Chapter 236: Female lawyer with cirrhosis, sympathizing with the weak
In addition to stomach cancer, this female patient also had three missing teeth, multiple soft tissue contusions, a mild concussion and other problems.
When Zhou Can saw the result, he couldn't help but sigh inwardly.
I finally understood why the woman was crying.
She is only 22 years old and she is not bad looking, she can be considered quite pretty.
She looks tall and has a pretty .
Her skin was a sickly yellowish waxy color. If she were not sick or malnourished, her skin would be fair and radiant without any maintenance.
Men are afraid of choosing the wrong career, and women are afraid of marrying the wrong man. This is a famous saying that has been passed down through the ages.
If she had married the right person, she would have been a charming super beauty. But if she had married the wrong person, she would have become what she is now. She was so young that she was treated like a nobody and even lost her life.
When a girl chooses a boyfriend, if she only looks at his appearance and only listens to his sweet words, the final outcome will be that she will swallow all the bitter consequences herself.
"Did Director Shang tell me about the treatment plan?"
Zhou Can asked the admission nurse.
They are responsible for the allocation of patients' beds, input of basic information, processing of drug orders, processing of expense orders, etc. Nurses are relatively clear about the basic information of patients.
It must be mentioned here that the person who allocates the beds is the head nurse, and the person who makes the beds is the nursing nurse.
It can be seen that nurses also have different statuses.
The person who measures the patient's vital signs and fills out the three-measurement form is also a nursing nurse.
"Director Shang suggested that the patient undergo hospitalization and surgery and then chemotherapy to consolidate the therapeutic effect. The patient's current prepaid hospitalization fee is far from enough, and the specific treatment plan needs further discussion."
The nurse glanced at the female patient with concern.
She was rather cryptic.
Zhou Can, however, was an insider in the industry, so he naturally understood it as soon as he heard it.
Hospitals are not charities. They can provide necessary emergency treatment for critically ill patients. However, if cancer patients cannot afford the medical expenses, they will most likely just have to wait to die.
Don’t even think about asking the hospital to advance money for surgery and chemotherapy for patients.
Zhou Can sighed inwardly. He sympathized with the patient's situation, but there was nothing he could do.
If the family members do not pay the money, the patient may be forced to be discharged from the hospital tomorrow.
The use of medication will also be greatly reduced.
Director Shang must have been very kind to admit her to the hospital.
Tuya has a bed assessment mechanism. If the patient's hospitalization period is too long or the treatment quality does not meet the standards, points will be deducted and fines will be imposed. Since this is related to the income of the medical staff in the department, the attending doctors are usually more cautious when admitting patients to the hospital.
After checking the patient's information, Zhou Can gave the patient a general examination. She said that except for the irregular stomach pain and inability to eat, everything else was fine.
He returned to the office to complete the patient's medical record information, but before he finished, the admission nurse called him at the door.
"Doctor Zhou, there is a new patient in bed 79. I would like you to admit him."
"Assign me another patient?"
Zhou Can was a little nervous.
After proving his strength and gaining Director Shang's initial trust, is he preparing to desperately exploit his labor?
We had clearly agreed that he would go to the outpatient clinic with us in the afternoon.
If Zhou Can had too many patients to take care of, he would not be able to spare any time. How could he go to the outpatient clinic?
"Don't complain that it's too many! Only the talented interns in our department can take care of multiple patients! Director Shang specifically asked you to take care of this patient!"
The nurse explained with a smile.
Zhou Can couldn't help but smile bitterly. He was not a rookie in the workplace who could be easily fooled.
He doesn't want to agree to some so-called honors, be asked to take care of many patients and exploit his labor.
But this kind of thing was arranged by Director Shang himself, so he really couldn't refuse.
Following the nurse to the ward, I saw that the original patient in bed 79 had just been urged to be discharged, and a new patient came in. It was also a female patient, about 40 years old, with delicate makeup, and the demeanor of an urban beauty.
Even though he was sick, he still looked very capable.
Compared with the gastric cancer patient in bed 77 next to her, this female patient was treated much better.
There were five family members surrounding the bed, all of them dressed quite well.
The middle-aged man, about the same age as the patient, was dressed in casual clothes and looked like a wealthy and successful man.
The elderly couple standing by the bed and talking to the patient seemed to be the patient's parents.
There was also a woman in her fifties, with wavy hair dyed brown, carrying an LV bag, and dressed very fashionably.
Rich people seem to be surrounded by rich and successful people.
The poor are surrounded by poor people.
The eight words "birds of a feather flock together" are interpreted vividly.
This phenomenon belongs to the natural objective laws of human beings.
The strong like to associate with the strong, and the weak like to associate with the weak.
When a poor person whose total assets do not exceed 200 yuan and whose monthly income is less than 2,000 yuan stays with a rich person whose assets exceed 10 million yuan and whose monthly income exceeds 100,000 yuan, he will naturally run away without anyone saying anything.
Because the sense of oppression that the rich brought to him was too great.
No one likes to be abused.
While watching the rich eating sumptuous meals, he could only eat steamed buns and couldn't even afford to drink mineral water that cost two yuan a bottle, but could only drink cheap tap water.
When they walked together, passers-by looked at the rich with respect and envy, but looked at the poor people next to them with ridicule and contempt.
Who can bear it?
So, poor people like to hang out with poor people, and successful people like to hang out with more successful people.
"Hello, I'm your attending physician Zhou Can. If you have any questions during your hospitalization, you can always tell me. If it's inconvenient, you can also ask the nurse to tell me."
Zhou Can’s current net worth is far beyond that of ordinary rich people.
Facing these well-dressed family members and white-collar beauty-type female patients, he appeared calm and composed, and his conversation was appropriate and natural.
"Hello, Dr. Zhou. I'm sorry to trouble you during your hospitalization!"
She greeted Zhou Can with a very polite smile.
"A cigarette, please!"
Her husband took out a pack of soft Zhonghua cigarettes and gave them to Zhou Can.
"Thank you, I don't smoke. Also, smoking is not allowed in the ward. If you want to smoke, you can go to the special smoking area at the end of the corridor outside."
Zhou Can waved his hand and declined the other party's kindness.
"Let me see her examination report and medical records!"
The family members consciously walked to the end of the bed to make room for the patient and were very cooperative with the doctor's diagnosis and treatment.
I have to say that the social classes above the middle class are easier to deal with.
Doctors also prefer this type of family members.
What I fear most is that the family members of the patient, who have a little money or are relatively poor, would ask questions even with a cotton swab, fearing that it would cost them more medical expenses.
"It means that he has only been diagnosed with liver cirrhosis, and the cause of the disease has yet to be investigated, right?"
Zhou Can asked the patient after reading the information.
"Yes, yes, yes! Professor Shang personally examined me. After looking at the test results, he said that my cirrhosis of the liver was most likely caused by other causes. He asked me to be hospitalized for further investigation."
The female patient nodded and replied.
Cirrhosis is actually a very dangerous disease, which can be divided into compensated stage and decompensated stage.
Generally speaking, timely treatment during the compensatory period can achieve good therapeutic results.
When the disease progresses to the decompensation stage, liver function declines rapidly, kidney failure occurs, and multiple organs are seriously affected. Severe ascites, splenomegaly, gastrointestinal bleeding, hematemesis, black stools, etc. may also occur.
However, the liver is the most silent organ in the body, and it is usually difficult to detect cirrhosis in its early stages.
The female patient went to the hospital for treatment in time because she was experiencing abdominal discomfort, loss of appetite, fatigue, and was worried that something was wrong with her body.
Fortunately, she has a strong sense of health.
If you delay too long, the consequences will be very serious.
"Is it convenient for me to ask some questions about your symptoms and medical history now?" Zhou Can asked the patient for his opinion.
The nursing nurse had skillfully measured her vital signs and kept records.
"It's convenient! If you have any questions, just ask!"
The female patient readily agreed.
However, from the way she frowned from time to time, it could be seen that she was feeling unwell.
When many patients feel unwell, their attitude towards medical care becomes very bad.
For someone like her, even though she is clearly ill and feeling very uncomfortable, she still maintains a gentle and polite attitude towards others. This is a kind of cultivation that is engraved in her bones.
"What do you do for a living?"
"My main job is as a lawyer, and my secondary job is to be a legal consultant for some businesses and companies."
Turns out she's a lawyer. No wonder she looks like an elite among white-collar beauties.
Lawyers' income is also quite considerable.
Famous lawyers are always overwhelmed with cases.
"Are you experiencing any pain in your abdomen?"
"There is one thing, it's not particularly obvious. It's just that this area always feels a little bloated."
She pointed to an area of her abdomen near her liver.
Zhou Can asked while taking notes of the medical consultation.
Doctors are sometimes very busy and have to deal with multiple outpatients a day, so they don't ask patients too much questions. Some doctors will not talk to patients for more than three minutes when encountering some common diseases.
They usually just do a brief physical examination and then prescribe a bunch of tests.
It often takes a whole day for patients to complete all the tests and examinations. It is a blessing to be able to get the test results before the doctor goes off work.
Big hospitals are a bit tricky in this regard.
If the patient does not get the test results on the same day, when he gets the results the next day and goes to see the doctor again, the nurse will often ask the patient to register again.
"When did you start feeling unwell?"
Zhou Can continued to ask.
Cirrhosis of the liver cannot develop in a day or two, but requires a long course of development.
Our immune system and protective mechanisms are very sound.
When our body becomes sick, it will send out a distress signal immediately.
Pain is the most important part of the protection mechanism.
Many people do not understand how pain is produced. In fact, in most cases, pain is caused by the release of a large number of chemicals before a large number of cells die and are captured by nerve endings.
The level of danger can basically be judged based on the degree of pain.
Severe pain has the highest risk level.
Mild pain is safer.
"It's been about two or three months. I can't remember exactly when it started. I just know that I have no appetite for anything during this period. I used to love braised carp. My husband made a dish of braised carp for me on my birthday more than a month ago. But after just two bites, I felt nauseous and wanted to vomit. At the time, he thought it was too fishy and not well done."
She tried to remember when the illness had occurred.
A sudden change in taste is actually a signal that you need to be particularly vigilant about.
A sudden loss of sense of smell, blurry vision, double vision, or a sudden change in taste may all be signs of a serious illness.
Zhou Can then carefully asked her whether she had any medical history, underlying diseases, family history of liver cancer, allergy history, etc.
After clarifying the situation and taking the patient's examination data back to the office, the first thing I do is to write a medical record.
In many cases, medical records are not written all at once, but are improved step by step.
Some trainees have too many patients to manage and are under time pressure, so they will think of some ways to cope with it, such as directly downloading some application templates, filling in basic information, and then automatically generating the rest.
The medical record task was completed with a few minor modifications.
This method is not a problem even if it takes care of a large number of patients, but its disadvantages are also extremely obvious.
Medical records are almost all the same, so when the higher-ups do spot checks, they definitely won't be very satisfied.
Moreover, the trainees themselves did not get any training.
If you don't learn any skills during the regular training period, you will have to learn everything from scratch after officially practicing medicine, and explore step by step, which will cause a serious decline in the quality of medical care.
Zhou Can never slacks off when writing medical records and medical history.
But write seriously.
Tuya Hospital has never heard of any senior doctors in any department being stupid enough to exploit interns to the extreme and force them to use templates to complete tasks such as medical records.
The hospital management will not allow this to happen.
Because in the long run, it will do more harm than good to the training of new doctors.
It also increases the risk of medical errors.
It's impossible to guarantee the quality of a resident in training who is in charge of forty or fifty beds.
He sat in his office, writing medical records while thinking about the real cause of the patient's illness.
Currently, the patient's main symptoms are abdominal distension, accompanied by mild abdominal pain, and liver cirrhosis.
Judging from the examination results, there is no obvious abdominal fluid accumulation.
There are not many causes of liver cirrhosis.
Zhou Can couldn't help but pick up the patient's liver function test results again.
Aspartate aminotransferase and alanine aminotransferase increased to varying degrees.
The increase of these two indicators indicates that there is a problem with the liver.
He picked up the film and checked it again. Compared with normal people, the liver was somewhat enlarged.
However, this information was still not enough for him to successfully diagnose the cause of the patient's illness.
At this time, Zhou Can suddenly realized that he should ask the patient again whether he had diarrhea.
I ran to the ward and it was just lunch time.
The family bought fast food for the patient.
It would be somewhat inappropriate to ask her if she had diarrhea at this time .
"Hey, Dr. Zhou, have you eaten? Is there anything you want to ask me?"
The patient was worthy of being a lawyer. She could tell at a glance that Zhou Can came to the ward to ask her something.
"I haven't eaten yet. I was going to finish writing your medical records before eating. Suddenly I remembered that there is still some information I need to get from you, so I came here directly. You eat first, and I will ask you after I finish eating."
Zhou Can didn't dare ask her about her defecation while she was eating.
It's so disgusting.
She had a poor appetite to begin with.
He turned and walked out of the ward, his eyes naturally looking at the patient in bed 77 under his care.
This poor stomach cancer patient was lying on the bed, seemingly shedding tears silently.
"Chen Xiaohong, are you feeling any pain?"
Zhou Can asked with concern.
He couldn't bear to see the suffering of the world, especially the disadvantaged groups, which made people feel particularly sad and distressed.
"No!"
She bit her lip and wiped away her tears secretly.
But when she looked at Zhou Can, her eyes were red and tears were still there.
After being diagnosed with stomach cancer, she must have cried many times in secret. Her eyes were very red and swollen.
"How are you going to eat? Without family members to accompany you, you can either order fast food or eat in our hospital cafeteria."
Zhou Can was sure that she had not eaten lunch.
His lips were dry and bloodless.
I'm already so sick, how can I not eat?
This will only make the condition worse.
"I'm not hungry! Don't worry about me!"
She said somewhat weakly.
"When will your mother be able to arrive at the hospital? You can't go without food. I'm going to the cafeteria to eat, so I'll pack some for you. What dishes do you like?"
It was impossible for Zhou Can to advance her medical expenses.
But there's absolutely no problem in treating her to a few meals.
Even out of humanitarianism, we should provide her with some assistance.
This woman is actually quite pitiful.
"Dr. Zhou, thank you, I'm really not hungry!"
She still refused.
But just as she finished speaking, her stomach started to growl.
This made her face instantly blush.
It’s not that she’s not hungry, but she might have no money on her, and she was worried that Zhou Can would buy her a meal, so she couldn’t give Zhou Can the money.
So I lied and said I wasn’t hungry.
