My medical skills add experience

Chapter 569 As a teaching assistant, the serious consequences of myocardial necrosis

Nearly five and 10 minutes later, Zhou Can hurried to the director's office in the Internal Medicine Building.

In terms of status, Director Tan is already second only to the Vice President.

According to some gossip, if Tuya successfully completes the reform of all departments this time, the director of each major department may be automatically promoted to vice president.

This is also an opportunity for Zhou Can to quickly rise to the top.

At present, his only hope is to improve his academic qualifications as soon as possible.This is related to his future developments such as the evaluation of professional titles, competition for important positions, and comprehensive evaluation of famous doctors.

The door to the director's office was closed.

Boom boom boom!
He knocked on the door politely, and then Director Tan's gentle and honest voice came.

"Please come in!"

Pushing the door open, I saw Director Tan holding a yellowed ancient book and reading it.

It is a Chinese medicine book.

Physicians like to study medical theory and pathology. After reaching a certain level, they will even study pulse.

Now at least three developed countries have developed automatic pulse-diagnosing instruments based on the pulse-diagnosing technology of traditional Chinese medicine.Unfortunately, the effect is always unsatisfactory.

This is because TCM pulse diagnosis needs to be based on the doctor's pulse knowledge, pulse meaning, and diagnostic experience, and then comprehensively consider it.

Among them is the very important human autonomous intelligence, which is ever-changing and requires flexible diagnosis.

With the current artificial intelligence, it is impossible to imitate it.

It is estimated that even in the past 50 years, it is still difficult for automatic pulse diagnosis instruments to achieve major breakthroughs.

Chinese medicine is extensive and profound, and people who don't understand it think it is metaphysics.

People who understand it will think it is medicine.

Most of the young doctors in China now think that Chinese medicine is more 'metaphysics'.There is a most common phenomenon, when encountering some difficult patients or terminally ill patients who cannot be cured, everyone will unanimously persuade these people to see Chinese medicine.

From this point of view, Chinese medicine must have been seriously belittled.

At least Zhou Can has experienced the power of traditional Chinese medicine. If Su Qianqian's kidney disease is treated according to Western medicine, there will be no other way except kidney transplantation.However, taking traditional Chinese medicine prescriptions, supplemented by diet therapy, gymnastics and other methods, he was finally cured.

Now she has been reviewed three times, all showing that her urine test results are normal and her kidney function is normal.

"Director Tan!"

"Come on! Sit!"

Director Tan got up and made him a cup of health-preserving tea.There are wolfberry, astragalus and other things.

There are not many people who can let Director Tan make tea for himself.

Zhou Can is an exception.

"There are two reasons for asking you to come here. The first one: the identity of the myocardial infarction patient yesterday is very special. He is the director of the Third Hospital."

When Zhang Qilian's identity was mentioned, Director Tan showed a narrow smile on his face.

It's really interesting.

The Third Hospital itself is mainly engaged in the diagnosis and treatment of cardiac surgery. There was a time when it was so famous that even its father was not known.

It's good now, the dean has a myocardial infarction, and his own hospital can't handle it, so he sent him to Tuya Hospital for emergency treatment.

The point is, Tuya really succeeded in rescuing him.

"The Third Hospital has dealt with our hospital before. This time it is a good promotional opportunity for our Department of Cardiology and Cardiothoracic Surgery. The hospital is already preparing to arrange interviews and reports to create a wave of publicity."

When Director Tan said this, there was a hint of murder in his calm tone.

Righteousness does not do business, compassion does not command soldiers.

No one who can become an important leader of the hospital is easy to be with.When it's time to be ruthless, the means are extremely iron-blooded.

It is not too late for a gentleman to take revenge.

It can be heard that Tuya Hospital is going to seize this opportunity and make a serious blow to the situation.

It is a big taboo for a country to be weak but not to be humble, to be weak without fear of strength.

When the Third Hospital attacked Tuya Hospital, it should have expected such a day.

Tuya Hospital can be magnanimous, but it does not mean blindly magnanimous.

"Because it involves you, I would like to say hello to you in advance. It's a discussion. The hospital may need your cooperation in the publicity."

Zhang Qilian's thrombus was taken out and the blood vessels were unblocked, which was basically done by Zhou Can.

Now that we want to use this matter as a publicity, out of respect, we must communicate with Zhou Cantong in advance.

As for 'discussion', just listen to it.

When leaders discuss things with their subordinates, they often just say hello.In fact, the leaders have already made a decision, and the subordinates can raise objections, but it has little effect on the result.

"I will fully cooperate with the hospital in publicity work."

Zhou Can made a statement on the spot.

He knew that Director Tan would report his attitude to the hospital leaders.

Taking the Third Hospital as a stepping stone is no psychological obstacle for Zhou Can.Non-toxic no husband.

It's ridiculous to still have the heart of the Virgin, benevolence, righteousness and morality when it's time to kill.

Taking advantage of its illness and killing it is the way of life it should have.

The law of the jungle has always existed.

Lions and tigers never sympathize with the weak, but think about how to get the food they need to survive at the least cost.

"The second thing: Your interventional surgery is so smooth, the level is already very high. The level of interventional surgery in internal medicine has always been very good, which is not in line with the competition of modern strong hospitals. I would like to hire you as a teacher of interventional surgery in internal medicine. Teach internal medicine doctors to do interventional surgery. I know you are very busy, but every doctor will go to a teaching position, and only in this way can medicine be passed on forever."

"Your current part-time teaching position will be of great benefit to you in promoting your teaching position in the future. If you agree, the only thing I can get for you from the college is the teaching assistant position. Even the doctoral supervisor of the college will start from this position. It went up step by step."

Director Tan must have made an in-depth evaluation and analysis of Zhang Qilian's interventional surgery and postoperative effects.

After discovering that Zhou Can's level of intervention has far exceeded his imagination, he moved his mind and wanted to hire Zhou Can as a teacher of interventional surgery.

This is something that benefits both parties.

"I am very happy to accept this position. Teaching itself is also a very pleasant thing. I am a little worried that my level is not enough and I can't teach well."

Zhou Can said it more modestly, which is actually equivalent to agreeing.

It's like visiting relatives. When stuffing red envelopes, everyone will often say a few polite words.

He said no, no, how embarrassing it was, but he took it honestly in his hand.

Teachers in colleges and universities are promoted, usually teaching assistants, lecturers, associate professors, and professors.

After being promoted to professor, there will be first-level professors, second-level professors, and third-level professors.

Among them, first-level professors are the highest level, and they are often "Pangu"-level figures in a certain teaching field.There is absolute authority in that field.The third-level professor is the lowest position among professors, but those who can be awarded this title are also very good.

Not everyone can comment on it.

There are thirteen levels of teachers in colleges and universities, just like doctors in hospitals have multiple levels, and they need to be promoted step by step.

The level is not enough, the ability is weak, and the promotion is very slow.

There are many college teachers who may not be rated as third-level professors in their entire lives, and stay in the position of lecturers until they retire. There are many of them.

There are even a few teachers who are unlucky and have some flaws, and they are still teaching assistants when they retire.

In short, the competition in every professional field is extremely cruel.

Those who are capable will go up, and those who are mediocre will stand still or be eliminated.

It is definitely a great thing that Zhou Can can step into the teaching position now.

Many talented people start cheating after the age of 30.He can start his journey in the teaching position before the age of 30, which will be very beneficial to his future promotion.

The promotion of the position, step by step, step by step.

"Don't worry about whether the teaching is good or not. Everyone starts as a toddler. The college will definitely give you enough time and opportunities to grow up, and you won't make extremely strict requirements as soon as you come up."

Director Tan comforted him and said.

"Alright, since you trust me so much, there's nothing to say, just roll up your sleeves and do it. Everything will be arranged by you then."

Zhou Can readily agreed.

There is no need to be too hypocritical, because it is difficult to miss this kind of opportunity.

……

On the third day, Zhou Can was undergoing an emergency surgery when the cardiothoracic surgery department suddenly called for help and asked him to go for an emergency consultation.

Saving people is like fighting a fire, Zhou Can handed over the operation to two assistants.

They are now fully capable of handling the general surgery part of primary and secondary surgery and tertiary surgery.

Yang Zhi and Pu Dingdong were not able to do a good job in the difficult second-level surgery and many important parts of the third-level surgery.This is already very fast progress.

Because Yang Zhi has a good surgical foundation, he is obviously better than Pu Dingdong in terms of surgical ability.

However, Pu Dingdong's progress is very stable, and he has been progressing at a balanced speed.

It is hard to say who will be stronger and who will be weaker between the two in the future.

Zhou Can was very satisfied with his two medical assistants.

It is impossible to ask them to grow to Zhou Can's level in just one or two years.That's unrealistic.

If you compare them with ordinary doctors of the same level, the progress is already amazing.

He rushed to cardiothoracic surgery soon.

In the consultation room, the atmosphere is dignified.

"This patient underwent an emergency interventional thrombectomy in the Cardiovascular Department of this hospital three days ago. He began to experience obvious symptoms of discomfort last night. He was short of breath, had severe pain in the heart area, and a severe drop in blood pressure. Now he suspects acute myocardial infarction. After the occurrence, a large amount of myocardial ischemia took too long to cause necrosis. The patient's current state is very dangerous. After evaluating with several directors, I think the operation risk is very high. You know the patient's condition best, and I specially invite you to come over for consultation .”

Director Xueyan sat at the head of the consultation table.

The first seat on the left was empty, which was specially reserved for Zhou Can.

Most of the doctors in the department acquiesced that Zhou Can was number two in cardiothoracic surgery.

The ancients have respected the left since ancient times.

The first seat on the left is usually seated by number two.

Zhou Can took a look at the examination materials, mainly chest color Doppler ultrasound and CT examination.

This helps spot anomalies.

"When this patient was sent for rescue three days ago, the best time for rescue has been delayed. When the interventional dredging operation was performed, I had a bad feeling. I felt that his myocardial necrosis area might be very large. I didn't expect it to be true now. It became like this."

Speaking of Zhang Qilian's condition, Zhou Can also had a headache.

This is an absolute tough bone.

"In his current situation, according to my clinical experience, if he does not undergo surgery, he will die. Even if surgery is performed, the survival rate will not be higher than 50%. After we discussed just now, there are two ways. The first one is to try surgery first. Let’s see the situation. The second is to directly consider heart transplantation. Of course, if you want to do heart transplantation, the donor is a big problem. Artificial heart is the first choice.”

Director Xueyan gave some discussion opinions.

After Zhou Can listened, he was still very worried.

"Both surgical methods are feasible to a certain extent. The key is that the arteries and vessels of the patient's body are severely deformed, and atherosclerosis is very obvious. During my rounds, I found out through chatting with family members that the patient has had blood vessels since childhood." Abnormal. Since then, he has been taking medicine to control it. For this reason, the patient once studied in Japan, specifically to find a way to treat systemic arterial vascular disease."

The patient's situation is very special.

Even if it is an ordinary patient undergoing a heart transplant, there is still a very high risk of death.

What's more, it is a patient with severe arterial malformation.

After everyone heard this, they were in trouble for a while.

In patients with acute myocardial infarction, if a large amount of myocardial necrosis occurs, myocardial remodeling will occur, resulting in cardiac enlargement, myocardial contractility, decreased cardiac output, heart failure, decreased blood pressure, and even cardiogenic shock.

If it is not treated in time, the necrotic myocardium will expand outward, and cardiac aneurysm or papillary muscle rupture may occur, and even the heart may rupture.

Weekly, due to myocardial necrosis, the infarcted myocardium becomes thinner, the non-infarcted myocardium thickens, and the myocardial contraction is uncoordinated. There will be a wall thrombus in the left ventricle. If it falls off, it will cause arterial embolism in the brain, kidney, spleen, lung or limbs.

Therefore, when Zhou Can went to the ward to check Zhang Qilian's postoperative situation that morning, he reminded his family members that the real danger period was far from over.

He was able to successfully remove the thrombus for Zhang Qilian, but he couldn't guarantee that the myocardium would not suffer from necrosis.

Because during thrombectomy, part of the myocardium has been necrotic due to ischemia.It's just that if you don't open the pericardium, you can't find it.

The treatment of western medicine is often relatively passive.

It can also be understood as a secondary version of defensive medicine.

For example, if a patient is found to have a tumor, but the size of the tumor is not large, the doctor will ask the patient to observe first, and then re-examine every three or six months.If it doesn't continue to grow, just let it go.

This is called living with disease in medicine.

The entire diagnosis and treatment thinking of Western medicine is basically the same.Prolong the life of the patient as much as possible, and then find ways to alleviate the suffering of the patient.

For example, cancer patients are first given chemotherapy or radiotherapy to control the spread of cancer cells.The purpose of doing this is not to cure, but to prolong the survival period of patients.

Then the patient will be prescribed some painkillers to relieve the pain of advanced cancer.

Many people think that trigeminal neuralgia has the highest level of pain, and some people think that childbirth is the most painful. In fact, these pains are nothing compared to cancer pain.

Cancer pain is what really makes life worse than death.

Especially the pain in the late stage of cancer is enough to make people feel miserable.

(End of this chapter)