Doctor of Healing

Even worse than writing a composition.

It's hard to imagine that this is a medical record written by a doctor, and it's no wonder that the director scolds people, and he would probably say even worse things in his own words.

……

……

In hepatobiliary surgery, nurses usually leave after the shift is over to dispense medicines, administer drips, and infusions.

Director Yang sat in the middle of the front row, looking at a patient's medical record on the projection.

"The patient is a very rare gallbladder torsion, Xiao Zhai, who will report it?"

"Zhao Mengmeng."

Zhao Mengmeng heard Zhai Yuhan calling her, walked to the computer and began to click on the medical records.She was very nervous, her steps were stiff, and she turned slightly, which was very funny to watch.

Her operations were projected onto the screen, and the moment Director Yang saw the main complaint, his face became extremely ugly.

Chief complaint - abdominal pain for 3 hours.

At first glance, there was nothing wrong with it, but the smile on Director Yang's face disappeared.

"Your chief complaint was copied from the emergency medical records." Director Yang said coldly.

Zhao Mengmeng tensed her legs together and twisted them into twists.

The feet under the table trembled slightly, obviously Zhao Mengmeng was very nervous.She was afraid that she could not write well, so she copied the emergency department's medical records and complained, but she didn't expect to be seen through by Director Zhao at a glance.With just one sentence, Zhao Mengmeng felt embarrassed, apprehensive, and even vaguely afraid.

"Next, what's the medical history?" Director Yang asked sharply.

Zhao Mengmeng was extremely nervous, and she didn't know how to answer Director Yang's question.

"Expand the main complaint to describe the patient's disease process in detail. It's not for you to write in a cloud. If you can't describe the patient's disease process clearly in dozens or hundreds of words, who are you writing for!"

……

……

The guests in the comment room were awe-inspiring, as if they were sitting at the scene, they clearly felt Director Yang's gradually serious and sharp words, and felt the oppressive atmosphere.

That kind of powerful aura belongs to the professional field, and the guests felt the same, as if they had transformed into Zhao Mengmeng, sitting in front of the computer and being reprimanded by Director Yang.

"So serious." A guest muttered in a low voice.

"It's normal. The lower-level doctor's medical record is not well written, and the superior doctor must point it out." Professor Shen said seriously, "Zhao Mengmeng's medical record is indeed not well-written. I guess she has never written a medical record before. No point."

"If I change to my old hospital, I guess the medical records will be thrown aside." Maomao said in a low voice.

……

……

In the doctor's office, Zhao Mengmeng has entered the state of fugue again.

This time, it was directly shut down by Director Yang's training, and my mind went blank.

"In the emergency department, what is muscle guard? In today's terminology, few people say that. Only old doctors with more than 20 years of experience occasionally use muscle guard to describe it. Zhao Mengmeng, tell me about the concept of muscle guard." .”

"..."

Zhao Mengmeng stared at the screen in a daze, and water began to appear in the circles of her eyes.

"Zhao Mengmeng." Director Yang emphasized his tone.

"Director, I watched the patient last night, how about I answer it?" Ji Xiang asked tentatively.

Director Yang glanced at Ji Xiang.

His stern tone chilled the atmosphere in the doctor's office, and even the professors in the group all looked away, for fear that he would not be able to answer a question without being scolded.

But Jixiang was as usual, he couldn't see any nervousness, and blocked Zhao Mengmeng's eyes to meet him.

Want a hero to save the beauty?Hey.

"You answer." Director Yang nodded.

"Muscle guard is also called muscle resistance, which is the antagonistic contraction of muscles to local touch and tenderness stimuli..."

Ji Xiang began to talk about the concept of muscle guard.

But his explanation was not long-winded, and Director Yang did not interrupt him. After briefly describing the concept of muscle guard, he returned to the patient's medical record.

At that time, Jixiang had a physical examination with the emergency physician, and he described the patient's condition in detail.

"Well." Director Yang was satisfied with Ji Xiang's answer, and said lightly, "Dr. Ji Xiang, you said that you were observing patients in the emergency department at that time, not mentioning the medical records, but why you were interested in this patient at that time."

"That's right, Director." Ji Xiang replied, "At that time, I was worried that the emergency department was too busy, and I didn't tell the patient to pay attention to the position when vomiting, so I went to give a warning. But when I went to the emergency department, the patient appeared again. Abdominal pain and fear of pressing."

"What are you thinking about?" Director Yang asked.

"Gastrointestinal spasms were not considered at the time."

"I asked you what you were thinking about at the time." Director Yang pressed every step of the way, with an aggressive tone.

The chilling wind howled in the doctor's office, and the professors in the group all lowered their heads at the same time, as if they were the ones being asked the question.

Zhai Yuhan also lowered her head, she was afraid that if she and the boss looked at each other, she would be dragged by Ji Xiang.

At this moment, Ji Xiang's answer must not have any flaws, as long as he is caught by the boss, he will be scolded.

But Ji Xiang was not nervous. He smiled and said, "Since it's not about the hollow organs of the gastrointestinal tract, I'm thinking about whether there will be gallbladder torsion."

"Why do you think about it, gallbladder torsion is rare."

Chapter 431 Highly rated

Chilling wind.

Except for Professor Shen and Mao Mao, no one of the guests expected that the hospital rounds would be so serious, and no one expected that Director Yang, who seemed amiable at first, would suddenly change his face, making people afraid to look at him.

"The last time I recorded a law firm program, I thought they were too serious. I didn't expect them to be too gentle compared to the doctors in the hospital."

"Yes, Director Yang is going to scold someone."

"I couldn't stand it even if I wasn't there, my legs were shaking a little. Did Director Yang do it on purpose?"

The guests exchanged in low voices.

Their voices were lowered subconsciously, as if they were worried that Director Yang on the screen would hear them.

……

"The gallbladder is normally located in the gallbladder fossa at the front edge of the interface between the left and right livers. It is relatively fixed and not prone to torsion. So far, the exact cause of gallbladder torsion is still unclear."

"However, the medical community believes that there are several possibilities. First, congenital anatomical variation: mesenteric gallbladder, free gallbladder, sagging, and increased mobility."

"Second, the elderly have fat atrophy, ligament relaxation, and increased gallbladder activity."

"Third, hunchback causes viscera to sag and change in position."

"The fourth triggering factor is body position changes during exercise or strong gastrointestinal peristalsis, and even cholestasis and incarcerated stones can also induce gallbladder torsion."

"The patient reported that he had passed by before the abdominal pain, so I became suspicious." Ji Xiang was not intimidated by Director Yang's aura, and answered the questions well-founded and clear.

"Intermittent pain, tender point in the mid abdomen, differential diagnosis..."

After Ji Xiang finished talking about the predisposing factors of gallbladder torsion, he began to talk about the differential diagnosis. Director Yang's expression did not change, but Ji Xiang's words set off huge waves deep in his heart.

It seems that Ji Xiang is "dropping the book bag", but the senior doctors know that Ji Xiang is talking about his own mental journey at that time.

That is to say, at that moment, Ji Xiang thought about countless things from the muscle guard performance of the physical examination.

"In summary."

After 3′12″, Jixiang finished speaking, he was still smiling, “Because gallbladder torsion is a relatively rare disease, and there are many differential diagnoses, so it can only be diagnosed initially. It is suspected to be gallbladder torsion and it is recommended that the patient check the upper abdomen, Mid abdomen CT. "

"Why is there no cholelithiasis in the diagnosis?" Director Yang suddenly asked an extremely strange question.

"There is no significant correlation between gallbladder stones and gallbladder torsion, and about 70% of patients with gallbladder torsion have no gallbladder stones at the time of diagnosis.

Congenital factors are the main cause of gallbladder torsion in children, while age-related physiological changes are more likely to be the cause of gallbladder torsion in adults.

There was also no significant correlation between the direction of gallbladder torsion and the degree of torsion 180°, incomplete torsion, >180°, and complete torsion. "

"Later, the patient completed auxiliary examinations, which confirmed the above judgment, and the diagnosis was clear. It was gallbladder torsion with acute acalculous cholecystitis."

After listening to Ji Xiang's speech, Director Yang seriously looked at the young man in his prime.

He wanted to ask Ji Xiang a difficult problem, but the so-called "difficult problem" could not trouble him at all, and Ji Xiang answered it fluently.

From being cautious at the beginning, to accidentally discovering that the patient's condition is wrong, to directional signs, to various judgments, the order is clear and impeccable.

Director Yang was in a daze. Even if he answered this question by himself, it would not be as simple and clear as Ji Xiang's answer.

"Doctor Ji Xiang, this is a rare disease, how do you know so much about it?"

Director Yang's tone finally softened, and he asked with a calm expression.

"Our local hospital has come into contact with similar cases." Ji Xiang laughed, "Park Heyun, Liu Yulin, Xie Guanghua and other teachers wrote a similar report-a case of laparoscopic resection of gallbladder torsion with necrosis."

Director Yang nodded.

"As for the medical records..."

"Wait to pick up patients, you write." Director Yang looked at Ji Xiang and said.

"it is good."

……

……

There was no sound in the comment room.

The atmosphere at the scene was too depressing, the host's bald head lit up, one corner of his mouth twitched, and he started to save the scene.

"I didn't expect our interns in this reality show to be so good." The host said haha.

The lay guests didn't know what to say, even if they wanted to say something, they didn't know how to say it.

The semi-expert guest Maomao stared blankly at Ji Xiang on the screen, wondering what he was thinking.

Professor Shen was the only expert, and he was even more silent, and ignored several reminders from the film crew, just frowning thoughtfully.

"Professor Shen, are interns like Ji Xiang common in hospitals?" Seeing that no one answered his words, the host had to throw out a question to forcefully enliven the atmosphere.

"Intern?" Professor Shen smiled wryly.

"Yes, he is still a regular training doctor."

"Let's put it this way." When Professor Shen saw the screen switched to another ward, he immediately became interested, remembered his status as a guest, and started talking, "Dr. Ji Xiang gave me the illusion that he is not a doctor with no clinical experience Interns, but those who have worked in the clinic for more than ten years, are slippery..."

As he said that, Professor Shen felt that something was wrong with his description, so he laughed, "Slippery is a word we occasionally describe, cut this part out."

The host also laughed, this matter is over.As for whether to cut it in the end, it depends on Director Fan.

"How should I put it, he is like the kind of doctor who had a medical malpractice, was almost sentenced, and has a deep sense of guilt in his heart... I can feel a very strong aura of obsessive-compulsive disorder in him. "

"Obsessive-compulsive disorder? How do you say this?"

"Everyone knows that there are small probability events in everything. Small probability events in medical treatment are the most troublesome. Seeing dozens or hundreds of patients every day, no matter how small the probability is, it will become a high probability event after a long period of time."

"It's not wrong, it's because you don't see enough patients."

"But the medical industry has its own particularities. What if something goes wrong? It's human life. So many doctors have obsessive-compulsive disorder, just like Dr. Ji Xiang. The patient has already gone to the emergency department, and he is still worried about the emergency department. , Emergency doctors don’t have time to tell patients to pay attention to their posture when they vomit.”

"As for the physical examination, if you find any problems, you must continue to investigate. That's nothing special. I just feel that a young doctor like him knows responsibility before he manages the bed."

"Responsible?" The host was a little confused.

"Yes, interns don't have to be responsible, so the pressure is not so great, and there are often problems at work. And only when you take care of your patients and take responsibility, can you be a real doctor."

"Let's not talk about curing diseases and saving lives, but about going all out. I think Dr. Ji Xiang is already a qualified clinician."

Professor Shen's evaluation is high enough.

Chapter 432 Came with parents?

The big round of the hepatobiliary surgery is over, Director Yang looks at Ji Xiang with admiration.

As expected, Boss Qin Chuqin of the Magic City took the initiative to solicit, and even arranged enough appointments to invite academicians to sit in the town, but was directly rejected and scolded the autistic medical students.

His basic skills are extremely solid, and he has rich clinical experience, and he also solved two major events in one day.