This doctor is not short of money

Chapter 462
"Five years of undergraduate studies, one cold, and it's so ridiculously wrong, why do you want them?

And from those two questions, it can be seen that they definitely didn't study hard during the internship last year, and they didn't take the internship seriously at all.

Otherwise, after a year of internship in the hospital, at least I can catch a cold. I don't like their work attitude. "

Li Jianwei asked, Du Heng would definitely say, and what he said was his true feelings.

Du Heng's answer made it difficult for Li Jianwei to continue the conversation.

At this time, he suddenly felt that with a student like Du Heng and himself as a teacher, he seemed a little less comfortable than before.

But at this time, who wants to say that Du Heng should be fired, no more, and Li Jianwei can definitely fight that person desperately.

Li Jianwei clicked his tongue, "Pull the general out of the box, pick one, it's really not enough to accept it." Then he pointed to Xiao Su who followed behind him, "Just say Xiao Su, Now he looks like a dog, which seems to be the case. But you don't know, when he first came, he was not as good as these two children to be honest."

Xiao Su never expected, as he was talking, the matter suddenly jumped to his head, and he was also called "human like a dog" by his "respected" teacher, and his mentality immediately exploded , directly became a look of dying.

Li Jianwei glared at Xiao Su, telling him not to make trouble.

Du Heng felt a little suffocated during this period of time, so he took the opportunity to complain, and he is also a person who has been working for seven or eight years, so it is impossible for him to be so indifferent.

"If you really want to choose, then I suggest that the teacher choose the student who is No. 2 in the written test."

"Tell me your reasons."

Du Heng sighed leisurely, "There are two reasons. First, in terms of grades. I don't think the No.1 student has much advantage.

The two of them had almost the same grades in their professional courses, and the higher grades were all in English and politics. To put it mildly, if we study Chinese medicine, is English useful?
So grades are the same thing. If you want to choose, the thesis and research ability of No. 2 students should be more practical.

Second, the teacher must have heard it in the interview just now. In the case analysis, although both of them were completely wrong, the student with the first grade was directly wrong. Although the second student was wrong, But at least it's still a little sideways.

Another one, I think it’s okay to be a doctor if you have selfishness, but it’s not good if you have too much selfishness. "

After Du Heng finished speaking, Xiao Su, who was standing by the side, interjected, "I also think the student with the second grade is not bad. But the written test score between him and No.1 is a few points.

The performance of the two of them in the interview was similar, and this score is not easy to make up for. "

As he spoke, he glanced at Li Jianwei and Du Heng worriedly, "If we forcibly raise the score of No.2, but they both interviewed together, and their performances are similar, No.1 must have a problem.

But if the interview scores are the same, the gap in the total score is too big.

In this way, will the No.1 student say that we have shady things?Will this do harm to the teacher's reputation? "

After listening to Xiao Su, Du Heng didn't say anything, but just looked at Li Jianwei.

All I can do is make suggestions, and in the end it must be Li Jianwei who really makes up his mind.

If I really helped Li Jianwei make this decision, then I would really be doing it on my behalf, and I am a little confused.

Li Jianwei also fell silent. What Xiao Su said was exactly what he was most worried about, but what Du Heng said was also correct. He doesn't like the mentality of that student No.1.

Du Heng and the two of them didn't bother Li Jianwei, and who was going to be recruited couldn't be settled overnight.

Just at this time, the phone in Du Heng's pocket rang, and Du Heng got up with the phone and walked out of Li Jianwei's office.

"Director Xu, what's the matter?"

"Director Du, where are you now? Will there be time?"

"I'm at school, what's wrong?"

"Then trouble you to come to Corey, there is a patient here, please take a look at it."

"Okay, I'll be right there."

Du Heng put away his mobile phone, turned around and entered the office again, saw that Li Jianwei was still silent, said something about the phone call, and then rushed to Shengyi.

At this time, the two deputy directors of the Digestive Department, Xu Pinglin and Corey, as well as several attending physicians all gathered together, watching the film in front of them in silence.

Xu Pinglin frowned and glanced at a few people, "Everyone, let's talk about our own ideas, we can't just do this and wait for Director Du to come over."

Next to him, a doctor about the same age as Xu Pinglin coughed lightly, "Director, my opinion is that we are doing a more detailed examination on the patient, and I still think it is not bile duct cancer."

Xu Pinglin glanced at the doctor who spoke, "I think so too, but the patient's condition is very bad now, it has been three hours, and the patient's condition has not been controlled, but vomiting and pain intensified, just want to do other examinations, temporarily can not do this."

"Director, the patient's serum amylase test has come out. Acute pancreatitis can be confirmed, but I still have doubts about the diagnosis of cholangiocarcinoma. I still think that the patient is more likely to have acute cholecystitis."

"Right upper quadrant cramps, body temperature 39°C, blood count white blood cells 18500/ml, neutral 90%, obvious gallbladder problem, if it is cholecystitis complicated by pancreatitis, at least the patient's right upper quadrant cramps and vomiting are okay until now under control.

But now everyone has seen the situation, the patient's condition has no sign of remission, and it is getting more and more serious.And the film clearly shows that the bile duct is abnormal, so I still insist on the judgment of bile duct cancer. "

. . . . . .

Hearing what everyone was talking about, Xu Pinglin had a headache, and couldn't help reaching out and knocking on the table, "Everyone, let's not discuss the issue of bile duct and gallbladder, let's talk about acute pancreatitis first?
Because of the pain, the patient is already in a forward-bending chest position, with increased abdominal distension, continuous vomiting, and persistent high fever. If it is not controlled, it will endanger the patient's life. "

Everyone was silent for a while, only the deputy director in front said, "We have used all the available medicines for the patient, but the patient's high fever persists, and the pain has not been relieved even after giving an injection of pethidine. Therefore, the root cause of the problem is still the gallbladder.

If the cause of the gallbladder cannot be found and cannot be resolved, then pancreatitis cannot be controlled. "

Xu Pinglin looked helplessly at these people in front of him, he was trying to find a way to find them, but listening to what these people said, it was useless.

"Director, Director Du doesn't know when he will arrive, let's call for a consultation."

"Director, my opinion is to perform an operation now. The patient's pancreatitis is very serious, and the medicine can no longer control it."

"I am opposed to surgery. The patient has pancreatitis, and it is very severe pancreatitis. But now there is an unknown gallbladder problem. The postoperative complications of pancreatitis have become an inevitable problem. How do you solve this?

Moreover, if you open the abdomen, the condition of the gallbladder and pancreas does not support the operation, why don't you do nothing and just close the abdomen again? "

"Okay, no..."

"Dangdang"

Before Xu Pinglin could say anything, there was a knock on the door of the office, and Du Heng pushed the door open, panting lightly, "Sorry, I just rushed back from school. I'm not late, am I?"

Seeing Du Heng, Xu Pinglin seemed to see a savior, and felt relieved suddenly, "It's not too late, it's just in time."

After finding a stool for Du Heng to sit down, Xu Pinglin took the initiative to introduce, "A 56-year-old female patient suffered from colic pain in the upper right abdomen after breakfast, and frequently vomited. She was admitted to the hospital at [-]:[-] noon. once.

In the following time, the paroxysmal cramps intensified, the entire abdomen could not be pressed, and the hands screamed with pain, and there was rebound pain, and the patient was cold and hot for a while.

This is the patient's examination report and film, Director Du, please take a look. "

Du Heng didn't show any pretense, and took it directly, and asked while looking at it, "What's your diagnosis?"

"Choledochocarcinoma is complicated by pancreatitis, but now because of the patient's abdominal distension and unbearable pain, some tests cannot be done, so cholangiocarcinoma is suspected."

Du Heng's film-watching skills, compared with these people here, don't say that there is a world of difference, but the difference between two gaps is not a problem.

These people can't see a definite answer from the film, let alone themselves.

And my strengths are not watching movies.

But, just looking at the film in front of him and their treatment process, Du Heng also felt that the patient did not have cholangiocarcinoma.

"What's the result of the Chinese medicine examination?" Du Heng put down the film in his hand and asked Xu Pinglin.

Xu Pinglin directly looked at the only TCM doctor in their department who had been silent in the crowd, "Doctor Zhou, tell me about your examination results."

On Monday, which was originally like a quail, I saw Du Heng sitting in front, and he also straightened his back slightly, "The pulse is deep and stringy, the moss is yellow and dry, the mouth is bitter, and the breath is bad. Recently, I have been stagnant for seven days. inconvenient.

According to his family members, the patient is addicted to fat, sweet, wine, cheese and other foods. "

Du Heng frowned. This eating habit is not good. After a long time, there must be dampness and heat in the body.

I looked at the inspection report and the video at hand again.

Du Heng's mind was spinning rapidly, using the information in his hand and Dr. Zhou's diagnosis results as a joint reference.

Yellow and thick dry fur, bitter mouth and bad breath are all manifestations of damp heat.

But the pulse condition was as many as Shen Xian's four, no matter how tight Du Heng's brows were.

This is not to suspect that Dr. Zhou made a wrong diagnosis. After all, this Dr. Zhou is older than Du Heng, and he can participate in the promotion of the deputy director next year, so how could he make a mistake in diagnosing the pulse.

He frowned, just saying that the patient's condition was really urgent and messy enough.

huh~~~
Soon, Du Heng came to a conclusion in his mind, the patient had damp heat inside, and the evil heat obstructed the spleen, stomach, liver and gallbladder, and became a severe case of heat solidifying the chest and Yangming viscera.

This diagnosis is not difficult, but the evil heat blocks the spleen, stomach, liver and gallbladder, who can block it?

Gallstones?

Even if Du Heng's ability to watch movies is poor, he can still understand the movie about gallstones.

In the present film, the volume of the gallbladder is increased, the intrahepatic bile duct and common bile duct are dilated, and the pancreatic duct is slightly dilated.

Overall observation, no stone-type high-density shadow was found, but soft tissue density shadow was seen in the middle and lower part of the common bile duct, which is very strange.

Soft tissue density shadow, viscous bile?

Du Heng scratched his head very puzzled.

But this is not the most critical now, but to control the development of the patient's condition.

The patient now has the three major symptoms of pancreatitis, and every second of delay will make the patient feel uncomfortable for one more second, and the risk will increase by one point.

Moreover, what Xu Pinglin and the others discussed had nothing to do with his own treatment, so treating patients by himself did not require the results of their discussions.

"Director, can I take a look at the patient first?"

"Row."

Then a group of people walked to the ward in a mighty manner.

As soon as Du Heng and the others walked to the door of the ward, they saw the patient lying on the edge of the bed, retching hard, and could hardly keep up the gas, while her family members were patting the patient with worried faces. the back.

His face was yellow and his expression was listless.

After retching, the whole person began to cry out in pain again.

Du Heng walked to the front and took the patient's hand to make another diagnosis. The result he got was no different from what Dr. Zhou told him.

It's just that this woman's nails, although cut very short and neatly, still have a layer of dirt in the shallow nail crevices, very black, very black dirt!
Du Heng exhaled lightly, looked at Gu Ping who had just followed but was standing at the back, and said, "Gu Ping, bring the needle kit."

Xu Pinglin hurriedly asked, "Director Du, what are you?"

"The patient has dampness and heat inside, and the evil heat obstructs the spleen, stomach, liver and gallbladder. Now I will relieve the patient's gallbladder and stomach stasis and heat, and then the patient's pain will stop."

Just as Du Heng finished speaking, someone behind him frowned.

Du Heng's level is high, they are clear about this.

But from what he said just now, he knew that Du Heng wanted to treat with acupuncture. Did he really think that acupuncture could relieve pain better than Dulantin?

But now in the ward, even if they have doubts in their hearts, they won't say it out. They still have this bit of professionalism.

At the same time, they don't agree with Du Heng's behavior in their hearts now, but Du Heng spent a year telling them last year that it's best not to question casually, or they will be slapped in the face.

Xu Pinglin didn't think too much about it. Hearing what Du Heng said, he hurriedly asked, "Then what medicine are you going to use? Tell me now, and I'll send someone to prepare it right away. Let's hurry up."

Du Heng was silent.

He knew that it was the evil heat blocking the liver and gallbladder, but how the evil heat was blocked, and how it turned into evidence, remains to be explored.

I haven't figured this out, and I really don't know how to start dispensing medicine for the time being.

"Wait, I'll let the patient relieve the pain first, and I'll check her again when she calms down, and then take the medicine according to the situation."

(End of this chapter)