There were no cars on the road in the third year of junior high school, so the speed was very fast.The poplar trees on the side of the road flashed in rows, and Li Min noticed that the branches in the distance had no snow attached to them after the baptism of the northwest wind.It's so ugly to be bare!
That is, the gray-blue sky is high, which makes people feel not depressed.After a while, Li Min also leaned on the back of the chair and squinted his eyes."
Uncle Qin, Director Qin, I'm here, I want to check my documents."
Li Min was awakened by Feida's voice.Santana stopped, she didn't even notice.She sat up straight and looked in the rearview mirror, and saw that Director Qin and Zhang Zhengjie were also stunned and woke up.It's okay, it's okay, it's not that I'm really asleep by myself.Director Qin handed a letter of introduction out of the car window.The guard with a gun took the letter of introduction and looked at Santanari, whose window was wide open.The cold wind poured in, making Li Min shrink his neck.And the guard couldn't help but be stunned for a moment when he saw Li Min, who was covered in red, and Li Min also noticed the badge on the inspector's hat.After checking the number of people, the doorman politely returned the letter of introduction to Director Qin, and enthusiastically showed them the way: "Drive along this side of the road, turn right at the second fork, and someone will be waiting for you at the door of the building." ”Apparently someone had already greeted him, "Thank you." ”After Director Qin signed the visit registration book, he watched the doorman accept the letter of introduction."
Director Qin, you can.We're all stained with your light, so we don't have to get out of the car. ”Zhang Zhengjie has lived in the compound for many years, and he praised Director Qin by the way."
Everywhere, it's a letter of introduction from the provincial hospital that has face.You don't have to call me any director, just call me Lao Qin.Calling me Brother Qin is lifting me up. ”The words are here, Zhang Zhengjie is naturally good.Director Qin nodded with satisfaction.My daughter-in-law is right.Aren't you just missing a foundation in the clinic?
Isn't it just a lack of foundation in surgery?
Zhang Zhengjie, who has no foundation in the provincial hospital, but is very motivated and not bad at technology, is also a section director, if he can unite with himself, wouldn't it be just right?
!
Adapt to the situation, guide according to the situation.Director Qin silently recited it in his heart a few times, and then he didn't feel that Zhang Zhengjie's dress comparable to that of the captain of the Japanese military police squadron was an eyesore.Even Li Min, who was covered in dazzling red, didn't let him hold his breath and block his heart.
*Feda slows down and follows the doorman's instructions.Sure enough, after turning the second intersection, I saw a man wearing a white coat and a dark blue cotton coat outside, standing at the front door of a three-story small building made of red bricks, looking at the appearance of others.Santana came to a steady stop in front of the strange little red brick building.As soon as the car stopped, Director Qin opened the door and got out of the car, Zhang Zhengjie slowed down a few beats, and only when Director Qin bypassed Santana and bypassed the door where he was in the car did he push the door and get out of the car.Li Min originally got out of the car at the same time as Director Qin, but at this time she stopped and let Zhang Zhengjie walk in front of her.Just look at Director Qin greeting that person."
Lao Zhou, for the New Year, I'm sorry to invite you out of the house.""
Ha, you old Qin still know how to write if you're embarrassed.What's the matter, you brought a beautiful girl with you?
”"Don't underestimate pretty girls.This is the attending physician of the neurosurgery department of our hospital and the advanced worker of the provincial hospital.Let's get acquainted.This is Director Zhang Zhengjie and Director Zhou of the Department of Trauma Surgery.This is Dr.
Li Min, who graduated from the Medical University the year before last. ”Director Zhou shook hands with them."
Fortunately, Director Zhang.Dr.
Lee.After graduating the year before last, he was promoted to attending doctor, such a young attending doctor.Graduate students?
”Li Min shook his head with a smile, indicating that he was not a graduate student.Director Qin said, "After finishing the business in a while, let's drink and talk."
Have all the people invited arrived?
”"A few minutes ahead of you.I said, Lao Qin, your battle is a bit big.The first forensic doctor in the provincial city was invited out by you for the New Year; There is also a professor of anatomy at the Medical University, Dr.
Li, you may know. ”Li Min smiled at him, in response to his question."
The rest of you, I asked you to be the deputy director of our provincial forensic appraisal office, and he also has the right to sign independently.Three people come from three places, and it is absolutely guaranteed that justice is put first. ”"Thank you for your hard work.In a moment, I will respect you several times more. ”Director Qin is very familiar with and close to Director Zhou.Li Min and Zhang Zhengjie followed behind the two, listening to the two chatting and walking back, almost at the end of the corridor, the man looked back at Li Min and said, "Doctor Li, if you are afraid, you will wait for us outside." ”Li Min shook his head, "Thank you, I'm okay." ”Got here and said scared?
How can it be."
Then come with me."
Push open the door at the end and there is a suite.Director Zhou stopped, took off his cotton coat and hung it up, turned around and said, "You can put your things here." ”Li Min opened the schoolbag in her hand and took out a plastic bag, which contained her white coat.Changing out of the red tweed coat and putting away the scarf, Li Min calmly put on a hat and mask and tucked his hair, as if he was about to go to the dressing room.Zhang Zhengjie said with a smile: "Xiao Li is still fully prepared." ”Director Qin saw that the three of them were wearing white hats and white masks, and only then did he realize where he was wrong.There's no way, let's go in.The temperature in the room was very low, and Li Min couldn't help but shiver when he entered.Director Zhou casually took off the blue coat hanging on the wall and said, "One piece for each person, pick out the clean one for yourself." ”Li Min followed Zhang Zhengjie and took a coat, and the cold suffocated her, so she hurriedly put on her coat.But the heaviness that followed made her forget the cold.In the small room, there is an autopsy table in the middle of the ground, and the white cloth covering it from head to toe should be yesterday's deceased.By the window there is an old three-drawer desk, on which are scattered clips and notebooks.Against the wall was a row of long tables with various surgical instruments, torn paper pockets of latex gloves, and several large and small white enamel rectangular plates.Li Min knew that the purpose of those plates was to hold the organs that were taken out for a while for further dissection.Three men in white clothes and white hats and masks were also tightly covered, standing on either side of the dissecting table.Seeing that two of them were still wearing gloves, they probably just came in."
Zhou, start now?"
The old man with the glittering scalpel asked.Li Min judged from his half-white sideburns and voice that he should be the oldest.Let's call it an old man.Director Zhou didn't introduce it."
Let's get started."
Li Min took out his notebook and unscrewed the pen to prepare for the record.Before she came, Chen Wenqiang specially reminded her to write down everything she saw, record it objectively, and not mix personal consciousness.…… The lungs are dull and the person has a history of smoking.There is calcification in the hilus, which should be old tuberculosis calcification.The location is here in the hilum of the lungs, probably adolescent tuberculosis.It is not easy for people of the deceased's age to be able to resist tuberculosis in the past adolescence.One of the three would occasionally say a few words, and Li Min felt that his voice was a little familiar, but through the tight mask, she guessed that this was a professor of anatomy at the medical university.Except for him talking, everyone else watched the old man operate in silence.…… No blood clots in the pulmonary arteries!
All the dissected pulmonary arteries, trunks, and branches are exposed in front of everyone.It is clean, not only no blood clots but also no bruises.Director Zhou was also recording, he took notes and looked at it, and at this time, he couldn't help but fall his eyes on Zhang Zhengjie.Zhang Zhengjie's face immediately changed color."
Not a pulmonary embolism?
However, the patient had only three minutes to go from unwell to death.Definitely within three minutes.Isn't it, Xiao Li?
”"Yes."
Li Min replied to him simply.She just recorded what she saw faithfully and went back to Chen Wenqiang for reference."
Look at the heart.It's not right in the heart. ”Not only is it wrong, following Li Min, who has undergone several heart valve repairs, she already has an intuitive understanding of the normal pericardium.Intuition made her subconsciously cry out: "Cardiac tamponade!"
”Zhang Zhengjie, who was standing next to Li Min, shook with Li Min's words, he unconsciously bumped Li Min's arm, and the pen in Li Min's hand immediately scratched on the sticky note paper.Li Min glanced back at Zhang Zhengjie with his head sideways, and saw that the muscles on his cheeks were biting out obvious marks, and they were shaking rapidly.If cardiac tamponade......
Li Min could guess what was in his mind - the mistake was all from the hospital.Cut the heart pack, see the blood clot that has stasis, and the ruptured heart......
The old man took out the whole heart and put it on the large enamel plate held by the man who was familiar with Li Min's voice.Director Qin and another middle-aged man who didn't talk much lifted out one of the platforms against the wall, put the enamel plate on it, and changed the dissection location to this platform.Seven people gathered together again.* The old man continued to operate steadily, and Li Min's familiar voice also continued to explain.But Li Min somehow had the feeling that he was teaching himself a lesson.Dissect the blood vessels supplying the heart.Zhang Zhengjie gasped - there was a thrombosis in the coronary artery, and the coronary artery was completely blocked.Li Min and Director Zhou wrote down the man's truthful description at the same time.Now the cause of the patient's death is clear!
They are all wrong, the diagnosis is wrong, not a pulmonary embolism!
The male voice that Li Min was slightly familiar with calmly reported the cause of death: coronary embolism, myocardial infarction, heart rupture, and cardiac tamponade.Zhang Zhengjie looked at Li Min sideways.His voice was as vague as an edifice without support."
Xiao Li, I did an electrocardiogram before the operation, right?""
Yes.Normal age-appropriate ECG.There are no contraindications to surgery in all preoperative examinations. ”After Zhang Zhengjie got Li Min's answer, he staggered out a little.He muttered to himself: "We are all thinking about pulmonary embolism and going to rescue it."
I didn't expect it, I didn't expect it to be coronary embolism......
"And, most importantly, the patient's heart ruptures!"
The heart ruptures, causing severe hemopericardial hemorrhage and tamponade!
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This embarrassed the provincial court.In terms of clinical diagnosis and treatment, everyone thinks in the direction of common and frequent diseases.Who will think about rare diseases first after seeing critically ill patients?
However, when it fell on this patient, the mistake of the provincial hospital became obvious: the treatment direction of pulmonary embolism was anticoagulation and thrombolysis.- It is said that the amount of urokinase used must reach a quarter of the body weight to be effective, Li Min secretly thought, thrombolysis?
Is it in time?
For cardiac rupture and cardiac tamponade, pericardiocentesis may be needed to relieve the compression on the heart.The first aid ideas of the two are completely different.But whether it's pulmonary embolism or cardiac tamponade, these two diseases have one thing in common: die fast!
Whether it is the thrombosis of the pulmonary artery, whether it is a ruptured heart, or cardiac tamponade, it will cause the patient to lose his life instantly.Especially the latter, the heart is ruptured, and any rescue will not help.For this patient - even if the diagnosis is clear, pericardiocentesis is not possible for everyone; Even if a pericardiocentesis is performed, the heart is still ruptured, and the blood clot that blocked the coronary artery is also there......
There is no time for thrombolysis, and it is too late for thoracotomy......
However, the diagnostic error of the provincial hospital cannot be avoided.After Li Min and the other three experts signed the autopsy record, they followed Director Qin out of the autopsy room.She changed back into her clothes, packed up her white coat and notebook, and quietly stood beside Zhang Zhengjie, who was a little depressed, and whispered her thoughts to him.She added: "I remember the patient's doctor's order, and he was given anticoagulant drugs.Xiao Cao also wrote in the ward round record that the patient was instructed to move in bed and let the family massage both lower limbs.Director, we've done everything we need to do......"
"Xiao Li, thank you.Alas, I didn't expect it, I didn't expect it.Even if I studied medicine, I still couldn't do anything about the death that happened in front of me. ”Zhang Zhengjie's spirit was very bad, but he received Li Min's kindness."
I don't blame you, Lao Zhang."
Director Qin was born in internal medicine, and he was the earliest, two-year worker, peasant and soldier college student.Although he has not been clinically engaged in clinical practice for many years, he can still understand Li Min's explanation.He agreed with Li Min's words to comfort Zhang Zhengjie.also followed Li Min's words to persuade Zhang Zhengjie."
We didn't think in the direction of heart rupture, which is in line with the principles of treatment.After all, it's a pulmonary embolism that has a higher chance of occurring, isn't it?
But let's talk about that back in the hospital.After a while, you accompany them to have a few more drinks, and invite people out for the New Year, we can't be rude. ”"Okay."
Zhang Zhengjie understood that Director Qin's character who accompanied him to drink was to divert his attention.He accepted Director Qin's kindness, and also tried to support his spirits, and responded to Director Qin's request.Regarding drinking, he Zhang Zhengjie has never been afraid of anyone.What's more, the three introduced by Director Zhou just now, which one is worthy of him Zhang Zhengjie to befriend; None of them are the ones he can make friends with now.* After a long time, Director Zhou came to greet them."
Lao Qin, let's go.Let's follow the old rules. ”"Okay, I'll listen to you.Let me tell you that our Director Zhang can drink it, and I will make sure you enjoy it today. ”"That's good, can Xiao Li drink some?"
Director Zhou is quite concerned about Li Min.Li Min hurriedly shook his head: "I can't do it, just pour a cup." ”"That's not going to work, how can a surgeon do it without a drink.Just practice and drink more. ”Out of the red brick building, Zhou said to Lao Qin: "Your car is behind me."
Boy, can you keep up?
”Feda assured: "Don't worry, I'll follow." ”Director Zhou smiled heartily and got into the car not far away.The black crown 3.0 of the O brand, with its dirty and ruined appearance, has been corroded into a fist-sized hole at the taillights.It's not as good as Feida's Santana, although it is also an old car, but it is clean and clean.* The two cars drove one after the other out of the range of the solemn national emblem.Fei Da glanced at Li Min, and when she saw her heavy face, she asked, "Have you found out the reason?"
”"Hmm.""
What's the problem?""
Cardiac tamponade."
Fei Da bluntly still gave Li Min two words: "I don't understand." ”The implication is obvious.Li Min smiled and coughed lightly, and looked at Director Qin from the rearview mirror.Thinking she wanted to look in the mirror, Feda said, "There's a mirror on the visor." ”"Thank you."
Li Min accepted Feida's misunderstanding.Flip open the visor and carefully shine your lip gloss.In order to stop Feida from questioning again, she took out her lipstick and gently wiped it seriously.Director Qin saw Li Min looking at him through the rearview mirror, and thought about it and understood what Li Min meant.He said to Feida, "Feida, don't inquire about this, you should not know."
The results will be announced after the decision of the Council of Trustees. ”"Yes.Uncle Qin.I understand. ”Fei Da retracted his face and said seriously: "Uncle Qin, I won't talk nonsense."
Didn't I look at the fact that all the people in this car were my own people, so I couldn't help but ask.You didn't say it to me.Good no good?
”"Alright, don't be weird, I'm not going to tell your dad.Director Zhang and Dr.
Li are not talkative people. ”Li Min was the first to say: "What did you say?"
”Zhang Zhengjie bumped Director Qin with his elbow: "Look, let's be smart."
But let me tell you that Xiao Li doesn't drink much, she can't drink. ”"Director Qin, why don't you put me down first, I'll go back to the hospital by myself.I still have to be on duty. ”Li Min seized the opportunity to affirm his wishes."
How's that going to work?
After such work, it is customary to drink a few glasses to drive away bad luck. ”How could Director Qin agree at this time, just looking at Director Zhou's attention to Li Min, it was impossible for him to let Li Min go.He perfunctorily said to Li Min: "If you can't drink, you won't be reluctant."
Those are all highly respected experts, as well as professors from the Medical University, what are you afraid of?
”* There are few pedestrians on the street, the sun is slowly receding to the west, and Li Min is looking out the car window with his fingers.She began to regret coming out to see the autopsy, hoping that those people were not like Dr.
Yang......
In desperation, she could only tell from the shadow of daylight that their car was driving in a southeasterly direction.Most of the shops on the street are closed, and there are only sporadic shelves and carts on the sidewalks with boxes of New Year's pastries.The salesman in the oil pool twist overalls, in the debris of firecrackers, in the northwest wind caressed by the loss of warm sunshine, stomped his feet, covered his ears, and saw the occasional passerby, they all shouted with eager eagerness, probably hoping that the passers-by would buy pastries.The car drove through the streets that Li Min was familiar with.Is this back to the vicinity of the medical university?
Get out of the car, wipe the clean century-old deer spring signboard, reflecting the quaint light in the last afterglow of the sunset.Feida's driving skills are very good, and he always maintains a distance of about twenty or thirty meters from the car in front of him all the way.* "It's a holiday for the Chinese New Year, so let's deal with it here." ”Zhou Shi greeted the three people who had just come down behind them, and walked inside."
I've set a location, in Changchun."
Director Zhou reported the name of the room, and the waiter leaned sideways and led the group inside.When you enter the house and sit down, you naturally want to say hello and give way.Li Min stood by the door, looking at the professor of the medical university who spoke in a familiar voice, unsure of his surname.Without him, many professors and associate professors only take one or two classes.But this voice, Li Min thinks that he has heard it more than once.The professor of the medical university seemed to sense that Li Min was looking at him, and beckoned to her and said, "Li Min, come here, sit next to me."
I have something to say to you. ”Director Qin hurriedly responded: "Doctor Li, sit down next to your teacher." ”Li Min sat down as he said.On her right is Zhang Zhengjie, on her left is the professor of the Medical University, and then on the past is Director Zhou, the old man who is in charge of the autopsy, and the visitor who arrived with the professor, Director Qin.There was a vacant position between Zhang Zhengjie and Director Qin.But Feda did not appear at their table.After everyone sat down, Director Zhou solemnly introduced the people present to know each other.Only then did Li Min know that the professor next to him was the deputy director of the anatomy teaching and research department, associate professor Sheng.He introduced himself that he went to the first anatomy class for undergraduates every year.That was supposed to be in the fall of '86.I've only taught myself a big lesson.Li Min was not ashamed that he couldn't call his last name.But she just couldn't figure out why she always felt his voice familiar.The waiter begins to serve the food.Director Zhou said: "When I was positioning yesterday, I ordered all the dishes by the way.Lu Mingchun said that they can't do anything about this New Year, they don't have so many people to eat, and they can't prepare everything.I don't know what kind of dishes you like, if you find it unpalatable, let Lao Qin make it again next time. ”"Yes, yes, when the New Year begins, I invite everyone to get together again."
Director Qin took out two bottles of liquor from the bag in his hand, stood up to open the bottle, and poured the wine diligently."
The dishes are uneven, but the wine is good.Wuliangye at 52°.Tomorrow is still a holiday, and tonight we will not get drunk and not go home. ”Director Zhou looked at Li Min, who was about to open his mouth to refuse, and said, "This first cup must be drunk."
A hundred years ago, what we do today is just a job, drinking a glass of wine to get rid of bad luck. ”The glass is a bit on the big side.A glass of white wine entered his throat, and Li Min's face flew red, reflecting the clothes on his body.Among the six middle-aged men dressed in black and gray camel, it is even more prominent and conspicuous.Zhang Zhengjie stood up and wanted to pour a second round of wine for everyone, and this round he had to start pouring from Professor Sheng's side.Professor Sheng held the wine bottle and said, "Old Zhou, don't let Xiao Li drink anymore, I'm afraid of going home and being scolded." ”Zhang Zhengjie stopped pouring wine and asked, "Director Sheng, what do you pay attention to when you go home and be scolded?"
”Professor Sheng replied to him with a smile and explained to the whole table: "My wife works in the obstetrics department of the Affiliated Hospital of the Medical University, and Xiao Li's graduation internship was brought by her, and she has always regarded Xiao Li as her protégé.If I dare to let Xiao Li drink too much and get drunk today, haha......
It's better for girls not to drink. ”Director Zhou laughed and said, "What should I do?"
Lao Sheng, if you are afraid that it will be difficult to explain when you go home, let's not let the little junior sister drink.Lao Qin, you and Director Zhang may not know that Lao Sheng and her lover are in deep love.I watched them study and be classmates for 12 years, join the queue for 12 years, and then return to the Medical University together.I haven't seen them blush for so many years, and there is no one in this world who loves them more than them. ”It turned out that Director Zhou and Professor Sheng were classmates from childhood to adulthood, and they should have joined the queue together when they heard this.Since he is called Li Min's junior sister, he should have graduated from Medical University.Li Min smiled and said to Director Zhou: "Don't you dare to claim the title of 'little junior sister'."
She took the wine bottle from Zhang Zhengjie's hand and poured wine for Teacher Sheng and Teacher Zhou.Director Qin laughed, Director Zhou agreed that Li Min would not drink, and no one objected, so he immediately called the waiter to ask for a can of lychee drink for Li Min.Li Min poured wine for everyone and went back to her own seat, and whispered to Professor Sheng, "Teacher Sheng, thank you."
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It turns out that you and Teacher Chen are a family!
”No wonder I thought his voice was familiar.It should be because he looked for Mr.
Chen Huichi's phone and answered it for Mr.
Chen a few times."
yes.I didn't expect that. ”Professor Sheng looked at Li Min's surprised appearance with a smile and said, "The New Year's card you sent her last year was 'Unforgettable', but your teacher has been showing off to me for a long time."
I taught undergraduate students for ten years, and a year before she took graduate students, but I never received a greeting card like this. ”Professor Sheng remembered that his wife had a student like Li Min because of that New Year's card.But his joking jealous appearance made Li Min laugh.Director Zhou smiled and took Professor Sheng's words and asked, "Xiao Li, what kind of teacher does Lao Chen have for you?"
Let's talk about it quickly, lest you be so jealous that Mr.
Sheng will not drink spicy wine and eat delicious food. ”Li Min put the can away and recalled with a smile: "My right hand was not dexterous enough at that time, so Teacher Chen asked me to practice knotting on her fingers, using the right hand of the zero line to tie the knot. ”"Oh?"
Except for Professor Sheng, everyone else was surprised.Practicing knotting on the fingers, when did the teacher who took the undergraduate internship get tired of having such patience?"
It's because you need to control the strength of the knot.Like the hemostatic suture of the serous layer, it will tear if the force is too strong. ”Li Min explained."
I practiced on Mr.
Chen's fingers, and the strength was felt by Mr.
Chen, and he would immediately correct mine."
Director Zhou said, "Lao Sheng, you didn't take students like this, did you?"
”"Haha, my two graduate students, the boys are all hob meat, I don't let them practice picking pig bones, peeling and beef tendons, I have already treated them well."
Zhang Zhengjie interjected: "No wonder as soon as Xiao Li entered the clinic, those basic skills were recognized by Dean Chen. ”"That's not all the credit of our family Lao Chen.Our Lao Chen is because she has a solid foundation, obvious left-handed advantages, and people also lose their temper, so she is a good material for obstetrics and gynecology, so she is extra favored.I won't hide it from all of you, our Lao Chen started recruiting graduate students this year, and she has already muttered to me to see how to let Xiao Li take her graduate school exam in the future.Director Qin, I heard that your provincial court has very strict control in this regard, and you will have to let it go in the future. ”Director Qin replied with a smile: "I have no problem here."
Look at Dean Chen of our provincial hospital.Xiao Li has done a lot of craniotomy with Dean Chen in the past two years, and she has been promoted to the attending doctor of neurosurgery for this reason.Xiao Li, are you willing to do neurosurgery?
”Li Min smiled and didn't answer, picked up the wine bottle and poured wine for the audience again.The old man in charge of the knife said, "Lao Sheng, I know the temper of Chen Wenqiang of their provincial court.He is three times lower than me, the straightforward and fiery one when he was young, if it weren't for the Shu Wenchen who always followed him, if you Dean Shu took care of him, he, maybe how many people he would offend.Your lover wants to rob him of someone, you can do it right. ”The one sitting next to him said: "The meat is rotten in the pot, why are they all students of their old Chen family, let's not care so much, drink!"
The Wuliangye prepared by Director Qin today is good.Little junior sister, come, pour wine for me first. ”Yes, this one graduated from the medical university again.Li Min still called Director Zhou a teacher according to his example.Director Qin and Zhang Zhengjie sighed in their hearts, look at the people at this table, look at Li Min's luck, either the teacher's "senior brother", or the "senior brother" from the same medical university.And the two of them, as workers, peasants and soldiers college students who graduated from other provinces, naturally lack the alliance of these alumni and can set up close contacts.The two looked at each other, and in this moment of looking at each other, the two reached some kind of consensus.…… When I went downstairs, Li Min and Professor Sheng walked last.She said to Professor Sheng, "Teacher Sheng, I am now the general inpatient officer.When I have time, I will definitely go back to see Mr.
Chen.You can bring a good one for Teacher Chen for me. ”"yes, yes.She's always thinking about you.Not long ago, I asked Zhu Ercheng to take a look at you. ”"I met Teacher Zhu in the ICU.I didn't say a few words. ”Professor Sheng smiled, the two of them had heard from their neighbor Zhu Ercheng that Li Min was doing a good job in neurosurgery.He didn't expect to meet his wife's favorite student on such an occasion today.He saw Li Min's badge before she put on her cotton coat.Attending Physician of the Department of Neurosurgery of the Provincial Hospital: Li Min.100% the student that my wife likes.He earnestly encouraged Li Mindao: "Do a good job, neurosurgery is also good." ”"Hmm.I'll try. ”*It's late to get back to the provincial hospital.Even during the Chinese New Year, at the main entrance of the hospital, there are still many small vendors selling fruits and pastries with stalls and kerosene lanterns.Visitors passing by the vendors who were going to visit the hospitalized were greeted by the vendors, who stopped in front of the vendors' carts and carefully selected whole handfuls of bananas and big red apples.These are the most appropriate gifts for visiting inpatients.Of course, they also blocked part of the passage in front of the provincial courtyard by the way.Security guards drove the vendors back and forth at the main entrance, shouting loudly for them to back off the road for cars.Director Qin instructed Fei Da to drive the car to the garage."
Uncle Qin, I'll go directly downstairs to the dormitory.""
No, it's not a few steps, just take a walk after dinner."
I don't invite that tongue when I go out on business.After getting out of the car, Li Min said, "Director Qin, Director Zhang, I'll go back to the department for duty." ”"Okay, you can go back."
Director Qin's later attitude towards Li Min was that of the normal hospital leader to the hospitalized doctor.Therefore, Li Min is also respectful and polite to him.You respect me a foot, and I respect you.Hello, hello, everyone.Li Min was in no mood to cause trouble or offend people, but when the provocation came to her, she didn't shy away from it.Li Min returned to the twelfth floor, changed into a white coat, and went to the director's office to find Chen Wenqiang with his records.Director Liang was sitting in the office, chatting with Chen Wenqiang.There was no smoke, which surprised Li Min."
Director Liang has a good New Year.""
Happy New Year.Come, give you a New Year's money. ”Director Liang took out a red packet, and Li Min unceremoniously reached out to take it."
Thank you, Director Liang."
Chen Wenqiang patted his head, stood up and went to the wardrobe to take out a red packet, walked back and handed it to Li Min."
I forgot to give it to you."
Li Min smiled and took it, "Then I'll say goodbye to the next year, good New Year, teacher." ”Chen Wenqiang smiled."
Is it going well today?"
Li Min handed over his record."
I recorded it all, it's not a pulmonary embolism."
Director Liang was discussing this matter with Chen Wenqiang, and after listening to Li Min's words, he asked, "Isn't it?"
What is that?
Cardiac tamponade?
”Without waiting for Li Min to answer, Chen Wenqiang had already swept Li Min's record in ten lines at a glance.He sighed and said, "You guessed it. ”Director Liang stood up and leaned over to him, and carefully read Li Min's record with him.Then persuaded Chen Wenqiang, whose face was gloomy: "It's not your fault, who would have thought of it?"
”"But in this case, I can't excuse this diagnostic error.""
You can pull it down.It is to invite all the people from the appraisal committee, associate professors, deputy chief physicians and above from the provincial capital, and give them a minute to judge pulmonary embolism and cardiac tamponade.Can you tell me about a few people who can think about cardiac tamponade, heart rupture?
”"Teacher, the preoperative examination has been done, and the results of his electrocardiogram and other examinations are in line with the physiological manifestations of his normal age.This patient has no contraindications to surgery such as coronary heart disease. ”Director Liang immediately followed up and said, "That's it, Lao Chen, you have to accept that this is an accident."
If you have to take it on yourself, our surgeon will not be able to operate in the future. ”Chen Wenqiang still doesn't open his face much.Director Liang continued: "You see that our current preoperative explanation is complete enough, right?
Do you think we should add another one in the future?
Surgery may induce changes in the blood supply to the myocardium in older patients, leading to myocardial infarction and heart rupture, making it impossible to resuscitate?
”Li Min looked at Director Liang and persuaded Chen Wenqiang not to interject, because she knew that it was embarrassing.At the time of the incident, if Chen Wenqiang was not on the eleventh floor, it would be easy to say.But he is here, it must be him who will command the rescue, and it must be he who will come forward to take the responsibility for the diagnosis error."
If that's the case, then the patient won't be too scared to have surgery?!"
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Director Liang smiled and reminded Chen Wenqiang of this most likely scenario."
Director Liang, how do you define this age, it refers to people over 45 years old?
Or according to the retirement age?
Female 55, male 60.This is also not suitable for age, and I think it is better to do an exercise ECG screening first. ”"Look, we Xiao Li can all recognize things, I don't believe you understand.Patients with femoral neck fractures, you want to do exercise ECG screening, is it possible?
You, hurry up and let Secretary Tang come forward to have a good talk with the old lady, and we should bear our fault.If you can help the old lady deal with what you can, you will be worthy of her and the deceased.You say, don't you?
”"But the diagnosis was wrong.""
If we have the right diagnosis, can we save it?"
Chen Wenqiang was asked.In the middle of the night, he muttered the words "can't be saved".Then he rubbed his hands unwillingly and said to Director Liang: "But after this incident, we have to be like a method, how can we prevent such an accident from happening again?"
”"You're on the horns again.If an accident can be prevented, then it is not called an accident.For example, before this patient had this postoperative incident, we would have done a bedside electrocardiogram (ECG), which could find changes in the blood supply to the myocardium.But here's the problem: the ECG room is willing to come over and give the deceased a normal ECG.But there is no problem with the preoperative examination items, and you still give it to the patient after the operation, and there is something to say about the examination, but what if it is okay?
Will you have no opinion when a patient?
Will you be recognized as a patient?
”"yes."
Chen Wenqiang sighed."
No one would approve of such an inspection, and no one would charge for such a repetitive normal test result.Myocardial ischemia after surgery is by no means a matter of one or two days. ”"But it definitely didn't happen within 24 hours after surgery.The deceased also spent two days in the intensive care unit after surgery.After the operation, there are no discomfort symptoms, and it is impossible to monitor the ECG all the time. ”Chen Wenqiang was helpless."
Lao Liang, you're right.The cost of an intensive care unit is much different from the cost of secondary care.But how can this be avoided?
”Director Liang looked at Chen Wenqiang, who was frowning and thinking hard, and said, "How to avoid it is not something you can think of at a moment.It's time for you to go home for dinner.When you're full, think about it slowly. ”"Hmm.Then I'll go back.Lao Liang, Xiao Li, you two need to be careful tonight.I saw that the thirty nights who were brought in downstairs were slashed, and the humanity of that house was not good, so don't fight again in the ward. ”Chen Wenqiang put away Li Min's records."
Good.Let's go over and take a look. ”Director Liang took the lead and walked out, Li Min nodded to Chen Wenqiang, and went out behind Director Liang.* Chen Wenqiang transferred the patient's room in the afternoon and transferred him from a small room for four people to a single room, clearly saying that it was because his family's noisy three days in a row seriously affected the rest of the others, and he had to go to a single room and pay for the cost of a single room and an intensive care unit."
Don't do it?
If you don't do it, you will be discharged from the hospital.Can't be one for you to influence the other three.The 11th floor is basically full, and those who want to live in the custody room can't live in. ”Due to Chen Wenqiang's position as vice president on his badge, the patient and his family had to go to the intensive care unit.But the people have already made up their minds and are ready to celebrate the New Year, so they will go to the health bureau to complain about him.The two of them went to see the patients who were admitted today, but fortunately, during Li Min's absence, only one person was admitted.It was an old lady with a Clay's fracture, and Dr.
Wang did not dare to reduce it without authorization, so he was admitted to the ward and asked Chen Wenqiang to reduce it.The reason is that the old lady has diabetes, and her blood sugar is 12.3mmol/L after examination.After Chen Wenqiang reset the old lady, he asked the endocrine to come over and adjust the blood sugar for the old lady according to the regulations.After Director Liang took Li Min to see the patient, Director Liang said to her: "For this kind of fracture, you'd better learn to reduce the fracture." ”Li Min clenched his fist and released it, saying, "I can memorize the steps, but the strength of my fingers is not enough, so I don't dare to try to reset the position."
It's not good to do a reset under X-ray.Hey. ”When Director Liang saw Li Min say this, he no longer forced her.He changed the subject and asked, "I heard that you quarreled with Qin Guoqing again?"
”"No noise today.I have a lot of respect for him today. ”"Don't quarrel with him in the future.If you are not afraid of offending the gentleman, you are afraid of offending the villain.I think that when Lao Li was young, he was not much worse than Xie Xun now.He just didn't take the old dean in his eyes, the old dean was not the head of the medical department at that time, you see that he has been ruined in his life......
Alas!
If I had bent over, I wouldn't have been sent to the commune hospital.People, take a step back and open the sky and endure the calm for a while.Don't learn hard cap from your teacher, your teacher has a family to take care of.If someone else does it like him, the grave grass doesn't know how tall it will grow. ”"Hmm."
Li Min knew that Director Liang was doing it for his own good.At home, you and your parents can talk as much as they want, and they can say whatever they want, but you can't do that at work.But my parents said so, and Director Liang also said so, did I do it?
Is it wrong?"
When will Muljay come back?
I've heard people say you'll get married when he comes back?
”Look, this is what I said when I quarreled with Director Qin.Now that Director Liang knows, it is estimated that it has already spread to the whole hospital.But there's nothing to hide."
The marriage report he submitted was approved a few years ago, and when it was his turn to take a vacation.It should be soon.I can't say when. ”"Don't forget to tell me when the time comes, I'll give you a big portion.""
Well, I don't forget.Thank you in advance. ”An old man and a young man walked slowly in the corridor, walked outside the door of the monitoring room, and heard the quarrel inside, Director Liang frowned and pushed the door open.He coughed majestically twice, and only after attracting the attention of the people in the room did he step forward to examine the patient slowly, and then said, "Leave one person to accompany the patient, and the others will come back tomorrow." ”"Director Liang, let's talk for a while and leave.Soon. ”The room was quite crowded, and there were people close to Director Liang, who looked at his badge and called him very familiarly and spoke very affectionately."
Okay, then another ten minutes."
Director Liang's face also relaxed a little."
The Chinese New Year is at home during the holidays, and you can come back tomorrow so that the patients can go to bed early and rest early.""
Yes, yes.I'll be gone after a while.Thank you, Director Liang. ”The intention to drive people away is too obvious.Director Liang immediately turned around with his back and walked out with Li Min.These people can walk, and the sun comes out immediately from the west.When they arrived at the nurse's duty room, Director Liang called the security office and asked them to go to the 11th floor in 10 minutes to clear the visitors who did not have escort cards.The nurse on duty waited for Director Liang to put down the phone and immediately thanked him with a smile."
Director Liang, that is, you called, we can't call those people from the security department at all.""
yes, get rid of those people early, we can lock the door and sleep early."
Director Liang waved his hand and said, "I'll go back first."
If they don't come in fifteen minutes, you call me. ”"Okay."
The two little nurses hurriedly agreed.First all the visitors were cleared, and then the door of the ward was locked, saving a lot of trouble.Hmph, I don't want to wait for you to fight and then find someone from the police station.※※※※※※※※※※※※※※※※※※※※ this chapter is to make an "unreasonable scribble" for good looks, don't believe these descriptions with the naked eye, the results of the autopsy have to wait for pathology, wait for pathology, wait for pathology, and other pathological important things are said three times, cover your face and flee () The distance is a little far