"I'm a doctor in the anorectal surgeon, my name is Yang Zhi, and I've been working in the operating room for almost six years."

The man reported his origins.

"It turned out to be a doctor in general surgery. I heard that after the reform of general surgery, many departments have developed quite well! Many people still want to go in, you have been working in the operating room for six years, and you are also an old comrade, why do you want to come out? ”

Zhou Can felt very puzzled.

In terms of qualifications, this person is still Zhou Can's predecessor.

It's just that in any unit, it is always easy for the capable to get ahead. The mediocre and the unscrupulous are mixed into the old, and they are just low-level employees. I haven't heard of any unit that assigns positions to employees according to their seniority.

Zhou Can's surgical ability far exceeds that of ordinary doctors, so he rises very quickly.

At a young age, he was already the number two person in the operating room of the emergency department. If it weren't for the lack of seniority, it would be possible to even become the number one person directly.

"Alas, you don't know, some people are happy and some are sad. Several major subspecialties are indeed getting better and better, and our anorectal surgery and gastrointestinal surgery have a number of overlapping businesses. Director Mi of our department is too responsible, and he has failed to seize the opportunity in many rounds of competition, and has now been squeezed almost miserably by the gastrointestinal surgery. I really couldn't see any hope, so I wanted to find another way. ”

Yang Zhi sighed, his words full of bitterness.

The head of a department is equivalent to the leader of the flock. Whether this flock can eat the tender and fat green grass or gnaw the mud depends on where the leader leads everyone.

Development strategy, means, personal ability, department professional level, department cohesion...... There are too many factors that can affect the development of a department.

If there are many decision-making mistakes in the development of the department, or the means are insufficient, the decline of the department is almost a certainty.

Yang Zhi was unfortunate and met a department director who had a good level of surgery but poor leadership skills.

Looking at his sad face now, I'm afraid I don't even have soup to drink.

The Department of Gastrointestinal Surgery, formerly known as Digestive Surgery, is an incomparably powerful specialized department.

Anorectal surgery has to compete with gastrointestinal surgery, and I am afraid that I can only sigh to the sky, both Shengyu and He Shengliang.

"What will I do if I don't agree to accept you?"

After Zhou Can asked the reason, he unexpectedly asked Yang Zhi a tricky question.

"I personally have a deep affection for Tuya, and I am also optimistic about Tuya's future prospects, and if I can stay, I will try to stay. For a middle-aged man like me, making money is definitely also very important. The emergency department is currently in its initial stages of development and should be in great need of a variety of talents. To be honest, although Tuya recruits a group of very good general practice trainees every year, there is still a shortage of surgical talents. Because the training cycle of surgical talents is generally long. ”

Yang Zhi calmly analyzed the current situation.

As he said, there is a shortage of surgeons in any surgical department. Now, including the internal medicine department, they have also begun to compete for talents with good interventional talent and strong endoscopic surgery ability.

Pilots are admittedly difficult to train, but surgical talents are even more difficult than pilots.

In recent years, the emergency department has indeed been able to assign one or two general practice trainees every year.

is similar to Zhou Can, who was killed from thousands of troops, and only one or twenty people were selected from thousands of people.

Every one of them is the best of the best.

This is also an important part of Tuya's talent construction.

It's a pity that the emergency department is poor and white, and there is nothing to do, and there is no way to keep people. By the end of the training, there were very few people willing to return to work in the emergency department.

This has further contributed to the shortage of talent in the emergency department.

Always picking up doctors eliminated from other departments, how strong do you say it can be?

Run away from an elite general practitioner and then add in an eliminated doctor in a specialist department. This is the reality of the emergency department.

"If Dr. Chow doesn't catch my eye, that's okay. I'll go to other departments to find a way. In case other departments also reject me, then I will consider changing jobs to other hospitals. ”

Yang Zhi has a clear life plan for his future.

A strong sense of purpose.

"That's fine, you can come to me tomorrow or the day after tomorrow to help out for a while. Tomorrow is Wednesday, and I won't be working in the operating room until after 5:30, and the day after tomorrow, from 8 a.m. to 6 p.m. ”

Zhou Can has always wanted to find a better medical helper, and now the one delivered to the door seems to be quite reliable, so he is ready to find out the bottom first, and then decide whether to accept it or not.

The strength of the surgical ability can be known by simply trying it in the operating room.

If the surgical ability is poor, or the work attitude is not good, then it will definitely not be accepted.

His team has grown to this day, and it is relatively stable.

Luo Shishen's internship period is about to end, and he will definitely go to participate in the regular training at that time. Because the training certificate is one of the necessary documents for every doctor to rise.

It is as important as a medical certificate and a doctor's qualification certificate.

However, Luo Shishen also expressed his position early and begged Zhou Can to leave him a seat. When his training is over, he will find a way to return to Zhou Can's team work.

In the past year, he followed Zhou Can for surgery and learned a lot.

At first, it was stupid to even pull a hook.

When he encountered a patient's sudden convulsions, ventricular tachycardia, and even cardiac arrest, and needed to be rescued, he panicked so much that his brain went blank. Until now, after Zhou Can's one-year teaching by words and deeds, his abilities in all aspects are no longer the same.

Putting it in the interns of the same period, it is definitely like opening a hanging.

Especially the ability to operate.

Many interns may not have even been able to perform a single surgery to close the abdominal suture until the end of their internship.

Luo Shishen is now able to close the abdominal cavity proficiently.

Under the guidance of Zhou Can, the level of sutures has almost improved by leaps and bounds.

After sending Yang Zhi away, Zhou Can went back to the lounge of the operating room to hurriedly pick up food and fill his stomach. There are still surgeries waiting for him to be done in the cardiothoracic surgery department.

……

It was close to eight o'clock, and Zhou Can appeared on time in the operating room of the cardiothoracic surgery.

After a year of growth, Director Xueyan's surgical ability has been quite powerful. Just do some major surgery, she will still invite Zhou Can over to escort her.

In the operating room, there are basically old acquaintances.

Even the anesthesiologist is very familiar with Zhou Can.

"Doctor Zhou, can I go to the intensive care unit to help see a patient who has just had a lobectomy after the operation?"

The one who made the request to him was Deputy Director He.

Under normal circumstances, Deputy Director He rarely performs surgery with Director Xueyan.

Tonight's surgery is a cardiac surgery, and Deputy Director He usually only focuses on chest surgery, and he is so old that he does not have the time and energy to learn about cardiac surgery again.

Then there is only one possibility, to wait for Zhou Can here.

"What's wrong with that patient?"

Zhou Can asked.

Patients who need postoperative monitoring are generally critically ill and major surgeries.

It's definitely a bad one.

Deputy Director He's surgical ability and diagnosis and treatment ability are quite good. The experience is also very rich.

Being able to force him so late, and making a special trip to wait for Zhou Can in the operating room, shows that the patient's condition is far more complicated than imagined.

Resection of lung lesions is extremely common in thoracic surgery.

The number of smokers in our country remains high, and the number of victims who are forced to smoke second-hand smoke is even more alarming. If you meet a man who does not pay attention to the safety of his family, he may smoke alone, causing the whole family to be forced to smoke second-hand smoke together.

You know, secondhand smoke is much more harmful than direct smoking.

In addition, smog has also caused a serious decline in air quality, and the high PM25 index is a major factor in the high incidence of lung diseases.

PM25 refers to particulate matter in the atmosphere with a diameter of 2.5 microns or less, also known as particulate matter that can enter the lungs.

It is an important culprit in the high incidence of asthma and lung cancer.

Especially in developed cities in the north, many people must wear masks when they go out. If possible, install an air purifier at home in order to deal with PM25 in the air.

"The patient had persistent alveolar air leakage and was in a very unsatisfactory condition. I'll tell you more about it when the surgery is over. ”

Deputy Director He was very knowledgeable, and he didn't dare to delay Director Xueyan's operation.

Now, a year has passed, Director Xue Yan not only has a strong surgical ability, but also the entire department has taken on a new look under her management, showing strong viability and cohesion, and unprecedented unity.

Talent training is also very good.

Zhou Can's three good strategies proposed to her at the beginning were all implemented by her.

"Zhou Can, Director He hasn't left after work for this matter! You see, why don't you let Deputy Director He go to the duty room to rest for a while, and then you can go to him when the operation is over. Don't let him stay up all night with us and suffer. ”

Director Xueyan and Zhou Canqing are like sisters and brothers, have a close relationship, and they don't have any worries when they speak.

It's very straightforward.

"Sins, sins! It's really flattering to let Director He wait for me like this. "The necessary polite words still have to be said." You go to the duty room to rest first, and I'll come to you after the operation. The surgery is estimated to take as little as three hours. ”

Zhou Can felt that although Deputy Director He had many shortcomings, he was very responsible for the patients.

This is particularly admirable.

Then again, he is only responsible for the patients he manages.

This really can't rise to the height of medical ethics. Under the high pressure of various regulatory systems, Deputy Director He is afraid of accidents and is highly responsible for patients, which is also the real working state of many doctors today.

As soon as some patients enter the hospital, they question the doctor and question that, and the medical compliance is extremely poor.

I really don't have to do that.

Unless you really encounter a very unreliable doctor.

Otherwise, I believe that no doctor will risk ruining his job and come to harm patients.

In some small and medium-sized hospitals, doctors have certain task indicators, prescribing more drugs to patients that have no harm in eating and have average treatment effects, and prescribing a few more examinations, which is also for survival.

When encountering patients who are self-paying, doctors generally try to prescribe drugs and examinations as much as possible.

Patients with medical insurance, everyone who understands this.

The current environment is like this, if you don't make money from medical insurance, the vast majority of hospitals will go out of business.

At that point, it will be more difficult for ordinary people to see a doctor.

Deputy Director He is old, and he really can't stay up late like young people like them. Hearing this, Zhou Can opened his mouth and immediately left the operating room happily.

Zhou Can picked up the patient's information and began to quickly check it.

"This patient's illness is a bit tricky! I thought it was just an ordinary congenital heart disease, but I didn't expect it to be tetralogy. ”

"It's not tricky, and I won't invite you here. I know that your day in the emergency department is also very heavy. As long as we are sure of the operation ourselves, we will try not to call you over to help. ”

Director Xue Yan replied with a smile.

"Sister Yan can call me at any time if she has something, don't worry about me being tired from work."

Zhou Can could feel her thoughtfulness.

Tetralogy of Fallot is the most common type of cyanotic congenital heart disease.

Without surgical intervention, patients typically do not live to be seven years old. The average life expectancy of a child with this disease is only about 12 years.

It manifests primarily as cyanosis at three to six months of age.

Cyanosis can occur on the face, lips, nails, fingertips, and even the entire body.

Cyanosis is especially severe when children cry.

In medicine, the disease has been incurable before. Later, some doctors pioneered cardiac surgery, and continued to explore, and finally found a surgical method to treat this congenital heart disease.

The so-called tetralogy of Farlot refers to pulmonary artery stenosis, ventricular septal defect, aortic straddle, and right ventricular hypertrophy.

Any one lesion is enough to call it congenital heart disease.

The integration of the four diseases also increases the difficulty of treatment by geometric multiples.

Surgery is the only option for the treatment of this disease.

Without surgery, children are very susceptible to death.

Because this disease is a congenital heart disease, children may not be able to tolerate surgery when they are young, because they are stunted or because their physical condition does not allow it.

In this case, it is generally not possible to complete radical surgery in one go.

Experienced surgeons often choose to do palliative surgery first. First, the child's life is saved, and when the child grows up, the tolerance is stronger, and the operating conditions are mature, and then the second operation is done to completely cure it.

In Zhou Can's impression, Director Xueyan didn't dare to touch this kind of difficult operation before.

This time she dared to challenge a tetralogy of Fallot surgery, which also shows that she has full confidence in her surgical skills.

"Sister Yan, have you checked the coronary arteries of the child?"

After reading the basic information of the child, Zhou Can asked.

"I've checked it, and there is coronary artery imaging of the child below."

Xue Yan knew that Zhou Can would never ask questions.

Since I asked, there must be something.

"Can this surgery be done?"

At present, the child has only been anesthetized and has not been operated.

"Don't be nervous, I just want to see where the anterior descending coronary artery originates. If the anterior descending coronary artery originates in the right coronary artery, the surgery may not be done. In addition, the child's left and right pulmonary arteries and peripheral pulmonary arteries are underdeveloped. ”

Zhou Can gave his opinion.

After Xue Yan heard this, she smiled with crooked eyebrows, "I know it's reliable to call you over to help." If there is any problem, it can also help us check together. Don't worry, I've checked both of these taboos, and it's fine. ”

Although she had already checked, Zhou Can was still a little uneasy, so she checked it again.

Fortunately, this child does not have either of these conditions.

"How's his left ventricle developing?"

Zhou Can asked again.

"Not bad, to be at a normal level. But it's not particularly good. ”

"Then there's nothing wrong with that. Is the child's preoperative hydration in place? ”

Zhou Can pressed the child's skin, and the elasticity was acceptable.

"It's in place."

This time, it was the itinerant nurse who answered.

"Okay, I'm basically fine."

Zhou Can looked at Director Xueyan.

It means waiting for her to call the shots.

"Anesthesia, can we begin?"

It is not rude to address the anesthesiologist directly by profession during the operation, but to facilitate communication.

Especially if some of the doctors in the operating room have the same surname as the anesthesiologist, they are more willing to call the anesthesiologist directly by the word anesthesia.

"The patient's vital signs are stable, and he has entered a state of general anesthesia and can be operated."

"Let's get started! As a rule, Dr. Zhou Can replaces me as the chief surgeon at a critical moment, and everyone else is in place. ”

Director Xueyan invited him over, in addition to the joint check, there was also a point, Zhou Can helped at the critical moment.

Today, many of Zhou Can's surgical skills have reached the intermediate level of deputy director, or even the advanced level. Coupled with his quick knife technique and steady knife technique, his strength is not inferior to that of the first-class chief surgeon.

(End of chapter)