Li Min had a good night's sleep, and when the alarm clock rang and she was awakened, she was still sleepy, and she refused to accept that she couldn't sleep anymore and that it was time to get up."
Minmin, get up, it's 6:50."
Muljay shouted for the third time."
Okay, get up.AhhWhen Li Min finished eating and changing clothes, Mu Jie told her about pulling out the phone last night, and also told her about Director Shi coming down to look for it."
I'm worried about whether Dean Chen has an emergency surgery to find you.""
I am not the only one in the provincial hospital who can perform craniotomy, and Director Liang can also accompany Dean Chen to the stage.""
Your surgery the night before was not a craniotomy.You're still prepared. ”Mu Jie reminded Li Min."
Hmm.I see, don't worry, it's okay.I said I was tired and asked you to unplug the phone.There are some surgeries that can never be done.That's what Dr.
Chen said to me when he reduced the number of elective surgeries. ”In Li Min's heart, she likes and loves major surgery like the night before.But let Mu Yu in her stomach take the risk, she would rather not have surgery, whose life is not life.Seeing that Li Min didn't mind, Mu Jie put his mind down and asked, "Did you bring these materials with you today?"
”"Take them all.Those that have been corrected, I will show them to Dean Chen.If it's okay in the morning, the rest can basically be sorted out. ”So Mu Jie helped Li Min pack up his things, Li Min carried his schoolbag and held a bulging file bag, and he was in a happy mood and walked out of the house with relaxed steps.After Li Min handed over the shift in the morning, he handed over the parts he had sorted out to Chen Wenqiang."
Teacher, let's see if there is anything that needs to be changed.If I'm okay in the morning, I'll be able to sort out the rest. ”"Did you put it on that plate?""
Nope.The original Pan Mujie did not move. ”Li Min handed the original plate to Chen Wenqiang."
Mu Jie saved the changed content in this encrypted disk.When the time comes, let's give this to Director Qiu. ”"Okay.I'll take these back and see them first.Well, I'll bring it back in the afternoon when I do my rounds. ”Chen Wenqiang took the full file bag, he got off the night shift, his daughter went back to school yesterday, he didn't have to be on duty in the department.As for his phone call last night, he didn't mention it, and Li Min didn't think it was like that.* But the ideal is always beautiful.After Li Min sat down for a while, the nurse called her for a consultation."
Hospitalization is always not in Corey?""
Yes.""
According to the regulations, I always go to the consultation when I am hospitalized."
Li Min didn't want to overstep his bounds.About half an hour later, Xie Xun called."
Senior sister, come over here and show you a fresh case.""
What patient?""
From a stomach problem to a neuropathy."
Li Min felt that he was starting to have a toothache, Xie Xun was sick, right?
But she had to quickly reply to him: "I'll go right over." ”Xie Xun's next sentence was: "Neurology." ”Li Min explained his whereabouts to the nurse, and while walking to the internal medicine inpatient building, he calculated in his heart, this is what Dr.
Zheng didn't diagnose in the consultation just now, and then invited Xie Xun, the deputy chief physician who led the group, to go according to the regulations?
The corridors of the neurology wards were quiet.During the holidays, patients who can be discharged from the hospital go home for the holidays.Most of the interns and doctors have gone home because they have three days off.The doctor on duty in the neurology department, looking at a man who was less than 30 years old, Li Min couldn't tell what his surname was, so he could only nod and say hello, and he opened his mouth first to explain: "Director Xie called me to come and see the patient." ”"Well, I know.Director Xie called you just now, and I was here. ”"Where's the others?""
It's back to the general public.I took the hospitalization of your department with me. ”The doctor on duty saw that Li Min was stunned, and he was amused by Dr.
Zheng's promotion in his heart.But before Li Min gave the diagnosis of this patient, he had to cover the diagnosis.So he smiled and said, "Director Li, do you want to take a look at the medical records first?"
”"Okay."
The 51-year-old male patient complained of simple weakness in both lower limbs and numbness in the limbs for half a month, which worsened for one day.Numbness of the limbs without obvious cause, which is overcharged and worsened by neck movement.Occasional palpitations and sweating.Then there is the history of stomach disease, repeated medical treatment, long-term medication, sometimes good and sometimes bad, for more than 20 years.He has a history of hypertension for more than 7 years, and his regular medication is controlled at about 150/90mmHg.Complete blood count Hb114.The result of gastroscopy is a chronic atrophic gastritis.CT of the cervical spine showed abnormal curvature of the cervical spine.That's all you can get in your inpatient medical records.Li Min looked at the consultation opinion given by Xie Xun to do a neck MRI examination and make an appointment for electromyography.And then, no more.For patients admitted to the emergency department last night, the long-term medical order only has a secondary care, and the temporary medical order has no content.Li Min went to see the patient and came back to call Xie Xun."
Senior brother, what do you suspect?"
She was a little confused for a moment."
Have you read the patient and the medical records?""
Yes.""
Where's the test sheet?""
There is mild anemia.Chronic atrophic gastritis for more than 20 years, anemia appears, which should be a symptom of gastritis for 20 years. ”"What else?"
Li Min was asked."
Then come back.Remember to keep track of the results of this patient's MRI. ”"Okay."
Li Min agreed very happily, but the direct judgment in her heart - there is definitely something wrong with this.Li Min understood that she was put on the table, but she was not annoyed, she pondered the diagnosis of this patient, from the weakness and numbness of the limbs, what disease can have these symptoms.After thinking about it for a while, she basically clarified her thoughts in the expectant eyes of the doctor on duty in the neurology department."
Well, I think this patient should first pass cervical spondylosis, because CT shows a change in physiological flexion of the cervical spine.But the patient didn't have a CT scan in his hand, so I don't know to what extent this has changed.That's what I'm used to thinking about from surgery.Don't laugh at me.Anemia in the blood routine.What is the nature of this anemia, and if you can do a detailed examination to determine the nature of the anemia, it can also be helpful in diagnosis. ”Li Min was most dissatisfied with the results of this blood routine.At least 10 items."
This patient has long-term stomach problems, chronic atrophic gastritis, and will have malabsorption.This can lead to hypohemoglobinemia; It can also lead to vitamin B12 deficiency.Do you want to check the concentration of B12?
I am predisposed to this patient to have neurodegeneration due to B12 deficiency.My opinion is to do an MRI to see if there are imaging changes in the posterior and lateral cords of the spinal cord, which will be helpful to determine whether there is subacute combined degeneration of the spinal cord.I can't think of anything more. ”"So your opinion, like Director Xie, is implemented in the imaging diagnosis provided by MRI?""
Yes.""
What if there is no magnetic resonance?
What do you want to do?
”The doctor on duty in the neurology department smiled and examined Li Min."
If this patient were in charge of me, I would give him intramuscular B12 and oral folic acid for a two-week trial treatment."
Free novels bring you joy and joy ---> storyskyline.net
After Li Min answered, he took his leave and left.Back in the surgical hospitality, she thought about it and thought something was wrong.But she still had some of the handouts not finished, so she put the matter aside and concentrated on her own business.* In the middle of the afternoon, Chen Wenqiang called."
Xiao Li, have you sorted it out?""
It's done.""
Then I'll go now."
After Chen Wenqiang arrived in Corey, he returned the handouts he had taken away in the morning to Li Min."
What needs to be modified, I have changed it with a red pen, you remember to change it and save it.""
Yes, I'll change it when I get home in the evening."
Chen Wenqiang quickly read the rest of the part, and made slight changes to Li Min."
Director Qiu will come over tomorrow, you can save the rest of these disks tonight, give them to me tomorrow morning, and I will ask the hospital office to print out two copies.""
Okay."
After the evening rounds, Li Min told Chen Wenqiang about the case in the morning, and finally she said, "Teacher, I think it's so strange."
The patients who were admitted to the hospital yesterday are all this morning, and his long-term medical order is only one secondary care. ”Chen Wenqiang thought about it and said with a smile: "They joined forces to test you." ”Li Min's face fell when he heard this."
That's where it goes.If you can do surgery alone, you're an operator.Even in terms of vascular anastomosis, no one in our provincial hospital has done a better job than you.If you don't expand widely, you are likely to end up needing vascular anastomosis, and everyone will remember you.The reason is that your academic position as the head of the department is not determined. ”Li Min listened carefully to Chen Wenqiang's teachings."
What is the administrative director, and so is Zhang Zhengjie.You read the consultation list, does he dare to take it?
”"He's better than being hospitalized."
Chen Wenqiang shook his head and said: "There are always mistakes in hospitalization, and everyone can accept it."
However, the deputy chief physician is the highest technical level among the clinical doctors in our provincial hospital.An associate chief physician, I mean before Xie Xun.There is no restriction on special skills and specialized fields.Plausible disease, you see when I said that this patient is not my brain surgery, it is not under my control.You see when Director Liang has quit. ”Yes and no."
Even Director Xiang, although I hate him, I have to admit that his general surgery, even if it is hepatobiliary pancreas, which he rarely touches, is also very beautiful.""
What about Director Xu and Director Bian?""
The level of each deputy chief physician in the team on duty is not much different.Director Xu and Director Bian have never had the opportunity to encounter liver cancer due to historical reasons.Their ability to cope with the emergency partial lobectomy was fine.The same goes for Director Wang of the Department of Orthopedics. ”In this way......
"Xiao Li, if you make an exception this year, no matter whether you are promoted in the end or not, there will be more and more such things."
That's the price to pay for getting ahead.Are you afraid?
”"I'm afraid.""
Then this year's report is unusual?""
Report."
Li Min was provoked to be competitive, "Anyway, I read books every day except for surgery, so being tested is better than being admitted by a patient in the emergency department." ”"Okay, come on."
Chen Wenqiang encouraged Li Min, and then went to the twelfth floor to find Dr.
Zheng, the chief hospitalist.If you want to take the test in other subjects, Li Min is just fine, and people from your own subjects can't be mixed in.Eating inside and outside is not allowed at any time.
*Although Li Min said that she was not afraid of the exam, she knew in her heart that she had not even seen all the diseases of neurosurgery, so where would she take care of the diseases of more departments such as neurology.She was not in a good mood and changed out of her white coat and came home from work.At dinner, she muttered about it to Mu Jie."
I don't have so much energy.This is simply too much. ”Mu Jie comforted Li Min and said: "When I first got out of the company, the first test was a 10-kilometer rapid march.A hurried march in full gear. ”"Dismount?""
yes.All the graduates of the military academy in the lower company will go through such a similar test.As the saying goes, you have to be hard to strike iron.If you fall behind during the rapid march, not to mention that you will not be able to interfere in the company's training in the future, even if you are given the opportunity to train, those soldiers will not obey.After the one-year internship period, I can only go to be a small staff officer, and then go to the agency to hang up.Even if you graduated from the command department, it is useless. ”Li Min was reminded of Mu Jie's words, and she said with deep feeling: "When I first went to work, it was the same.Even nurses can put up a little bit of a barrier.Maybe I was hospitalized in the first half of the year, and I thought I had passed the test.I didn't expect it to get worse now, and it became another doctor to test me. ”"If you already have a thesis for the deputy high school, others will treat you as a break in the report.Think about your admiration and dependence on the deputy high.Even if it's not a subject.Isn't it?
”"Then they are also idle.I've done the neurosurgery done, and I'll be the one who needs to be treated.Like today, huh!
Xie Xun actually joined them. ”The more Li Min spoke, the more angry she became, how she thought about it, how unwilling she was, put down her chopsticks and went to dial Xie Xun's phone.It was Su Ying who answered the phone."
Senior sister, I'm Li Min.Could you please ask my brother, what is the initial diagnosis of the patient in the morning?
”After a while, Xie Xun came over to answer the phone: "You will know when the results of the MRI examination come out." ”Then, snapped the phone.Li Min on the other end of the phone was even more angry when he heard the blind voice coming back from the microphone.Mu Jie looked at Li Min's appearance and persuaded her: "If you have a tendency to test you, the more people help you, the more difficult it will be for you to be recognized."
You're on your own. ”Well, even if it makes sense.Li Min pulled the rest of the rice into his mouth, and said in his heart that he must go to Xie Xun tomorrow to ask, if he doesn't give himself a satisfactory answer, he will never go over if he has such a call next time.Mu Jie saw that Li Min was puffing out her mouth, with a hint of anger, so he persuaded her again: "Minmin, are you afraid that you won't see what the disease is in the end?"
”"Yes."
Li Min was blunt."
You said that if I couldn't touch the edge, they would laugh at me when I turned around.I'll talk about it in 10 or 20 years.will say that it's just that Li Min, don't look at her five or six people now, she can't even recognize a spinal cord subacute combined degeneration at the beginning.I'll be disgraced twenty years from now. ”"Should you recognize it, then?""
It's a neurology disease."
Li Min replied a little weakly, and she explained to Mu Jie: "If Dean Chen and them, they will naturally recognize them."
I've been worse than twenty years by them.At least twenty-four years. ”Murjey nodded and said, "Well, what you say makes sense, but what if you meet it in the outpatient clinic?"
”"The nurses at the triage desk can't be mistaken.It is impossible for them to even distribute medical and surgical diseases. ”When Li Min said this, he immediately realized something that had never been in his brain.- The work of a triage desk nurse.Mu Jie saw that Li Min was thoughtful, so he stopped talking to Li Min.And Li Min pressed the questions about the work of the nurses at the triage desk to the bottom of her heart, and went to Yan Hong's house as usual.When she returned, she watched as Murje typed the revised handouts into the computer.I flipped out the "Neurology" and read it roughly, firmly believing that the diagnosis in the morning should be the closest to the patient's condition.She jotted it down in her notebook and started reading medical English.* When Li Min called Xie Xun's house, Xie Xun was washing dishes in the kitchen, and Su Ying took her son to clean up the table and sweep the floor.When Xie Xun picked up Li Min's phone, Su Ying asked him."
Senior sister asked you what kind of patient's diagnosis?""
A spinal cord lesion in the neurology department.They went to the consultation with Dr.
Free novels bring you joy and joy ---> storyskyline.net
Zheng, and they called me over before they could find a clue.Then the doctor on duty in the neurology department said that the younger sister refused to go.That means as if the junior sister can't recognize it. ”Xie Xun told Su Ying about the morning.At the end, he added: "Those things that look down on people with dogs' eyes." ”The baby asked on the side, "Dad, what is a dog's eyes looking down on people?"
”Su Ying saw that Xie Xun didn't answer for a while, and couldn't help but say to Xie Xun: "Yes!"
Let you talk in front of your child without paying attention. ”The baby pestered Xie Xun for answers.Xie Xun had no tricks, so he could only make up nonsense: "What you see in the dog's eyes belongs to the dog." ”The baby didn't understand, but grabbed the dog behind him and asked, "Dad, I want a dog." ”Xie Xun was shocked and immediately objected: "No." ”"Why?""
Dogs don't dress themselves, they don't carry chopsticks on their own, they don't go to the toilet on their own.You have to go to kindergarten every day now, and you have to go to school later, so you don't have time to help the puppy. ”Xie Xun replied seriously, and then he was afraid that his son would make a request, so he quickly added: "Dad is not available."
You see, Dad is sometimes so busy that he can't come home all night. ”The baby was stunned by his father.Before going to bed, the baby took his mother's hand and asked, "Mom, can you help the puppy get dressed?"
”"Mom sometimes has to work night shifts, so I don't have time.""
But I want a puppy.""
When mom doesn't have to go to work, help you take care of the puppy.""
Mom, when are you not going to work?""
At 55, you don't have to go to work."
The baby is at a loss, he doesn't know what 55 years old is.
*Director Zhao of the Dry Consultation Department, after dinner, I found Chen Wenqiang, "Old Chen."
I'll tell you something. ”"You say.""
Today I received a call from Lao Sun, who is the most likely to take over as the head of the Organization Department at the end of the year.""
Let you help arrange the surgery?""
yes.How did you guess?
”"Yang Weihua took someone to Corey last night.I didn't say yes to her at the time. ”"Why?"
Chen Wenqiang smiled and said, "Wait for Lao Sun to find you."
I remember the last time you said that his ex-wife ended up in a doctor's office. ”"Lao Chen, this is not like you."
Director Zhao smiled and nodded at him.Chen Wenqiang was stunned.But he said eloquently: "Not exactly.The night before, the surgeon performed an emergency aortic replacement operation, from the descending aorta to the iliac left and right.Lao Liang and I did the abdominal section, and Xiao Li and Lao Shi did the chest section.I worked all night.Xiao Li was so tired that he got off the operating table and lay down in the locker room.Then last day, I made up for sleep during the day, and went to bed again at 8 o'clock in the evening.Her lover unplugged all the phone lines. ”"Are you worried that Xiao Li has a different opinion?""
She won't have different opinions, I'm worried that I won't be able to block the opening of the platform.""
Don't you have two more doctors?
If you add another stage, let the doctor go to the advanced training doctor. ”"They don't do all the surgeries as well.Let me tell you about the child's surgery, although there is only one brain CT, but the prognosis is not optimistic.The younger the child, the more malignant the child.The child was just over three years old. ”"It has nothing to do with you giving him early surgery.Benign or malignant nature does not change just because you have surgery a month late.And the sooner the surgery, the better, right?
”"Hmm.""
Then what do you have to scruple about?
Good or bad, you've got to take care of it.It's rare that he sent it to the door, so I don't have to contact him in a roundabout way. ”Chen Wenqiang turned this matter back and forth several times in his heart, and finally said: "If I can complete the examination this week, I will do it for him according to the emergency on Saturday." ”"Good.Then that's how I answered him. ”"Okay.You first reveal the prognosis to him, and don't hope too much and can't bear the blow of disappointment. ”"Uh-huh.I know. ”Director Zhao achieved his goal and went home without staying long at Chen Wenqiang's house.* When Director Zhao left, Xiao Yin asked, "What kind of surgery?"
”"Meningioma.The location is not so good. ”"It's a pity for such a small child.""
Who's to say it isn't.He had to do it with a microscope all the time, which was very exhausting. ”"Then you and Xiao Li Ke will have to work hard.It would be nice to have so many people outside of your department. ”"There will be.It won't take ten years. ”The old couple looked forward to the future development prospects of neurosurgery in the next ten years, and Xiao Yin said: "I don't know how our daughter can take the exam tomorrow?"
”"It should be good.It's just a little bit worse, it's just a mock exam, and it's not a formal college entrance examination. ”"The results of the same model are basically the same as those of the college entrance examination."
Based on her current grades, it's no problem to go to undergrad.Anyway, she has medical school at the bottom, so you don't have to worry about her.After the exam, I went to the Medical University, and if I did the exam, I went to the Golden State Medical College.We all graduated there, and after twenty or thirty years, we are no worse than those who graduated from medical colleges. ”"But in the end, in terms of academics, it is still inferior to the Affiliated Hospital of the Medical University.""
They have the backing of a medical university, so they naturally have more opportunities to engage in scientific research than we do in medical care.When Lao Shu goes to the provincial medical college, we also have the opportunity to increase investment in scientific research.Give those clinical doctors a correct orientation, and I believe they will catch up. ”Xiao Yin smiled and told Chen Wenqiang about Director Shi's son, who went to Lao Li's house early in the morning to take Niuniu shopping."
I really didn't expect Little Stone to fall in love with Niu Niu so much.You said Lao Shi, one is his son and the other is his student, and his relationship with Yang Weiguo is good. ”"Are you worried that Yang Weiguo will have any unhappiness with him?"
Xiao Yin nodded."
No, it won't.That Yang Weiguo is a person who understands current affairs.Lao Shi is the director of the twelfth floor, the urology department is not independent, Yang Weiguo is now in charge of the thoracic surgery, he will never contradict Lao Shi. ”"That's good.Otherwise, if he offends people over the years, he will make the twelfth floor unrestful, and he will cause you trouble in the end.Zhang Zhengjie also attracted the anger of many female doctors and nurses because of his favoritism to Dr.
Yang. ”"Lao Shi is a smart man, he knows how powerful he is, and he can suppress him.Otherwise, I wouldn't dare let him go on the twelfth floor. ”※※※※※※※※※※※※※※※※※※※※ corrected the typo () and the distance is a bit far