Dean Shu came in with two security guards, and the contrast of the number of people in the director's office changed, and the atmosphere changed accordingly.The man who was still talking just now, looking at the bearing of the people who came in and the sturdy security guards, he was a little wilted.Luo Ying sneered.If she is still the identity of the women's captain, she will make people regret it for the rest of her life for such a person who has no courage, no brains, talks nonsense, and wants to shirk responsibility.But now that I am the head of the department, there is no need to go down in person.So she looked at Section Chief Lu in the medical office.The implication: This is the job of your medical department.Dean Shu took people to watch from the side, but Section Chief Lu couldn't avoid it, so he coughed first before he spoke."
Your daughter-in-law is dead, and we can understand your eagerness to find the reason now.But your daughter-in-law was already in a coma when she sent it, and that, ahem, her condition is very serious.You know that.After coming to our hospital, our doctor did his best to save her, and she woke up yesterday. ”"yes, she's all fine yesterday."
The husband of the deceased yelled with a white face.Without waiting for him to say anything else, Director Luo preemptively cut him off and said, "The reason why the patient came to the hospital is because she didn't use insulin well at home.As his husband, you use the excuse that you can't dissuade her, which we can't understand.Because of this diabetic, she didn't just get sick, and she didn't take insulin for a year or two.If she had used her insulin and controlled her blood sugar as instructed by her doctor, she would never have had such a severe ketoacidosis coma. ”The two men who accompanied the deceased's husband spoke up at this time: "The doctor has said so, what else do you have to say?"
”"You just wish my sister was dead, did you?""
I didn't.Your sister was sober and okay yesterday.If she had been watching," the deceased's husband's hand pointed inexplicably, "then your sister wouldn't have died." ”Another man persuaded the three uncles who were arguing: "The hospital naturally wants to say that it is not their responsibility."
My sister-in-law is just over 40 years old, and it is not a fatal illness, how can she be sent to the hospital and die. ”Director Luo listened to this person's words, which provoked the family of the deceased to point the finger at the hospital, and immediately refuted him: "You ask him if he knows that high blood sugar can kill people?"
Who else told you that the acute complications of diabetes ketoacidosis don't kill people?
The patient's blood sugar was too high and arrived too late......
If he had sent his wife a few hours later, she might not have even had a chance to wake up. ”Director Luo snorted and pointed the finger at the deceased's husband, the implicit meaning of her words was so rich that the people in the room seemed to have pressed the pause button, and none of them immediately moved.But Director Luo continued: "If the patient hadn't woken up yesterday afternoon, we wouldn't have known that she didn't use insulin as prescribed."
If your daughter-in-law dies, you don't blame others, you can only blame yourself and your daughter-in-law for not using insulin on time and in sufficient amounts. ”Luo Ying has seen too many men who have different thoughts about their daughters-in-law.This is the experience she has taken root in the countryside, at the bottom of life, and has been tempered from many years of life.But she didn't have any evidence that the man had bewitched his wife and didn't need to take insulin as prescribed!
Otherwise, she would have called the police yesterday.And Section Chief Lu's skills in observing words and seizing opportunities are very powerful.When he saw that the deceased's husband had lost his arrogance, he immediately said, "All right, all right, you should go back and do whatever you want."
There are a lot of inpatients in our hospital, so don't make any noise about other people's recuperation. ”The two security guards also cooperated with Section Chief Lu to come over and pick up people, and pushed the four men away.
*"Dean Shu, I'm sorry to trouble you to go this way. ”Director Luo waited until the family members of the deceased had left before talking to Dean Shu."
It's fine.Your name is inexplicable, isn't it?
”"Yes."
Inexplicably, seeing such an unreasonable family member of the deceased for the first time, she inevitably brought a look of horror on her face."
You don't have to be afraid, be on duty.I would instruct the security guard to keep an eye on the stairs and elevators. ”"Thank you, Dean Shu."
Dean Shu, Director Luo and Dr.
Yang left endocrine together.In the elevator, Director Luo stared at the flashing and beating red floor prompt numbers, and suddenly said faintly: "That man has bad intentions. ”Dr.
Yang knew that there was no room for him to speak in front of Dean Shu, so he pursed his mouth and kept silent, leaning against the elevator wall, pretending that he did not exist.And Dean Shu knew that Director Luo had been in the countryside for many years and was the captain of the women's team, and she had more life experience in this area than herself, so she nodded and replied: "It should be the situation you said."
But then again, the deceased was type I diabetes, and she didn't just get it, how to use insulin, she should be more experienced than inexplicable, and she is also more aware of the consequences of not following the doctor's instructions. ”"Yes, her life is her own, she doesn't listen to the doctor's advice, she is killing herself, and she can't blame her husband."
Luo Ying asked the patient this question yesterday when he was awake, but the patient obviously didn't listen to his words."
Director Luo, go back and summarize the medical records, and when it's our turn to ask questions from the Department of Internal Medicine, we will use this ketoacidosis to test those hospitalized doctors.""
Okay."
Director Luo immediately agreed.In this way, I also have a reason to go to the neurology department and go to the medical department to seal the medical records.She wanted to see how the neurology department used medicine during the day today, and why the patient died.* The three of them broke up in front of the fund-raising building, and Director Luo heard the sound of his own TV, so he didn't need to ask the Luo family if they were watching TV.She followed Dr.
Yang into the unit.Dr.
Yang took out the key to open the door, and the moment he opened the door, he turned around and said, "Luo Ying, why don't you find a time to test your parents' hearing to see if you need hearing aids."
Now it's cold at night, and the neighbors are closing the doors and windows, so there is nothing in the way of such a loud noise.But in another month or two, everyone will open the doors and windows, and it will affect others at night. ”Luo Ying knew that his TV was loud.That's because my parents are older, and they still don't feel enough to carry their ears.And Luo Tian doesn't live at home, the sound insulation of this fund-raising building is very good, unlike the original living in the tube building without sound insulation, so she didn't interfere with her parents' little interests.After a long time, parents have developed the habit of no longer watching silent movies.If you don't see goodbye on the TV screen, you will never turn off the TV and go to sleep.If the sound only affects oneself and the couple, forget it.Seeing that the window is about to be opened in the hot weather, it is still not good to affect the neighbors.The husband's reminder was just in time.Luo Ying should take her parents to have her hearing tested.The couple entered the door together, and after greeting the old couple, they went back to the bedroom to read together.Dr.
Yang picked up the book, but asked Director Luo, "Is this over?"
”He didn't fully understand the endocrinology department just now."
It's not over.When I asked for leave yesterday, I read that all her doctor's orders were correct. ”Director Luo looked at her husband with an inquiring look and said, "Don't just look at the patient's blood sugar drop and acidosis correction, it's actually not fast.Not only did she not take medication as prescribed by the doctor 24 hours before the onset of the disease, but her insulin dosage was insufficient during this period.She is not only ketoacidosis, but also hyperosmolar hyperglycemia.However, according to clinical diagnostic criteria, the former is more obvious.The mortality rate of the latter is more than 50%.I also gave her all the drugs she should use, and she can only blame herself for the rest. ”Dr.
Yang still knows about the hyperosmolar hyperglycemic state.Therefore, he is a little unacceptable to the patient, this patient with a long-term chronic disease, who should use insulin privately.He asked in a low voice, "Does the patient not know that there will be complications and death if he changes his insulin?"
”"Humph!
What she knows and doesn't know, now only heaven and earth know. ”Director Luo's attitude brought out a little disdain.Dr.
Yang reluctantly nodded in response to his wife.His expression fell in Director Luo's eyes, and Director Luo wanted to say a few more words to him.She explained seriously: "You don't have to think it strange, I have been working in endocrinology at the Affiliated Hospital of the Medical University for more than ten years, and in recent years, there have been more and more patients with diabetes, and I have also seen many cases of ketoacidosis.When the disease progresses to the stage of cerebral edema, some patients have immediate effect on dehydration treatment, and there are no sequelae after re-examination and follow-up after giving nutritional nerve treatment.But some, it's really a lack of skills. ”Dr.
Yang had never been in contact with such a case in internal medicine, so he nodded blankly and waited for Director Luo to continue."
Diabetes itself is not terrible, it is terrible in its complications.Ketoacidosis is an acute complication, and the textbook specifically focuses on this in the chapter on diabetes to remind all medical students.But this patient is obviously not so lucky...... too."
It still depends on luck.* Inexplicably, after everyone left, the more she thought about it, the more uncomfortable she became, she desperately wanted to find someone to talk to, but she couldn't leave her post.With nowhere else to go, she went back to the nurse's office.The nurse on duty tonight is on duty with an intern from the health school.Since Corey was not seriously ill, after locking the door of the ward, she held the wool and knitted it alive.She is over 40 years old, and she came to the provincial hospital in the same year as Director Liao of the Nursing Department, and she is also a person who has been in the countryside and joined the queue in the countryside for many years.Seeing that her inexplicable mood was not high, she persuaded her: "Doctor Mo, you don't need to be upset about that dead man's business.I have been in the Department of Gastroenterology for more than ten years, and I have seen a lot of people who know that they have ulcer disease, but they still don't eat and take medicine on time.We as doctors and nurses say it ten times, it's better to say it to the people around them. ”thanked her with an inexplicable smile, and then sighed faintly: "I just can't figure it out, obviously all the doctor's orders are right, why did she have cerebral edema?"
”"You have to ask Director Luo about this.The endocrinology of our provincial hospital was established after Director Luo came, and you all know that this patient was the first to die of diabetes.In the past, the Department of Gastroenterology also admitted diabetic patients, but those who reached the ketoacidosis stage like this were not sent to our hospital, and everyone went to the Affiliated Hospital of the Medical University themselves. ”Inexplicably sighed deeply."
If I had known that she was going to die, I wouldn't have been back to the University yesterday afternoon.""
It didn't work.Can you still watch it in Corey last night?
I'm telling you, it's a type I diabetic patient, and if she hadn't used insulin well in the previous years, she wouldn't be alive now.She is now dying by herself, and she can't blame anyone else. ”"But if she weren't for my patients, alas!
The one I was treated was heavier than her, and she was cured and discharged from the hospital in less than half a month. ”This is the most inexplicable place in my heart."
Humph!
Clinically, there has never been a saying that a mild illness will not die. ”The old nurse changed a needle, reversed the direction of the sweater in her hand, and worked as she spoke."
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When you see too much of your own death, you don't care.Hey, Dr.
Mo, have you heard that Dean Chen and Li Min have died two craniotomy patients in a row. ”Inexplicably, I stayed at the Medical University last night and didn't return to the provincial hospital, and I will take over tonight.She really didn't know that another one had died."
Isn't that the one who didn't come off stage on Thursday?
Why did you die again?
”"Dead in the ICU.You said that Dean Chen and Li Min opened their brains and how much brain cancer they had.I heard that patients who are going to come to the provincial hospital for craniotomy are because there are few dead people in the provincial hospital, and I heard that the surgery will be scheduled until a month later. ”"At the beginning of last year, it was going to be a month away.At one point, it was a month and a half.The side of the Affiliated Hospital of the Medical University has been added, and there are fewer queues on this side, but the side of the Medical University has a longer queue. ”Inexplicably, she knows more about neurosurgery, because Xu Qiang has two small varieties of medicines, which are almost used only in neurosurgery, and she also pays attention to these two departments."
But there are more than two deaths in a row.A few days ago, someone died after surgery.You said that the people who come to our side to have a craniotomy will be affected, will there be fewer people?
”The old nurse stopped the woolen work in her hand and looked up to ask inexplicably."
I don't know."
Inexplicably, he immediately sealed.I don't know if it will be affected, but she knows that this topic is too dangerous - no matter how you answer, it is easy to get into the pit.So she didn't want to talk to the nurse on duty anymore.She picked up the phone, thought about it, and said to the old nurse, "I'll go to the doctor's office to call." ”"Okay, there you go."
The old nurse bowed her head again and continued knitting.Her movements were fast, and in a few moments, she changed the needle again.The intern nurse asked her, "Teacher Zhang, aren't you afraid of checking the post." ”"Afraid, how not afraid.The doors of the wards were locked, and the general duty had just left our department, so he wouldn't come to check. ”The little nurse nodded teachably.The old nurse shook off the yarn a little and continued knitting.But glancing at the nurse trainee who had carefully taken her temperature and recorded her stool, she felt that she should provide a little extra teaching to this honest child.So she said: "Don't look at the nurses in surgery who earn more, who is tired knows for themselves."
These two people live, in addition to going to work together, they still have to be women to take care of all the work at home.Gentlemen will smoke, play mahjong and chat, and if women don't hurry up and knit sweaters and pants, they will be dumbfounded in autumn. ”"Well, my mom always knitted with wool.""
yes, I have to knit with wool.There are only three people in this family, and there is little wool work.Sweaters and pants are not to mention re-knitting once a year, but they must be re-knitted every two years.Although our department earns less, we don't have to be busy at work like surgery, and we don't have to tie people up like we do on the Changbai shift, who dares to take out this work during the day.Just waiting for Sunday to work, where can I get busy?
”"The advantage of our department is that I work night shifts and I don't work at all, which is basically not much different.After the night shift, you can have more time for the whole day, and you don't have to delay doing any housework if you want to.Those who can figure it out, look at the idle department that doesn't drill in the front line.I'm telling you, even if I am asked to leave work, I won't be out. ”The little nurse nodded again in understanding."
You follow me for an internship, and I will teach you a good job.Don't wait for the child to be born and then have to be a good wife and mother.You have to be virtuous first, a steady and quiet appearance.Don't learn from those minx.Let me tell you, in the past few years, our provincial institute has been able to divide a lot of college students every year.After working for a year or two, your personality and work will be recognized by everyone.Naturally, it will fall into the eyes of those college students who have just been separated, and there will be people who ask for someone to be a matchmaker.Choosing a doctor in our provincial courtyard is much more reliable than marrying someone who works in a factory. ”The little nurse's cheeks flushed, and she stopped nodding her head.But it was clear that she listened.* When the phone rang, Li Min put down the pen and walked over, grabbed the receiver and said, "Hey, I'm Li Min." ”"Li Min, I'm inexplicable.""
Well, do you have a consultation in your department?""
Nope."
Inexplicably, he was stunned by Li Min's question.But she immediately said: "My patient, who had an MRI this morning, had extensive demyelination, cerebral infarction. ”"Cerebral edema and cerebral infarction should be transferred to the neurology department, not to our department for treatment.""
I was transferred to the neurology department, and when the MRI results came out, my supervisor immediately called the neurology department, and they also took the patient.But in the evening the patient died. ”Li Min asked cautiously: "Inexplicably, does the patient's death have anything to do with you?"
”"Probably not.I worked the night shift tonight, and I asked my supervisor for leave before noon yesterday, and went back to the library of the Medical University to check the information, and the patient handed it over to my supervisor. ”"Oh, so what are you worried about?"
Li Min's range is inexplicable."
I received one heavier than this last time, and I was discharged from the hospital after less than half a month.This time it's the same treatment......
""People are different. ”"Yes.I mean, the principle of treatment is the same, and I have adjusted the specific medication. ”"Hmm.And then what?
”"And then?"
Inexplicably, he paused for a moment, and then said, "The patient has cerebral edema."
Do you think it's possible that it's because the blood sugar and acid correction are too fast?
”"I don't know.If you ask the interns in your department for answers, they are all more reliable than I say. ”"I didn't mean that."
Inexplicably, he hurriedly confessed."
I know."
Li Min scratched the windowsill with his fingernails."
I mean, I've spent the last two years in neurosurgery.The level of my internal medicine is definitely not even able to catch up with the internship time.Do you understand?
”"yes, I see."
Inexplicably, I understood that Li Min didn't want to discuss with herself whether it was too fast to lower blood sugar and correct acid.But she also accepted Li Min's admitting that internal medicine was inferior to an intern.She then asked tentatively, "I heard that your patients have died two in a row after surgery?"
”"Yes."
Li Min replied in a simple, slightly hard-nosed tone."
Will it affect your future work?"
Inexplicably, he asked in a tone of obvious concern: "You are like me, just an intern in the lower department of the provincial hospital." ”"The impact on me?
The patients are now coming to the provincial hospital for surgery, and they are all going to be Dean Chen.I'm just Dean Chen's assistant. ”"Will that have an impact on Dean Chen?
I have heard that patients come to the provincial hospital for surgery because your postoperative mortality rate is lower than that of the hospital attached to the medical university. ”"Our mortality rate is still lower than that of the Medical University.""
Then it won't be affected."
Li Min took the microphone with a smile on his face and asked inexplicably, "Are you okay tonight?"
You don't have to take that open-book exam for abdominal pain?
”"Hmm.I just wanted to talk to you, and I left it. ”"Okay."
Li Min gently buckled the microphone down."
Who?"
Mujay asked."
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Inexplicably, a classmate from a department, that graduate student in endocrinology, you've seen it.is the one who fell in love with Liu Na's ex-boyfriend. ”Mu Jie nodded, inexplicably impressed."
Is there something wrong with her?""
It's okay, small talk."
Li Min grabbed the pen again and continued to answer the open-book exam of "abdominal pain"."
It's a bit of a delay with the phone, but luckily there's no one like her."
Mujay laughed silently and continued to crack on the keyboard to enter the code.He had already seen that Li Min and the inexplicable relationship was not as close as she and Yan Hong, but he heard that the two of them performed a pas de deux on stage last November.It's a pity that I didn't lose my eyes in the provincial capital at that time.* Li Min was busy for several nights, and he finished answering the open-book exam of "abdominal pain" that he thought was flawless.Unexpectedly, when the list was finally released, the first place was Dr.
Gu from the Department of Orthopedics, the oldest worker, peasant and soldier college student in the provincial hospital, and one of the oldest attending physicians with the most qualifications.Li Min picked the bulletin board of the hospital office when there were few people, and compared his roll paper with Dr.
Gu's roll.Everyone is copying books in the front, and there is basically no difference, but at the back of almost every item, Dr.
Gu will attach one or two special cases, and mark the patient's hospitalization time and hospitalization number, explain the patient's medical history, physical examination, etc., and also specifically indicate that his abdominal pain is a special situation.In some cases, he even encountered it when he went to the medical university for further study.When Li Min finished copying all this, he turned around and saw Chen Wenqiang standing behind him."
Teacher."
Li Min rolled up the roll paper in his hand."
Let's go, let's go back to Cory for rounds.""
Hmm."
Li Min looked at his watch and realized that it was already past five o'clock."
Oops, I forgot to look at the time."
In fact, she didn't have that much time reserved when she came, but it took too long to check and copy."
There's no hurry.Do you think there is anything you have gained from this exam?
”"Dr.
Gu has a lot of clinical experience.There are many special cases that I have never heard of.He got the first place and deserved the prize money. ”Li Min said honestly: "Compared with him, all of us are copying books." ”Li Min is also very sorry that he didn't get the first place and get the 200 yuan bonus.But she can't compare with Dr.
Gu at all, and she admires her very much for winning beauty.Chen Wenqiang smiled: "Copying the book is also the harvest of this exam."
He was the first batch of workers, peasants and soldiers college students, and his twenty years of clinical experience were not fake. ”After getting out of the elevator, Li Min saw that Chen Wenqiang was in a good mood, so he asked, "Teacher, why hasn't he entered the deputy high school yet?"
”"Historical reasons.I don't know the specifics.It is estimated that he should apply for the deputy high school this year.In addition, the hospital council has approved the proposal to nominate him as deputy director of the Department of Orthopedics. ”"Then I'm going to call him Director Gu from now on
.
"() The distance is a bit far