"When Director Liu chatted with me, he mentioned you more than once. At the beginning, he promised to accept you as an apprentice and teach you personally. However, when several major departments selected general practice trainees, they were selected by the emergency department. You also know that the competition between departments is very fierce, and the interests are intertwined. Lao Liu is only the deputy chief physician, and he is in a position that is not up or down, and he has no ability to take you from the emergency department. ”

Director Jia's personal relationship with Liu Lao seems to be very good.

Otherwise, it would be impossible for the two to talk about these topics.

Liu Lao's status in general surgery is okay, but if he is placed in the entire Tuya Hospital, he may not be ranked well.

In these years, doctors who have not made much achievements in academics, even if they have rich experience in diagnosis and treatment, their status is generally not too high.

The status of a doctor is determined by three key factors, first, the ability to perform surgery or the ability to diagnose and treat. Able to cure diseases, able to overcome some incurable diseases, and extremely good at a certain field.

Such doctors are often famous doctors and experts in a certain field.

They have a lot of influence and can bring a large number of patients to the hospital.

Such a doctor belongs to the banner of the hospital and has a transcendent status.

Even if the academics are not good, it still does not affect their status in the hospital and the industry.

Second, academic achievements are remarkable.

There are many important journal and core journal papers published, and at least one of them has caused a sensation in the industry. It even leads the industry trend and creates a precedent. Or the scientific research achievements are outstanding.

Such doctors often hold senior teaching positions in medical schools, and basically start as third-level professors.

The most common and common is also a third-level professor.

As for those who can mix with first-class professors, they are often at the academician level.

Not only do they have a very high status in hospitals, but they also have a high status in society even in academia.

That's why all doctors, whether they're that material or not, spend a lot of time studying academics.

Since ancient times, there has been a law that everything is inferior, and only reading is high.

The same applies to the profession of doctors.

The third type is that the administrative position is high, or there are people above it.

This one is not explained.

No matter how good a doctor is, he is a younger brother in front of this kind of person.

Of course, everyone generally respects each other and lives in harmony.

Liu Lao's academic achievements are difficult to describe, and his surgical ability can only be said to be above the level, and his rich experience in diagnosis and treatment can barely be regarded as an advantage. It's just that at the level of deputy director, which doctor is not experienced?

Therefore, Liu Lao's status in the hospital is relatively poor.

It can't be compared with big guys like Wu Baihe, Yin Hua, and Hu Kan at all.

With his status, he really has no power to transfer a general practitioner selected by the emergency department.

At the beginning of the operating room, Liu Lao just said casually that he wanted to train Zhou Can himself.

Even Zhou Can didn't dare to take it too seriously.

Unexpectedly, the person who said it always remembered this promise.

"Lao Liu asked me to teach you, which can be regarded as an indirect fulfillment of the promise he made to you, I hope you can understand."

Director Jia said to him again.

"I understand! Thank you, Mr. Liu, for always remembering me as a little person. Thank you for your willingness to teach me personally. ”

Zhou Can expressed his attitude very seriously.

"From today onwards, you can stay with me whether I'm sitting in a clinic, operating on a patient, or doing ward rounds. As long as you have the ability, you can go on at any time. If you don't understand something, you can ask me directly. ”

Director Jia's meaning is basically to tell Zhou Can that he will do his best to take him.

And give Zhou Can the greatest freedom of development.

This kind of treatment is something that no regular trainee dares to think of.

For Gui Peisheng, being able to get the appreciation of a chief physician is already a big luck, and the ancestral grave is smoking. To be able to get the full cultivation of the chief physician, the probability is similar to buying a lottery ticket.

"Knock knock!"

At this time, a rather young and beautiful female doctor stood at the door and knocked.

"Director Jia, it's early! Is it convenient for you to go over to the ward rounds now? ”

The female doctor asked with a smile.

"I'll be right over! Qiu Hong, I have a new student, his name is Zhou Can, and he has just been transferred to the Department of Digestive Surgery. If there is anything he doesn't understand in the future, you can help him more. ”

Director Jia is obviously very familiar with this female doctor.

After the introduction, he looked at Zhou Can again.

"Her name is Qiu Hong, and she has been studying with me for almost five years. He has attained great achievements in the fields of gastritis and ulcerative enteritis in digestive surgery. The diagnosis of various malignant diseases, as well as the surgical program for diseases of the digestive tract, she has reached a considerable level. ”

Director Jia was quite satisfied with this female student and gave a high evaluation.

"Hello Senior Sister Qiu, please take care of me in the future."

When Zhou Can should have a sweet mouth, he will never be rigid.

Senior Sister Qiu directly exchanged for the happy smile of the female doctor.

"Hehe, you don't recognize life. Director Jia rarely brings regular trainees, and you should be the first regular trainee he brings after he is rehired. However, I have heard of your name, and it is said that it can be on a par with Dr. Du, a returnee. I'm looking forward to seeing what you're really capable of! ”

She smiled and winked at Zhou Can, looking at Zhou Can with a curious and probing gaze.

Unfortunately, she was soon disappointed.

Because Zhou Can looks a little handsome, a little handsome, and he can't see the demeanor of any master.

The dress under the white coat is also very casual.

The lower body is a pair of casual sweatpants, and the feet are also casual shoes. Compared with Du Leng's well-dressed clothes, the gap in image is still quite large.

Du Leng wears a formal dress every day to work, and suits, leather shoes, shirts, and ties are almost his standard outfits. The hair is also meticulously groomed, and it is properly dressed as a social elite.

"Senior Sister Qiu, don't look forward to it, because I'm afraid of disappointing you. It's good that you treat me like an ordinary trainee. ”

Zhou Can said with a humble smile.

"You say it's ordinary, but your performance isn't ordinary! Male doctors as young as you are generally very good-looking and have a strong sense of self-esteem. They like to be complimented, but you're the opposite of them, thinking only about how to keep a low profile. Under Director Jia, hiding clumsiness has never been popular, if you have any real skills, you must use them. Only in this way can Director Jia help you point out potential problems. ”

Qiu Hong didn't buy his account at all.

This female doctor is not easy to fool.

"Xiao Zhou, you really don't have to deliberately hide it, whether you follow me to do ward rounds or sit in the clinic, as long as you don't provoke doctor-patient disputes, you can casually express your views and opinions."

Director Jia also told him that there was no need to be too low-key.

"Understood!"

Zhou Can is very smart, when to show his skills and when to hide his clumsiness, he has never been ambiguous.

When he first entered the Department of Digestive Surgery, as long as he had the opportunity to make meritorious contributions, he would definitely seize the opportunity to perform well.

"Let's go, let's go to the ward!"

Director Jia was the first to stand up and staggered outside.

Qiu Hong naturally stepped forward to support him.

Looking at the age, Director Jia must be over sixty years old. But you need someone to help you walk, which is really a bit unexpected by Zhou Can.

Even if you are working as a light manual laborer, it is difficult to tell your real age from your appearance.

The man has forty-one flowers, but he is not called for nothing.

As soon as I walked to the corridor around the corner, I saw more than a dozen doctors and nurses standing there.

Among them, there are many middle-aged and elderly doctors over the age of 50.

It seems that Director Jia is quite popular in the digestive surgery.

Zhou Can actually doesn't like this mode of ward rounds, because of his low status, following the director's rounds is more like a walk-through.

After entering the ward, he found that Director Jia's ward rounds were more direct.

He doesn't check ordinary beds.

Only key beds are checked.

Go straight to bed No. 3 and stand still.

On the bed lay an old man with a withered face, pale lips and bloodless lips, and deep-set eyes.

"The third patient, a 71-year-old male, had a history of recurrent abdominal pain for 17 years. About three months ago, the condition began to worsen. Five days ago, I fainted many times in pain, and finally came to our hospital for treatment after four days of black stool. ”

As soon as the doctor in charge of the bed introduced the basic situation of the patient, Zhou Can became interested.

Diagnosing a variety of cases, this is his favorite.

Pathological diagnosis and traceability, this is one of his best areas.

A history of abdominal pain for nearly two decades indicates that the patient must have a chronic condition.

This type of disease is generally not fatal.

Many people live with the disease by taking medications to relieve their symptoms.

In fact, more than 90% of people over the age of 30 in China have various chronic diseases. Just because it does not affect life, it will not bring particularly serious consequences, such as unbearable pain, life-threatening and so on. So many people are living with the disease, and they have never even undergone any treatment.

If nothing else, just a fungal skin infection is the most common disease in the vast majority of middle-aged and elderly people.

For example, ringworm of the hands and feet, tinea capitis, itchy vulva, beriberi and so on.

As for chronic gastritis, enteritis, diabetes, high blood pressure, asthma, etc., it is also very common.

Tumors and polyps are also chronic diseases.

The patient has abdominal pain and a recent appearance of melena, suggesting gastrointestinal bleeding.

The lesions are likely to be in the stomach and intestines.

"Six days ago, the patient had abdominal pain and various malaise, nausea, and vomiting contents twice without obvious cause. No coffee-style blood, no significant bloating, no significant acid reflux, no heartburn. Then there was fainting again, and after the fall, fecal incontinence. More than 200 grams of black stool was discharged, no convulsions, no foaming at the mouth, and then it didn't take long to wake up on its own......"

This case is puzzling and challenging.

No wonder Director Jia focused on this patient for the first time.

After that, the patient had another black stool and a positive test for occult blood. and accompanied by vomiting. The patient's urine is not yellow. He was admitted to the hospital with duodenal ulcer and hepatosplenomegaly. ”

Judging from the patient's symptoms, it does look like a duodenal ulcer.

Hepatosplenomegaly also needs to be included in the diagnosis.

"When the patient had abdominal pain before, he had taken primetalin intermittently, and the stomach was flattened. Symptoms can be effectively relieved after each dose. ”

This is the case for most people with chronic diseases.

No one wants to be hospitalized.

Buy some medicine and deal with it.

"The patient had been treated at a local hospital 11 years ago and was diagnosed with duodenal ulcer with superficial gastritis. He was discharged from the hospital after treatment. ”

"The patient currently has a temperature of 36.8 degrees, a pulse of 76/min, and a blood pressure of 120/80 mmHg......"

The doctor in charge of the bed told the patient's basic situation, past medical history, and treatment history.

Zhou Can stood at the end of the bed, and several resident doctors and trainees could only watch from afar. In fact, he would like to take a look at the patient's examination report and then make a comprehensive diagnosis.

Now, I can only listen to Director Jia's opinions.

Director Jia finally diagnosed the patient with duodenal ulcer and arranged for surgical treatment.

For many gastrointestinal bleeding disorders, surgical treatment is the only cure.

"Bed 13, male, 45 years old, felt discomfort in the upper abdomen, felt nauseous and stuffy, and suddenly vomited a large amount of blood with food residue......s in the stomach two hours ago"

This bed patient is another dangerous case.

Basically, the patients who are hospitalized are those with such acute and severe diseases.

Zhou Can felt at first glance that this person's face was pale, dull yellow, and a typical anemic appearance.

And there is a high probability of liver disease.

In particular, the patient's palm, which is clearly the palmar of the liver.

This hospitalization should be classified as acute upper gastrointestinal bleeding.

The patient's current blood pressure is very low. It should be related to vomiting blood.

Surgery must be scheduled as soon as possible.

After checking two patients in a row, Zhou Can had a general understanding of digestive surgery.

The amount of surgery here is very large, and it seems that in the next two months, as long as Director Jia is really willing to give him power. I'm sure I'll be able to earn a lot of experience in surgery.

You don't have to think about doing the surgery alone, but you can work hard to get involved in the important part of the surgery.

When the time comes, Director Jia will be on his side to guide, and he will be able to quickly accumulate surgical experience in digestive surgery.

……

After the ward inspection, Director Jia gave guiding opinions to those key patients.

For example, medication guidance, temporary treatment guidance, and then review the surgical schedule of these patients.

For emergency patients, whose lives are in danger, surgery will be prioritized.

I thought that Director Jia would take them into the operating room for surgery immediately, but I didn't expect Director Jia to take Zhou Can and Qiu Hong directly to the outpatient clinic for consultation.

Sitting with the chief physician is something that Zhou Can wanted before, but couldn't get.

Because he has not yet obtained his double certificate, it is impossible for a senior doctor to take a person like him with him.

Unless he pleaded with a dead face, the senior doctor would consider taking him once or twice.

Now it's different, Director Jia said when he talked to him alone, and Zhou Can can follow him every day for consultation and surgery.

It seems that Zhou Can's pathological diagnosis experience value can finally rise.

His pathological diagnosis is currently at the fourth level, and the attending physician is inferior.

This level is definitely incomparable with that of the chief physician.

But much better than the average resident.

The three of them came to the outpatient room, and they actually entered the 1st room of the special needs specialist outpatient clinic.

Good guy, it seems that Director Jia's status in the Department of Digestive Surgery is much higher than he imagined!

During the ward rounds just now, listening to Director Jia's diagnosis of those patients and the treatment plan given, I can also get a glimpse of Director Jia's strength.

Other doctors rarely use affirmative tones when they explain treatment options to patients during ward rounds.

When Director Jia faced the patient's inquiry, he answered in the affirmative with great confidence.

"We can treat your disease, and the recurrence rate will not exceed 1%."

"You can cure this disease, don't worry, I've done many cases, and there are no ones that can't be cured."

Look, this is the confidence that Director Jia showed when he spoke.

After hearing this, the patient felt as if he had taken a reassuring pill.

If there is no real skill in hand, what doctor would dare to say such a certain thing to patients and their families?

"Xiao Zhou, the outpatient clinic has a large number of consultations, and every patient who comes to see a doctor has different demands and conditions, so you must listen carefully and think carefully. If you have a question that you don't understand, you can ask me again after the patient leaves. ”

Director Jia was afraid that he was too young, and when he was treating patients, he asked all kinds of untimely questions.

"Okay, understood!"

Zhou Can looked a little absent-minded.

Because during the ward rounds just now, the patient in the third bed made a deep impression on him.

Although he didn't check the patient's specific examination report, Zhou Can recently made up for the basic knowledge of medicine in many fields. These include immunology and digestion.

Director Jia ordered the patient to have duodenal ulcer, which was consistent with the diagnosis of the attending doctor.

However, Zhou Can felt that the patient's disease was probably not as simple as it seemed.

This is related to the fact that Zhou Can worked in the intensive care medicine department for three months.

He comes into contact with a large number of terminally ill cancer patients every day.

In many ways, the patient gave him an instinct that looked like cancer, not a simple ulcer.

(End of chapter)