Chapter 145: Soaring into the sky, epilepsy case consultation
Dr. Zou was the only one who was too embarrassed to greet Zhou Can proactively.
When he was operating on a patient, he made a mess and Zhou Can cleaned up the mess for him. The key point was that he even scolded Zhou Can a few words.
Now Zhou Can successfully inserted all the coils in no time, and the patient's cerebral aneurysm threat was eliminated. When he was compared with Zhou Can, anyone could tell who was better.
"Who is Xiao Zhou currently receiving regular training with?"
Director Wen asked this, probably indicating that he has already started to eye this talent.
It is not just top doctors who like excellent medical juniors. Senior doctors with weaker medical or surgical abilities have an even stronger desire for such talents.
Because as long as you recruit some subordinates, they can help a lot.
It has high utilization value.
"I follow Dr. Cheng Gang in the inpatient department to do some ward rounds and follow up on patients' surgeries."
Zhou Can told the truth.
"Cheng Gang? Is he the resident doctor in charge of the ward?"
If Cheng Gang heard this, he would probably be so angry that he would vomit blood.
After all, he was a resident with the ability to manage patients independently, but the chief physician in the same department couldn't even remember his name.
There are not many doctors in the neurosurgery department.
It is absolutely sad that Cheng Gang has worked in this department for several years but ended up like this.
Unlike trainees and interns, residents are full-fledged department employees. They participate in various performance and bonus sharing. You should have some impression of them.
Besides, not long ago, the patient in bed 22 developed a postoperative complication - epilepsy.
Cheng Gang also called Director Wen to report the situation.
Compared with other departments, doctors in the neurosurgery department are particularly indifferent to each other.
There are layers of invisible and intangible barriers.
"Yes, Cheng Gang is in charge of the ward."
Dr. Ou answered the question on behalf of Zhou Can.
It can be seen that Dr. Ou's eyes reveal a desire to curry favor with Director Wen.
"Cheng Gang's academic and surgical abilities are very average. If you follow him, you can only learn some basic patient management methods. I will transfer you to my team, and you will follow me in performing surgeries, seeing patients, and managing beds."
Director Wen was indeed planning on targeting Zhou Can.
Not to mention anything else, the level of implantation skills demonstrated by Zhou Can alone is enough to help him in many interventional surgeries.
The key is that such talents are completely free.
Resident trainees do not participate in surgical commissions or various bonus distributions of the department.
Even medical instructions and medical records cannot be written with one’s own name.
It's like hiring a free helper.
It would be strange if Director Wen didn't rush to take advantage of such a big opportunity.
"Thank you Director Wen for your cultivation!"
Zhou Can smiled happily and thanked him.
In fact, he hoped to have a chance to be appreciated by Wu Baihe and follow Wu Baihe for two months.
Because Director Wen's surgical skills are only average, what we can learn is really limited .
Right now, he had no other choice but to agree 'happily'.
Director Wen didn't even ask him whether he agreed.
The decision was made immediately.
If he said he disagreed at this time, Director Wen's face would definitely be longer than a donkey's.
If a small trainee does not know how to appreciate the kindness given to him, the consequences will be serious.
Zhou Can can only lower his expectations, gain a firm foothold first, and then seek development and greater progress.
Now that I'm following Director Wen, I still have a chance to gain Wu Baihe's appreciation in the future.
If you can't wait for that opportunity, that's your fate.
I can only find an opportunity to study neurosurgery later.
"Doctor Ou, that Cheng Gang is your resident doctor, right?"
"Yes! I am usually responsible for him."
Doctor Ou was filled with envy when he saw that one of his interns was poached on the first day of his neurosurgery internship.
He also particularly hoped that Director Wen would recruit him.
Not every attending physician has a senior doctor to protect him.
Dr. Ou is a 'wild child'.
If there is a problem with the patients he is caring for, he can report it to the director or deputy director of the department. It doesn't matter who he finds.
But no one took him as an apprentice.
Basically, I would perform a level three or above surgery with this director today, and then perform another one with another director tomorrow.
This is the only way to make progress with difficulty.
" I'll talk to Cheng Gang about this later."
Dr. Ou once again took the initiative to show goodwill.
"Well! Thank you for your hard work!" Director Wen nodded with satisfaction.
It can be seen that he is very happy to have discovered a good talent.
The patient had woken up at this time under the call of the anesthesiologist.
Generally speaking, about ten minutes after the anesthesia is stopped, the patient can be woken up by patting the shoulder or calling the patient's name.
General anesthesia is also considered a deep sleep.
After examination, the patient was found to have vomiting and headache reactions after waking up from anesthesia, and neck stiffness still existed.
It seems that there is no improvement in the condition after the operation.
Actually, it’s not like that.
After the bleeding stops, the aneurysm will no longer have new blood flowing in and its size will shrink appropriately.
This process does not take too long, perhaps even less than twenty-four hours.
By then, the patient's intracranial pressure will be reduced.
In addition, the blood accumulated in the skull will be slowly absorbed by the brain tissue, and the intracranial pressure will be further reduced.
If nothing unexpected happens, the patient's condition will be relieved soon.
The symptoms gradually disappeared.
It is definitely not the case that the operation was unsuccessful or useless as the family members think.
Many family members and patients do not understand medical expertise, and interventional surgery is almost non-invasive.
They will think that they have spent hundreds of thousands of dollars and were cheated by the doctor.
Maybe the condition will improve on its own in a day or two without surgery.
That's not really the case.
Doctors and nurses will do the explanation work.
Although most family members are skeptical, they will eventually accept the doctor's explanation after seeing their loved ones recover and be discharged from the hospital.
From this point of view, the credibility of a hospital is very important.
For a famous provincial and ministerial top hospital like Tuya, there is actually no need for too much explanation, and patients will naturally trust it.
…
After the operation was completed, Zhou Can followed Director Wen straight back to the doctor's office.
What are you doing?
Director Wen performed surgery on the patient in bed 22. Now complications have arisen, and we must find a way to resolve them.
The most basic thing is to call all the doctors in the group for a consultation.
As soon as he arrived at the corridor of the inpatient department, Cheng Gang, who had just come out of the ward, saw Director Wen walking towards him with a large group of doctors from afar.
He immediately stood there respectfully, with a smile on his face, ready to say hello.
"Hello, Director Wen! I heard that the operation on the patient in bed 31 was very successful. After the patient was transferred back to the ward, the family members were extremely grateful to you!"
"Haha, really! Relieving patients' suffering is our duty as doctors. Tell the family members and patients to cooperate with the doctor's requirements and do a good job of postoperative care."
There are thousands of holes in something, but flattery is the only thing that cannot be worn out.
Director Wen smiled widely after hearing Cheng Gang's flattery.
At this time, Cheng Gang caught a glimpse of Zhou Can actually mixed in with Director Wen's team.
His eyes were fixed on Zhou Can.
"Xiao Zhou, go to the ward to work after you finish the operation. The patient in bed 27 has signs of infection in his wound. Go take care of it."
Cheng Gang was as fawning as a pug in front of Director Wen.
But when he spoke to Zhou Can, he used a condescending and commanding tone.
The higher the rank of an official, the more powerful he is, but this does not only apply to the officialdom.
The same applies at work and in hospitals.
Zhou Can looked at him with a defiant look.
I won’t listen to you, I won’t listen to you, what can I do?
"Xiao Cheng, Zhou Can has been transferred to my group to participate in the regular training."
Director Wen's words were like a bolt from the blue, shocking Cheng Gang.
Incredibly, he asked, "He, he was transferred directly to your group?"
"Why, do you have any objection?"
Director Wen's tone turned cold.
When talking to a resident like Cheng Gang who had no sense of existence, Director Wen did not have the slightest intention of being friendly or even humorous.
"No problem, no problem, don't get me wrong. I'm really happy for him!"
Cheng Gang noticed that Director Wen's tone and expression were wrong, and he was so scared that he hurried to explain.
"Xiao Zhou, it's a great opportunity to be able to join Director Wen's team, don't you understand? Director Wen's attending doctors and residents are all elites among the elites. You must be diligent when following the new residents in the future, understand?"
According to Cheng Gang, Zhou Can was lucky enough to be appreciated by Director Wen.
The most Director Wen could do was to ask one of his resident doctors to take care of Zhou Can.
After all, this is a routine operation for chief doctors.
"Dr. Zhou's surgical skills are extremely strong, but we are not qualified to take him. Instead, Director Wen will take care of him personally."
The three residents quickly clarified.
This Cheng Gang is just a chatterbox.
He talked a lot, but the key point was that he almost got three residents implicated.
"What? Director Wen will personally take care of him?"
Cheng Gang's eyes almost popped out of his head in shock.
Only now did he understand that Zhou Can did not get lucky, but rose to the top through his own strength.
Directly won the high appreciation of Director Wen.
Otherwise, given Director Wen’s status, not to mention a resident trainee, even the attending physician might not teach him personally.
Director Wen ignored Cheng Gang's shocked and jealous expression and led the doctors in the group directly into the office. In his mind, Cheng Gang was no different from the weeds on the roadside.
Zhou Can just glanced at Cheng Gang indifferently.
If nothing unexpected happens, the days of Cheng Gang giving him orders are completely over. From now on, Cheng Gang will probably find ways to lick him whenever they meet.
After entering the office, Zhou Can was considered a new member of the team.
He consciously sat at the last seat .
It’s even further back than the seats of the three graduate students.
Being low-key is an attitude and a kind of self-cultivation. It can make people feel like a spring breeze, greatly increase others' favorability and greatly reduce the chance of making enemies.
The only thing you need to overcome is your inner vanity and desire to show off.
"Tang Li, put the patient information of bed 22 and the latest EEG on the screen for everyone to see."
Director Wen gave instructions to the female attending physician.
"OK!"
She projected the patient's latest EEG onto the screen.
"This patient had a cerebrovascular malformation surgery yesterday. I'm sure you all still remember it. It's common for him to have postoperative complications. He has postoperative epilepsy and has been in a coma twice. His family members are very emotional and are making a lot of noise. Let's take a look at the EEG and enhanced CT scan of his head that were just taken."
Director Wen was actually very annoyed when he encountered this situation.
Postoperative complications are, to put it mildly, common.
But to put it bluntly, it can also be understood that the doctor's surgical skills are poor, the operation was not done thoroughly or not done well, which caused other symptoms.
When it comes to responsibility, Director Wen certainly cannot escape.
As for the possibility of it being classified as a medical accident and being punished, that is not the case.
After all, the surgery was done only after I signed the consent form.
And no doctor can guarantee that the operation will be successful.
Not to mention craniotomy.
Even if it is just a minor surgery, there is a possibility of failure.
For example, suturing a wound is a simple, first-level minor operation, right? Even a barefoot doctor in a small clinic can do it.
However, after a few days of suturing, the wound became infected and festered.
Whose responsibility is this?
The doctor certainly doesn't want to take this responsibility.
In the end, the patients have to pay for it themselves.
Then again, if something goes wrong during surgery, should the family members make a fuss?
Actually, there is no harm in making a fuss.
On the one hand, there is a need to vent emotions. On the other hand, if the situation is more serious, the hospital will pay more attention to it. The follow-up treatment, even if the patient pays for it himself, will be more guaranteed.
Even the hospital will make some compromises and reduce some fees.
Therefore, it is more in line with the interests of the family members and the patient to make a fuss when it is necessary.
Being too easy to talk to will make people feel that you are easy to bully, like a lamb to be slaughtered. You will suffer greater losses and endure more pain.
Most of the doctors have already looked at the patient's information in bed 22.
And I know it by heart.
Before the operation, when formulating the surgical plan, we will understand the patient's medical history, condition, examination reports and other information.
Therefore, when passing the information around, many doctors just flipped through it and passed it to the next person.
Zhou Can is the only doctor who has not read the information of the patient in bed 22.
When it was passed to him, he was already the last one.
So I took it and started reading it carefully.
At present, his pathological diagnosis skills are at the lower level of resident doctors.
Compared with the doctors here, I may be only slightly better than the three graduate students.
The strength of those three residents is not clear yet.
The attending physician's diagnostic level is beyond doubt.
There is no need to mention Director Wen’s level.
As long as they can get a senior professional title in Tuya, no one is easy to deal with. Director Wen's poor interventional surgery skills do not mean that his other abilities are also poor.
After viewing the latest EEG and head CT scans, everyone has begun extensive discussions.
Zhou Can was not disturbed by external sounds and focused on looking at the patient's information.
"Gao Zongyi, male, 46 years old, has symptoms of intellectual impairment. He had a history of epilepsy before admission, and the frequency of his seizures is increasing..."
After all the fuss, it turned out that the patient had a history of epilepsy before being admitted to the hospital!
The fact that the family members were making such a fuss shows that they are not easy to deal with.
He is the kind of person who is difficult to deal with.
Zhou Can defined the patient's family members.
After examination, it was found that the patient had a venous malformation in his brain, but this part was very close to the internal capsule.
Many people may not know where the internal capsule is.
The internal capsule is the name of a place through which nerve fibers connecting the cerebral cortex to the brainstem and spinal cord pass. It is located between the basal ganglia and the thalamus.
The motor nerve fibers and sensory nerve fibers leading to the cerebral cortex all pass through the internal capsule and radiate upward in a fan-shaped pattern.
It is not difficult to see from here that the internal capsule is equivalent to a connection point between the cerebral cortex, brainstem and spinal cord.
Its danger is second only to that of brainstem surgery in intracranial surgery.
Generally, surgery needs to be performed near the internal capsule. Even the well-established tertiary hospitals in the area will tactfully tell the family that they cannot perform this operation.
Because the risk is too great.
Tuya Hospital is currently able to basically ensure that there are no surgical restricted areas within the brain.
Of course, this is for external publicity and has some truth to it.
If surgery really had to be performed on the brain stem area, even Wu Baihe would be scared.
Fortunately, the pregnant woman with hypertension who was in the emergency department last time had a false aneurysm, because Wu Baihe clearly stated that he was not even 50% sure of the success of the operation.
As for Tuya's divine power, it is not particularly powerful.
It may not even be the strongest in the province.
The Provincial People's Hospital and a certain digital hospital both have strong neurosurgery capabilities.
Not to mention the Renhe Hospital in the imperial capital.
In addition, the neurosurgery departments of two large hospitals in the Demonic Capital are also very strong. They are even stronger than Tuya and comparable to the neurosurgery department of Renhe Hospital in the Imperial Capital.
The fact that Director Wen dared to perform this operation shows that his traditional surgical skills are quite high.
Maybe I don't have much talent in interventional surgery.
Zhou Can made a new evaluation and understanding of Director Wen.
The surgical record clearly states that the diseased venous segment will be removed.
Since the resection was successful, why did the patient's epilepsy worsen after the operation?
Zhou Can looked up at the latest inspection report.
Electroencephalogram, obvious abnormal discharge.
In fact, epilepsy patients basically suffer from abnormal brain discharges.
As for the cause of abnormal discharge, it must be thoroughly investigated. It is not just brain arteriovenous aneurysms that can cause it.
Varicose veins, telangiectasias, and cavernous hemangiomas may all cause abnormal electrical discharges in the brain.
