My medical skills add experience

Chapter 477 Medical ethics, it really is pneumothorax
"You mean a larger operation, how big is it?"

Director Xueyan relies heavily on Zhou Can's opinion.

In terms of surgical thinking, Zhou Can's ability in this area seems to be more monstrous than pathological diagnosis.Especially after his surgical experience became more and more abundant, because of his extensive knowledge and the collection of the essence of many chief physicians of internal medicine and surgery, even Dr. Xu praised him many times when he formulated the surgical plan.

Most geniuses in this world are 30% their own talent, 60% sweat and hard work, and 10% opportunity, which finally makes them stand out.

"Total sternotomy may be required! Specifically, I am afraid that it needs to be tailored according to the patient's current situation."

Although Zhou Can visited the patient once in the ward, he was kicked out by the patient's daughter.

"Go, while you're here, I'll accompany you to the ward, and try to finalize the operation plan today." She knew that Zhou Can was a busy person and had endless tasks every day.

Many difficult cases in cardiothoracic surgery require Zhou Can to help solve them.

The two returned to the ward.

When the patient's daughter saw Director Xueyan enter the ward, she immediately put on a flattering smile.

"Hello, Director Xue! It's really touching that you came to visit my father at such a late hour."

"Your father's condition is progressing rapidly, and if the infection worsens, there will be unpredictable dangers. The sooner it can be resolved, the better. No, taking advantage of Dr. Zhou's arrival, I hurriedly dragged him over for a consultation, and tried to come up with one today." Here comes the solution."

Director Xueyan also responded with a smile.

At the same time, I also focused on introducing Zhou Can's weight.

"Ah...he, he..."

The patient's daughter covered her mouth and looked at Zhou Can in surprise.She regretted so much that her intestines broke.

From director Xueyan's words, she couldn't tell that she had to rely on Zhou Can to treat her father.

If I had known that this young doctor had such a great ability, I should never have treated him like that.

"Don't look at Dr. Zhou's young age, but his medical skills are very famous in the hospital! Your father's condition is very complicated, and the treatment is very troublesome. Dr. Zhou has rich experience in treating such difficult diseases. How helpful he is!"

Director Xueyan tried her best to improve Zhou Can in front of patients and their families.

But what she said is not exaggerating, Zhou Can is indeed so good.

"That... Doctor Zhou, please take care of me!"

The patient's daughter did not say a word of apology after all.It's just that the expressions, eyes, and tone of voice already showed an apology to Zhou Can and flattery to him.

Some family members are very concerned about face, even knowing that they are wrong, they will not admit it, and their mouths are stubborn.

This female family member is already considered good.

Since Zhou Can didn't care about her, he began to conduct in-depth preoperative examinations for patients to determine the operation plan.

This time, I can clearly feel the active cooperation of the patient and the attentive assistance of the family members by the side, answering all questions.

The attitude is quite different from last time.

"Sister Yan, I've finished watching."

Zhou Can asked all the questions that should be asked and what should be actually understood.

Including the scope of the patient's last operation, as well as the postoperative films, and even some necessary palpation of the patient's wound range.

When he entered the ward for the first time, he only asked the first question, and the family members were already extremely unfriendly.

He dared not perform such painful palpation on patients.

The family members are furious, but he is not afraid.

There's no need to cause such trouble.

To be more realistic, if the family members and patients really don't cooperate, he doesn't have to treat them.

You can ask them to hire someone else.

"Go to the office with us to discuss the operation plan!" Director Xueyan turned to the family members.

"Ok!"

The patient's daughter couldn't help but think highly of Zhou Can.

Now even a fool understands that Zhou Can is the key doctor who treats her father.It seems that Director Xue is just a foil.

In Director Xue's office, Zhou Can and Director Xue Yan discussed the patient's operation plan, while the family members listened.

She may have considered that the time is very tight, so she simply called the family members over to listen together, so as to save the pre-operative talk.

After some discussions, Zhou Can and Xueyan basically finalized the operation plan.

"Zhou Can, it's up to you to convey the operation plan to the family!"

Director Xueyan just felt that Zhou Can basically determined the idea of ​​the operation, and it would be better for him to talk directly to the family members now.

When answering family members' doubts, it can also be more accurate and fast.

This is also the reason why subordinate doctors are not allowed to talk to family members when performing some major operations, but the chief surgeon himself.

"Because your father's sternum has already suffered from osteomyelitis, and the incision is seriously infected, so the artificial material must be removed, and the sternum needs to be completely removed. Our sternum originally served as a good fixation and support function. It caused thoracic instability. In order not to affect your father's life in the future, and to ensure his safety with the least impact after the operation, we are going to take his ribs to reconstruct the chest wall."

He briefly explained the operation plan.

"My dad's wound is difficult to heal, is it caused by the use of artificial materials?"

asked the family.

"There are reasons for that."

Zhou Can's answer was more flexible.

"Then my dad had an infection after surgery and he hasn't recovered. Is it because the operation in the previous hospital was not done well?"

Her questions are straightforward.

Hearing this tone, it seemed that he was going to trouble the first hospital.

This is also the instinctive reaction of most family members who have problems after the patient's operation.

The hospital didn't do the operation well, so they naturally think the hospital should be responsible.

"Postoperative complications are a situation that all doctors and nurses are unwilling to appear, but no one can avoid it. I believe that the doctors and nurses in the last hospital must have tried their best to treat your father. Using artificial materials to reconstruct the chest wall, completely It is feasible and in line with medical standards. It’s just that each patient’s recovery and immunity level are different. Before using artificial materials, no one knows whether it will cause postoperative infection.”

Zhou Can's answer is of high moral character.

There is no rhetoric to discredit Xinxiang Hospital, and they are even abdicating the responsibility of the doctors and nurses who performed the operation on the patient for the first time.

This is true in itself.

Before the operation, who knows if it will be infected?
Now that there is a problem, it is definitely not advisable for the family members to seek medical care.

"Thank you for your answer. May I ask when my dad can have the surgery?"

The family didn't bother with the matter any more.

"Sister Yan, can you line him up tomorrow?"

"At that time, I will coordinate with the operating room and try to arrange surgery for him. It may be after seven o'clock in the evening. Ms. Zhao, do you think it's okay?"

Director Xueyan scheduled the operation until night, because she must have wanted Zhou Can to help with the operation.

In front of family members, many things are inconvenient to say.

I can only let Zhou Can understand.

"Yes, yes, thank you Director Xue, thank you Doctor Zhou!"

The family members nodded in agreement.

It was a complete surprise to the family that the operation could be arranged so quickly.

She understood that a lot of credit for this belonged to the young doctor Zhou.

"Okay, let's do it for now! If there are no changes, the nurse will notify you tomorrow morning, and then the doctor will ask you to sign. The anesthesiologist will come to evaluate the patient and talk to you. You must cooperate as much as possible."

Director Xueyan indicated that the family members could leave.

"Okay, I will fully cooperate. Then I will go first. If you need anything, you can come to the ward to find me at any time." When the family members left, they were obviously in a good mood.

For many family members, they are looking forward to the early operation.

Especially for such refractory patients, because the treatment in other hospitals has not worked for a long time, the family members are under great pressure.

After the family members left, Xueyan looked at Zhou Can.

"You have to come and help tomorrow!"

"no problem!"

Zhou Can readily agreed.

"Sister Yan, there is something I need to ask you for help. Director Lou told me today that there is an opportunity to study on the job, and he has already signed up for me. I tried to pass the postgraduate entrance examination when I was in my senior year, but unfortunately failed. This time I retake the postgraduate entrance examination, to be honest, I still don’t have a clue.”

Although his current strength has improved a thousand times compared to when he was a senior.

But the setback of the postgraduate entrance examination still brought him a long-term psychological shadow.

"Hehe, you are so strong, why are you so unconfident in the face of the postgraduate entrance examination? Under normal circumstances, the admission rate for the postgraduate entrance examination is one to three. On average, one out of three students who pass the postgraduate entrance examination successfully lands. Now the competition has become more intense. A little bit, it was close to one to four last year. But I'm sure you'll be fine."

Director Xueyan smiled and said to him.

"Besides, since the hospital arranged for you this time, as long as you can pass the written test and the re-test, the landing rate will be close to [-]%."

She is very clear about some unspoken rules of the hospital.

"The problem is, I'm afraid I won't pass the written test and the retest!"

Zhou Can lacks successful experience in this area, and he still has no idea.

"Which tutor is applying for the exam? Considering your special situation, the hospital will definitely arrange for you a tutor who has more free study time and is relatively easier to obtain a certificate."

"I heard from Director Lou that he is a mentor in the field of orthopedics and trauma."

"That is probably Professor Wu Xuesheng. He mainly does scientific research and teaching, and rarely engages in clinical work. If you study with him, it can help you improve your academic ability and scientific research level. There are two important surgeries to be performed today. After the operation, if I have time, I will conduct a basic knowledge survey for you first, and then give you a learning direction. In fact, I think you can find the chief physician of orthopedic surgery. The examination questions for the postgraduate entrance examination of medical schools are generally prepared by the admissions unit itself They must know the direction of the exam questions better than me."

Although Director Xueyan is a proper female academic master, she is by no means omnipotent.

In the field of orthopedic trauma, which she is not good at, she is definitely not as good as the chief physician of orthopedic surgery.

"I'm fairly familiar with orthopedic surgery. After you help me formulate a study direction, I'll find out with the chief physician of orthopedic surgery. It will be safer. I'm afraid it's not good to ask them for exam questions directly?"

Zhou Can is worried that this kind of thing is illegal.

"Haha... Last time you took the lead in protesting against the inaction of the security department of the hospital, and the personal safety of the doctors and nurses was not guaranteed. You were very courageous. Why are you so timid now? Don't worry, the test papers for the postgraduate entrance examination are highly confidential. Chief physicians in orthopedic surgery do not have the possibility of leaking questions. It’s just that they have more experience in this field, and many chief physicians even directly participate in the annual examination papers. They help you define the scope of examination questions, which will be more accurate.”

Seeing her laughing wantonly, Zhou Can scratched his head in embarrassment.

"Hehe, that's how it is! I'm really worried that it's illegal for them to help me, and I'll be let in. Sister Yan hasn't laughed for a long time, and it's actually pretty good to be able to do what she did just now."

Time will smooth everything and dilute everything.

She gradually came out of the haze of divorce.

……

"Doctor Zhou, the test result of that patient has come out, please take a look."

The intern came to Zhou Can with the examination results of the patient with chest pain and dyspnea.

"Let me see!"

Zhou Can took the patient's examination report.

Director Xueyan asked curiously, "Xiao Chen, which patient is it?"

"It was a patient in the emergency department who informed us to pick up the patient. At that time, my teacher was undergoing surgery, and it happened that Dr. Zhou came, so I asked him to help."

After Zhou Can preliminarily reviewed the patient's blood routine and chest X-ray, he handed over the examination report to Director Xueyan.

"This patient really had a left pneumothorax. Plain chest X-ray showed that the left lung was severely compressed, a small amount of hemothorax, the left costophrenic angle was blunted, and the trachea and mediastinum were shifted to the right. Fortunately, the ribs were not fractured. I think You can try to do a brooch puncture first."

For him, the management of this disease is simply a trivial matter.

The higher the level, the easier it is to solve various diseases that other doctors think are difficult to diagnose and treat.

"This patient is only 28 years old, quite young! How did he develop a pneumothorax?" Director Xueyan had no objection to Zhou Can's treatment suggestion after seeing it.

Women, love gossip and are naturally curious.

As the head of the department, she is no exception.

After all, she is still young.

In their 40s, they are definitely not as indifferent as those old ladies in their 60s.

"When the patient was having dinner at home, he was urged by his mother to get married and complained that he was not working hard. In fact, the patient worked very hard, working night shifts every day, and he probably did hard work. The work was hard, and the pressure to get married was great. Being nagged by his mother, he got very angry and yelled twice. As a result, he developed a pneumothorax."

Zhou Can feels very distressed for this patient.

Men in their 20s are especially not easy.

If there is anything, there is no one to discuss it.If you are married, at least you can talk to your wife about your troubles in work and life.

"So that's how it is. Your puncture technique is recognized as the best in our department. Go and help him do a chest puncture!"

Director Xueyan nodded after hearing this, and directly handed over the treatment to Zhou Can.

……

After the needle was used to exhaust the patient, the effect was not satisfactory.

Facts have proved that no matter how good the puncture technique is, sometimes it may not be able to solve the problem.

In this case, there must be no way to do further treatment.

Zhou Can realized that the patient's pneumothorax might be more serious than imagined.

Considering the patient's family situation, he felt that surgery should be avoided as much as possible.

(End of this chapter)