Chapter 281: Everything came true, the quack doctor killed people
Du Leng's theory is strong, but his diagnostic ability is probably at the bottom among many attending physicians, which is totally inconsistent with his super high theoretical level.
The reason for this is that Du Leng did not realize that true medical skills are not learned from books, but need to be learned from patients in clinical practice.
You need to understand it yourself through clinical diagnosis.
Real skills are never taught by others, but need to be understood by oneself and transformed to become one's own skills.
He has an enviable doctorate degree and graduated from a prestigious overseas university. He is also very knowledgeable. Unfortunately, after he entered Tuya Hospital, he was always complacent and had a high opinion of himself. He never thought about getting down to earth and starting from the most basic clinical practice.
Instead, he has always been keen on participating in various director-level consultations on difficult cases and various difficult major operations.
This ultimately led to Du Leng making a fool of himself during the expert consultation.
Only when the water recedes can you tell who is swimming naked.
This time, Du Leng was dragged to Xinxiang Maternity and Child Health Hospital for a real combat, which immediately exposed his true colors.
At this moment, his face was ashen and his expression was gloomy.
I guess he must be feeling bad.
Come to think of it, he used to jump so high, and now he's fallen from that height, so it must be extremely tragic.
But for him, it may not be a bad thing.
As long as he finds out his own problems, learns from them, and calms down and starts training from the most basic clinical practice after returning to Tuya Hospital, I believe that with his foundation, he can become a truly capable doctor in a few years.
Gao Jian followed Director Jiang back to their consulting table.
Before leaving, Gao Jian looked at Du Leng with sympathy. Compared with Du Leng, Gao Jian was very lucky.
At least Gao Jian has been diligent and down-to-earth during the nearly two years of regular training. He is not like Du Leng who is ambitious and only does things for the sake of appearance.
"Xiao Zhou, I have high hopes for you! You should take good care of Yang Chan in the future. Aren't you classmates? You should help each other."
Director Zhang Bihua also took Yang Chan back to her own desk.
There were quite a few patients who came to see her. Although she was participating in the consultation, there was a long queue in front of her table. Under the organization of the nurses, the patients and their families waited patiently in line.
This is the appearance of a top-notch doctor.
Patients and their families are willing to buy into her advice.
When Yang Chan followed Director Zhang to leave, she glanced at Zhou Can with a faint , and then quickly retracted her gaze. For the first time, Zhou Can saw a look of embarrassment on her face.
This is not like the heroic, domineering and bold squad leader of 512.
Defeating her three times in a row, and conquering her?
Zhou Can would never dare to think so.
In his impression, Yang Chan was very proud and never admitted defeat. She would definitely find a way to win back next time.
After Director Jiang and Director Zhang left, their clinic table became deserted again.
There is no way, reality is so cruel. Patients and their families will never hand over their lives to an unknown "expert".
Deputy Director Shi is still too unknown.
Time passed by little by little in boredom.
This kind of idle consultation is what Zhou Can hates the most, nothing else.
In his opinion, it was a waste of life.
But in the current situation, if he reads with his mobile phone in hand, it will have a very bad impact.
Fortunately, not long after, the super obese female patient came back after the examination.
Although the family members had a very good impression of Zhou Can and had a certain basis of trust in him, they did not take the test results to Zhou Can, but instead went to Director Zhang Bihua for further diagnosis.
Compared with the young Zhou Can, the family members still trust Director Zhang Bihua more.
"Doctor Zhou, Doctor Zhou, please come over and take a look. Your diagnosis is really accurate. The patient's thyroid function is indeed problematic. The bone examination results show osteoporosis."
After looking at the patient's test results, Zhang Bihua waved to Zhou Can excitedly.
The results of both tests were similar to what Zhou Can had predicted.
This made Director Zhang Bihua more confident in Zhou Can's diagnostic ability.
"Her sleep apnea syndrome should be diagnosed as being caused by endocrine and metabolic diseases. The lesion is the thyroid gland lesions."
Zhou Can was also very happy when he saw the results.
"No wonder the patient's symptoms are very similar to mixed SAS, but the real cause has never been found! Who would have thought that it would be caused by thyroid disease! Now it's better, symptomatic treatment should be able to cure the disease."
Director Zhang Bihua was also very happy.
After successfully diagnosing a difficult case, every medical staff involved will feel a special sense of accomplishment.
"Dr. Zhou has strong surgical skills and rich experience in diagnosing and treating thyroid and breast diseases. Do you think she needs surgery?" Zhang Bihua was somewhat unconfident about the treatment plan she had prescribed.
Because this patient has seen many doctors, including many famous doctors in related fields in the province, but none of them could cure this patient.
She found it somewhat unreal that now it could be cured with just a prescription.
"You can try medication first to see the effect. If it doesn't work, then consider surgical treatment. However, any surgery will cause irreversible physical damage to the patient, so try not to have surgery if you can."
Zhou Can does not recommend patients to undergo surgery.
Use the medicine for a while to see the effect.
…
Director Zhang prescribed medicine for the patient and told him to pay attention to weight control. It would be best if he could exercise every day to lose weight.
Excessive obesity can easily cause a variety of diseases, and her thyroid function degeneration is likely related to obesity.
From a medical perspective, there are four causes of hypothyroidism. The first is inflammatory infection, including bacterial infection and autoimmune disease. The second is tumor. The third is trauma, thyroidectomy and isotope radiotherapy, and even radiotherapy for nasopharyngeal carcinoma can cause thyroid damage and lead to hypothyroidism. The last one is the well-known insufficient iodine intake.
Adding iodine to salt is to solve the problem of insufficient sulfur intake and prevent the occurrence of goiter.
This female patient had bad living and eating habits, and her excessive obesity also easily led to insufficient iodine intake and absorption.
If she does not control her weight at a reasonable normal level, the long-term burden on her heart, lungs, liver, kidneys and other organs will be increased, which can easily lead to a series of serious diseases.
The treatment plan given by Director Zhang was to gradually supplement thyroid hormone to correct the problem of hypothyroidism, and then asked the patient to lose weight.
All are effective treatments.
Zhou Can watched the obese patient leave, hoping that her sleep apnea syndrome could be cured after taking the medicine.
Not long after, the patient who had a minor cold that had not been cured for two years came back after the examination.
Under normal circumstances, pathological examinations take three to seven days to produce results.
For example, tumor tissue needs to be tested at the immunohistochemistry or molecular pathology level, which will take a week or so.
If it is just intraoperative pathology, this can be tested quickly and the results can be obtained in 30 minutes.
Intraoperative pathology usually refers to the rapid freezing of the excised diseased tissue in a freezing microtome to make slices. After multiple processing steps such as staining and sealing, the pathologist conducts pathological examination and diagnosis under a microscope.
This young female patient was very unfortunate; she was actually diagnosed with a tumor in her left pharynx.
The doctor at Xinxiang Maternity and Child Hospital took tumor tissue from the upper and upper posterior part of the lateral pharyngeal cord for pathological examination and initially suspected non-Hodgkin's lymphoma.
Seeing this result, Director Zhang's face became very solemn.
Although Zhou Can had expected this, he couldn't help but look sad and felt sorry for the young female patient.
"Doctor Zhou, the test results are out now. There is indeed a tumor in the throat. And it is lymphoma. What should we do?" Director Zhang Bihua was not unaware of how to deal with it, but she felt sorry for the female patient.
Based on her experience in diagnosis and treatment, she was very worried that the female patient's tumor had already metastasized and spread.
In fact, tumor spread is generally divided into three ways.
The first is infiltration into adjacent tissues, which is the easiest way to control. As long as it is discovered in time, all affected tissues are removed, and chemotherapy is used to consolidate the therapeutic effect, satisfactory treatment results can basically be achieved.
The second is the transfer of tumor cells through the blood. This is more difficult, but for a tumor cell to take root in other places and proliferate wildly and grow into a tumor, it requires multiple immune defenses of the body.
It’s like a bandit running to a strange place and wanting to develop into a force, but the success rate is actually not high.
We are unfamiliar with the place and might be killed by local officials or organizations.
It takes time for tumor cells to travel to a new location via the blood, take root, and then develop into a second tumor.
It is relatively easy to detect with the help of modern medical examination methods and diagnosis by experienced clinicians.
It is also possible to achieve better therapeutic effects by simply removing the primary lesion and metastatic lesions and then performing radiotherapy.
The third way tumors spread is through lymph. The lymphatic tissue of the human body is an important immune organ of the body. When it is conquered by tumor cells, it is like a government being infiltrated and controlled by bandits.
You can imagine how serious the consequences are.
If I have to describe it, it's lawlessness.
Therefore, once lymphoma is diagnosed as malignant, the prognosis is often poor.
When the girl's mother learned that her daughter had lymphoma and saw the serious expressions of the doctors, she almost collapsed. She held the edge of the table tightly with both hands and trembled slightly. Tears welled up in her eyes, her breathing became short, and her face turned pale.
"Doctor... please save my daughter. Her father worked hard outside just to give his child a good living environment. If I find out the result now, how can I explain it to her father..."
The family member's voice was choked with sobs and was already crying.
In other words, I pretended to be strong in front of my daughter, otherwise I would have broken down and cried long ago.
"Don't worry, this is just the initial diagnosis. First of all, lymphoma is not necessarily malignant. Second, even if it is malignant, it can be removed surgically. The key now is to further clarify the pathological nature and then check whether it has spread."
Director Zhang Bihua comforted the family members.
She looked at Zhou Can again. "Doctor Zhou, I know you have performed many operations in many departments of surgery, so you must be very experienced. Which parts do you think should be the key targets for investigation?"
Director Zhang is not ashamed to ask questions because everyone has their own expertise.
She performs a lot of obstetrics and gynecology surgeries, but very few tumor surgeries.
Normally, when we encounter patients with cancer, they are usually handed over to the corresponding specialists for treatment.
For example, breast tumors are usually handled by doctors in the Department of Breast Surgery. Cervical tumors and ovarian tumors are more often handled by the Department of Obstetrics and Gynecology.
The most common operations performed in obstetrics and gynecology are cesarean sections, curettage, and ligation.
Lymphoma in the throat, a disease she had rarely seen.
There is also little relevant processing experience.
"The patient now has liver disease and hearing loss, and has been diagnosed with intrapharyngeal lymphoma. For further examination, I recommend a bilateral ear CT scan and a chest CT scan. The eardrum and lungs are the key areas to be examined. In addition, it would be best to do a lumbar puncture to check for routine cerebrospinal fluid."
This time Zhou Can did not refuse, but seriously gave further examination suggestions.
Director Zhang nodded slightly and looked at the family members.
Without waiting for Director Zhang to speak, the family member bit his lip and nodded vigorously, "Yes, we will do all these tests."
It can be seen that Zhou Can successfully diagnosed a tumor in her daughter's throat last time, and now it has been confirmed after examination. Her trust in Zhou Can has risen to an extremely high level.
She accepted all the examination suggestions Zhou Can gave.
After Director Zhang wrote an application for examination for the patient, she took her daughter for the examination without mentioning anything.
After she left, Director Zhang sighed, "It would have been great if the cause of this girl's illness could have been found out earlier. Two years have passed now, and her liver has been damaged, and she has multiple lesions throughout her body. I'm afraid the results of the examination will be very bad."
"Her illness really delayed her treatment."
Zhou Can was cursing in his heart, this quack doctor is harming people!
Some quack doctors are literally killing people when they treat them.
This girl just turned 19, at the prime of her life. It would have been great if she had been diagnosed with laryngeal lymphoma two years ago!
It has now affected multiple body tissues and organs, and has most likely spread and metastasized.
I'm afraid the only thing we can do is chemotherapy.
The prognosis will be very poor.
People like her probably won't even survive five years.
"Doctor Zhou, may I ask, have the three examinations you requested for her determined to which parts the tumor has metastasized?" Yang Chan watched Zhou Can diagnose these difficult cases one after another, and all of them were verified.
His diagnoses were all correct.
This made her secretly admire her, but also filled her with curiosity about the female patient's condition.
With her current level of expertise, she naturally could not determine as accurately as Zhou Can whether the tumor had metastasized and to which parts it had metastasized.
Driven by strong curiosity, she asked Zhou Can for advice.
Zhou Can looked at her, his mood was still a little heavy, so his expression was relatively serious.
"It's basically confirmed. The hearing loss is definitely because the eardrum has been attacked by tumor cells and has become diseased. And her liver disease, including fatty liver, should be a superficial symptom. When lymphoma metastasizes, it is more likely to invade the lungs, so I asked her to check a chest CT scan. The liver is known as the most silent organ, with no sense of pain, and its resistance is naturally stronger than other organs."
To put it bluntly, it means solid defense .
According to Zhou Can's understanding, the liver is a warrior wearing heavy armor, with high attack and strong defense.
For example, no other organ can match the liver's detoxification ability.
This can be regarded as high attack power.
“Then why do you need a lumbar puncture?”
"This is simple. It mainly involves checking the routine test results for cerebrospinal fluid. Although the head is at the top of the body and is known as the head of the six yang meridians, the patient's primary lesion is located in the throat of the head and neck, so it is very easy for the disease to invade the patient's head. In addition, some of her symptoms also indicate that the brain, cerebellum, and nerves in the head may have been affected."
Zhou Can patiently answered Squad Leader Yang’s questions.
When she was studying, she was the one who taught others because she was a top student.
Zhou Can did not pursue graduate studies because he failed the entrance exam.
She was fully capable of taking the postgraduate entrance examination, and was even directly admitted. She gave up on her own initiative and insisted on entering the society after completing her undergraduate studies, probably because her family conditions did not allow it.
Many girls are very sensible.
They know that their family conditions are not good, so they are not only frugal in school, but also try every means to earn their own tuition and get various scholarships. And even though they can continue their studies, they choose to enter the society and work early.
Yang Chan was a girl with a very strong self-esteem and she never told her classmates or teachers that her family was poor.
Also, as far as Zhou Can knew, she had never applied for poverty scholarship.
But seeing that she usually dressed very simply, and as the class monitor, she never participated in some expensive activities held by the class. There were many other small details that made Zhou Can understand that her family must be very poor.
