Because Dr. Gao, the youngest and most promising doctor in the Department of Neurology, when he saw this emergency doctor, his expression was not only surprised, but also respectful.

The hospital is also a small society, if you have a future, or if you have strength, others will respect you.

Otherwise, it's the dust in the corner.

Tuya Hospital has thousands of employees, most of whom are part of the general public.

"I can tell you that Dr. Zhou is the most promising doctor in the emergency department, and having a good relationship with him is only good for you, not harmful." After Gao Jian finished speaking to the nurse, his eyes looked at Zhou Can again.

"Doctor Zhou can't be here to see me, right? Ha ha! I'm a bit narcissistic ha! ”

Although Gao Jian and Zhou Can are competitors, they are very enthusiastic when they meet.

The nurse girl looked at Zhou Can again in surprise.

There was no more contempt in the eyes.

There was a flattering smile on his face.

It's a pity that Zhou Can didn't look at her again.

"I'm here to ask Director Yin some questions, do you know where he is?"

"Director Yin is my teacher, do you know where he is? Let's go, I'll take you there. The teacher mentioned you two days earlier. You're lucky today, and the teacher happens to be working overtime today. Under normal circumstances, on weekends, Director Yin does not go to work. Recently, there were a lot of patients, and the teacher was worried that his expert number would be fired by scalpers, so he chose to work overtime. ”

At the level of Director Deyin, there is no need to undertake a lot of basic work.

The main thing is to take students, sit in clinics, hold meetings, and so on.

If you are the chief surgeon, you will need to have surgery in addition to sitting in the clinic.

From this point of view, physicians have a natural advantage in academics.

Surgery is above the majority, basically half a day of sitting consultation, half a day of surgery. It is also necessary to conduct ward rounds, take students, lead groups, and bring topics...... There's really not much time to spend on learning to recharge.

Many people feel that surgeons earn more than internal medicine.

This is very one-sided.

Surgeons are certainly able to earn overtime for their surgeries. However, the physician's drug fee is also quite a lot.

In the case of hospitalization, internal medicine can crush surgery.

One or two hundred thousand ICUs a day, that's a gold-swallowing monster.

Even so, many hospital leaders often scold the ICU as a money-losing department.

Under the leadership of Gao Jian, Zhou Can went straight to the outpatient clinic of the Department of Neurology.

There were still quite a few patients sitting in the aisle outside.

Tuya's specialist outpatient clinics are actually quite numerous.

The cheapest expert number is 50 yuan, and the most expensive special needs expert clinic number is more than 1000.

This world is very strange, but not many people want cheap expert numbers, but hundreds or thousands of expert numbers, many of which are seconds.

Now it's a little better, and I need to register my ID card.

The operating space of scalpers is much smaller.

In the past, there was no self-service registration machine, and when it was all operated manually, the good expert number was monopolized by scalpers.

If you want to see a doctor, you have to buy it from them.

It doesn't matter if you don't buy it, there are many patients who are willing to buy it at a higher price.

Because the patient simply can't afford it.

"Liu Yan, how many patients does Director Yin still have to read?"

Takami asks the nurse in check.

The role of these nurses is to guide patients in line, to maintain order, and to call numbers.

As long as the patient hands over the medical record book and registration slip to her, she will call the numbers one by one in the order of priority.

This prevents people from cutting in line.

Patients and their families simply sit on benches in the hallway to rest and wait.

"There are three more patients."

"Okay!"

Gao Jian nodded and looked at Zhou Can.

"There are three more patients, and you will have to wait about half an hour. I still have to work in the inpatient department, so I can't accompany you. ”

The trainees of the junior college are all very hard.

Managing patients, writing medical records, working night shifts, and doing all kinds of chores...... I can be so tired that I fall asleep with a pillow on my head every day.

"Go ahead and get busy! Thanks! ”

Zhou Can waved at him.

Fortunately, I met Gao Jian today, otherwise it would not be easy to find Director Yin.

After seeing Gao Jian leave, Zhou Can found an empty seat and sat down.

He found that many patients came to the clinic with various examination reports done at other hospitals. They couldn't find the cause at the local hospital, or the treatment didn't work, so they went to Tuya Hospital to find a specialist for diagnosis.

Zhou Can glanced casually, and the outpatient rooms inside were basically all expert outpatient rooms.

Director Yin Hua's room is hung with the sign of Special Needs Expert Outpatient Clinic No. 1.

There are at least six or seven clinics like this for specialists.

The four words that can be worthy of special needs experts are generally made significant achievements in a certain sub-discipline field.

After a rigorous review, only then can we be eligible to add the word "special needs".

Tuya's strength is still quite strong.

After all, just a subdivision of neurology, there are already so many top experts.

In the entire Tuya's weighted departments, the number of top experts is probably more than a hundred.

Many doctors have a lifelong wish to become top specialists.

In fact, it's remarkable that three or four out of a hundred doctors can become top specialists.

As long as Zhou Can continues to work hard like this, sooner or later, he will be able to sit in the outpatient room of special needs experts and treat patients as a top expert.

While he sat here and waited, he took out his mobile phone and looked through Qiu Jie's inspection report again.

One by one, look closely.

He even read some inspection reports more than ten times.

But nothing was discovered.

At about five o'clock, Director Yin finally finished the outpatient clinic.

Zhou Can hurriedly walked to the door and knocked on the door.

Yin Hua raised his head and saw Zhou Can, and couldn't help but be stunned.

"Xiao Zhou!"

"Director Yin, you said last time that I can ask you at any time if I have any questions. I'm really cheeky to bother you. ”

Zhou Can walked in with a smile.

"Welcome! Waited outside for a long time, right? ”

Director Yin's attitude towards him was quite enthusiastic.

Looking at this expression, he sincerely welcomed Zhou Can to come to him for advice.

"I didn't have to wait long, it was only about half an hour. But it's not easy to find you. I'm not familiar with neurology, so I'm asking around where you work. Luckily, I met Takami, and he brought me here. ”

Zhou Can didn't see anything outside.

walked over, picked up Director Yin Hua's empty teacup, and took the initiative to help him refill the water.

A small move made him instantly shorten the distance between him and Yin Hua.

Usually only students will refill the teacher's teacup in time.

It's a respect.

It also has the meaning of dedication.

"Next time you come to see me, one, three, five, I'll be here for an outpatient visit. During the day shift, most of them are in the inpatient office or minimally invasive operating room. You only have to go to these three places to find me. I really can't find it, just call me, do you have a number? ”

Dedication or effective drops.

Director Yin Hua took the initiative to give him his phone number.

This is not something that everyone can get.

"I don't have your number, it's convenient to report it to me, let me remember it?"

Zhou Can took out his mobile phone and got ready.

Director Yin reported his private mobile phone number, and Zhou Can wrote it down. It will be much more convenient to contact you in the future.

Famous doctors of their level, in order to reduce unnecessary trouble, generally do not give mobile phone numbers to irrelevant people.

"What questions do you want to ask?" I'll go to the inpatient department for rounds later, so hurry up!"

Director Yin is really busy.

When others came to him for medical treatment, they not only had to spend 800 yuan in registration fees, but also had to wait in line.

Because Zhou Can won his appreciation, he saved these things.

"I met a patient who had been paralyzed for several years because of a miscarriage. However, after visiting famous doctors, the cause of the disease was still not found. You're a top expert on nerves, and you're well-informed, so I wanted you to take a look. ”

Zhou Can clicked on Qiu Jie's inspection report, and then put the mobile phone in front of Director Yin.

"Some of her inspection reports are here."

Director Yin clicked on it, and a strange expression suddenly appeared on his face.

Zhou Can also noticed that Director Yin's expression was different.

"This patient came to me three years ago. As soon as you say that she was paralyzed by a miscarriage, I guessed something. Because there are so few such patients, it is difficult to have one miscarriage case in every 100,000 cases. ”

Thinking about it, Li Hao and his wife live in this city, how can they not go to Tuya to seek medical treatment?

As long as you arrive at Tuya Hospital, this kind of difficult neurological case will definitely be consulted by Director Yin in the end.

Although he diagnosed Qiu Jie three years ago, he still opened the patient's examination report to the public.

He looked very closely.

"I was deeply impressed by this patient named Qiu Jie. She committed suicide the day after she was admitted to the hospital, but fortunately the nurse found out in time. Unexpectedly, three years later, she still hasn't been able to find out the cause. ”

Director Yin sighed.

Hospitals are actually quite afraid of the dead.

Even if it is a normal death, it will increase the case fatality rate in hospitals. Not to mention this kind of suicide patient.

It will have a certain negative impact on the hospital, and it will bear the responsibility of inadequate management.

"When the patient was diagnosed, she had just had a miscarriage. At that time, my diagnosis was weaker and my experience was weaker. Thinking about it now, I fell into a misunderstanding at the time. I think she was in shock for too long, which led to a large degree of disease, coupled with complications such as co-infection, which caused natural paralysis. ”

"When she was examined at the time, it was found that the spindle was more sensitive to the stretch reflex than normal, especially the flexor and extensor muscles of the upper and lower limbs were very tentonic. The kind where the initial resistance is large, and then the resistance drops rapidly, and the kind that falls off a cliff. Based on the subtle results of these tests, I diagnosed her as a natural paralysis caused by a lesion and complications of infection. I think there is no cure. ”

Three years have passed, and after reviewing the information again, Director Yin still remembers the events of that year clearly.

Doctors are like this, when they encounter some difficult cases, it is easy to remember them for a lifetime.

First, because difficult cases are rarely repeated, and second, because of the painstaking efforts in the diagnosis process, the memory is particularly profound.

"Do you have a new discovery now?"

Zhou Can asked.

In the past three years, Director Yin's diagnosis level and experience have improved to a certain extent.

There may or may not be a new discovery.

"There are still no major discoveries. However, this inspection report of the Imperial Capital Hospital gave me a little idea. They performed an electromyography test on Qiu Jie's female patient. We Tuya can also measure EMG, but because the equipment is not so advanced, the detection cannot be as accurate as theirs. You see, in the EMG test, the conduction capacity starts to decay from here. There is still a weak signal to the base of the thigh, and I think that if this patient's lesion can be found, it will definitely be able to turn around. ”

Zhou Can can understand the common problems of electromyography.

But it is difficult for him to see things that are too advanced, or that require a combination of experience and medical knowledge.

It's kind of similar to a picture where someone can see two faces, someone can see seven, or even more.

According to the examination report and some clues of the patient's symptoms, you can see the abnormalities that other doctors can't find, which is the master, and this is called the level.

Zhou Can already has a very high talent in diagnosis, and when Yin Hua reminded him, his eyes lit up slightly.

"You're saying that if the EMG signal reaches the base of the thigh, it means that the patient's nerves are not completely necrotic. It's just that the nerve signal is severely attenuated and cannot be transmitted to the more terminal parts of the lower extremities. At the same time, because the nerve signal is already very weak when it reaches the base of the thigh, it is impossible to respond to limb movements. ”

As long as the nerves are not necrotic, there is still a chance.

Because nerve cells are the only non-regenerating cells, once they die, they are difficult to treat.

"Clever!"

Director Yin gave him a thumbs up.

This kid's talent and understanding are indeed very high.

A little bit is thorough.

"The patient's EMG attenuation is gradual, not precipitous, and in my experience, this is not much different from the outcome of neuronecrosis. Like an aging wire, its conductivity has become seriously problematic. Unless you get a new line, there's no way to fix it. ”

Director Yin shook his head and sighed.

This patient is simply incurable.

The nerves in the lower limbs are quite abundant, and I am afraid that no doctor can replace it with a new one.

Zhou Can was stunned, frowning, staring at the corner without speaking.

Director Yin noticed that Zhou Can didn't respond, and when he looked up, he couldn't help but laugh dumbly.

This kid is very much in the style of his time.

When he was delving into medical problems, he often plunged headlong into it, close to the point of going mad. After unremitting efforts, this has become today's status.

Director Yin did not interrupt Zhou Can's contemplation.

Instead, look down and continue to look at the patient's profile to see if there is anything more to discover.

After more than ten minutes, Director Yin was about to go to the ward round, and he was about to get up, leaving Zhou Can here to continue thinking.

At this time, Zhou Can had a result.

"Yes, yes, probably that's it."

He chattered, his eyes were bright, and his face was excited.

"You've made a new discovery?"

Director Yin had seen Zhou Can's alternative diagnostic ideas, so he didn't despise him because he was a trainee.

Speaking of which, Director Yin admired Zhou Can so much that he did not hesitate to open the door for him.

is also because of Zhou Can's alternative diagnostic thinking.

"I think this patient can be treated. Her EMG signal will decay all the way, do you think it has something to do with blood supply? Zhou Can asked, obviously with a major diagnostic discovery.

Why do paralyzed patients need to check an ECG?

What is checked is actually blood supply.

(End of chapter)