whole process only takes about 15 seconds, so that the ventricular fibrillation can be terminated in time and lives can be saved.

The advantage is that the success rate of the shock is almost 100%, and the patient's heart rate can be monitored around the clock.

If a patient has a fatal arrhythmia, it can be automatically recognized and treated with a discharge to return the heart to a normal state.

Yu Zhiming thought of another question and asked with concern: "Teacher, what is the total cost of this ICD implantation?" ”

Qi Yue said casually: "Using the best ICD, using minimally invasive implant surgery, the total cost is about 150,000 yuan." ”

"It's not cheap." Yu Zhiming sighed lightly.

Qi Yue chuckled, "This is something that can save lives at a critical moment." Besides, if it is implanted again, it can be used for ten years, and the average is 15,000 a year, which is not too high. ”

After a pause, Qi Yue turned to say: "The young man who was transferred over in the afternoon is not narcolepsy, but narcolepsy. ”

"This is a genetic mutation that causes the hypothalamus to secrete too many neuropeptides, causing the patient's sleep switch to malfunction, resulting in irresistible short-term sleep."

"This disease is not treatable, it can only be controlled."

When Yu Zhiming heard that this was a genetic mutation disease, he knew that this disease was difficult to cure.

I listened to Teacher Qi continue: "I have received dozens of cases of this disease, and I have rich experience in treatment. ”

"Observe for two days, do a few drug tests, let the teenager do willpower resistance sleep exercises, and then take the medicine I prescribed for a long time to maintain a general life, it can still be done."

Yu Zhiming said with deep feelings: "This kind of disease of teenagers will make life and work a lot inconvenient. ”

"At least driving is impossible, and I can't think of anything bad for a while."

Qi Yue said: "Not only driving, but all high-altitude work and dangerous work cannot be engaged. ”

Yu Zhiming's heart suddenly moved, and asked, "Teacher, is there any equipment similar to ICD?" ”

"When this kind of sleeping sickness attacks, give him an electric shock directly, and immediately make him feel more energetic."

Qi Yue was slightly stunned and said, "I haven't seen a similar device yet." ”

He pondered for a moment and said: "Although this narcolepsy is a rare disease, there are six or seven hundred thousand patients in China's population base, and there are many new cases every year. ”

"If there is such a device......

Qi Yue thought about it and said: "I can ask domestic companies that make medical instruments and equipment, whether there is such a thing in the world, and whether there is research and development value." ”

"Maybe it's worth it."

Qi Yue looked at Yu Zhiming, hesitated for a moment, and asked, "Zhiming, are you having lunch with Zhou Mo at noon?" ”

Yu Zhiming was a sigh in his heart, and hurriedly explained: "It was she who thanked her for giving her mother a physical examination and specially brought lunch, which I wanted to refuse." ”

"It's just that Zhou Mo is too enthusiastic......"

Qi Yue sighed, and continued: "I know that Zhou Mo is very good, and it is inevitable that you have some ideas. ”

"It's just that Zhou Mo's mother has spoken first, and she resolutely does not allow Zhou Mo to associate with the doctor......"

Yu Zhiming said in his heart, since he didn't consider the doctor, why did he still let her work in the hospital, a typical contradiction.

Teacher Qi said this, that is, there are no three hundred taels of silver here, and Zhou Mo's mother's words are used as a shield.

Yu Zhiming was very knowledgeable and hurriedly expressed his position.

"Teacher, if you put a hundred hearts, I will definitely not have any thoughts about Zhou Mo."

"I'm focused on improving my medical skills, and for at least a year, I will never think about personal problems!"