Chapter 569: Assistant Professor Ren, Serious Consequences of Myocardial Necrosis
Nearly fifty minutes later, Zhou Can hurried to the director's office in the internal medicine building.
In terms of status, Director Tan is second only to the vice president.
According to some gossip, if all of Tuya's departments successfully complete the reform this time, the director of each major department may be automatically promoted to vice president.
This is also an opportunity for Zhou Can to quickly rise to the top.
At present, his only hope is to improve his academic qualifications as soon as possible. This is related to his future professional title evaluation, competition for important positions, comprehensive evaluation of famous doctors, and many other developments.
The door of the director's office was closed.
Boom boom boom!
He knocked on the door politely, and then Director Tan's gentle and sincere voice came.
"Come in!"
When I pushed the door open, I saw Director Tan reading a yellowed ancient book.
It turned out to be a book on traditional Chinese medicine.
Internists like to study medical theory and pathology. When they reach a certain level, they will even study pulse diagnosis.
At least three developed countries have developed automatic pulse diagnosis instruments based on traditional Chinese medicine pulse diagnosis technology. Unfortunately, the results are still far from satisfactory.
This is because Chinese medicine pulse diagnosis requires comprehensive consideration based on the doctor's knowledge of pulse theory, pulse meaning, and diagnostic experience.
There is very important human autonomous wisdom, which is ever-changing and requires flexible diagnosis.
With current artificial intelligence, it is impossible to imitate it.
It is estimated that even after another fifty years, it will still be difficult for automatic pulse diagnosis equipment to make a major breakthrough.
Traditional Chinese Medicine is profound and extensive, and people who don’t understand it think it is metaphysics.
Only those who understand it will consider it medicine.
Nowadays, most young doctors in China think that Chinese medicine is more like "metaphysics". There is a most common phenomenon that when encountering some difficult patients or incurable terminally ill patients, everyone will unanimously advise these people to see a Chinese medicine doctor.
From this perspective, traditional Chinese medicine has definitely been severely devalued.
At least Zhou Can had experienced the power of traditional Chinese medicine. If Su Qianqian's kidney disease was treated with Western medicine, there would be no other solution except kidney transplantation. However, she was finally cured by taking traditional Chinese medicine, supplemented by diet therapy, gymnastics and other methods.
She has now been re-examined three times, all showing normal urine test results and normal kidney function.
"Director Tan!"
"Come on! Sit down!"
Director Tan got up and made him a cup of health tea, which contained wolfberry, astragalus and other ingredients.
There are not many people who can be entertained by Director Tan personally making tea.
Zhou Can is an exception.
"I'm calling you here for two reasons. The first is that the patient with myocardial infarction yesterday had a very special identity. He was the director of the Third Hospital."
When mentioning Zhang Qilian's identity, Director Tan showed a mischievous smile on his face.
It's interesting indeed.
The Third Hospital mainly provides diagnosis and treatment services in cardiac surgery. It was once very prosperous for a period of time and was so high-profile that even people didn't know who its father was.
Now the director has suffered a heart attack and his own hospital cannot treat him, so he was sent to Tuya Hospital for emergency treatment.
The key point is that Tuya actually succeeded in rescuing the person.
"The Third Hospital once attacked our hospital. This is a good opportunity to promote our cardiovascular and cardiothoracic surgery departments. The hospital is already planning to do interviews and reports and make a big publicity."
When Director Tan said this, there was a hint of murderous intent in his calm tone.
A man of righteousness cannot do business, and a man of kindness cannot command an army.
No one who can become an important leader of the hospital is easy to deal with. When it is necessary to be ruthless, the means are extremely ruthless.
It is never too late for a gentleman to take revenge.
It can be heard that Tuya Hospital is ready to seize this opportunity and add insult to injury.
It is a big taboo for a country to be weak but not humble, and for a country to be small but not afraid of the strong.
When the Third Hospital attacked Tuya Hospital, it should have thought that this day would come.
Tuya Hospital can be generous, but that doesn’t mean it is always generous.
"Because it involves you, I'm letting you know in advance so that we can discuss this matter. The hospital may need ."
The removal of Zhang Qilian's blood clots and the clearing of his blood vessels were basically all done by Zhou Can.
If we want to use this matter for publicity now, out of respect, we must inform Zhou Can in advance.
As for 'discussion', just listen.
When leaders discuss things with their subordinates, they often just say hello. In fact, the leaders have already made the decision, and subordinates can raise objections, but it has little impact on the results.
"I will definitely fully cooperate with the hospital to do a good job in publicity."
Zhou Can expressed his position on the spot.
He knew that his attitude would be reported to the hospital leaders by Director Tan.
Zhou Can had no psychological barriers to using the Third Hospital as a stepping stone.
It's ridiculous to still have a saintly heart and moral principles when it's time to kill someone.
Kill it while it's sick; this is the way to survive.
The law of the jungle has always existed.
Lions and tigers never sympathize with the weak, but instead think about how to obtain the food they need to survive at the lowest cost.
"The second thing is: you are so good at interventional surgery, your level is already very high. The level of interventional surgery in the Department of Internal Medicine has always been very low, which is not in line with the competition of modern strong hospitals. I would like to hire you as a teacher of interventional surgery in the Department of Internal Medicine, specifically to teach doctors in the Department of Internal Medicine how to perform interventional surgery. I know you are very busy, but every doctor will take up a teaching position, and only in this way can medicine be passed down and continue to thrive."
"Your current part-time teaching position will be of great benefit to your future promotion to a higher teaching position. If you agree, I can secure a teaching assistant position for you at the college. Even the college's doctoral supervisors were promoted step by step from this position."
Director Tan must have made an in-depth evaluation and analysis of Zhang Qilian’s interventional surgery and postoperative results.
After discovering that Zhou Can's level of interventional surgery had far exceeded his imagination, he decided to hire Zhou Can as an interventional surgery teacher.
This is a win-win situation for both parties.
"I am very happy to accept this position. Teaching itself is a very pleasant thing. I am just a little worried that my level is not high enough and I can't teach well."
Zhou Can's words were quite modest, but in fact, it was equivalent to agreeing.
It’s just like when visiting relatives and giving red envelopes, people often say a few polite words.
How could I say no with my mouth, but I honestly took it with my hands.
Teachers in colleges and universities are usually promoted to teaching assistant, lecturer, associate professor, and professor.
After being promoted to professor, there will be first-level professor, second-level professor, and third-level professor.
Among them, the first-level professor is the highest level, and they are often the "Pangu" level figures in a certain teaching field. They have absolute authority in that field. The third-level professor is the lowest position among professors, but those who can be awarded this title are also very impressive.
Not everyone can be evaluated.
There are thirteen levels of teaching positions in colleges and universities, just like there are multiple levels of doctor positions in hospitals, and you need to be promoted step by step.
If your level is not high enough and your ability is weak, your promotion will be very slow.
There are many college teachers who may never be promoted to the third-level professor in their entire life, and many of them remain as lecturers until retirement.
There are even a few teachers who are unlucky and have some serious flaws and still work as teaching assistants until retirement.
In short, competition in every professional field is extremely fierce.
The capable ones will be promoted, while the mediocre ones will remain where they are or be eliminated.
It is definitely a good thing that Zhou Can can become a teacher now.
Many talented people start to cheat after the age of 30. If he can start his journey in teaching before the age of 30, it will be very beneficial for his future promotion.
To get promoted in a position, one step ahead means one step ahead at every step.
"Don't worry about whether the teaching is good or not. Everyone starts from scratch. The academy will definitely give you enough time and opportunities to grow, and will not make extremely strict requirements right from the start."
Director Tan comforted him.
"Okay, since you trust me so much, there's nothing much to say. Just roll up your sleeves and get to work. I'll follow your arrangements when the time comes."
Zhou Can readily agreed.
There is no need to be too pretentious, because once you miss this opportunity, it will be difficult to come by again.
…
On the third day, Zhou Can was undergoing emergency surgery when the cardiothoracic surgery department suddenly called for help, asking him to come in for an emergency consultation.
Saving lives is like putting out a fire, so Zhou Can handed the operation over to two assistants.
They are now fully capable of handling the general surgical aspects of level I and II surgeries as well as level III surgeries.
Yang Zhi and Pu Dingdong were not yet able to perform the difficult second-level surgery and many important parts of the third-level surgery. This was already considered a very fast progress.
Because Yang Zhi has a good foundation in surgery, his surgical skills are obviously better than Pu Dingdong.
However, Pu Dingdong's progress is very stable and he has been improving at a steady pace.
It is hard to say who will be stronger and who will be weaker in the future.
Zhou Can was very satisfied with his two medical assistants.
It is impossible to ask them to grow to Zhou Can's level in just one or two years. That is unrealistic .
If we compare them with ordinary doctors of the same level, their progress is already quite amazing.
He quickly rushed to the cardiothoracic surgery department.
The atmosphere in the consultation room was solemn.
"This patient underwent an emergency interventional thrombectomy in the cardiovascular department of our hospital three days ago. He began to experience obvious discomfort last night. He had shortness of breath, severe pain in the heart area, and a serious drop in blood pressure. It is now suspected that after an acute myocardial infarction, a large amount of myocardial ischemia lasted too long and caused necrosis. The patient's current condition is very dangerous. After evaluating with several directors, I believe that the risk of surgery is very high. You have the deepest understanding of this patient's condition, so I specially invited you to come for a joint consultation."
Director Xueyan sat at the main seat at the consultation table.
The first seat on the left was empty. It was the seat reserved for Zhou Can.
Most doctors in the department tacitly agree that Zhou Can is the second-in-command of cardiothoracic surgery.
Since ancient times, the ancients have respected the left.
The first seat on the left is usually occupied by the second-in-command.
Zhou Can took the examination data and looked at it, which mainly included chest color ultrasound and CT examinations.
This helps detect anomalies.
"When this patient was sent to us for emergency treatment three days ago, the best time for rescue had already been delayed. When I was doing the interventional surgery, I had a bad feeling. I thought the area of myocardial necrosis might be very large. I never thought it would really turn out like this."
Speaking of Zhang Qilian's condition, Zhou Can was also quite troubled.
This is an absolutely tough nut to crack.
"In his current situation, according to my clinical experience, he will die if he does not undergo surgery. Even if he does undergo surgery, the survival rate will not be higher than 50%. We just discussed that there are two options. The first is to try surgery first and see how it goes. The second is to directly consider a heart transplant. Of course, if you want a heart transplant, the donor is a big problem. An artificial heart is the first choice."
Director Xueyan gave some discussion opinions.
After listening to this, Zhou Can still felt very worried.
"Both surgical methods are feasible to a certain extent. The key is that the patient's arterial blood vessels throughout the body have serious malformations and lesions, and atherosclerosis is very obvious. When I was making rounds, I learned from chatting with the family that the patient had vascular abnormalities since childhood. He has been taking medication to control it since then. For this reason, the patient once studied in Japan, specifically to find a way to treat systemic arterial vascular disease."
The patient's situation is extremely special.
Even for an ordinary patient, there is still a very high risk of death when undergoing a heart transplant.
What’s more, this is a patient with severe arterial malformation.
After hearing this, everyone was at a loss for a moment.
In patients with acute myocardial infarction, if massive myocardial necrosis occurs, myocardial remodeling will occur, leading to heart enlargement, weak myocardial contraction, reduced cardiac output, heart failure, low blood pressure, and even cardiogenic shock.
If not treated in time, the necrotic myocardium will expand outward, causing ventricular aneurysm or papillary muscle rupture, or even heart rupture.
After weeks, due to myocardial necrosis, the myocardium in the infarcted area becomes thinner, the non-infarcted myocardium thickens, and the myocardial contraction becomes uncoordinated. A thrombus may appear in the left ventricle wall. If it breaks off, it may cause embolism in the brain, kidneys, spleen, lungs, or limbs arteries.
Therefore, when Zhou Can went to the ward that morning to check on Zhang Qilian's postoperative condition, he reminded the family that the real dangerous period was far from over.
He was able to successfully remove the thrombus for Zhang Qilian, but he could not guarantee that the myocardial necrosis would not occur.
Because when the thrombus was removed, part of the myocardium had already died due to ischemia. It was just that it could not be discovered without opening the pericardium .
Western medicine treatment is often passive.
It can also be understood as a secondary version of defensive medicine.
For example, if a patient is found to have a tumor, but the tumor is not large, the doctor will ask the patient to observe it first and check it every three or six months. If it does not continue to grow, just leave it alone.
This is called coexisting with the disease in medicine.
The whole diagnosis and treatment concept of Western medicine is basically this idea: to prolong the patient's life as much as possible, and then find ways to alleviate the patient's pain.
For example, cancer patients will first undergo chemotherapy or radiotherapy to control the spread of cancer cells. The purpose of this is not to cure the disease, but to prolong the patient's survival period.
The patient will then be prescribed some painkillers to relieve the pain in the late stage of cancer.
Many people believe that trigeminal neuralgia is the most painful disease, and some people believe that childbirth is the most painful. In fact, these pains are nothing compared to cancer pain.
Cancer pain is truly what makes life worse than death.
Especially the pain in the late stage of cancer is enough to make people want to die.
