Because when Dr. Gao, the youngest and most promising doctor in the Department of Neurology, saw this emergency resident, the expression on his face was not only surprise but also respect.
The hospital is also a small society. If you have a promising future or ability, others will respect you.
Otherwise, it is the dust in the corner.
Tuya Hospital has several thousand employees, most of whom are ordinary people.
"Let me tell you, Dr. Zhou is the most promising doctor in the emergency department. It will only benefit you if you have a good relationship with him." After Gao Jian said this to the nurse, he looked at Zhou Can again.
"Dr. Zhou, are you here to see me? Haha! I'm a bit narcissistic!"
Although Gao Jian and Zhou Can are competitors, they were very enthusiastic when they met.
The nurse looked at Zhou Can again in surprise.
There is no more contempt in his eyes.
There was a somewhat flattering smile on his face.
Unfortunately, Zhou Can didn't look at her again.
"I'm here to ask Director Yin some questions. Do you know where he is?"
"Director Yin is my teacher. Do you think I know where he is? Come on, I'll take you there. The teacher mentioned you two days ago. You are lucky today because the teacher is working overtime today. Normally, Director Yin doesn't work on weekends. Recently, there are a lot of patients seeking treatment, and the teacher is worried that his expert appointments will be sold at sky-high prices by scalpers, so he chose to work overtime."
When you reach the level of Director Yin, you no longer need to undertake many basic tasks.
The main thing is to supervise students, see patients, attend meetings, etc.
If you are the chief surgeon, in addition to seeing patients, you also need to perform surgery.
From this point of view, internists have a natural advantage in academic research.
For surgeons above the chief surgeon level, they basically spend half a day seeing patients and half a day doing surgeries. They also have to make rounds, supervise students, lead groups, and lead projects... There is really not much time left for studying and recharging.
Many people think that surgeons earn more than internists.
This is very one-sided.
Surgeons can certainly earn surgery fees and overtime pay through surgery, but internists also receive a lot of commissions from drug costs.
When it comes to hospitalization, internal medicine can crush surgery.
An ICU with 10,000 or 20,000 patients per day is a money-eating beast.
Even so, many hospital leaders often criticize the ICU as a money-losing department.
Under the guidance of Gao Jian, Zhou Can went straight to the outpatient clinic of the Department of Neurology.
There were still many patients sitting in the corridor outside.
Tuya actually has quite a lot of specialist clinics.
The cheapest expert appointment is 50 yuan, and the most expensive special expert outpatient appointment is over 1,000 yuan.
This world is very strange. Not many people want cheap expert appointments, but many expert appointments costing hundreds or thousands of dollars are sold out in seconds.
It’s better now. You are required to show your ID card for registration.
Scalpers have much less room to operate.
In the past, when there were no self-service registration machines and everything was done manually, the better expert appointments were monopolized by scalpers.
If you want to see a doctor, you have to buy it from them.
It doesn’t matter if you don’t buy it, there are plenty of patients who are willing to pay a higher price to buy it.
Because the patients simply can’t afford to delay.
"Liu Yan, how many patients has Director Yin not seen yet?"
Gao Jian asked the nurse who was guiding him.
The role of these nurses is to guide patients to queue, maintain order and call out numbers.
As long as the patient hands her the medical record and registration slip, she will call the numbers one by one in order of priority.
This prevents people from cutting in line.
Patients and their families just need to sit on the benches in the corridor and rest and wait.
"There are three more patients."
"OK!"
Gao Jian nodded and looked at Zhou Can.
"There are three more patients. You will have to wait about half an hour. I still have to work in the inpatient department, so I can't accompany you."
All the trainees in technical colleges have a hard time.
Taking care of patients, writing medical records, working night shifts, doing all kinds of odd jobs... every day I am so tired that I fall asleep as soon as I touch the pillow.
"Go do your thing! Thanks!"
Zhou Can waved to him.
Fortunately, I met Gao Jian today, otherwise it would be very difficult to find Director Yin.
After watching Gao Jian leave, Zhou Can found an empty seat and sat down.
He found that many patients came to see a doctor with various examination reports from other hospitals. They could not find the cause of the disease in the local hospital, or the treatment was ineffective, so they came to Tuya Hospital to seek expert diagnosis.
Zhou Can took a casual look and found that most of the outpatient rooms inside were specialist outpatient rooms.
Director Yin Hua's room has a sign that says Specialty Clinic No. 1.
There are at least six or seven special specialist clinics like this one.
Those who are worthy of the title of special experts generally have made significant achievements in a particular sub-discipline field.
Only after rigorous review can one be eligible to add the word "special needs".
Tuya is still quite strong.
After all, there are so many top experts in the department of neurology alone.
If all the important departments of Tuya are added together, the number of top experts is probably more than one hundred.
The lifelong wish of many doctors is to become a top expert.
In fact, it is amazing if three or four out of a hundred doctors can become top experts.
As long as Zhou Can keeps working hard like this, sooner or later he will be able to sit in the special specialist clinic and treat patients as a top expert.
While he was sitting here waiting, he took out his cell phone and looked through Qiu Jie's medical report again.
Look at them carefully, one by one.
He even read some examination reports over and over again for no less than ten times.
But there was still no significant discovery.
Around five o'clock, Director Yin finally finished his outpatient clinic.
Zhou Can hurried to the door and knocked.
When Yin Hua looked up and saw Zhou Can, he was stunned.
"Xiao Zhou!"
"Director Yin, you said last time that I could always ask you questions. I'm really shameless to bother you."
Zhou Can walked in with a smile.
"Welcome! Have you been waiting outside for a long time?"
Director Yin's attitude towards him was quite enthusiastic.
Look at his expression, he sincerely welcomes Zhou Can to come to him and ask questions.
"It wasn't long, only about half an hour. But it wasn't easy to find you. I'm not familiar with the Department of Neurology, and I asked around to find out where your office is. Fortunately, I met Gao Jian, who brought me here."
Zhou Can was not shy at all.
He walked over, picked up Director Yin Hua's empty teacup, and took the initiative to fill it with water.
This small action instantly brought him closer to Yin Hua.
Usually only students will help teachers refill their teacups with water.
This is a kind of respect.
It also means to show courtesy.
"Come and see me next time. I'm here as an outpatient on Mondays, Wednesdays and Fridays. During the day shift on Tuesdays and Thursdays, I'm mostly in the inpatient office or the minimally invasive operating room. You can find me in these three places. If you can't find me, just call me. Do you have my number?"
Being attentive does work.
Director Yin Hua took the initiative to give him his phone number.
Not everyone can have this treatment.
"I don't have your number. Can you tell me so I can write it down?"
Zhou Can took out his cell phone and got ready.
Director Yin gave Zhou Can his personal cell phone number and he wrote it down. It would be much more convenient to contact him in the future.
In order to reduce unnecessary trouble, famous doctors of their level generally do not give their cell phone numbers to irrelevant people.
"What do you want to ask me ? I have to go to the inpatient department for rounds later, so hurry up!"
Director Yin is really very busy.
If others go to see him for treatment, not only do they have to pay an 800 yuan registration fee, but they also have to wait in line.
Because Zhou Can was appreciated by him, he was spared from all these troubles.
"I met a patient who had been paralyzed for several years because of a miscarriage. However, after visiting many famous doctors, the cause of her illness could not be found. You are a top neurology expert with extensive knowledge, so I would like to ask you for help."
Zhou Can opened Qiu Jie's examination report and put the phone in front of Director Yin.
"Some of her medical records are here."
Director Yin clicked it and immediately a strange expression appeared on his face.
Zhou Can also noticed that Director Yin's expression was different.
"This patient came to see me three years ago. When you said she was paralyzed due to miscarriage, I guessed something. This is because there are so few patients like this. It is difficult to see one case out of 100,000 miscarriage cases."
Come to think of it, the Li Lao couple live in this city, so how could they not go to Tuya for medical treatment?
As long as we go to Tuya Hospital, this kind of difficult neurological case will definitely be consulted by Director Yin.
Although he had diagnosed Qiu Jie three years ago, he still opened and enlarged the patient's examination reports one by one.
He looked very carefully.
"I was deeply impressed by this patient named Qiu Jie. She attempted suicide on the second day she was admitted to the hospital. Fortunately, the nurse discovered her in time. I didn't expect that three years later, the cause of her illness has not been found."
Director Yin sighed.
Hospitals are actually quite afraid of death.
Even if it is a normal death, it will increase the hospital's mortality rate, not to mention this kind of suicidal patient.
It will have a certain negative impact on the hospital, and the hospital will have to bear the responsibility for inadequate management.
"When I diagnosed this patient, she had just had a miscarriage. My diagnostic skills were weaker than they are now, and my experience was also less. Now I think I made a mistake. I thought she was in shock for too long, which led to a serious degree of damage, and combined with complications such as infection, which caused her natural paralysis."
"When I examined her at that time, I found that the muscle spindles were more sensitive to stretch reflexes than normal, especially the muscle tension of the upper limb flexors and lower limb extensors was very high. The initial resistance was high, and then the resistance dropped rapidly, like a cliff. Based on the subtle results of these examinations, I diagnosed her with natural paralysis caused by lesions and complications of infection. I thought there was no cure."
Three years have passed, and after reviewing the information, Director Yin still remembers what happened back then clearly.
Doctors are like this, when they encounter some difficult cases, it is easy for them to remember them for a lifetime.
Firstly, difficult cases are rarely repeated, and secondly, great effort is put into the diagnosis process, so the memory is particularly deep.
"Have you made any new discoveries?"
Zhou Can asked.
Three years have passed, and Director Yin's diagnostic level and experience have improved to a certain extent.
Maybe there will be some new discoveries.
"Still no significant findings. But this report from the Imperial Capital Hospital did give me some ideas. They conducted an electromyography test on this female patient Qiu Jie. We at Tuya can also do electromyography, but because the equipment is not that advanced, the test cannot be as accurate as theirs. You see, in the electromyography test, the conduction ability gradually decays from here. There is still a weak signal when it is transmitted to the thigh root. I think if the lesion of this patient can be found, there will definitely be a turnaround."
Zhou Can can understand common problems in electromyography.
However, it is difficult for him to see some things that are too advanced or require a combination of rich experience and medical knowledge.
It's a bit like in a picture, some people see two faces, some people see seven, or even more.
Based on the examination reports and some clues from the patient's symptoms, one can spot abnormalities that other doctors cannot find. This is what a master does, and this is what level of expertise is.
Zhou Can already possessed a high talent for diagnosis, and his eyes lit up slightly when Yin Hua reminded him of this.
"You mean, the fact that the electromyographic signal can be transmitted to the thigh root means that the patient's nerves are not completely necrotic. It's just that the nerve signal is severely attenuated and cannot be transmitted to the more distal parts of the lower limbs. At the same time, because the nerve signal is very weak when it reaches the thigh root, it is impossible to make a limb movement response."
As long as the nerves are not necrotic, there is still a chance.
Because nerve cells are the only non-regenerative cells, once they die, they are difficult to treat.
"clever!"
Director Yin gave him a thumbs up.
This kid's talent and understanding are indeed very high.
One word is enough.
"The patient's electromyographic signal attenuation is gradual, not abrupt. Based on my experience, this is actually not much different from the result of nerve necrosis. It's like an aging wire. Its conductivity has serious problems. Unless you replace it with a new wire, there is no way to solve it."
Director Yin shook his head and sighed.
This patient is simply incurable.
The lower limbs have a very rich number of nerves, and I'm afraid no doctor can replace them with new ones.
Zhou Can, however, seemed to be possessed by a demon. He frowned, stared blankly at the corner of the wall without saying a word.
Director Yin noticed that Zhou Can did not respond, and when he looked up, he couldn't help but laugh.
This kid really has the style he had back then.
When he was studying medical problems, he often immersed himself in them, almost to the point of obsession. After unremitting efforts, he has achieved his current status.
Director Yin did not interrupt Zhou Can's thoughts.
Instead, he lowered his head and continued to check the patient's information to see if there were any more discoveries.
After more than ten minutes, Director Yin was going to make rounds. He was about to get up, leaving Zhou Can here to continue thinking.
At this time, Zhou Can had a result.
"That's right, yes, that's probably the case."
He was mumbling something, his eyes were bright and his face was excited.
"Have you made any new discoveries?"
Director Yin had seen Zhou Can's alternative diagnostic ideas, so he did not look down on him just because he was a resident intern.
Speaking of which, Director Yin admired Zhou Can so much that he was willing to make things convenient for him.
This is also because of Zhou Can’s alternative diagnostic thinking.
"I think this patient can still be cured. Her electromyographic signals decay all the way. Do you think it has something to do with blood supply?" Zhou Can asked, and it was obvious that he had made a major diagnostic discovery.
Why do paralyzed patients need to have an electrocardiogram?
What is actually checked is the blood supply.