Morning, nine o'clock.

In the academic lecture hall of the First People's Hospital of Changshi, Professor Zhou Cheng, Fang Yun and Professor Gong Ziye sat in the speaker's seat, and the audience was full of people.

"Okay, almost, I don't need too many people to listen. I'll just say a few words, and I'll leave the rest to Professor Fang Yun to report to you, Professor Gong and I, we still have something to do, and we have to leave early. ”

After Zhou Cheng finished speaking, he stood up and bowed to everyone.

I sat down and began to speak. With a click of the mouse, the big screen in front of me played a video of the patient's emotions and tears in the corners of his eyes.

Blurred his other looks, only his eyes.

Zhou Cheng then said: "Today, we don't talk about big truths, we only talk about minor diseases, and talk about the development status of our medical treatment." ”

"This patient, who is only 28 years old this year, is unmarried. Truck driver, bachelor's degree, business failure once. ”

"Of course, none of this is important, the important thing is that after he was destroyed, the pictures of the scene are like this."

After Zhou Cheng finished speaking, he changed the next photo.

Inside is a non-crash scene, a scene in the emergency department and a 120-car scene.

One of the more classic pictures is that the skin on the chest is stained with feces, and the primary sexual characteristics are curled up in the curved disc next to it.

The patient was drenched in blood, and a group of green clothes were rescuing him.

"High-energy violent injuries are becoming more and more common these days. Since 20 years ago, with the popularity of cars and highways, high-energy violent injuries have become a common disease in almost all prefecture-level city hospitals and even county hospitals. ”

"At this point, if there is a doctor or traffic police who have followed 120 cars, it is the most emotional."

"High-energy injuries, as a result, destroy the damage. The fortunate damage is the destruction of the limbs and the destruction of the skull. One is only disabled, and the other is directly lethal. ”

"The less fortunate ones are the damage to the chest wall, abdomen, and lower abdomen."

"Although the current medical development can allow these patients to go from death to survival, it is clear that the loss of function brought about by their injuries is a lifelong ......"

"This is a technical difficulty that trauma centers and various specialties need to overcome in the face of emergency patients, how to save the lives of patients to a greater extent, and at the same time, rescue their basic functions, especially personality and sexual functions."

"It's not just the loss of urine and urine function caused by the dismemberment, but also the loss of the residual limb caused by the damage of the limbs."

"Although the patient's life is safe after amputation, what kind of impact it will have on his future life is also a question that our emergency staff need to discuss."

When Zhou Cheng said this, he drank a cup of tea first.

The people below are recording Zhou Cheng's words, and Fang Xian also wrote these words in his notebook, it is obvious that Professor Zhou Cheng's understanding of diseases is still different.

"The second problem is also the problem of talent shortage faced by all prefecture-level city hospitals and county-level city hospitals since the development of the Medical Association."

"Since the medical association has carried out the certification of physician level and medical skill level, it is true that for many excellent doctors, they have their own way out and can find a more suitable matching unit."

"But the problem that has been set aside has not yet been resolved. Although, in recent years, we have been exploring the mechanism of horizontal displacement, to a certain extent, to make up for the problem of high-level brain drain in prefecture-level city hospitals. ”

"However, the mobility of personnel is relatively large, so that after the various departments of the prefecture-level city hospital form a team, the team is dispersed, resulting in the diseases that could have been cured have to be overcome and re-run-in."

"In the face of such a problem, we have come up with a way, which is the 'high-bottom model'."

"What do you mean?"

Zhou Cheng paused, and then said: "For example, Director Fang Yun of the First People's Hospital of Changshi City is the director of the Original Injury Center of the Affiliated Hospital of Xiangnan University, and his level is very high. In some areas, I'm definitely going to be on the sidelines. ”

Fang Yun glanced at Zhou Cheng and did not speak.

And Zhou Cheng continued: "The reason why he came to the First People's Hospital of Changshi is mainly to come to the bottom line. It is the most important line of defense, where it is needed, he can go to replace it, so as to make up for it, and minimize the mortality and disability rate in the process of building a new team. ”

"It allows the new team to improve the fault tolerance rate to a certain extent. After such a line of thinking, after the progress, the effect is also there, that is, the current Changshi First People's Hospital is already the largest medical center in the northwest region of Hunan Province, and it is the third medical center in Hunan Province in addition to Hengshi and Shashi. ”

"It is the most important line of defense for patients with acute and severe diseases in Hunan Province......"

“……”

“……”

Zhou Cheng first talked about some issues related to strategy, talent, and medical development, and finally brought the topic to Fang Xian.

"I've talked so much before, and it all needs to be done naturally and slowly paved."

"But I think Changshi is a very good research area, it's a transportation hub, and any car going in and out of the northwest of Hunan Province will go through it. It is a central area in the northwest of Hunan Province. ”

"Obviously, such damage patients are not uncommon, and it can even be said that they are common, after all, the high-speed section here has a high slope and many tunnels, and the probability of driving is extremely unsafe."

"As long as it's a holiday, there are a lot of car accidents in the neighborhood, even if it's not a holiday."

"I have also been in the city's traditional Chinese medicine hospital before, and I still have experience."

"So, if you want to do such a topic as damage, then you can't avoid the problem of functional reconstruction, and I think that the patient we went to see today, although the current medical development, has not been able to preserve part of his function."

"But part of the function that exists in him is already a breakthrough."

"Even bigger, at present, for the treatment of damaged injuries, the most perfect surgical method and the most perfect plan are in our Changshi, which is the first case of reconstructing stool function after damage and is expected to be successful."

"This is a good thing, and besides, the doctor who is the chief surgeon of this surgery is from our Changshi people, so on this basis, if we can do a good job in building a team, then in the future, we will definitely be able to shift the center of gravity in terms of damage and damage......

"I really have some other things on my side, so ah, the rest of the questions will be discussed with Professor Fang and Dr. Fang Xian! ~”

Zhou Cheng squeezed the time to speak, and was about to hurry away after speaking.

A lot of people got up to see each other, and of course, some people sat down to listen to the more important points and reports.

Zhou Chenglai's lecture was completely improvised, and he said a few words, which was regarded as a start.

Naturally, the content hidden inside is also relatively sharp.

Under the system of climbing the ladder of the medical association, the question of how to keep talents is difficult to deal with in many prefecture-level city hospitals, and the talents that have been cultivated with great difficulty are gone.

People go to higher places, and water flows to lower places.

And if you don't let others go, so that others can't see hope, then tell you, some must be people who are messing around, not people who work hard.

If you can see the head for a lifetime, why bother to work hard and create the future?

Zhou Cheng took a note of Gong Ziye and left.

The director of the Department of Orthopedics of Changshi Traditional Chinese Medicine Hospital spoke: "Professor Fang, isn't there only West China Hospital, Jishuitan Hospital in Kyoto, and several hospitals in Modu that conduct research on this disease?" ”

"In our Hunan Province, at last year's annual meeting, didn't I hear any professor say that there was follow-up and research on this disease?"

Changshi Hospital of Traditional Chinese Medicine is the hospital with the highest level of orthopedics in Changshi.

Originally, it was still a little precarious, but since Professor Zhou Cheng went there to support before, his strength has increased again, and now decades later, he is still in the leading position.

Naturally, this calculation must not be able to calculate the trauma center of the First People's Hospital of Changshi, and Dr. Fang Yun is an individual case, not at the level of discussion.

When Fang Yun heard this, he smiled and said, "Director Zheng, actually, our research on this disease in Hunan Province is half-done. ”

"Professor Xu Fengnian, a trauma surgeon in West China Hospital, who is doing damage and injury diseases, went to the trauma center operating room of the Affiliated Hospital of Shonan University in the middle of this year, and came to fill the relative gap in the routine process of damage treatment in our province."

"On the one hand, it is actually to discuss with Professor Yang Yifeng about the reconstruction of the damaged vascular bed."

"However, during this period, Dr. Fang Xian and Professor Xu Fengnian set up a temporary team, and a certain spark collided, which led to this step."

Director Zheng is the director of Changshi Traditional Chinese Medicine Hospital, named Zheng Xuanlin.

His eyes flickered a few times, and he continued to ask: "Professor Fang, the disease of destruction and injury, even the conventional treatment and rescue specifications have not yet come out, why did it suddenly jump to functional reconstruction?" ”

"Functional reconstruction, if it is classified according to the classification of skills of the medical association, is already an absolute specialist skill, and even an advanced and cutting-edge surgical method of the specialty, it is not an exaggeration at all."

Zheng Xuanlin actually said, don't lie to me, we are all experts in orthopedics, and we have been doctors for so many years, and no one can fool anyone.

The development of a new disease.

First, ask for a team to keep a small number of patients from dying, and then ask for more teams to keep more people from dying, and form a routine rescue or treatment process.

Immediately after that, it is the basic surgery of the specialty, the treatment plan of the specialty, and then the specialist skills, which are advanced step by step.

Fang Yun said: "Since Director Zheng understands this, he should know that the most important topic of discussion for emergency patients is whether they die or not. ”

"To discuss whether to die, in fact, the most fundamental work is the basic skills of medicine, which plays a major role in medical rescue."

"Therefore, during the exchange of Professor Xu Fengnian at the Affiliated Hospital of Shonan University, Dr. Fang and Professor Xu have completed the preliminary accumulation work, but the current set of plans has not been reviewed and made public by the Medical Association, and has not yet been written."

"However, the corresponding data has been recorded."

Fang Yun said: "According to the provisions of the medical association and the National Health Commission, the emergency treatment plan for dangerous diseases and diseases of the third level and above, in the treatment of new diseases, as long as the patient's life can be saved in principle, the principle of no harm is guaranteed. ”

"There can be a certain degree of flexibility in the right of disposal. This topic has already been discussed by the Ethics Association of the Affiliated Hospital of Shonan University and the Medical Ethics Branch of the Huaguo Medical Association, so there is no need for Director Zheng to pay much attention. ”

Fang Yun could understand the side question in Zheng Xuanlin's words.

Zheng Xuanlin stopped talking.

However, President Lin, who had gone and returned, heard that there seemed to be a bit of tension at the scene, so he hurriedly persuaded him: "Director Fang, Director Zheng, let's leave the debate on these ethics-related issues to more professional people." ”

"In the process of applying and developing each topic, there will be people from the Medical Ethics Society who will participate in and follow up, so we don't have to worry about it."

"Damage is a new disease, a big topic, and a world-leading topic, the task is heavy, the subject is of great significance, how should our medical system in Changshi face this challenge and opportunity."

"Actually, that's what we have to think about at all."

"You're right, Director Fang." Chairman Lin smiled and asked.

When Fang Yun heard this, he said: "This topic belongs to Dr. Fang Xian, and whether Dr. Fang Xian wants to do it in our Changshi or in the Affiliated Hospital of Shonan University has not yet been decided. ”

"Dr. Fang Xian is currently a regular employee of the Affiliated Hospital of Shonan University, and he ran outside with the results as soon as he joined the company, which is not very authentic."

"President Lin, let's not discuss this matter yet. Today's small gathering is actually a small, temporary exchange meeting. ”

"If you are interested, why don't you ask our doctor Fang Xian to tell you about the common forms of damage and injury, as well as the diagnosis and definition......

Fang Yun is also a person who is very good at throwing problems, so he directly threw the problem to Fang Xian, reducing the expectations of others layer by layer, this is the only way to deal with it at present.

Fang Yun said so, and Fang Xian could only go up and talk about it.

However, regarding the theoretical-related issues, Chairman Lin and others did not pay special attention to them, he just cared about whether this topic would be done in Changshi and whether it would be beneficial to the development of Changshi.

On the contrary, some orthopedic people, especially trauma surgeons, sound quite relish, after all, it is something new.

When locating, defining, and grading the degree of injury of new diseases, it is also helpful to start from the basics and advance one by one, so that they can explore the diseases related to trauma surgery.

Fang Xian's basic theories of orthopedics and trauma surgery are all level 5, and the definition of the disease of destruction and injury is directly framed into the disease of trauma surgery.

Although it was an impromptu performance, he also spoke freely for several hours, and it lasted until two o'clock in the afternoon before the small party was dispersed......

As soon as the meeting ended, Fang Xian saw that his Uncle Fang Yun lost his temper, and directly slapped the teacup on his chest over, and scolded in his mouth: "What is this thing today?" ”

"An academic conference is not like an academic conference, a report is not like a report, and a discussion is not like a discussion."

"This Chang Geng really doesn't have a little brain."

Fang Yun was angry, and Fang Xian was responsible for cleaning up.

His eyes flickered and he said, "Uncle Yun, maybe Professor Zhou's fame is too great, and these people all want to get a little light, and also show their attention, so they have engaged in such a big battle." ”

Fang Yun sighed when he heard this: "Originally, it was a good person, just a few of us, gathered in private, sat down and discussed it together, and made it like this, this formalism?" ”

"I don't want to stay in TM's regular market?" This time, Fang Yun said his true heart.

Fang Xian stood beside him and didn't say a word.

In fact, Fang Xian also wants to work well with Professor Zhou Cheng and Professor Gong Ziye to grind and damage this disease together, such as the next development plan.

But it was smashed like this, and there was no direction to guide him, so Fang Xian had to find an idea of how to rebuild the urination function.

However, Fang Xian knew that by now, he might need to use his highly privileged physician card to go to the library of the Medical Association.

The function of urine and urine is only a basic function, and perhaps, for some young people, the maintenance of reproductive function and even sexual function is also quite important.

Functional disability is also a type of disability, and it may be a psychological disability.

……

On the way back, Fang Xian asked: "Uncle Yun, if you want to do the task of functional reconstruction, is it better to do it in Changshi or Shashi?" ”

"You just said that I am from the Shonan University Hospital."

Fang Yun said: "Take it to Changshi and do it, do it here, you can get started faster, and there are very few people who can affect you, otherwise if you are in the Affiliated Hospital of Shonan University, there will be too many covets and eyeliner." ”

"Do you still remember Jiang Yang's incident, if you stuff a group of similar people around you at that time, you won't have a place to cry."

When Fang Xian heard this, he asked again: "Uncle Yun, Dr. Jiang's theory, in fact, I think it's okay, but it's a little confused, is it possible that Professor Yang and Professor Zhou have nothing to do about the current situation?" ”

"If they can help sort it out, Dr. Jiang Yang will definitely be able to move forward in the advancement of surgical theory."

Jiang Yang really has something, at least, he can provide himself with some ideas and cognition, and then, through his level 5 Ruyi level skills, he can know which theories are feasible and which are not.

With such a creative ability, don't your Uncle Yun and Professor Zhou feel amazed?

"You said Doctor Jiang Yang, he?"

Fang Yun wanted to speak and stopped: "Doctor Jiang Yang has a teacher, and his teacher's inheritance, we ordinary people are not good to go around. ”

"The development of disciplines and research should be a hundred flowers blooming, and if Jiang Yang can really follow his own path, he may really be able to bring more surgical diseases to its ultimate destination. Let's go back to internal medicine. ”

"At least Dr. Jiang Yang has completed a disease from surgery to internal medicine so far."

"What?"

"Stones, large urinary stones." Fang Yun also seemed to have a deep memory of Jiang Yang.

When Fang Xian heard this, he was slightly stunned and asked: "Is the ban on the surgical operation of urinary stones in our hospital related to Dr. Jiang Yang?" ”

It's amazing.

In the past, cystoscopic surgery and ureteroscopic surgery for stones were too common, and although there were some medical treatment methods, there were always some stones that could not be quickly dealt with by internal medicine.

"Hmm, though?"

"These treatment options are still in the clinical trial period, but they are currently in routine application in the Affiliated Hospital of Shonan University, and the corresponding surgical procedures are still routinely done in many places."

"Moreover, at present, the relevant companies that do ureteroscopy are trying to find the defects of this set of treatment plans, which is something that will affect their interests after all."

"If you want to do pure theory in surgery, the road is too difficult, even more difficult than the development of surgery."

When Fang Yun said this, he said again: "Oh, by the way, Professor Zhou sent a message before, let me tell you, you are actually very awesome, but today, this matter is very troublesome, he didn't say this to his face." ”

"You can't feel a sense of disparity."

"Professor Zhou does not directly hold academic hearings to ensure that you can have more free time to do your own profession well."

"Otherwise, look at Professor Zhou now, I'm now? will be dragged down by a lot of mundane things. ”

"Moreover, Professor Zhou has always had to find a suitable compensation plan for the lack of talents in lower-level hospitals after the establishment of the medical association system, otherwise."

"It will only lead to more and more high-quality resources gathering in big cities, crazy gathering, and small hospitals can only become flow stations, stepping stones, and no one can go to work in a down-to-earth manner."

Fang Yun sighed with emotion, as if he was pitying Zhou Cheng.

Hearing this, Fang Xian's brows moved slightly.

Then he said, "Uncle Yun, thank you." Thank you, Professor Zhou, you must have carried a lot of things for me, so that I can stay in the operating room of the trauma center and learn more with peace of mind. ”

Fang Xian's sentence is very sincere and direct.

He can not be disturbed much now, it is estimated that these two have carried everything and blocked everything, otherwise, Fang Xian will definitely face more temptations and troubles, where will he be like now, relatively free choice?

"Learning is part of it, and outside of learning, you have to do a little bit of learning."

"Doing knowledge, doing medical knowledge, cannot be separated from clinical practice. You know, right? ”

"In this world, there are many unknown problems, and there are many that can be developed and developed. If you don't have the freedom to choose, then there are a lot of things that you are forced to choose. ”

"Ask if it's worth the time."

"Because, apart from me, even Professor Gong and Professor Zhou, they may let you do something more meaningful, rather than let you do what you want to do."

"This one makes more sense, and it definitely makes more sense for them to think it is." Fang Yun said as he became taller and greater.

Fang Xian nodded.

The space he is in now is actually a relatively dreamy space, and the most he can hear is gossip, without many social factors......

Only the people closest to you will care about what you want to do more, and what you do will make you feel happier, and what others discuss with you is only interests, unless you grow big enough and strong enough.

"Let's go, I'll take you to meet someone." Fang Yun said.

"Who, Uncle Yun." Fang Xian asked.

"Zhou Xiyin~"

(End of chapter)