Chapter 595 The doctor can only give advice. He is just a father at this moment.
"That little boy was clearly diagnosed with a brain tumor and was showing symptoms of a brain disease. How could it be related to cardiovascular disease?" Director Qu's wrinkled face was already flushed.
The shame, embarrassment and unwillingness made her lose face.
This kind of old expert values face more than anything else.
Lin Jinzhi just listened silently without saying anything, but from his expression, it can be seen that he trusts Zhou Can more.
"The brain tumor was just a benign meningioma, not very large, and did not cause any substantial damage to the patient's brain. Later, it was found that the aorta, the artery that supplies blood to the head and neck, was congenitally narrowed, resulting in insufficient blood supply to the boy's brain. Especially when the boy turned his head, the narrowed section of the blood vessel was compressed and stretched, aggravating the blood supply tension of the blood vessel, which is why he often fainted. Dr. Zhou inserted a vascular stent and expanded the narrowed blood vessel section. The boy was able to recover and be discharged from the hospital."
Director Zhuang was also very curious about the cause of the little boy's illness at that time.
So I made some special inquiries.
In the end, I didn’t expect the harvest to be so great.
After listening to his detailed explanation, Director Qu looked gloomy and said nothing more.
"Okay, let's continue to study the cause of Aixi's illness! Doctor Zhou, tell me why you think she has malignant tumors."
Director Tang Fei saw that Director Qu's face had turned from red to white and was worried that something was wrong with her health.
For the sake of department unity, I quickly spoke up to change the subject.
Discussing the little boy's meningioma further would only embarrass Director Qu further.
She also wondered secretly, many doctors in the department got along well with Zhou Can, why were some experts so confrontational towards Zhou Can?
People become weirder as they get older.
Moreover, many senior experts have an instinctive sense of protection for their own authority and achievements. When too young doctors surpass them in the medical field they are good at, they will feel a sense of crisis and jealousy.
This eventually led to them developing hostility and opposition towards Zhou Can.
This is just normal.
As Zhou Can becomes stronger and stronger, they will eventually lower their proud heads and accept his rise and excellence.
To be honest, many newly graduated doctoral medical students at Zhou Can's age may not even be able to do a simple skin suture properly. They take a long time to tie a knot, and will be scolded by the senior doctor for cutting the thread.
There are many residents and interns who do not know how to cut threads in clinical practice.
Needless to say, the internship rotation is almost entirely a cursory initial exposure to clinical practice. They are basically doing miscellaneous work with very low technical content. The most common thing many interns do is learn to write medical records and run errands.
As for entering the operating room, not to mention interns, even residents have to rely on luck.
If you meet a good teacher, he may take you into the operating room and give you a chance to observe.
Most of the interns are treated as if they have to work hard but don't have the opportunity to grow and learn core skills. Because the department is not stupid, they know that you will leave after two or three months of rotation. Instead of spending time and resources to train you, it is better to focus on training doctors in the department.
Speaking of this, let’s discuss the importance of choosing this department for regular trainee students.
For example, Zhou Can originally entered the emergency department, which is his major department.
Generally speaking, the department will put a lot of effort into the training of its trainees, and basically provide them with sufficient opportunities for growth.
As for rotation to other departments, that depends on fate.
If they were a demon like Zhou Can, or a special talent with top academic qualifications like Du Leng, they would be given preferential treatment in any department. Ordinary trainees who rotated to other departments, especially the surgical department, might not even have many opportunities to enter the operating room.
You don't even need to make a pinky promise.
Seeing that Director Qu had behaved herself, Zhou Can stopped paying attention to her.
Instead, he said aloud, "The symptoms of intestinal malignant histiocytosis vary. I have come across such cases in both the Department of Digestive Surgery and the Department of Digestive Internal Medicine. It presents with an acute onset and a fierce onset. Patients often have a long-term high fever and will experience progressive exhaustion, jaundice, and bleeding. If you want to confirm whether Lin Aixi has malignant histiocytosis, there is another way, which is to check whether her liver, spleen, and lymph nodes are enlarged."
"Also, her decreased blood count is consistent with this disease. Judging from the current symptoms, many of them are highly consistent with this disease. In addition, the Provincial Children's Hospital used antibiotics and glucocorticoids to treat her but there was no effect, which can also indirectly prove that it is very likely that she has malignant tumors."
Zhou Can listed several reasons why he was highly suspicious of the disease.
These are all rich clinical experience and profound medical knowledge, and they need to be applied flexibly in clinical practice to be so free and easy and to get to the root of the disease.
"I have examined Aixi. Her liver is indeed enlarged. The right upper abdomen is even asymmetrically enlarged, which can be seen with the naked eye. The lymph nodes are also enlarged, especially the axillary lymph nodes."
Director Tang Fei said.
Once these words were spoken, the cause of the child's illness was directly pointed to malignant tumors.
"I have also come across two cases of malignant tumors, which are relatively rare in clinical practice. In the two cases I came across, no abdominal masses were found. Malignant tumor cells have a characteristic that they are mostly scattered and unevenly distributed after they appear."
An old expert raised an objection.
"Its symptoms are variable, and I don't think it should be used as the only gold standard, as it is mostly scattered and unevenly distributed."
Zhou Can argued.
"Okay, even if this cannot be used as the gold standard, the Provincial Children's Hospital has already performed a bone marrow puncture on the patient, and the test result was negative. No abnormal cells were found. This can at least overturn the conclusion of malignant tumors, right?"
This old expert's level is still quite high.
We seized some important doubts and used them to argue, thus overturning Zhou Can's diagnosis.
This is also the biggest difference between Zhou Can’s diagnosis and that of the veteran experts.
Zhou Can has a young mind, is bold and careful, and often dares to think and act. Some difficult diseases have complex symptoms and the results of various examinations are confusing. It is difficult to draw effective conclusions using conventional diagnostic ideas.
Old experts tend to be conservative and overly cautious, so the probability of making mistakes is certainly much smaller.
But it is also difficult to diagnose the true cause.
"I don't agree to rule out malignant disease based on a negative bone marrow puncture result. In intestinal malignant histiocytosis, bone marrow involvement is relatively rare, and a negative bone puncture result is normal. If you really want to find out the cause, I recommend laparotomy or abdominal puncture. However, abdominal puncture is extremely difficult, and laparoscopic exploration should be a patient-friendly method that can identify the cause to the greatest extent."
Zhou Can also knew that the little girl was very young, only five years old.
Moreover, he is currently seriously ill and his condition is extremely dangerous.
In this case, it is difficult for the family to accept the laparotomy.
It also causes great harm to sick children.
"Thank you to all the experts, Director Tang, and Dr. Zhou for the in-depth discussion on the cause of my daughter's illness. However, my daughter's current condition is not ideal. Can she withstand laparoscopic exploration? Will it be dangerous?"
Lin Jinzhi objected.
Doctors can only provide treatment plans, but family members are the real decision makers.
No matter how good the treatment plan given by the doctor is, it will be useless if the family members do not agree to the treatment.
"Any surgery has risks. The risk of laparoscopic exploration is lower than that of laparotomy, but there are still significant risks. The risk of abdominal puncture is relatively low, but the operation is extremely difficult, and the puncture results may not be accurate. In clinical practice, malignant tumors are usually diagnosed by autopsy. If Director Lin has concerns, based on the location of your daughter's abdominal mass, I suggest a fiber colonoscopy with biopsy, which should also be able to clearly diagnose the cause."
Zhou Can proposed a new inspection plan.
Generally speaking, malignant tumors are located in the colon and can be easily detected by colonoscopy plus biopsy.
But the little girl's mass was in the ileocecal region, so the conclusion is unknown.
Taking into account the family's concerns, Zhou Can could only propose this compromise.
"Choosing fiber colonoscopy is indeed more suitable for Aixi."
Director Tang Fei spoke.
"I'll listen to the experts. Since you think it's necessary to do a colonoscopy, then let's do one."
Lin Jinzhi no longer hesitated.
Especially when I heard Zhou Can say that the cause of the malignant group disease was often found in corpses.
This made him very scared.
"Okay, since Director Lin agrees, I'll arrange it right away. Malignant tumors are very dangerous, and the disease has been delayed for such a long time. In fact, there has been some delay. I'll go check on Aixi's condition first. If she meets the requirements for a colonoscopy, I'll arrange for her to have one tonight."
Director Tang Fei's words were obviously intended to give Director Lin's daughter a green channel.
There are many ways to show goodwill.
Her way of showing goodwill was much more clever than Director Qu's attempt to take credit for himself.
"Director Tang, Director Lin, a fiber colonoscopy is certainly a good idea, but considering that Lin Yuxi currently has blood in her stool, a colonoscopy may not be possible. If that doesn't work, I still recommend a laparoscopy."
Zhou Can spoke to the two of them very sincerely.
"Okay, thank you, Dr. Zhou. I will consider it carefully."
Director Lin obviously still has some concerns about the risks of laparoscopy.
After all, life is not a joke.
He never wanted anything to happen to his daughter.
…
After the consultation, Zhou Can went home.
He was very tired after a busy day, and since then he was busy every day and no longer cared about the affairs of Director Lin's daughter.
About six days later, according to the rules, he had to go to the pediatric department for consultation the next day.
But late at night on the sixth day, I received a strange phone call.
At that time, Zhou Can was sleeping with Su Qianqian in his arms. Seeing that it was an unfamiliar number, he was not prepared to answer it.
Out of his sense of responsibility as a doctor, he finally accepted the case.
As soon as the call was connected, I heard a trembling voice of a middle-aged man with a crying tone on the other end of the line.
"Doctor Zhou, help me..."
"Excuse me, who are you?"
Zhou Can's heart tightened. Could it be that this person had a sudden heart attack or some other acute illness? In this case, it would be more efficient to ask a doctor like him for help.
"I'm Lin Jinzhi from the Health and Family Planning Bureau! My daughter's condition continues to deteriorate and she's almost dying. I really regret not following your advice to do a laparoscopy. Please come and save my daughter! I really have no other choice..."
The fact that the boss of the Health and Family Planning Bureau could burst into tears shows that Director Lin’s daughter is extremely ill.
During the consultation that night, Zhou Can repeatedly urged Director Lin to give his daughter a laparoscopy.
When a surgeon performs any operation, he or she will fully consider the harm and benefits of the operation to the patient.
Laparoscopy causes considerable damage , but compared to saving lives, this risk is really nothing.
This is because medical technology is now advanced, and Tuya Hospital's laparoscopic surgery is very advanced. Otherwise, according to the traditional method, only open abdominal examination can be performed.
"Okay, I'll rush to the hospital right away!"
Considering the other party's special identity, Zhou Can found it difficult to shirk this matter.
In his heart, he actually knew that even if he got there, it would be difficult to save the person.
There are so many experts in pediatrics and they are not there just to eat.
They could think of all the treatment methods that Zhou Can could think of.
When he arrived at the hospital, Director Tang Fei was already there.
Only a boss of Director Lin's level could make her rush to the hospital in the middle of the night.
The directors are actually very busy on weekdays, and their work and rest schedules are disrupted, which has a great impact on their health and work.
"Doctor Zhou, please find a way to save my daughter! I really regret not listening to your advice and not hesitating. Now my daughter has become like this..."
When Lin Jinzhi saw Zhou Can, he quickly grabbed Zhou Can's hand and asked him for help in a crying voice.
In the face of life and death, status, fame, power, majesty... everything is just a passing cloud.
At this moment, Lin Jinzhi was just an ordinary father, feeling fear and worry about his daughter's impending death. He tried his best to ask the doctor to save her.
"Director Lin, please don't worry. Let me understand the situation first."
After Zhou Can finished speaking, he looked at Director Tang Fei.
"Director Tang, where is the patient now?"
"The situation in the ICU is very bad. I'm afraid... you should go check it out first!"
Director Tang Fei should have wanted to say that she was afraid she wouldn’t survive the night.
In the end, he swallowed his words back.
She has to consider the feelings of the family members.
Zhou Can was actually not willing to go to the ICU because of the various strict disinfection and sterilization procedures, which was very troublesome.
It takes a while just to clean my hands.
You also need to change into protective clothing and shoes.
Moreover, the atmosphere inside was extremely solemn, which made him really dislike the oppressive feeling of constantly fighting with death.
After entering, he saw that the little girl was very thin, with a more obvious swelling in her upper abdomen, shortness of breath, and a pale face that was almost the same as that of a dead person.
"well!"
He let out a long sigh.
After watching it, Director Tang and his companion Lin Jinzhi went to the lounge outside.
"The situation is too bad, and malignant tumors are very dangerous. Every hour of delay may lead to a significant progression of the disease. My ability is limited, and I am really powerless to help."
Zhou Can is not a god. His medical skills are very high, but there is a limit.
If he could upgrade his medical skills to level seven, he might be able to try to save the little girl's life. Now, he didn't even want to try.
Because there is really nothing we can do.
"Doctor Zhou, I have heard many medical staff and family members talk about you in the pediatric department these days. I know you are very capable, please save my daughter. Just let go and save her, you don't need to bear any risks."
Lin Jinzhi begged again.
