Chapter 311 Area e!
Who wouldn’t want to graduate early?
Most of today's doctors don't think about continuing their studies as long as they can graduate early. In their opinion, theoretical knowledge is not as important as practice. The most important thing is that students who are studying do not make money. .
Of course, Wu Xiaofu didn’t think so. It is always good to learn more, especially the resources of a good school.
However, for Wu Xiaofu, the current school study is really meaningless. It would be best to graduate early.
To be honest, every time I saw those friends on the Internet who were delayed in graduation, they looked so sad with a lot of hair falling out, Wu Xiaofu felt heartbroken. At that time, his biggest wish was not to delay graduation, but now it is better, not only can he graduate early, but he can also graduate early. Graduation in two years.
After this, Wu Xiaofu can also say that he is a doctoral graduate.
"Also, the Health Commission has approved it. Now you still have the title of attending physician. If you say it, it will make people laugh. You will go through the process during this period. In a few days, you will take the test and you will be promoted directly. Deputy Chief Physician.”
Deputy Chief Physician!
That’s it! Although he had started planning for promotion after returning this time, it was still surprising to receive Rongqiao's promise so suddenly.
Since Rongqiao said it, there must be no problem.
After following the procedures, it is estimated that his professional title will be up to next month at most.
This is the privilege of top technicians. Situations like Wu Xiaofu's are actually found in many hospitals. Some doctors look young, but in order to give them adequate treatment, they will basically be promoted in terms of professional titles. Convenient.
It is actually very difficult to go from attending physician to deputy chief physician.
Not only has the exam become more difficult, it is also difficult to get hired in the hospital. At the current Donghai No. 1 Affiliated Hospital, of the ten deputy directors, at most two or three can be hired, while the rest are still the same. I was admitted as deputy chief physician, and my professional title is still chief physician.
It doesn't matter how many doctors there are, just hire as many as you want.
The most important thing is that after being promoted to deputy director, it is justifiable for others to call him director.
Later, Rongqiao directly gave Wu Xiaofu a series of salary improvements, such as performance 2.3. Wu Xiaofu also accepted all comers. He also saw it. If he didn't accept it, Rongqiao wouldn't even accept it. rest assured.
"By the way, Xiaofu, Donghai TV station contacted our hospital and said that it is preparing to start filming offer2. When the time comes, I would like you to be a mentor. You should consider it."
offer2.
In the past few days, the Internet has gone crazy, talking about this matter. Of course Wu Xiaofu knows about it and is just a mentor. In fact, except when shooting scenes, it will not delay Wu Xiaofu's usual work.
The protagonists are still a few interns, training new people, Wu Xiaofu is really interested.
"Okay, I'll think about it."
Back in the department, Zuo Hui held a small celebration ceremony for Wu Xiaofu, which was a big cake, and then the entire department celebrated Wu Xiaofu together.
Looking at Zuo Hui, Wu Xiaofu was also a little embarrassed. Zuo Hui has been having a hard time recently. There was such a trouble last time because of the relationship between the leader's family, and he made some small mistakes again and again. .
Therefore, he was often said to be old, so that something was wrong with Zuo Hui's condition.
When Wu Xiaofu was looking at Zuo Hui, Zuo Hui was also looking at Wu Xiaofu. Zuo Hui knew that Wu Xiaofu could no longer suppress him, and it was not something he could suppress. Simply, he had no thoughts now. If it comes to this kind of thing, just follow Wu Xiaofu. If you have a good relationship, you won't go wrong.
Wu Xiaofu felt Zuo Hui's attitude and was pleasantly surprised. The head of the department was getting better and better towards him.
When Wu Xiaofu was away, it actually didn’t mean that the patient was completely ignored.
When encountering some difficult cases, Feng Lingling and others would send them to Wu Xiaofu for review and ask for Wu Xiaofu’s opinions. If there were some problems during the operation, they would basically start the video and handle them on the spot. Therefore, Wu Xiaofu was very concerned about the problems in the group. Many patients actually know a lot about it.
Of course, this is also normal for doctors.
When you go on vacation, doctors have to turn on their phones 24 hours a day. There may be department matters or patients looking for you at any time. Other jobs may not be fatal, but doctors’ work is often Life is at stake, so it has become normal to answer the phone in the middle of the night. Complaints are made, but no one will actually turn off the phone.
“Boss, have you heard?”
“What did you hear?”
“Hepatobiliary surgery in our hospital is very popular now. I heard that the hospital is preparing to The e-area is open. Isn’t this graduation season? There are announcements on the hospital’s official website to recruit people, especially in the hepatobiliary surgery department.”
A new department is opening!
Don’t mention it, Wu Xiaofu really hasn’t heard of this matter.
"Just open it, it doesn't have much to do with us."
"Boss, why is it not big anymore? If it were before, it would be fine, but now if we open a new district, boss Don’t you want to be the section director of this new section?”
Department Director!
Wu Xiaofu also paused when he heard this. Not to mention, if Yuna hadn't reminded him, Wu Xiaofu really hadn't thought about this matter. After all, he himself subconsciously felt that it was too early for him to become the department director.
But that was based on seniority. If it was based on strength, Wu Xiaofu suddenly felt that he could do it.
"Okay, these are issues that the dean should consider. Why are you worrying so much? Take good care of the patients."
Yuna looked at Wu Xiaofu's calm expression and felt a little confused. Disappointed, this boss is not proactive at all.
No, she must do a good job in intelligence work later. If Wu Xiaofu had not won the World Surgery Competition Championship and made such great contributions to the First Affiliated Hospital, Yuna would not have had too many ideas. But now Wu Xiaofu needs credit and strength, and he has been leading a team for a while. Why can't he be a department director?
Boss, don't be anxious, they must be more active.
Everyone knows that a rising tide lifts all boats. The higher the boss goes, the faster they can go.
In the ward.
"The patient, a 16-year-old male, was admitted to the hospital two days ago due to 'recurrent fatigue, jaundice on the skin and sclera for more than one year.'
Height: 165cm; weight: 55kg; BMI: 20.2 .
The patient developed chills, fever, nasal congestion, and runny nose after catching a cold 1 year ago. After treatment, the patient improved, but gradually developed yellowish skin and upper abdominal distension and pain, accompanied by nausea and vomiting. The vomiting was gastric contents.
The patient later went to a local hospital for relevant examinations and was diagnosed with ‘acute jaundice hepatitis’. He was given treatment such as liver protection and anti-jaundice treatment, and he was discharged after a slight improvement.
Polyene phosphatidylcholine, ursodeoxycholic acid, compound glycyrrhizin and other drug treatments were given outside the hospital, but the effect was not good, jaundice persisted, and the TBIL level was 50~100 μmol/L.
Two months ago, the local hospital considered the patient's clinical diagnosis of 'autoimmune hepatitis' and added prednisone 30mg/qd and azathioprine 50mg/qd. The patient's family reported that the patient's pain was normal. Obvious changes include facial hair thickening and pigmentation.
One week ago, the patient again experienced nausea, vomiting, severe abdominal pain, and vomited brown gastric contents twice, about 150ml/time. An abdominal plain X-ray performed at the local hospital showed: pneumatosis in the colon, dilation, and a large amount of gas. Fecal shadow, the diagnosis of 'incomplete intestinal obstruction, emergency ulcer bleeding' was considered, prednisone was stopped, and symptomatic treatment such as fasting, liver protection, stomach protection, and anti-infection were given, and the patient was discharged automatically. (Supplementary medical history: urinary porphyrin negative)
He visited the emergency department of our hospital 2 days ago. Whole-abdominal CT showed: a small amount of fluid in the pelvic cavity, slight gas accumulation in the transverse colon and ascending colon, and slight expansion of the intestinal cavity. The structure of the ileocecal part was slightly blurred. The appendix was not clearly displayed. There may be some fecal stone shadows in the cavity, and multiple lymph nodes near the superior mesentery were displayed. The density of liver parenchyma is slightly reduced, mild fatty liver is possible, bile is stratified, and the spleen is enlarged.
..."
Feng Lingling's voice echoed beside the patient's bedside. Today is Wednesday, and Wu Xiaofu has just come back, so the whole team is doing a ward round. Wu Xiaofu is the leader, and next to him are Chen Zhendong, Zhang Xuewen, followed by Feng Lingling and Yuna.
Whose patient is responsible. During the ward rounds of new patients, the attending doctor will introduce the details.
Well, they don’t look at the medical records. , the kind that comes as soon as you open your mouth.
If a doctor cannot even clearly understand the conditions of his patients, how can he ensure the safety of his patients? Even if you have too many patients, that is your own business. What should be done must be done.
This is a patient who was admitted to the hospital two days ago. Wu Xiaofu has not been in contact with him yet, and he knows nothing about his condition, so Feng Lingling needs to be more detailed when explaining his condition.
While Feng Lingling explained the condition, Wu Xiaofu looked at the patient's examination.
"What's the diagnosis?"
"Incomplete intestinal obstruction, autoimmune liver disease? Others include stress ulcers and splenomegaly."
Wu Xiaofu nodded. In fact, the latter ones are all internal medicine diseases, and the work of gastroenterology should be done. The reason why they were connected to their hepatobiliary surgery department was because of intestinal obstruction, which required emergency surgical treatment. Which department you enter will generally determine the main diagnosis.
This is not only the reason why the patient's condition is more urgent, but also the reason for medical insurance reimbursement and payment, and the latter is the main reason.
Nowadays, single-disease payment is the so-called main diagnosis payment.
Just like this patient, if the main diagnosis is replaced by several other diagnoses, then the set of examinations and operations they performed may not be reported.
"What are you going to do next?"
"Now the patient's obstruction cannot be relieved by medication, not even after a long time. It is easy to develop into complete intestinal obstruction, so I suggest surgery to relieve the obstruction first."
< br>Surgery to relieve obstruction!
Wu Xiaofu frowned and came to the patient. This was actually just a sixteen-year-old child.
For such underage children, if it is really possible to avoid surgery, there is no need for surgery.
Of course, if you really need surgery, you can't hesitate, but the most important thing is that surgery can really completely solve the problem.
What causes intestinal obstruction? In fact, children of this age rarely suffer from intestinal obstruction unless there is a specific clear cause. If the root cause cannot be identified, surgery can be performed directly. Surgery Then, most likely not long after, the patient developed another obstruction.
What to do at that time? More surgery!
Doctors can perform surgery, but the patient's body may not be able to bear it, and the patient's family may not be able to accept it. If it cannot be done, it will be another lawsuit. Therefore, such matters that can easily cause disputes still have to be dealt with. Try to avoid it.
Surgery is always the last resort. To sharpen the knife before chopping wood, we still need to find out the cause of the disease.
"Have you considered the cause of the patient's obstruction?"
"With indigestion caused by liver disease, the patient also has stress ulcers, so the chance of obstruction is still very high."
This is pure Judgment is based on experience. In medicine, old doctors like to use experience to judge patients. However, one of the characteristics of modern medicine is that it is evidence-based. What does this mean? Everything written in writing must be supported by evidence.
Experiential judgment is not enough as evidence.
Shaked his head, "Not necessarily, the obstruction is not that serious. Don't rush for surgery, just do a liver biopsy."
Liver biopsy!
Everyone was shocked when they heard this. Not to mention Chen Zhendong and the others, even the patient’s family members were excited. What does liver biopsy mean? It is no longer ten years ago. People still have little understanding of basic medical knowledge. There is understanding.
This is to take liver tissue for examination.
"Doctor Wu, what's going on, the liver needs to be removed, he is so young..."
The patient's family members were crying when they spoke, and Wu Xiaofu could only do it when he saw this Whisper comfort.
"Liver biopsy is actually just a puncture, a small incision, and a small piece of liver tissue. It will not cause much damage to the child. With his recovery ability, he can recover in a few days. The child is so young, so There is no history of liver disease, and you have no family history of hereditary disease. So what is the cause of liver disease?
Liver biopsy is the fastest way to determine the cause of the child's disease."
At this time, Chen Zhendong and the others also calmed down and looked at Wu Xiaofu, "Do you suspect a hidden disease?"< br>
Recessive diseases are actually diseases whose causes are difficult to identify.
For example, it is a genetic disease, an unspecified disease, etc.
"Well, it is also best to do a genetic test. For patients with unexplained abnormal liver function, liver biopsy histopathological examination can help to clarify the diagnosis and further narrow the scope of differential diagnosis. For the diagnosis of hereditary metabolic liver disease, molecular and genetic testing is even more important. Very important."
Wu Xiaofu and Feng Lingling said, she is the attending doctor, and Feng Lingling needs to discuss these with the patient's family.
The direction of diagnosis is given by Wu Xiaofu, but how will the follow-up proceed and how Feng Lingling and her family will discuss it? Wu Xiaofu will not intervene now. If it is difficult to proceed later, he will continue to come forward.
After the ward rounds, Feng Lingling did not delay and directly found the patient’s family members and had a conversation.
She also figured it out now. She really thought it was simple before. If there is really a hereditary liver disease and she hastily performed the surgery, then if there are problems later, it will not only be It's as simple as delaying the condition.
"Dr. Feng, I'd better think about it first."
It is always difficult for the patient's family to decide. Although Wu Xiaofu is famous, this is a liver biopsy and a genetic test. Feng Lingling said before Surgery was performed to remove the obstruction, and now she had an idea as to who she should listen to.
Especially the genetic test, which is really not cheap and cannot be reimbursed.
After thinking about it for a while, the patient’s family made a few calls.
Wu Xiaofu is having a pre-operative discussion meeting with Yuna and others in the office. During this period, he has accumulated a lot of surgeries, and Wu Xiaofu wants to do them all as soon as possible.
Bang bang bang!
Wu Xiaofu looked at the door that was pushed open, it was an acquaintance.
Director Fang of Group B is the deputy director of the Department of Group B. He is an old chief physician and has rich experience.
"Director Fang, why are you here when you are free? Do you have something to do with me?"
Director Fang looked at Wu Xiaofu and smiled.
"Xiao Wu, there is a patient in your group named Fang Wenfan, a relative of mine. His mother called me just now and said that you asked for liver biopsy and genetic testing. I looked at his medical records and examinations and thought Come and have a chat with you.”
Yeah!
Listening to Director Fang’s words, everyone frowned, especially when they heard Director Fang call him Wu Xiaofu Xiaowu. Who else in the whole hospital has such no emotional intelligence? Just call him Wu Xiaofu Xiaowu. .
Those who are close to each other, such as Rong Qiao and Yu Shifu, are all called Wu Xiaofu and Xiaofu.
Those who are on average terms with each other will always be Dr. Wu when they meet, so they have to call him "boss".
They are all leading the team. Wu Xiaofu's current status is different after all. This Xiaowu Xiaowu's, even in private, if there are other people present, it would be somewhat inappropriate. Fortunately, there are no patients, otherwise, This sounds like a junior, so I don’t know what to think.
Moreover, it is against the rules to interfere with the conditions of patients in other groups.
However, since they are relatives, they can understand it, but it seems that Director Fang is questioning Wu Xiaofu’s diagnosis and treatment methods.
Just now, Wu Xiaofu has focused on Fang Wenfan's situation, and they have also reacted at this time. Not to mention, after Wu Xiaofu's analysis, it may really be some kind of troublesome hereditary liver disease.
However, they are not in a hurry to speak. After all, they are seniors, so they still have to respect him and listen to what he has to say first.
"Director Fang, give me a call. I'll just go over and find you. You have to go there in person. Come, sit down first and let's talk slowly."
Wu Xiaofu's face was calm. Who doesn’t have a relative yet? That’s understandable.
Director Fang was also very satisfied when he saw Wu Xiaofu's attitude.
"Xiao Wu, I looked at Fang Wenfan's medical records and examinations. There is no genetic history in their family. They were admitted to the hospital because of intestinal obstruction this time. The child's mother also said that the child's immunity has been weak since he was a child. .
I think it’s an autoimmune liver disease that keeps jaundice recurring. I think it’s better to strengthen immunity after the intestinal obstruction is relieved. Liver biopsy and genetic testing are expensive. I won’t say it anymore, I don’t think it’s necessary.
Xiao Wu, I understand your worries, but what are the chances? It doesn’t look like it no matter how you look at it. Also, I think there is no need for surgery for intestinal obstruction. Just transfer it to me. I will take medicine and it should be fine. That's it. "
As soon as Wu Xiaofu said anything, Feng Lingling's face turned dark.
What do you mean!
It means that she can't be relieved by the medicine. Obstruction, all I need is surgery, Director Fang is dead with one blow
(End of this chapter)