Chapter 137: The Correct Answer to Being Well-educated and Well-mannered, Neurosurgery
"Doctor Zhou, Doctor Zhang, please pay attention to my reduction technique!"
After Dr. Fu touched the patient's temporomandibular joint, his expression became slightly solemn.
If the operation is not difficult, he will definitely let Zhou Can practice it.
Now I find that the situation is not good, and the patient is not very talkative.
He can only do it himself.
"Come, sit with your back against the wall and your head against it."
Doctor Fu guided the patient to sit down.
"Yes, that's it! Keep this position and don't move."
After the patient sat down, Dr. Fu asked the nurse to get two pieces of clean gauze, then wrapped the thumb with it and put it into the patient's mouth.
"Pay attention, when repositioning, hold the patient's back teeth masseter muscle with your thumb. It's right here."
After Zhou Can and Dr. Zhang saw it clearly, he placed four fingers on the lower edge of the mandible.
"Pull this area with your fingers, and then slowly press the jaw. Remember, press downward and backward. While doing this, lift the patient's chin upward, like holding a bowl of soup."
This metaphor is quite vivid.
Zhou Can is concentrating on his studies.
Carefully understand the key points of operation and the purpose of each action.
"Have you seen my operation clearly?"
“I see clearly!”
Zhou Can and Dr. Zhang nodded at the same time.
"Very good! Relax, relax again! Yes, that's it!"
Doctor Fu saw that the time was right and pushed back gently. A slight bone cracking sound was heard.
Then, Dr. Fu quickly pulled his finger out of the patient's mouth.
"It's that simple! After resetting the patient's joint, be sure to quickly pull your hand back to prevent being bitten."
The patient was unable to bite when his temporomandibular joint was dislocated.
After reduction, the patient may feel pain and bite the doctor's hand out of inertia and instinct.
Zhou Can understood what he meant.
The patient opened and closed his mouth to try it out, and a smile of extreme joy broke out on his face.
"Haha, it's really okay, it's okay! Haha... uh uh uh..."
The patient had just laughed twice when his joy turned into sorrow and his jaw was dislocated again.
This scene stunned several doctors and nurses.
"Dislocation will cause the joint to become loose. You can't laugh or open your mouth wide after the manipulation. I just repositioned it for you, and it fell off again. What should I do?"
Doctor Fu was particularly speechless.
I have never seen such a capable patient.
"Doctor, when we buy a mobile phone or TV, we can enjoy the three guarantees policy if there is any problem. My brother just finished treatment and hasn't even left the treatment room yet. You have to be responsible!"
The patient's younger brother, who was about 40 years old, did not look for problems with his brother, but directly brought up the three guarantees policy for home appliances.
It's obvious that he just wants the doctor to treat him again for free.
In fact, there are quite a few such cunning family members.
As long as money is involved, they will never be polite to doctors.
"In theory, we have successfully reset his bone. You should register and pay again for another treatment. I see that it has been difficult for you two brothers, so I will not charge you any extra treatment fees, but you can pay for the consumables. Is that ok?"
Dr. Fu gives his patients the best care within his ability.
"That's no problem, thank you doctor."
After hearing this, the patient's brother smiled with satisfaction.
Thanks again and again.
If we ask him to take another X-ray or pay for treatment again, the cost will definitely be huge.
"Doctor Fu, can I do the operation this time?"
Zhou Can just watched and learned the whole process, and thought he had grasped the key points.
Now is a great opportunity to practice, he wants to strike while the iron is hot and combine learning with practice.
"OK!"
Dr. Fu readily agreed.
The family member was a little reluctant and said, "Is this young doctor okay? Please don't hurt my brother."
"Don't worry, he is the best young doctor in our department, there will be no problem at all."
Doctor Fu flattered Zhou Can.
The family members said nothing more.
Zhou Can followed suit, asked the patient to sit down, and then repositioned the patient according to Doctor Fu's technique.
In the extremely distrustful gazes of the patient and his family, he held the patient's jaw and pushed gently.
The bone-rattling sound rang out again.
The temporomandibular joint was successfully repositioned.
“It’s very well done!”
Doctor Fu praised him highly. Zhou Can's learning ability and practical ability were indeed the best he had ever seen.
After the patient was cured, he dared not laugh anymore.
Learned from the lesson and became more cautious.
Doctor Fu used gauze to fix the patient's jaw, explained some precautions, prescribed some medicine, and sent the patient away.
In the following days, although Dr. Fu didn't say anything, he obviously relied more on Zhou Can.
Zhou Can has plenty of opportunities to practice bone setting and realignment every day.
The level of bone setting and reduction is becoming more and more advanced.
The fulfilling days always pass by especially quickly.
In the blink of an eye, Zhou Can's training in orthopedics was over. His bone-setting skills were now close to the mid-level of residents.
The orthopedic surgery department gave him an excellent evaluation for his residency training.
He is also the only one among the 18 trainees to receive this evaluation.
After get off work, Zhou Can went to the pharmacy and bought a ginseng.
He definitely can't afford the ones that cost hundreds or even hundreds of thousands.
I chose the 3,000 level.
After purchasing, wait at the exit of the hospital’s staff parking lot.
Not long after, Dr. Fu came out driving a white Honda.
Zhou Can quickly waved his hand to stop him.
"Doctor Zhou, do you want to take a ride with me?" Doctor Fu asked with a smile.
Zhou Can opened the passenger door and got in directly.
"Isn't my residency in orthopedics over? I'm going to neurosurgery tomorrow. I'm afraid it will be difficult for me to see you again in the future."
After completing his training in orthopedic surgery, his next stop was neurosurgery.
This was not arranged by him, but by the hospital.
"Haha, you've been following me for half a month, have you developed feelings for me?" Doctor Fu drove the car slowly out of the hospital.
Being blocked at the entrance of the parking lot is unimaginable.
No staff member of the hospital dared to do such a cruel thing.
"Don't worry if you're cheesy, there really is a hint of affection. There are only the two of us, so I won't beat around the bush. When I was first transferred to the orthopedic surgery clinic, I was like an abandoned baby. You didn't shy away from suspicion and let me learn bone-setting techniques from you. This is a great favor. It is said that it is easier to add icing on the cake than to send charcoal in the snow. I see that you have a lot of white hair on your temples. You must be very busy every day. This old ginseng is a small gift from me. I hope you don't mind it."
Zhou Can put the old ginseng in the glove box next to the main driver's seat.
"Oh, why did you give me such a valuable gift? Take it back quickly. I appreciate your kindness."
Doctor Fu refused again and again.
"It's not worth much. I heard that old ginseng can replenish essence. I don't mean anything else. I just hope that doctors like you will stay young forever. You can benefit more patients and train more new doctors."
Zhou Can put a lot of thought into giving gifts.
Over the past half month, Dr. Fu taught him almost everything he knew.
The bone-setting skills he learned would be enough for him to use throughout his life, even if he opened a clinic.
Giving him a piece of old ginseng should be a good way to express his gratitude.
"I live in the hospital dormitory. It's just right for me to get off right in front. Please stop for a moment."
Zhou Can finished giving the gift he should give and saying what he should say.
Get off immediately.
"If you have time in the future and want to practice bone reduction techniques, you can always come to the manual reduction room to find me."
Dr. Fu slowly stepped on the brakes at the side of the road.
The old ginseng sent by Zhou Can has achieved very good results.
At least, Dr. Fu knew that he was a sensible man.
"You said so. I only spent half a month in the manual reduction room. It's definitely not enough. If I have time, I will really go to the manual reduction room to learn from you."
Zhou Can was overjoyed and took advantage of the situation.
It seems that the old predecessors were right. What does it mean to be well-read and well-mannered? It is not enough to just be able to read. You also have to be able to give gifts to be appreciated by your superiors. Like a fish in water.
At least this old ginseng was given at the right time.
"Haha, no problem. I welcome a good helper like you at any time. As long as you come, I will teach you everything I know." Dr. Fu parked the car, and Zhou Can opened the door and got out.
"On the day you were transferred to the orthopedic surgery clinic, Director Shen actually told me, Doctor Chi, and Doctor Shan to take good care of you and not waste such a talented person."
Dr. Fu revealed another thing that made Zhou Can feel very warm.
Hospitals are not all about intrigue and struggle for interests.
There are still many doctors with conscience.
"Some other day, I will thank Director Shen. Thank you for telling me this."
Zhou Can waved.
"Please drive slowly and be safe! Goodbye!"
After closing the car door and watching Dr. Fu's car drive away, Zhou Can turned around and left with a smile.
There are many doctors who, after completing their regular training, have basically lost contact with their senior doctors in the department.
On the one hand, they are inferior and dare not talk to their superiors. On the other hand, most of the superiors are aloof and it is impossible for them to be kind to every intern.
Zhou Can is both outstanding and humble, so it is no surprise that he is liked by many senior doctors.
Few people who truly engage in medical research are as calculating as Director Xie.
Because in Tuya Hospital, any doctor with a little bit of skill will have a good income.
When they come across some good seedlings, they like them from the bottom of their hearts.
Zhou Can currently provides training for two departments.
Needless to say, the emergency department has been appreciated by Director Lou and Doctor Xu. During the regular training in the Department of Orthopedics, I was also loved and cared for by Director Shen, Doctor Fu, Doctor Shan, Doctor Chi and others, and established a friendship with them.
His network of contacts in the hospital is expanding quietly bit by bit.
This will definitely be of great benefit to his future development.
…
The next day, Zhou Can and Jin Mingxi reported to the Department of Neurosurgery together.
"Old Jin, we are so destined to be together! We took the training exam together, entered the emergency department together, and the departments we rotated in are so similar."
Zhou Can laughed and joked.
"Hehe, it is fate indeed. The training period for this orthopedic surgery residency is a little too short. It would be great if I had the opportunity to learn more in-depth from doctors in the joint field."
Jin Mingxi complained.
"You are the only one who wants to master all the fields during the residency training. We are lucky to be able to enter the operating room. If you want to learn the surgical knowledge and advanced theories of bone and joint surgery, you can directly apply for advanced training in orthopedic surgery after becoming a resident doctor!"
Zhou Can gave him some advice.
From the current perspective, Jin Mingxi should have planned his development direction.
“Hey, have you decided on an area of specialization?”
Zhou Can asked him.
"Yeah! I thought it through last night." Jin Mingxi nodded. "When I first entered Tuya, I thought I could learn a certain level of medical skills in every field and work hard to become a general practitioner. During these three months of training at Tuya, I have broadened my horizons and learned a lot. A person's energy and talent are limited in his or her lifetime. Let alone mastering all fields, even if you want to do well in a niche field, you need to spend your entire life."
The fact that Jin Mingxi has such a high level of awareness shows that both his insights and medical knowledge have improved a lot in the past six months.
"You're right to think so! Tell me, what field are you going to focus on?"
Zhou Can asked with a smile.
"Surgery!" He answered with just four words.
"I have a good talent for surgery. But I don't have a high degree, so it's almost impossible for me to enter the internal medicine department due to limited conditions. Majoring in surgery is the only way out."
He should have made a profound summary.
Reality forced him to make the most rational choice.
"I think it's a good choice for you to choose surgery. At least after work every day, I can't sit there and practice the basic skills of 'steady' knife. You can persist every day, which shows that you are interested in this field. However, surgery is also divided into many departments. From what you said, it seems that you haven't given up the idea of becoming a general practitioner!"
Zhou Can has a medical experience value system, but he doesn't dare to say that he is sure to be a general practitioner.
Jin Mingxi may have to bow to reality again in the future and narrow his main focus.
"Anyway, I have given up on internal medicine. As for which sub-fields of surgery I should specialize in, we'll talk about it later. We can only take one step at a time and see how it goes."
While the two were talking, they had already arrived at Tuya Neurosurgery Department.
This time, I found the doctor's office without much difficulty.
Old process, fill in the form first.
The doctor who supervised the training was Liu Yongquan, a middle-aged doctor in his early 40s. He was tall and thin, with a lot of yellowish hair on his face and back of his hands. He looked like a human who had not evolved successfully, and still had ape characteristics.
"Fill it out carefully. There are a total of 20 trainees this time. You will be divided into two groups and take turns to complete standardized training in the inpatient department and the operating room."
Generally speaking, trainees who do not have a practicing physician certificate are rarely assigned to outpatient clinics.
Theoretically, it takes about a year and a half for a medical undergraduate to obtain a medical license after graduation, assuming that he or she can pass the exam successfully in one try.
Neurosurgery is recognized as a top department and the ceiling of surgery.
The surgery is known for its high-tech and precision.
Its surgical volume is not as large as that of orthopedics, but its revenue-generating ability is not weaker than that of orthopedics.
It costs hundreds of thousands of yuan to treat an aneurysm by a neurosurgeon.
When Zhou Can was interning, he met an unlucky patient who had four aneurysms and the total cost was more than 540,000 yuan.
The diseases treated by the neurosurgery department can be roughly divided into the following categories.
Craniocerebral injuries, such as skull fractures, cerebral contusions, cerebral hematomas, etc.
Many people think that craniotomy is the job of orthopedics, but in fact, this is too much of a compliment to orthopedics.
Orthopedics is mainly concerned with bone trauma, joints, ligaments, etc. Asking an orthopedic surgeon to perform a thoracotomy or craniotomy is like asking an elementary school student to complete a college student's homework.
It's so difficult.
The second category is vascular diseases, such as aneurysms, arteriovenous malformations, etc.
The third category is functional diseases, including trigeminal neuralgia, glossopharyngeal neuralgia, epilepsy, convulsions, etc.
It is not difficult to see from here that the top departments are actually closely connected.
Orthopedic surgery involves the spine, cervical vertebrae and other parts of the body associated with nerves, and requires the involvement of a neurosurgeon to perform the surgery together.
When neurosurgeons treat vascular diseases, they may also ask surgeons from other departments for help.
When treating functional diseases, if you are not sure, you may need to ask for help from doctors of neurology or urology.
Therefore, there has never been a .
There are intricate connections between the various disciplines.
"You have filled out everything, right? Now I will randomly assign tasks to you. Twenty people, two people in each group, will be responsible for dozens of beds. Our neurosurgery department has a total of 125 beds, including four intensive care units with 20 beds. For the time being, you only need to be responsible for 105 ordinary beds."
The number of patients in neurosurgery is relatively small.
However, the hospitalization period is longer.
In the general surgery department, many patients only need to stay in the hospital for two or three days before being discharged. In the neurosurgery department, patients are very lucky if they can stay in the hospital for ten days or half a month.
"If the patient in the bed you are in charge of has not yet undergone surgery, you will follow up. When the patient is undergoing surgery, you will be able to follow him into the operating room and have the opportunity to observe and learn. As for whether you can get the opportunity to get started, it depends on whether the surgeon is willing to give you the power."
The training mechanisms of different departments are obviously different.
The requirement of neurosurgery for trainees is one-stop follow-up.
From the time the patient is admitted to the hospital to the time he is discharged, we need to follow up and be responsible for the entire hospitalization period.
This is actually quite good.
It is easier to assign responsibilities to individuals and management will be more refined.
"A special reminder: neurosurgery inpatients, even if they are staying in ordinary beds, must not be taken lightly. Danger can happen at any time. If something goes wrong, the attending physician, the attending physician, and the department director will all be in trouble, but the intern in charge of that bed will not be able to escape either. The lightest punishment in our department is to cancel the intern qualification."
Doctor Liu Yongquan was very serious when he spoke.
What was said made every trainee feel tremendous pressure.
Canceling the regular training qualification basically means the end of your career.
That is, their chance of trial and error is zero.
"Zhou Can and Jiang Xiaohua, the first team, are responsible for beds 21 to 31. Jin Mingxi and Chen Hao, the second team, are responsible for beds 32 to 42..."
The number of ordinary beds is 105.
The first five groups are responsible for 11 beds each.
The workload is slightly heavier than that of the following groups.
Zhou Can didn't care. In his opinion, having an extra bed was actually a good thing.
It means one more opportunity to practice in the operating room.
He has already upgraded many advanced medical skills to above the level of a resident doctor, and he has a great talent in nerve anastomosis. If Director Xie stops suppressing him, he may get a lot of opportunities to work in the two months of neurosurgery training.
In short, he is still quite confident.
