Chapter 168: One trick to conquer the world. Zhou Can can do this
For any disease, as long as the cause and pathological mechanism are confirmed and then treated accordingly, it can basically be cured.
Unless it is a malignant disease, medicine is useless.
For example, for most cancers, even if we know where the lesions are, once they spread, taking medicine can only relieve pain and delay death. There is no drug that can accurately kill cancer cells.
However, as human medical science and technology become more and more advanced, medicines are also becoming more and more advanced.
The advent of a variety of anti-cancer drugs has brought hope for the cure of cancer.
Maybe one day, cancer will become like a cold and can be easily cured.
The real cause of the disease for the patient in bed 7 was found, and after targeted medication, the treatment effect was truly visible to the naked eye.
Unless there are any accidents, this patient will definitely be transferred out of the ICU soon.
Zhou Can felt that the value of his medical studies was greatly reflected.
At this time, the medical staff who were surrounding bed 14 not far away began to disperse, all with serious expressions. Two young nurses had tears in their eyes.
It looks like the patient is in critical condition.
The family member quickly put on isolation suits and was led in by the nurse.
The patient lying on the bed was an elderly man, but it was not clear what illness he had. The family members did not cry, and the whole farewell process was simple and silent. It was also very short, probably only about ten minutes at most.
After the tube was removed, the patient took his last breath and left this wonderful yet painful world forever.
After the nurses finished handling the body, the caregivers came in with a cart, put the body into a yellow body bag, and then pulled it out through the body transport door. A life ended just like that.
This time the person who died was an old man, which is much better than the elderly seeing the young die.
"Alas, the old man had advanced lung cancer and had been in our intensive care unit for nearly two months. The attending physician had long told the family that treatment was of little value. But the family insisted on giving the old man treatment, no matter how much money was spent. Now that he is gone, it is actually a relief for both the family and the patient."
After Dr. Hu came back, he took the initiative to tell Zhou Can the story of bed 14.
After hearing this, Zhou Can couldn't help but feel deeply moved.
In the intensive care unit, you can see the truest side of family members.
For example, the patient in bed 6 who drank paraquat yesterday, his wife cried harder than anyone else, but it is difficult for outsiders to know how much sadness she really has.
The family members of the patient in bed 14 did not cry or make a fuss, and the entire farewell process seemed very peaceful.
Although he seems cold and heartless , he is far more filial than you might think.
Knowing that the elderly man was very old and suffered from a terminal illness, they were still willing to spend huge amounts of medical expenses and insisted on letting the elderly stay in the best ICU ward and receive the best treatment.
What is spent is real money. Knowing that both life and property are lost, few family members are willing to spend the money.
"The patient didn't know he had cancer until he died. Otherwise, he would have asked us to remove the tube."
Doctor Hu said again.
"For patients, if they know that they have a terminal illness, they may choose to leave this world with dignity. The filial piety of the family members seems good, but if it were my parents who had to go through this, I would not hesitate to ask the doctor to remove the tube. Lying in this place without sunlight, I believe that every day is a torture for the patients."
Zhou Can expressed his own views.
"Hey, under the guidance of our Chinese ideas of etiquette and filial piety, your idea can easily make people call you an unfilial son." After hearing this, Dr. Hu was stunned and looked at Zhou Can as if he was getting to know him again.
"My parents have always told me that I don't need to care about other people's opinions. I should live my life to the fullest and stick to my heart. That's enough! For the sake of the so-called reputation of filial piety, it is better to let my parents lie in bed in pain and live without dignity. "
Zhou Can’s ideas are indeed different from many people’s.
He seemed to have understood many life philosophies that were not appropriate for his age.
Even if he seems to be unorthodox in the eyes of the world, he still doesn't care.
Patients in the intensive care unit need someone to take care of their eating, drinking, defecating and urinating.
For example, the patient in bed 17 is also very old. I heard that he is a retired cadre with a high position. Now, he needs a ventilator to breathe, a nasogastric tube to eat, and a catheter to urinate.
The person is conscious, but the body is paralyzed and unable to move.
Eating, drinking, defecating, urinating, turning over, raising hands and feet, all require the help of medical staff.
No different from a walking corpse.
But the patient insisted on treatment. I heard that he had been very strong before his retirement, and his family members did not dare to disobey him.
He has been lying in the intensive care unit for almost half a year.
It's just like holding your breath.
I really don't know what this person is after? Knowing that he will die, why suffer that punishment?
"Ha! I never thought that you, at such a young age, have such a deep understanding." Doctor Hu was praising him, but his eyes and tone revealed that he did not agree with Tongcan's approach.
Everyone has different ideas and ways of living.
"Okay, let's not talk about those great principles of life. Today I will continue to teach you how to use the various instruments here and how to give medicine to patients."
Dr. Hu changed the subject and began to teach him more critical care medicine techniques.
"First of all, I must tell you that the purpose of the Department of Critical Care Medicine is not to cure patients, but to save their lives."
Zhou Can nodded in agreement with this point of view.
The Department of Critical Care Medicine does everything possible to save the patient's life. Treatment is the job of specialists.
Because doctors have limited energy and time, the most important thing is to do one thing well. Doctors and nurses in the critical care department spend their entire lives trying to figure out how to better save patients' lives.
"You tried hard to find a cure for the patient in bed 7 yesterday. As a critical care physician, I don't agree with this. Professional matters should be left to professionals. Of course, since you succeeded this time, you may think that I am just sour grapes or that I am jealous of your contribution."
What Dr. Hu said is not without reason.
"I definitely don't think so. Although I haven't been dealing with you for a long time, I know that you are a very good doctor."
Zhou Can was not flattering him, but speaking from the heart.
Perhaps everyone has a different position, so their ideas are naturally different.
"Thank you for your approval. Let me continue to talk about why I don't agree with you. For example, the medication given to this patient now seems to be a simple intravenous drip, but do you know that the drug ratio, dosage, and infusion or pumping speed used for the patient need to be strictly calculated over and over again, and observed and adjusted at any time."
"It would take more than a decade for a doctor to learn all the rescue skills and medications in the intensive care unit and to be proficient in their use. It takes at least two to three years for doctors here to be able to manage patients independently. However, residents often encounter various problems that they cannot solve. Then they seek help from us, the attending physicians."
"Our attending physicians also have times when they are unsure, and at these times they have to seek help from the chief physician. In fact, the chief physician is not a god, and they often encounter conditions and rescue situations that they have never encountered before. They also need to keep learning, continue to delve deeper into this field, improve the success rate of rescue, and strive to reduce the mortality rate again and again."
Dr. Hu spoke so much to Zhou Can openly and honestly, and it was actually full of good intentions.
"I just want to tell you that to do one thing well, a lifetime of energy is far from enough. Even chief physicians need to keep learning and do more in-depth research in subdivided fields. For example, Director Liu has already reached a very high level in the field of respiratory research. But he did not turn to research other fields, but continued to delve deeper into the field of respiratory medicine."
"From your performance over the past two days, you have a very high talent for medicine. But a genius like you can easily make a serious mistake. Ambitiously thinking you can do everything the best, you end up biting off more than you can chew, and end up not having any achievements that you can really show off. It's actually a pity if it really comes to that."
Dr. Hu has good intentions.
Try your best to persuade Zhou Can not to pursue the career path of a general practitioner.
Lest you end up with nothing.
There is a principle in martial arts: One unique trick is enough to conquer the world.
It is better to master one move than to know a hundred moves.
"Thank you for your kind advice. When I choose to specialize in a field in the future, I will carefully choose one or two fields. I will not think of becoming an all-round miracle doctor."
After listening to Dr. Hu's words, Zhou Can thanked him solemnly.
Doctor Xu also told him about this matter.
"Haha, it's enough that you can listen carefully to what an old comrade like me has to say. As for your future career, I dare not interfere. I'll just share with you some of my experience and insights!"
Doctor Hu saw that his attitude was quite sincere, which meant that he really took his words to heart.
Dr. Hu was very satisfied with this.
I’m afraid that some geniuses are stubborn and will not listen to the advice of their predecessors.
"Okay, let me explain to you the dosage, pump speed and other techniques for bed 7 patient!"
Next, Dr. Hu patiently explained to him the medication for critically ill patients.
Especially some medication contraindications.
For example, patients with asthma should pay attention to certain issues when pumping medication.
Or for patients with renal failure, how should they use the medicine, what data should they closely observe, etc.
…
Zhou Can studied very seriously and even took a lot of notes.
It’s just that there is so much to learn that it cannot be learned in one day.
Now, as the hospital has asked him to undergo three months of resident training in the Department of Critical Care Medicine, he has deeply understood Vice President Ye's foresight.
Not to mention achieving mastery, even if you just learn the basics, three months is still a very tight time.
Learning how to use medicine from Dr. Hu today was like opening a new window for him.
I never knew that there are so many things to pay attention to when taking medicine.
Time flies by fast. There is no lunch break here. Even eating is done in just a few minutes.
The work pressure and intensity of medical care in the intensive care unit are really too great.
I was busy until around four in the afternoon , and it was time for the shift change, but the patient in bed 6 was in serious danger again.
Even an associate chief physician in his fifties came over to help with the rescue.
Finally, even an ice blanket was used.
We worked until after five o'clock, and the patient's condition finally stabilized again.
"Based on the patient's symptoms and the fact that his condition was under control after the ice blanket was used, we can infer that the patient's intracranial hemorrhage has not yet stopped. The dangerous situation just now must have caused severe intracranial hemorrhage. In addition, his intracranial pressure is very high. It is really hard to say whether he can survive tonight."
The deputy chief physician looked worried.
"Director Yu, can we increase the amount of coagulation factors and platelets we transfuse to help him stop the bleeding?"
Doctor Hu also had a worried look on his face.
I just sent one patient away yesterday when I was monitoring the patients, and I sent another one away today. That means I really won the lottery.
The patients here could not be saved after the medical staff tried their best to rescue them, but the medical staff did not take any responsibility.
However, the high mortality rate is definitely unfavorable to the doctors in charge of the patients.
"The patient's intracranial blood pressure remains high. Increasing the dose of coagulation factors will not help and may easily lead to cerebral thrombosis. In addition, the patient must have had acute cerebral hemorrhage just now, which is closely related to the sudden increase in blood pressure. His systolic blood pressure has exceeded 180 mmHg. I think intravenous antihypertensive drugs should be used to intervene actively."
Deputy Chief Physician Yu's level is obviously higher than that of Doctor Hu.
The treatment plan given goes straight to the core of the problem.
"You seem to have something to say? If you have any suggestions, just say it. Don't worry about your low title or lack of experience."
Deputy Director Yu glanced at Zhou Can's hesitant expression and encouraged him to speak boldly.
"I think surgery should be the most thorough solution."
Zhou Can had a very bad feeling.
There is a high probability that this patient will not survive tomorrow.
For critically ill patients, nights are more difficult than days.
Just like many elderly people are afraid of winter. Many elderly people die in winter. Because the temperature in winter is cold, it is more likely to be the last straw that breaks the camel's back for the elderly with weakened blood circulation.
"Surgery is indeed the best solution. But as you can see from the patient's condition, he does not meet the surgical criteria at all." Director Yu said helplessly.
"What if we perform endoscopic cranial surgery on the patient?"
Zhou Can already had an idea.
He has successfully completed dozens of difficult major surgeries in neurosurgery, including several intracranial surgeries, which also gave him some experience in judgment.
Judging from the patient's current physical signs, intracranial endoscopic surgery is between the red lines.
It can be done, but the risk is very high.
"Endoscopic surgery is still very risky, so few doctors are willing to do it. Because this surgery requires at least a chief neurosurgeon to do it, and they probably won't agree. And if they do it, tonight is more important. There are only a few chief neurosurgeons, and they can't arrange major surgeries for them on their schedules."
Deputy Director Yu is not at all arrogant.
He patiently explained to Zhou Can the many difficulties of the operation.
He mentioned that the surgery tonight was of greater significance, which meant that he had no confidence that the patient would survive the night.
Deputy Director Yu doesn't have the energy to arrange this, but Zhou Can does. He has been in neurosurgery training for two months and has a good relationship with the two directors of neurosurgery. If he personally takes the lead, it should be possible.
