Zhou Can looked at the back of the mother and son leaving, his lips moved, and finally swallowed the words back into his stomach.

Instead, sighs.

The only thing in this world that can be earned without work is poverty. She and her husband slept at the card table all day, and they were doomed to the current result. This kind of inert thinking has been deeply ingrained in the couple's bones, and the only way to make them industrious and motivated is to be whipped by society, and persuaded by relatives and friends.

Their children are the hope that will save the family.

If the child's illness is cured, he will enter the school in the future and get three good students every year, it will be enough for the couple to see good hope. They feel that when their lives are on the rise, they should want to find a job.

Zhou Can sent the names, addresses and other information of the mother and son to Director Tang Fei.

“OK！”

She only replied with one expression.

It is estimated that it is very busy, after all, it is the director of a large department. The workload is much larger than that of the average chief physician.

Zhou Can had just finished sending a message to Director Tang, and a new patient came in to see a doctor.

He was like a spinning top that had been whipped, and he devoted himself to the diagnosis and treatment work.

I thought there would be fewer patients in the afternoon, but I didn't expect there to be an endless stream of patients, one after another.

By about three o'clock, he had already received sixteen or seventeen new patients.

I really didn't expect that there would be such a large number of consultations on the first day of the official consultation.

Fortunately, most of the patients treated were common diseases. So far, only the little girl with symptoms similar to a cold, but not a cold, has not been diagnosed.

After Zhou Can finished receiving the patient in his hand, he stood up and walked to the door.

"Are you busy now?"

He said to the nurse.

"Doctor Zhou's what's the matter, no matter how busy you are, it's not as important as yours!"

Most of the nurses are older and belong to a marginalized group.

There are many people who are recruited by the society, graduated from technical schools, and so on.

Their wages are low and their status is low. Even if it's just the most ordinary resident, it's the object they need to curry favor with.

The invisible hierarchical relationship of the hospital is actually very similar to the ancient feudal kingdom.

Those with low status will want to curry favor with people with high status in order to gain convenience and care at work. At the very least, I have a good relationship with you, so that you don't make things difficult for me at work.

This is the truest thought of the vast majority of people.

"Can you help me check if the patient who fainted in the morning has woken up?"

Zhou Can was still a little worried about the pair of grandparents and grandchildren.

"Ward 0, huh? I'll just call you and ask the nurse over there. What is the patient's name? ”

The nurse in charge seems to be familiar with the nurse in the inpatient unit.

Snakes have snake paths, rats have rat paths.

Even if she is just a very low-status guide nurse, she has her own network.

What exists is reasonable.

They are able to survive in a highly competitive hospital and have their own way of survival.

"I really didn't ask what the old lady's name was, I only knew that her granddaughter's name was Chen Ziya."

At that time, the old lady fainted directly, and Zhou Can didn't have a chance to ask her name at all.

"It's okay, I'll call and ask the nurse over there to find out."

The nurse smiled and took out her mobile phone and began to look through the phone number.

"Then it's hard for you!"

Zhou Can has a good impression of this nurse, who is quick and has a good attitude.

"Come on, who's going to see a doctor next? Come on in! ”

Zhou Can looked at the patient sitting in the corridor waiting for treatment.

"It's me, it's me!"

A woman holding a child stood up and followed Zhou Can into the consultation room.

"You may be seated!"

Zhou Can beckoned the woman to sit down, and his eyes naturally fell on the child she was holding.

The people who come here are all children, and occasionally babies are a few months old, but such patients generally do not seek treatment from young doctors like Zhou Can, at least they will be called deputy directors.

Unless there is really no number, then a general outpatient number will be listed.

The child in the woman's arms looked small, with her head buried in his mother's arms, and did not move much.

When Zhou Can saw that the skin on the little boy's neck and other places was purple, his pupils shrank.

He was about to sit down, but quickly stood up again.

"What's wrong with this kid?"

"I just don't like to move much, and I eat very little." The child's mother seemed very calm.

"Has his skin always been this color?"

The skin of this child's whole body was a little blue, and Zhou Can first felt that this child's body was deprived of oxygen.

But the child's mother is very calm, indicating that this situation is not a day or two.

"That's right! My son was born with a reddish-purple skin. Later, as I grew older, the color seemed to get darker and darker. Many friends and elders joked that my son's life is precious, and Zi Weixing was born! ”

The woman replied with a smile.

Zhou Can was speechless for a while, he was really fearless for the ignorant.

The cyanosis of the skin has become like this, it is obviously caused by lack of oxygen, how can it be that life is expensive?

"His breathing seems to be a little heavy!"

When Zhou Can heard the boy gasping for breath, there was a loud noise.

Explain that the boy needs to inhale hard to maintain the body's oxygen needs. In fact, this is also a manifestation of hypoxia.

When normal people do some strenuous luck, because the oxygen in the blood is rapidly consumed, the body's demand for oxygen increases, so they will instinctively "whew" and gasp for breath.

"My friends said that my son's lung capacity is strong, which is why he breathes so heavily. My son is born to be extraordinary! ”

The child's mother praised her son a little proudly.

Zhou Can was speechless for a while.

What is the confidence of the fan?

This woman is probably a model of this.

When her friends see their children, they must say something nice, do they say that there is something wrong with her children when they meet? Believe that there are no people with such low emotional intelligence.

Others flattered her, but she took it seriously.

"I came to see the doctor this time because the child doesn't like to move and eats less, right?"

Zhou Can asked about the child's condition while measuring the child's physical signs.

"That's right! There are only these two minor faults. Doctor, do you say that my son is too noble because of his natural personality, so he will be like the emperor on TV, pampered and not like to move every day? ”

The woman's logic is really convincing.

It's simply breathtaking.

"Well, it's possible." Zhou Can actually nodded very cooperatively.

This kind of person must not argue with her, otherwise it will be easy to quarrel.

In her words, this is a wiser thing to do.

The doctor's purpose is to treat the disease, not to correct some of the family's opinions.

In fact, every adult's thinking is extremely stubborn, and you must not think about changing it. Otherwise, not only will they not be able to change each other, but they will also become enemies.

"Then you said, my son doesn't like to eat, is he born with the emperor's life?"

This woman is really brainy.

"Why?" Zhou Can asked her rhetorically.

"You think! The emperor eats delicacies from the mountains and the sea every day, so ordinary food can't satisfy his appetite at all. The woman replied with a serious face.

"Yes, you're right. In the future, you can get more delicacies from the mountains and seas for your son to eat. You see, he's so skinny, and from our doctors' point of view, it's called malnutrition. ”

Zhou Can persuaded the young mother from the side.

Looking at the age of thirty, it should be almost the same, why is the idea still so naïve and naïve? I really wonder if she has watched too many TV series.

After a preliminary physical examination, Zhou Can found that the little boy was stunted, malnourished, severe cyanosis all over his body, clubbing, screaming sounds between the intercostal spaces when breathing, low blood pressure, and weak pulse......

There is a big problem with the child's body.

"Has the child had a medical check-up?"

"Done it once. The young doctor at the community health service station who did the physical examination talked nonsense that my child might be seriously ill, and I scolded him. I haven't taken my son for a medical check-up since. My son is so great, how can he be seriously ill? Some doctors like to scare people, just to trick patients into buying more medicines. ”

When the woman mentioned this, she was still indignant.

Zhou Can couldn't help but wipe the cold sweat that broke out on his forehead.

Fortunately, I didn't argue with the woman just now. Otherwise, he would have been the next person to quarrel with the woman.

"When I was measuring your child's heart rate, I heard a screeching sound. I'll give him a cardiogram first, and you take him to a 2D echocardiogram. ”

Zhou Can said to the family.

"Okay! Do you say my son's problem is big? ”

The woman's conversation with Zhou Can before was quite pleasant, so she agreed very happily.

"It's hard to say, let's see if there is a heart problem first!"

Zhou Can felt that there must be a big problem with this child, but the doctor at the community medical service station was scolded for telling the truth. How dare Zhou Can tell the truth again!

Everything will wait until the results of the examination are available.

When the time comes, with the inspection data as support, no matter how big the truth is, it can be justified.

After the mother and son were sent away, a new patient walked into the consultation room.

"Please sit down and wait a moment while I check the results of one of the patient's tests in the morning."

After Zhou Can greeted the family members and patients, he directly looked for the little girl named Chen Ziya in the consultation system.

Tuya Hospital has now realized information networking. After the test results come out, the laboratory will be transmitted to the hospital intranet, and the patient or family member can print it with the ID card information.

It's much easier than before when you had to rummage through a large collection of materials in the window.

The attending doctor can view all the patient's examination results directly in the system. It's just that many doctors will wait for the patient to come in with a paper test report before looking at it.

On the one hand, doctors are very busy with their work, and they don't have time to go to see them one by one.

In addition, if the patient is not present, even if the doctor diagnoses the cause, he or she still has to wait for the patient to come and talk to him in person.

It is by no means the coldness and laziness of the doctor as the family thinks.

Zhou Can quickly found Chen Ziya's name.

After clicking on it, he found that the results of the little girl's biochemical test had finally come out.

The LDH, CK, AST, and ALT data were all higher than normal. Among them, the value of aspartate aminotransferase is even more frighteningly high.

"What kind of disease could this be?"

After reading the results of the biochemical examination, his mind quickly screened for diseases that might be the right number.

However, he racked his brains and still could not find a disease that matched these symptoms.

At this moment, he really hates less when he uses books.

The basic medical knowledge is so vast that it is almost impossible to learn it all. The main thing is that a doctor's energy and time are limited.

Learning is a long process.

He still insists on reading every day, and he is making up for basic medical knowledge every day.

This is not in a hurry, it can only accumulate over time.

Otherwise, why do doctors get older and more popular? Because some doctors really live to learn. Well-informed and experienced, their diagnostic efficiency is indeed much higher than that of young doctors.

If there is a misdiagnosis, the probability of missing a diagnosis is also much lower.

"There is a decrease in white blood cells and platelets, and at the same time, there is protein in the urine, and now the aspartate aminotransferase is also frighteningly high, is it poisoning?"

There is such a possibility.

Because symptoms similar to those of the little girl have also begun to appear in the little girl's grandmother.

The grandparents ate poisonous food and became poisoned, which is a real possibility.

At that moment, the door to the examination room was pushed open, and the nurse poked in a head.

"Dr. Zhou, what you asked me to ask has already been asked. The old lady had woken up and her symptoms had eased. She is worried about her granddaughter's condition and asks to come to you. ”

It's good that people have woken up.

"You tell the old lady that you don't have to come over yet, I'm diagnosing her granddaughter here. When the cause is found out, I will take the initiative to go to her. ”

Zhou Can was still a little worried about what kind of infectious disease his grandparents and grandchildren had.

In the event of transmission, it can cause serious harm to other patients and their families.

Besides, the cause of the little girl has not yet been found, and it is useless to come to him.

If it is indeed poisoning, the infectious disease can be ruled out.

"If it's not poisoning, what could it be?" After thinking hard, Zhou Can's eyes couldn't help but light up slightly.

How did you forget about this stubble?

If food poisoning is not happening, there is another possibility, and that is a viral infection.

As long as one of the grandparents is infected, it is possible to infect the other.

The more I think about it, the more it makes sense.

Either way, it's always a good idea to screen first.

To screen for viral infection, serological testing is a more effective method.

He immediately opened a test request and gave the patient a serological test.

After the treatment, the next step is to continue to see other patients.

When it was close to half past four, he took the time to take a look at Sun Ziya's serological test results, did it come out?

Luckily, the results are already in.

Positive for Igm antibodies and Igg antibodies.

Both of these numbers are elevated and the antibodies are positive, which means that the patient is likely to have been infected with a viral drug.

In general, after a patient is infected with a pathogenic microorganism, the body produces specific antibodies against the pathogenic microorganism, and IgM and IgG will be positive.

Zhou Can couldn't help but be excited, now it can basically be diagnosed, and the patient is very likely to have a viral infection.

A cold can usually be an infection with the flu virus, which is also a viral infection.

But Zhou Can directly ruled out the influenza virus infection. Because the patient's examination data clearly do not match the flu.

IgM is elevated and may be seen in macroglobulinemia and primary biliary cholangitis.

Significant elevations in IgG are common in autoimmune diseases.

In both cases, monoclonal elevation and significant decrease in other immune blood proteins are likely to be multiple myeloma.

Zhou Can insisted on his own diagnostic direction, that is, he determined that the patient was likely to be infected by a virus. And it's a relatively rare virus.

If it was a common viral infection, it would not be difficult for him at all, and he would have been diagnosed 800 years earlier.

"I'm afraid I'll have to check the information!"

After he couldn't figure out what kind of virus the patient was infected with, he decided to learn from his predecessors. When Director Dai first sat in the clinic, didn't he also bring a children's clinical manual, and secretly flipped through the book when he encountered an unsolved disease?

Now he has encountered a very difficult case, and there is nothing to be ashamed of when he looks up the information.

Thanks to the rapid development of smart phones and the Internet, doctors no longer need to secretly carry thick medical books into the outpatient room to check information.

Just use your mobile phone to find relevant information on the Internet.

However, there is a lot of medical knowledge, and it is still faster and more convenient to look up some specialized medical classics.

After some searching, a relatively rare disease came into his field of vision.

Novel bunyavirus.

Patients infected with the virus may experience a variety of symptoms. These include fever and thrombocytopenia syndrome.

"It's supposed to be this disease! If an etiological test can be done, the diagnosis will be more accurate. ”

Looking at the time, Zhou Can suppressed his eagerness to tell the patient the diagnosis conclusion, and then applied to the laboratory for pathogenic testing. In fact, this is also a serum check. Only this time the new bunyavirus was isolated directly from the serum.

(End of chapter)