MTL - My Medical Skills Give Me Experiences-Chapter 437 Some people are happy and some are sad, challenge the four syndromes of Fallot

【My medical skills can add experience points】【】

"I am a doctor of anorectal surgery, my name is Yang Zhi, and I have been working in the operating room for almost six years."

The man reported his background.

"It turned out to be a doctor of general surgery. I heard that after the reform of general surgery, several departments have developed quite well! Many people want to go in after squeezing their heads. You have worked in the operating room for six years, and you are also an old man. Comrade, why do you want to come out?"

Zhou Can was very puzzled.

In terms of seniority, this person is Zhou Can's senior.

It's just that in any unit, those with strong abilities are always easy to get ahead. A mediocre person, a person who is not good at making money, is just a low-level employee when he grows old. I haven't heard of any unit that assigns positions to employees based on their seniority.

Zhou Can's surgical ability far exceeds that of ordinary doctors, so his rise is very fast.

At a young age, he was already number two in the operating room of the emergency department. If it is not for the lack of seniority, it is possible to even become the No. 1 person directly.

"Well, you don't know. Some people are happy and some are sad. Several major sub-departments are indeed developing better and better. Our anorectal surgery and gastrointestinal surgery have many overlapping businesses. Director Mi of our department is too basic. I have failed to seize the opportunity in many rounds of competition, and now I have been squeezed by the gastrointestinal surgery department. I really can't see any hope, so I want to find another way out."

Yang Zhi sighed, his words were full of bitterness.

The department director of a department is equivalent to the leader of the flock. Whether this flock can eat fresh, tender and plump green grass or eat mud depends on where the leader leads them.

Development strategy, means, personal ability, department professional level, department cohesion... There are too many factors that can affect the development of a department.

If there are many mistakes in decision-making or insufficient means during the development of the department, the decline of the department is almost certain.

Unfortunately, Yang Zhi met a department director who was good at surgery but poor in leadership.

Looking at his frowning look now, I'm afraid he doesn't even have to drink soup.

The original body of gastrointestinal surgery is digestive surgery, which is an extremely powerful professional department.

If anorectal surgery wants to compete with gastrointestinal surgery, I am afraid we can only sigh to the sky, since Sheng Yu, He Shengliang.

"What will you do if I don't agree to accept you?"

After Zhou Can found out the reason, he unexpectedly asked Yang Zhi a tricky question.

"I personally have deep feelings for Tuya, and I am also optimistic about Tuya's future prospects. If I can stay, I will try to stay as much as possible. For a middle-aged man like me, making money is definitely very important. The emergency department is currently undergoing It is in the initial stage of development, and it should be in great need of talents in all aspects. To be honest, although Tuya recruits a group of excellent general practice trainees every year, there is still a shortage of surgical talents. Because the training period for surgical talents is generally long."

Yang Zhi calmly analyzed the current situation.

As he said, there is a shortage of surgeons in any surgical department. Now, including internal medicine departments, they are also beginning to rush for talents with good interventional talents and strong endoscopic surgery capabilities.

It is recognized that it is difficult to train pilots, but the training of surgical talents is even more difficult than that of pilots.

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【My medical skills can add experience points】【】

In the past few years, the emergency department has indeed been assigned one or two general practitioners every year.

It is similar to Zhou Can, who is killed out of thousands of troops, and only ten or twenty people are selected from thousands of people.

Each one is the best of the best.

This is also an important part of Tuya's talent development.

It's a pity that the emergency department is poor and empty, and there is nothing to ask for, and there is no way to keep people. When the regular training is over, there are very few people who are willing to go back to work in the emergency department.

This has further created a shortage of qualified personnel in the emergency department.

Always picking up doctors eliminated from other departments, how good do you think they can be?

Run away an elite general practitioner, and then make up for an eliminated doctor in a specialist department. This is the real situation in the emergency department.

"If Dr. Zhou fails to see me, that's okay. I'll go to other departments to find a way out. If other departments also reject me, then I will consider changing jobs to work in other hospitals."

Yang Zhi has a clear life plan for his future.

There is a strong sense of purpose.

"That's good, you can come to me tomorrow or the day after tomorrow to help. Tomorrow is Wednesday, and I won't be working in the operating room until 5:30. The day after tomorrow will be from 8:00 am to 6:00 pm."

Zhou Can has always wanted to find a better medical assistant, and now the one delivered to his door seems quite reliable, so he is going to find out first before deciding whether to accept it or not.

The strength of the surgical ability can only be seen in the operating room.

If the surgical ability is poor, or the work attitude is not good, then it will definitely not be accepted.

His team has developed to this day, and it has been considered relatively stable.

Luo Shigent's internship period is about to end, and he will definitely go to participate in the regular training at that time. Because the training certificate is one of the necessary documents for every doctor to rise.

It is as important as a medical license and a doctor's qualification certificate.

However, Luo Shishen expressed his position early and begged Zhou Can to reserve a seat for him. After his regular training is over, he will find a way to return to work in Zhou Can's team.

During this year, he performed surgery with Zhou Can and learned a lot.

At first, even pulling a hook was stupid as hell.

When encountering patients with sudden convulsions, ventricular tachycardia, or even cardiac arrest and needing rescue, he was even more panicked and his mind went blank. Until now, after a year of teaching by Zhou Can's precepts and deeds, his abilities in all aspects are no longer comparable.

Putting it among the interns of the same period, it is definitely like hanging up.

Especially surgical ability.

Many interns may not even get a surgical task to close the abdominal cavity suture until the end of the internship.

Luo Shishen is now able to skillfully close the abdominal cavity.

Under the guidance of Zhou Can, the sewing level has almost improved by leaps and bounds.

After sending Yang Zhi away, Zhou Can went back to the operating room lounge to grab a quick meal to fill his stomach. There is still surgery waiting for him in the cardiothoracic surgery department.

…

It was almost eight o'clock, and Zhou Can showed up in the cardiothoracic surgery operating room on time.

After a year of growth, Director Xueyan's surgical ability has become quite powerful. Just for some major surgery, she will still invite Zhou Can to **** her.

In the operating room, there are basically old acquaintances.

Even the anesthetist is very familiar with Zhou Can.

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【My medical skills can add experience points】【】

"Doctor Zhou, after the operation, can you go to the intensive care unit to see a patient who has just undergone a lobectomy?"

It was Deputy Director He who made the request to him.

Under normal circumstances, Deputy Director He rarely performs operations with Director Xueyan.

The operation tonight is a cardiac surgery. Deputy Director He usually only focuses on thoracic surgery, and at such an old age, it is impossible for him to spare time and energy to learn more about cardiac surgery.

Then there is only one possibility, to make a special trip here to wait for Zhou Can.

"What happened to the patient?"

Zhou Can asked.

Patients who need postoperative monitoring are generally severe cases and major operations.

The situation is definitely worse.

Deputy Director He's surgical ability, diagnosis and treatment ability are quite good. Experience is also very rich.

Being able to force him so late, and to wait for Zhou Can in the operating room on a special trip, shows that the patient's condition is far more complicated than imagined.

Pulmonary resection is very common in thoracic surgery.

The number of smokers in our country remains high, and the number of victims who are forced to smoke second-hand smoke is even more alarming. If you meet a male host who does not pay attention to the safety of your family, he may smoke alone, causing the whole family to be forced to smoke second-hand smoke together.

You know, secondhand smoke is much more harmful than direct smoking.

In addition, smog has also caused a serious decline in air quality, and the pm25 index remains high, which is also a major factor in the high incidence of lung diseases.

PM25 refers to particulate matter with a diameter less than or equal to 2.5 microns in the atmosphere, also known as particulate matter that can enter the lungs.

It is an important culprit in the high incidence of asthma and lung cancer.

Especially in developed cities in the north, many people must wear masks when going out. Conditional, install an air purifier at home, in order to deal with pm25 in the air.

"The patient's alveoli continue to leak air, and the situation is not ideal. I'll tell you more about it after the operation is over."

Deputy Director He is very knowledgeable, and he dare not delay Director Xueyan's operation.

Now, a year later, Director Xueyan not only has strong surgical ability, but also the entire department has taken on a new look under her management, showing strong survivability and cohesion, and unprecedented unity.

Talent development is also very good.

The three good strategies that Zhou Can proposed to her at the beginning were all implemented by her.

"Zhou Can, Director He hasn't left after get off work because of this matter! You see, why don't you let Deputy Director He go to the duty room to rest for a while, and then go to him after the operation is over. Don't let him follow us Stay up all night and suffer together."

Director Xueyan and Zhou Can are siblings and have a close relationship, so they don't have any worries about speaking.

Very direct.

"Sin, sin! I'm really flattered to have Director He wait for me like this." The necessary polite words still have to be said. "You go to the duty room to rest first, and I will come to see you after the operation. This operation is estimated to take three hours at the fastest."

Zhou Can felt that although Deputy Director He had many shortcomings, he was very responsible to patients.

This is especially admirable.

Then again, he is only responsible for the patients he manages.

This really can't rise to the height of medical ethics. This is what everyone eats. Under the high pressure of various regulatory systems, Deputy Director He is afraid of accidents and is highly responsible for patients. This is also the real working state of many doctors today.

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【My medical skills can add experience points】【】

As soon as some patients enter the hospital, they question the doctor about this and that, and the doctor's compliance is extremely poor.

There is really no need for this.

Unless you really encounter a very unreliable doctor.

Otherwise, I believe that no doctor would take the risk of losing his job to specifically harm patients.

In some small and medium-sized hospitals, doctors have certain task indicators. They prescribe more medicines that are harmless to patients and have mediocre therapeutic effects, and prescribe more tests. This is also for survival.

When encountering self-paying patients, doctors generally try their best to calculate and prescribe medicines and examinations.

Patients with medical insurance know all about this.

The current general environment is like this. Without money for medical insurance, most hospitals will close down.

When that step is really reached, it will be even more difficult for ordinary people to see a doctor.

Deputy Director He is getting old, and he really can't stay up late like young people like them. Hearing Zhou Can speak, he immediately left the operating room happily.

Zhou Can picked up the patient's information and began to quickly check it.

"This patient's disease is a bit tricky! I thought it was just a common congenital heart disease, but I didn't expect it to be tetralogy of Fallot."

"It's not difficult, and I won't invite you here. I know that your one-day operation in the emergency department is also very heavy. As long as we can do the operation with confidence, we will try not to call you if we can."

Director Xueyan replied with a smile.

"Sister Yan calls me anytime you need something, don't worry about me being tired from work."

Zhou Can could feel her thoughtfulness.

Tetralogy of Fallot is the most common form of cyanotic congenital heart disease.

Without surgical intervention, patients generally do not live past the age of seven. The average life expectancy of children with this disease is only about twelve years old.

It is mainly manifested as cyanosis in children at three to six months.

Cyanosis can appear on the face, lips, nails, fingertips, and even the entire body.

Especially when the child is crying, the phenomenon of cyanosis is particularly serious.

In medicine, this disease has always been an incurable disease. Later, some doctors pioneered cardiac surgery, kept exploring, and finally found a surgical method to treat this congenital heart disease.

The so-called tetralogy of Fallot refers to pulmonary stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy.

Any one lesion is enough to be called a congenital heart disease.

The combination of four diseases also increases the difficulty of treatment geometrically.

Surgery is the only option to treat this disease.

Without surgery, the child is very likely to die.

Since this disease is a congenital heart disease, when the child is young, he may not be able to tolerate surgery because of stunted growth or physical condition.

In this case, it is generally impossible to complete a radical operation at one time.

Experienced surgeons often choose to perform palliative surgery first. Save the life of the child first, wait until the child grows up a bit, the tolerance ability is stronger, and the operation conditions are ripe, and then a second operation is performed to completely cure the disease.

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In Zhou Can's impression, Director Xueyan never dared to do such a difficult operation before.

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【My medical skills can add experience points】【】

Dare to challenge a tetralogy of Fallot operation this time, which also shows that she has full confidence in her surgical skills.

"Sister Yan, have you checked the patient's coronary artery?"

Zhou Can asked after reading the basic information of the child.

"I've checked it, and there's an imaging of the coronary arteries of the child below."

Xueyan knew that Zhou Can would never ask random questions.

Since you asked, there must be something wrong.

"Can this operation be done?"

At present, only anesthesia has been implemented on the child, and the operation has not yet begun.

"Don't be nervous, I just want to see where the anterior descending branch of the coronary artery originates. If the anterior descending coronary artery of the child originates from the right coronary artery, then this operation may not be possible. In addition, the patient's left and right Pulmonary arteries and surrounding pulmonary arteries are underdeveloped, and it cannot be done.”

Zhou Can gave his opinion.

After hearing this~www.novelbuddy.com~, Xueyan said with a crooked smile, "I knew it was reliable to ask you to come and help me. If there is any problem, I can help us check it together. Don't worry, I have checked these two taboos." It's okay."

Even though she had checked it, Zhou Can was still a little worried, so she checked it again.

Fortunately, this child does not have the above two conditions.

"How is his left ventricle developing?"

Zhou Can asked again.

"It's not bad, it's up to the normal level. But it's not particularly good."

"Then there is no problem. Is the child's water intake in place before the operation?"

Zhou Can pressed the child's skin, and the elasticity was acceptable.

"It's in place."

This time it was the itinerant nurse who answered.

"Okay, I'm basically fine."

Zhou Can looked at Director Xueyan.

It means waiting for her to call the shots.

"Anesthesia, can we start?"

It is not impolite to directly address anesthesiologists by profession during the operation, but for the convenience of communication.

Especially when there are doctors in the operating room with the same surname as the anesthesiologist, everyone is more willing to directly use the word anesthesia to refer to the anesthesiologist.

"The patient's vital signs are stable, he has entered a state of general anesthesia, and can be operated on."

"Then let's get started! As usual, Dr. Zhou Can will replace me as the surgeon at critical moments, and everyone else will take their place."

Director Xueyan invited him here, in addition to joint checks, there is another point, Zhou Can helps at critical moments.

Today, Zhou Can's many surgical skills have reached the deputy director's intermediate level, or even advanced level. Coupled with his fast and steady knife skills, his strength is not inferior to that of a first-class chief surgeon.