medical simulator

Chapter 308: The Form of All Beings! (seeking subscription)

Auxiliary examination is an important tool for judging the severity of a condition. From the tool, one can roughly infer the severity of the patient.

Zhou Cheng turned around, looked straight at Ziyi's question, and listened to the answers one by one. At the same time, he evaluated the approximate identities of the elderly and middle-aged people by their attire.

The middle-aged man is wearing a shirt, formal pants, and a watch that should be expensive. When he speaks, he is quite polite, and his cultivation is not bad. What's more, the implication is that he actually misses his father very much. Through surgery or other means, to solve the current pain.

However, the old man heard Ziyi's suggestion: "Since the professor at the Affiliated Hospital of Shonan University recommends you to have an operation, why don't you choose to have an operation?"

The old man was probably in his 60s. Hearing this, he stepped back and shook his head like a rattle: "I don't do surgery, I don't do surgery. I don't do surgery that replaces bones. "

After shaking his head, he looked at Zhou Cheng with some disappointment in his eyes, and said, "Doctor Zhou, in fact, you don't have to be embarrassed. I know my own illness very well. You just need to prescribe some medicine for me." Painkillers are enough, but I don’t want surgery.”

Zhou Chengcheng quickly answered the call, stretched out his hand to comfort him and said, "Whisper, don't get excited, let's talk slowly."

"Your condition is very serious now. Every step you take is suffering. But your situation is not complicated. After the operation, you can mostly return to normal. What do you think?"

"At your age, it should be the time when you can take care of more children and enjoy family happiness."

Zhou Cheng was puzzled. Logically speaking, the old man's family background is not bad, and his knowledge is not superficial.Moreover, the current joint replacement surgery is very mature and the curative effect is very good. Therefore, Zhou Cheng hopes to find the old man's inner nostalgia through speaking skills.

In the past, when Luo Yun worked in the outpatient clinic, he communicated with patients through different speech skills and communication methods, allowing them to make the most suitable choice for themselves.

At that time, Zhou Cheng was just a foil, unable to take the position of sitting in the clinic. Now he has to take charge of everything on his own, and he has to slowly deliberate on the way he gets along with patients.

Hearing the words, the old man was obviously moved, but he shook his head resolutely.

"I don't want to have surgery."

Only then did the middle-aged man sigh slightly, and explained in a low voice: "Doctor Zhou, it's actually like this, and it's mainly my fault."

"My mother died unexpectedly because of the operation. I used to be young and ignorant, and we young people had some complaints about the old man. Dad, can't you get out of that knot? Mother's death has nothing to do with you."

Zhou Cheng's heart moved, but he didn't interrupt.

But the old man was even more stubborn. He stood up and was about to leave: "I don't want to have surgery, I don't want to have surgery."

A little anxious, he staggered out. Seeing this, the middle-aged man hurried over to help him, with a helpless expression on his face.Ziyi didn't know how to deal with it, so he turned his head and looked at Zhou Cheng, probably asking if he should stop him.

Zhou Cheng said: "Let's sort out all the patient's examination materials and return them to them."

Zhou Cheng couldn't understand how long it took for the outpatient clinic, the past between the old man and his son, and the extent to which the middle-aged man criticized his father.Perhaps, being young and ignorant, he has complained more than once that it was his father who killed his mother.

Or maybe the old man was afraid of his wife leaving, so he didn't dare to take risks. He had a kind of fear from the heart about the operation.

After Ziyi packed up, he was ready to go out, but Zhou Cheng snatched the plain film from his hand and said, "Let me deliver it. You lead the next patient to the consulting room."

Zi Yi nodded and said yes.

Zhou Chengcheng pushed the door and chased him out, and took the registered number in his hand.

After catching up with the old man and the middle-aged man, Zhou Cheng smiled and said, "Your film has pulled the outpatient room. In addition, you can also cancel the registered number. It's a pity that it didn't help you."

The middle-aged man took Zhou Cheng's flat film bag, thanked him, and explained: "Doctor Zhou, how can I return the number I registered? I'm sorry to cause you trouble."

"Dad, let's go home, we won't have surgery. I'll listen to you, I won't force you, I'm sorry!~ But I really know I was wrong." The middle-aged man apologized to his father with red eyes.

When he was a teenager, he lacked maternal love, so during the rebellious period, he hurt his only father's love. At that time, he was still underage, so how could he know whether his father's choice was right or wrong?

Now that she has achieved success and fame, it is already too late when she wants to be filial!

Old children, old children, old people are like children, when they get along with their own children, they are cautious, and they may still be afraid of themselves. The harm done to him back then cannot be reversed...

Zhou Cheng saw that the old man's legs were still trembling slightly, which must be caused by the pain.

The necrosis of the femoral head has collapsed to such an extent that it is impossible to walk anywhere, and it is impossible to stand.

Zhou Cheng didn't continue this topic either. He is not the old man's son, nor the old man himself. If he is not good, he will be relieved. If he does not suffer from others, don't persuade others to be kind.

Zhou Cheng just said: "Hey, if you really can't stand it, you can still come to me. I won't advise you today, but in your situation, if you lack exercise in the future, you will shrink. Then he became more and more unable to move, and became paralyzed over time, and it would be too late for surgery at that time."

"I don't advise you to have an operation, but there is always a way to relieve the symptoms. You can relieve the symptoms through hospitalization and make your quality of life better."

When money is no object when a patient sees a doctor, then the problem is more difficult to solve.

The old man looked at Zhou Cheng thoughtfully, but still resolutely walked towards the elevator, apparently not wanting to turn back.

Zhou Chengcheng could only turn around and return to the consulting room.

Doctors don't knock on doors. When patients have their own attachments and choices, don't regard yourself as the savior.

After briefly ignoring the patient, Zhou Chengcheng returned to the consulting room.

The second patient was younger, about six or seven years old. He was a little boy, quite ignorant. Seeing Zhou Cheng in a white coat and Ziyi, he was very frightened and hid behind his father. timid.

The person who brought him here was a middle-aged man, very simple and honest, dressed plainly, caught the child out, and took the initiative to purse his lips and said: "Doctor, this is my son."

"I have also taken him to many hospitals, but they found nothing, and they all said that there is no cure. I heard that Changshi has a great expert here, so I wanted to take him to have a look."

As he spoke, he exposed the wrists and feet of the child in long-sleeved trousers!
Then I saw that the child's right forearm and the middle of the thigh of the left lower limb were extraordinarily slender, and there was a curved deformity.

Seeing this, Zhou Cheng realized something, put on his gloves, carefully held the forearm of his right hand, and looked at it carefully in front of his eyes: "Have you ever had a fracture?"

The middle-aged man nodded: "It's easy to fracture, and you can't even touch it. A little force will cause a fracture. I have fractured several times before."

Osteogenesis imperfecta (brittle bone disease)!
It can also be called porcelain doll disease. It mostly occurs in children. The bones are very fragile. A little external force can cause fractures. At present, there is no special treatment method...

Zi Yi was a little stunned, but also looked at it curiously.

Zhou Cheng felt a little helpless, so he said, "Let me take a look at the flat film first."

Then with the help of Zi Yi, the plain film was spread out, and it can be seen that the bone of the child's affected limb is like a bow, very slender, the bone is quite loose, and the bone marrow cavity is extremely small.

After reading it, Zhou Chengcheng asked: "How old did this start? Which hospitals have you been to before?"

"I'm about 4 years old. It's been several years. I have suffered several fractures. After each fracture, I just put a plaster cast on it. They say it's a branch fracture and it hasn't moved. I have been to the Affiliated Hospital of Shonan University and I have been to the hospitals in Guangdong Province, and they all said that it can’t be cured, so I can only pay more attention.” The middle-aged man replied.

At the same time, looking at Zhou Cheng was full of anticipation, as if he hoped that Zhou Cheng could provide a specific treatment method.

Broken branches?Oh, it's a green stick fracture.

Such a disease is prone to fractures, even spontaneous fractures, and fractures occur without doing anything.

Most of the fractures are green stick type, less displacement, less pain, faster healing, relying on subperiosteal ossification to complete, malunion is more common, limbs are often bent or angled, generally after puberty, the number of fractures gradually decreases...

Regarding this rare disease, Zhou Cheng had only heard about it before, and had never seen it in the clinic. It is estimated that he was in the ward before, so he was shaved off by the teacher in the outpatient clinic.

Zhou Cheng nodded and said: "There is indeed no better treatment for this kind of bone quality. If there is no fracture, most of them should be taken care of, and then let the child grow to puberty, usher in the second growth period, and reshape the bone." After quality, it will be better."

"However, the bones are very fragile. Maybe the heavy schoolbags you carry at school will cause fractures. It is quite troublesome for you to take care of them, but parents still need to be careful."

The middle-aged man nodded: "Yes, that's how it is. I kept him with me all the time and didn't dare to go out. Once before, on the way to school, his grandfather broke his bone while walking with him. Now it's me Send him to the classroom with his schoolbag on his back."

"Then the teacher set up a special cabinet for his schoolbag to store, and he didn't dare to bring his homework home, and he didn't dare to let him play with other children, so he was very withdrawn."

In fact, it's not that he is withdrawn, the main thing is that he also confessed that the child should not play with other people, and other parents also confessed to their children to stay away from this porcelain doll.

The child didn't speak, but looked at Zhou Cheng with a little fear. However, his eyes actually had a kind of ignorant curiosity and a kind of longing. This kind of longing eyes moved Zhou Cheng's heart.

Zhou Chengcheng said: "Actually, it is very difficult to treat this kind of disease, but there are some special auxiliary tools. Do you want to try it? It is to customize a set of braces for the child, which can assist and protect his activities. , so you can feel a little more at ease."

"There is just one problem. This brace may need to be changed every year, because the child is growing, and the cost is not low. If your family can afford it, I can give you a suggestion. If your family is already in difficulty If so, you have to worry about it yourself.”

Zhou Cheng had designed an auxiliary device similar to a wheelchair and a walking aid for that old man, not just for that old man, when he was in Shanghai.

But the practicability is not strong, but it does allow patients with fractures to get out of bed early.The cost is very expensive, and it needs to be designed by a special person.

Although this little boy has no fractures, his condition is actually more fragile than the patients with actual fractures.

If this is not a child, Zhou Chengcheng would not suggest it.

The middle-aged man was overjoyed when he heard the words: "Doctor Zhou, what is the specific use of the brace you mentioned? How much does it cost?"

"The role of the brace is to protect and provide a certain amount of support, so that his bones can avoid excessive stress, and at the same time provide a certain amount of stress to help shape the shape."

"And the cost may be a bit expensive, and a set costs more than 1 points. Because this device is aimed at only a very small number of people, it cannot be used in large quantities." Zhou Cheng also confessed truthfully.

In fact, he could give one away, but if he met a patient and gave them all, then Zhang Zhengquan's company would not have to continue. This kind of brace is originally aimed at a minority of people, needless to say the rich.

Those who have no money can also use it.

When he was in Shanghai, the old man specially asked Zhou Cheng and Zhang Zhengquan to make a special wheelchair. On the fourth day after the operation, he could go to the meeting, he could walk by himself, and he could also sit and walk, which was better than a wheelchair. When you get up, it is much more convenient and normal.

At present, the old man has been unloaded, but because it is specially made, it cannot be used by others, and it is equivalent to tens of thousands of dollars.

But for the old man, tens of thousands of dollars can buy this brace, which is worth the money.

The middle-aged man frowned tightly upon hearing this.Obviously I was intimidated by this fee, and it is five figures once a year, which is not a small amount of money.

Annual income and disposable expenses are not the same!
Seeing the middle-aged man hesitate, Zhou Cheng said again: "You can go back and think about it carefully, or you can try it for a year first. If there is no effect and it is not helpful to the child, then there will be no further orders."

"This brace is currently only known to very few people, so even if you ask other doctors, they probably don't know about it, and they can't provide you with this resource."

Most of the time, doctors can only give one suggestion. Maybe this middle-aged man will go to other places to ask. Zhou Cheng also made it clear in advance that others may not know about it.

In the end, the middle-aged man left with the contact information given by Zhou Cheng.

After the patient left, Zi Yi reminded: "Doctor Zhou, it is very dangerous to ask the patient to appoint a device manufacturer and pharmacy to buy medicine. If he reports it, there will be a lot of trouble."

"I know." Zhou Cheng nodded back.

Today, what the medical industry is strictly investigating is pharmaceutical kickbacks, especially the purchase of medicines at designated places and then getting kickbacks.

However, Zhang Zhengquan was a coward and never gave Zhou Cheng any kickbacks for so-called things, and he was not afraid of investigation.

Although there may be criticisms, as long as I sit upright, I am not afraid of others to check. The positioning of the brace is a high-end product, which is unknown to ordinary people, and Zhou Cheng will not negotiate further.

"But this patient is very special. He went to many big hospitals, but he didn't get better medical services. Maybe he will report it, but I still prefer to believe that he believes that I am kind, and his heart is also very good. .”

"Go and call, the next patient will come in." Zhou Cheng made a decision.

If it was in the past, Zhou Cheng would never do such a thing. At that time, he was still hanging around with others, and when something happened, he had to be protected by others.

But it's different now. He is an independent practitioner himself, and he is about to get a mid-level professional title. He can act upright and sit upright, so he doesn't need others to protect him.

This is the foundation and background.

Ziyi didn't dare to point fingers at Zhou Cheng, but still felt that it was very risky, but Zhou Chengcheng had made up her mind, and she could only call in the next patient.

The third outpatient was a woman in her 50s who was overweight and suffered mainly from foot pain.

Especially the soles of the feet, when standing, the pain was excruciating, but after sitting down, the pain was relieved a lot. She came here independently and was very good at talking.

"Doctor Zhou, you are an expert. I came here specially for you. My foot has been in pain for several years, and it hasn't healed."

"Some people say that my feet need to be operated on, and others say that I need more physical therapy, but I have done physical therapy and massage many times. It was effective at that time, but the root cannot be removed." Le, a middle-aged woman. Ha ha, looks like an optimist.

Zhou Cheng came in from the other party, and he probably understood what the situation was like, so he said, "Auntie, your foot hurts. When you are standing, it hurts a lot, right? When you sit, it will be better?"

"Yeah, yes, yes, doctor, you are right." The middle-aged woman took off her shoes, which were hard-soled sandals and slippers, then raised her legs and pointed out the exact location to Zhou Cheng , probably in the center of the sole of the foot.

"It's here, even if you press it, it still hurts." The middle-aged woman gasped as she pressed.

Seeing this, Zhou Cheng smiled, put on the mask, changed a pair of gloves, and muttered in a low voice, it can be regarded as seeing a common disease, this is plantar fasciitis, a very common disease, frequent In middle-aged and elderly people, it is caused by the adhesion of plantar fascia.

However, even though he was hesitant, Zhou Cheng did a physical examination carefully, and then pressed the aunt's chubby feet, and found that the bones were fine.

Then I stood up and said, "Have you ever been injured? Have you ever taken any pictures?"

Empirical theory cannot be generalized. Although the possibility of plantar fasciitis is the greatest, in fact, it is still necessary to exclude spontaneous fractures, calcaneal arthritis and other differential diagnoses.

"It was taken, but I didn't take it. The doctor said it's okay. But it just hurts." The aunt stopped her foot, and then looked at Zhou Cheng eagerly.

Zhou Cheng also returned to his seat, took her medical records, began to write a physical examination, and then said: "I will prescribe some medicines for you, if you can follow the prescriptions, the pain can be relieved quickly, but, You have to keep using it."

"Okay, okay, you take it, I must remember it carefully and take it on time. My daughter-in-law just had a grandson. I hugged him for an afternoon a few times before. Oops, my feet are almost useless. I lay down for two days to get better. , I’m going to see a doctor immediately.”

"Alas!" The middle-aged woman looked happy and disappointed at the same time.

Zhou Chengcheng said: "After you go back, you buy a few pairs of good sports shoes, and you tell the shopping guide that they are the kind of shoes specially designed for running by athletes, and you should wear these shoes."

"Second point, don't eat too greasy food after you go back, only eat lean meat."

"Third point, your food intake should be reduced to at least a quarter of what it is now, and you should eat less and more meals. For example, if you eat three meals a day, change it to four meals. Each meal should not be too much. "

"Fourth point, you can go to the nutrition department to see if they have a diet for you. If you can control your weight and stick to wearing good, soft-soled shoes, your pain will be relieved a lot."

"Then if you continue to insist on foot soaking and physical therapy, then the pain will be gone, and it is not impossible."

The middle-aged woman opened her mouth wide: "This is the prescription. I thought there was medicine? I won't take it? Are you hungry?"

"You will be hungry, but it will be fine after a while. Eat less frequent meals, eat less fat meat, and eat less staple food. Otherwise, if you don't lose weight, this pain will always exist. And in the future your There will also be problems with the joints, and major surgery will be required at that time." Zhou Cheng said with a smile.

It's not alarmist talk. After seeing the weight of the aunt when she came in, he probably guessed what the problem was. In fact, this kind of plantar fasciitis can also occur in some thin people.

It is more common in women, and it is more common in young women.

High-heeled shoes, hard-soled, hard-soled stilettos that violate the arch of the foot, are simply natural raw materials for plantar fasciitis, and do not require any special cooking methods.

Even if the accident does not occur, the stress may accumulate to the tibia, and then a stress fracture will occur.

"Hey, what's the point of eating meat if you don't eat fat here. Let me tell you, Dr. Zhou, I think the meat is delicious, and the lean meat is all chai chai. How to eat."

"Then you can eat eggs, just eat egg whites, or eat beef, the fat content of fish is a little bit high."

With that said, Zhou Chengcheng finished writing: "That's about it. Remember to stick to it when you go back. It's more cost-effective to spend money on a few better pairs of shoes than taking medicine, and you will be able to hold your grandson when the time comes. After you lose weight, you will lose weight." , I will be much more relaxed..."

When it came to holding a grandson, the middle-aged woman nodded seriously: "That's fine, I will try it for the sake of my grandson, otherwise Sister Wang will say, I don't have a grandson, and my son will not care about me in the future."

With that said, she picked up the medical record and left, opened it and looked back, "Doctor, I know your name, don't you?"

Zhou Cheng smiled and didn't answer, but Ziyi went up and explained: "There are some incomprehensible characters, which are Latin characters or abbreviations. Not all characters are incomprehensible."

"Then I'm relieved." She turned around and went out. It could be seen that she had a good personality.

Probably without a grandson, she is so optimistic, it is impossible for her son to ignore her...

After Ziyi brought in the next patient, he asked Zhou Cheng: "What is the diagnosis of the aunt in front? Doctor Zhou, I also occasionally feel pain in my feet."

Hearing this, Zhou Cheng turned to look at her shoes, and said, "You don't need to buy flat shoes, just wear more nurse shoes, and you don't need to lose weight."

"While wearing high heels can make people look beautiful, it can also hurt your feet. We must pay attention to protecting them. Our orthopedic joint surgeons have never taken the elevator to take the stairs, just to protect our knees." Zhou Cheng explained carefully.

Ziyi asked in astonishment: "If you don't even climb the stairs, don't you want to keep fit?"

"Fitness, but we orthopedic doctors never do squats that hurt joints. We prefer swimming, low-speed jogging, and seldom use treadmills. Even if we are lifting weights, we will choose single-joint exercise. It’s not like choosing a multi-joint movement method.”

"Exercise is also particular. Look at the muscles you are exercising, and then find a more scientific exercise method in a targeted manner, otherwise."

Before Zhou Cheng finished speaking, he looked at the two young girls who had just come in. From their attire, he estimated that these two girls also danced, or they were doing aerobics at home or something.

"Hello, what's wrong with you?" Zhou Cheng asked.

"The back of the knee is uncomfortable. It's been several weeks. I went to other places before and said it was going to be operated on. I was a little scared and didn't do it. But recently, it still hurts. When I squat down and stand up , especially painful."

"Then I happened to see Dr. Zhou's outpatient clinic, so I came here." The elder sister who spoke was not very old, she should be around 20 years old, and beside her was a girl of seventeen or eighteen years old, who was somewhat similar to her, and should be It's my sister.

"Do you both have knee pain? Are you dancing Pamela at home?" Zhou Cheng asked tentatively.

According to the literature he has learned, girls in the city currently have a high rate of chronic knee joint injuries due to various factors such as maintaining their figure and doing aerobics.

And Pamela is a relatively common type of aerobics...

"Yes." Both sisters nodded at the same time.

Then my sister reacted and asked: "This is our MRI. Some doctors said that we are naturally thicker, and then we need surgery to cut it off, and then the pain will be fine."

She was still quite alert and didn't say which doctor it was.

However, even if what they said was incomplete, Zhou Cheng also knew that this was a very common meniscus in the field of sports medicine. The disc-shaped meniscus was easy to rupture and belonged to an abnormal meniscus.

However, after Zhou Cheng read the film carefully, he found out: "Hey, your meniscus is still relatively good. It is not broken. Why do you need an operation? What did the doctor who showed you before say?"

"Here." My sister took out the MRI report again.

Then I saw, on the report sheet, the words "suspicious meniscus injury" were written!

Well, Zhou Cheng probably understands that this is a medical doctor, that is, when Zhou Cheng participated in the annual meeting of orthopedics in Hunan Province, the old professor at the Second Affiliated Hospital of Hunan University criticized him for only reading the report card when seeing a doctor. that kind of existence.

Seeing Zhou Cheng's flickering expression, the girl asked anxiously, "Doctor, is our situation very serious?"

Zhou Cheng shook his head: "No, your knee joints are quite normal from the MRI. However, in order to make a more accurate diagnosis, I need to do a more systematic knee joint examination on you."

Simply looking at the report is a report card doctor.

It is not advisable to simply watch films, even film doctors.

One of the reasons why clinical doctors cannot be replaced temporarily is that there are many factors involved in diagnosis, which are not one-to-one correspondence.

Zhou Cheng then went to do the physical examination. After a while of operation, Zi Yi was completely dazed, not knowing how to draw a pen.

That's it, if you write down the physical examination of the knee joint in detail, including Zhou Cheng's key examinations, it will take at least four to five hundred words.

It is not common for ordinary medical students to understand such things as inner and outer Maxwell's sign, hyperextension and flexion pain, patella pressing pain, pain point examination, inner and outer stress test, etc.

In fact, the two of them only signed up for one number, so they only need to write a medical record. After finishing writing, they said: "In your situation, just take a good rest for a while, don't continue dancing, if you don't rely on this If you eat, rest, and control the frequency in the future."

"During this time, if you want to keep fit, choose a more soothing way of exercise like swimming."

"Then, shall we have an operation?" My sister hurriedly asked, this was the question she was more concerned about.

Zhou Cheng shook his head and said cautiously: "My personal opinion is unnecessary. You can also refer to the opinion of your previous doctor."

It is not kind to tear down the stage.

However, it is also necessary to give personal opinions.

But my sister said: "Doctor Zhou, then I must trust you. You are a great doctor in Shanghai, and you must have a lot of knowledge."

"Can I add you on WeChat, I can ask you some questions in the future." She blushed a little boldly.

Zi Yi was also taken aback.

Zhou Cheng smiled and said: "Thank you for your trust. Our doctors have clear rules that we cannot give out contact information casually, because we are afraid of causing corruption, and we will not be able to explain clearly at that time, so let's avoid such misunderstandings." .”

The two sisters hurried out.

Originally, it was a bit too much to have the courage to ask Zhou Cheng on WeChat, but now that Zhou Cheng refused, they were too ashamed.

Only a clear and beautiful voice came in from the door: "Sister, have you taken a fancy to this handsome big brother?"

"Me? I didn't. I just asked questions about fitness." My sister retorted.

"Oh, that's good. I think he is so handsome. I like her a little bit. He will be my new idol in the future." The younger sister breathed a sigh of relief.

Zhou Cheng: "..."

What the hell?

Zi Yi looked at Zhou Cheng again very curiously. He is tall, handsome, highly educated, and strong. He is definitely a very high-quality boyfriend.

"Doctor Zhou, these two beauties are pretty good-looking, why don't you add them on WeChat?"

"The hospital doesn't have a clear rule that doctors can't give patients contact information?" Zi Yi asked tentatively.

Zhou Chengcheng simply said: "Oh, I usually don't send WeChat messages to patients."

"Then can I add your WeChat account? Dr. Zhou?" Zi Yi then hurriedly asked expectantly, taking advantage of the opportunity to take over the question. Most men probably wouldn't refuse.

Zhou Cheng narrowed his eyes slightly: "Doctor Zi, do you want to discuss academic issues with me? If so, we can have a face-to-face meeting now."

Although Zi Yi looks good, she lacks a kind of temperament. It doesn't mean that she is not good enough. It can only be said that everyone's experience is different, and the people they meet are different.

In terms of cuteness, Ding Dian can hang her and hit her, Zhou Cheng thought to himself, if there is a comparison, it is much more appropriate for him to tease Ding Dian than Ziyi.

In terms of knowledge, she is not as good as An Ruo before, and in terms of being well-behaved and sensible, Tan Min is better than her.

Besides, if it wasn't for An Ruo, if Zhou Cheng was looking for a girlfriend now, there would probably be many people who would introduce him to girls from Kyoto and Shanghai, daughters of rich families, good-looking girls, education background, knowledge, or careers. able to reach.

Ziyi didn't reply.

Zhou Cheng continued: "What kind of physical examination did I just do?"

Ziyi continued not to answer, her face turned slightly pale.

Zhou Cheng continued to ask: "These two girls just now, what is the diagnosis they might consider? What are the differential diagnoses? Why did they consider meniscus damage in the MRI just now?"

"What do you think about the definition and diagnostic criteria of a discoid meniscus?"

Ziyi walked out the door, a little angry: "Doctor Zhou, I don't even know."

Zhou Cheng also ignored her anger, it doesn't matter whether Ziyi came here to be his assistant, she voluntarily, or someone arranged, it doesn't matter, you and I came to study, at least you came here for this reason.

If you don’t ask doubts, if you don’t understand the basics, and if you ask irrelevant questions, then what are you doing here?
I haven't done a good job on the surface, so I might as well bring Fang Yun here, maybe I can really discuss some issues.

Next, Zi Yi was honest, although her voice was still very sweet, but it seemed that she was really angry, as if she was doing business.

Zhou Cheng was happy to see that Ziyi was so serious about his work, and then he devoted himself to seeing the doctor.

The patients who came here were all kinds of strange things, every sub-specialty had them, and Zhou Cheng even saw two children who had relapsed after bone tumor treatment. The parents of the patients were almost desperate, so they brought them to Zhou Cheng to ask if there was any comparison. Good rescue plan.

Zhou Cheng gave several suggestions, but they were all told to go to Shanghai or Shashi.

It's not that Zhou Cheng is unwilling to do it in Chang City. The main reason is that the development of the pathology department in Chang City is not mature enough. Without the assistance of the pathology department, Zhou Cheng dare not do it recklessly. Cheng was also very helpless, looked at the two families, and left almost in despair.

I don't know what choice I will make in the future, whether to give up or continue to seek medical treatment.

Then, Zhou Cheng also saw a lot of patients who obviously needed surgery, but refused to do it. Some of them did it for money, while others were out of fear of the surgery. Therefore, taking medicine can help, But it is absolutely impossible to do surgery.

Moreover, there were those who forced Zhou Cheng to prescribe some painkillers, but Zhou Cheng could only agree, and Zhou Cheng did not prescribe other hormonal drugs that were within the rules.

Perhaps it was because of Zhou Cheng's relatively high reputation, although the patient was angry, he didn't make a big fuss.

However, for the last patient, after Zhou Cheng told him not to have surgery in his current situation, the patient started to make a fuss.

"Doctor Zhou, you have to see clearly. I am in such pain that I can't live (er). If you make a wrong diagnosis and treatment, then I will trouble you." The patient is a A man in his 40s, thin and shrewd looking.

He was injured in a car accident before, and this time he came for a follow-up visit. He wanted Zhou Cheng to give him a leave note for one or two more years, saying that he was not suitable for work.

Zhou Cheng only said: "I'm just making some suggestions based on your current symptoms and your auxiliary examination. Your current situation, the bone healing is possible, does not match the signs you described at present."

"Your current situation does not require surgery or other special treatment. If the pain is severe, I suggest you go to the pain department to see if there are other pain factors."

"If it's just because of the fracture two years ago, then the current level of rehabilitation does not support such a strong pain."

When the man heard this, he became annoyed: "Doctor Zhou, what do you mean by that? Do you think I'm faking it? You're not the one who co-authored the pain, right? I'm in pain? I just came to see the doctor, you, I'm here to see Did you solve the problem?"

But after finishing speaking, his tone softened again: "I can't stand the pain, I want to rest. But the unit needs your doctor to issue a certificate for me, please write one for me, please help, it's troublesome."

Speak politely though.

But Zhou Cheng shook his head: "Sorry, your temporary objective information does not allow me to write you such a long leave note. At most, I can only suggest to you to rest for half a month, review, and then according to the situation of the review, see if it is appropriate. An extended break is needed."

"What's the use of half a month? I come to see you once every half a month, and you're bothered, and I'm also troubled. Doctor Zhou, just give me a one-year prescription. That way you'll save trouble, and I'll be troubled too. "

"I can't bear the pain at all. Where can I go to work? Just help me." The patient had a painful expression.

"I'm sorry, I can't do anything. If you feel the pain is serious, I suggest you go to a higher-level hospital, or go to the pain department, or go to Kyoto or Shanghai to see." Zhou Cheng continued to give advice, such a person, in fact, the purpose very simple.

Lao Lai, he fell in love with the driver or someone who hit him, and wanted to get something for nothing!

The purpose is known, but it can't be said that the pain he mentioned is fake. The doctor can't say this directly.

The patient smiled: "Doctor Zhou, aren't you from Shanghai? The opinions you wrote are more regulated, and they are the same as when I went to Shanghai. Please help me if you can." Write a sick note."

Zhou Cheng really didn't know when doctors had the right to issue sick leave notes to employees of other professions.

He just perfected the patient's medical records and then pushed them to the patient.

"My personal opinion, according to the current objective conditions, and the suggestion of transferring to another hospital have been written. I'm sorry, I can't help you. I'm going to get off work. Please be smart!" Zhou Cheng handed over the medical record .

The patient also stood up and stopped Zhou Cheng.

"Doctor, you can't do nothing? I'm in great pain." He started to make a high profile.

"My ability is limited! I won't see your current illness." Zhou Cheng was still very patient.

"You don't know how to read it. Write me a leave note. I want to go out to see a doctor. I also need a leave note, right?" The patient continued to raise his voice.

Zhou Chengdao: "I'm just an outpatient doctor, and I'm not qualified to issue any false notes. You've found the wrong person."

"Heh, our unit said that your doctor will issue a leave note. You just want to evade responsibility." The patient clung to Zhou Cheng.

"Then your unit must have made a mistake in the procedure. You can go back and ask. Doctors, you don't have any qualifications to issue leave slips to other people." Zhou Cheng said.

"Then I've written it before."

"Then you go to your former doctor. I only refer to your condition today and the results of the plain film I saw. I don't know anything about it before. Yes. I don’t know why the previous doctor gave you a leave note, but, at most, I can only suggest you to take half a month’s rest. "

"And, I will only write it in your medical record."

After Zhou Cheng finished speaking, he took a deep breath: "What we have established is a medical treatment procedure, not a kidnapping regulation. I have expressed everything that I can do nothing about your situation now. I ask you to hire someone else. If you still stand in the way If you do, you are imprisoning me in disguise, and I can call the police."

"You still report to the police, you report? You think I don't understand the law? Let me tell you, if you don't fix my situation today, don't even think about leaving." The patient looked like I was not afraid.

Then, under his gaze, Zhou Chengcheng first called the police, and then called the security department...

(End of this chapter)