Nineteenth Century Medical Guide

Chapter 322 318. A Very New Speech
Kavi stood by the bed and put on all the outfits for today. He was about to sit at the desk and look at his next itinerary when suddenly there were some unknown noises outside the door.He immediately realized what happened outside the door, and quickly got up and walked towards the door:

"How many days have passed, even a waiter has to check?"

"This is an order, Dr. Carvey, you have also served in the army, and you know there is nothing we can do."

Carvey opened the door, and the gloom of the man in black passed by, and finally the attendant's bright voice sounded in his ears: "Dr. Carvey, there is breakfast downstairs, and you can go downstairs to enjoy it until ten o'clock. If If you don't have time, we can provide package service."

The speech is at 9 o'clock, and Carvey has plenty of time.

But there are too many people who need to be greeted in this hotel, he doesn't like to socialize very much, he was going to pack, but now he changed his mind: "Bring the breakfast."

"I don't know what you want to eat?" The hotel waiter stood at the door and took out a small book, "Today's main dish is."

"You can figure it out, don't eat too much, I can't eat too much."

"Ok."

The morning sun hadn't fully shone into the hotel room, and Kavey simply sorted out yesterday's harvest.

Except for the last enamel unicorn which was bought by Eugenie for 5 francs, Carvey almost sold most of them, including three paintings, two manuscripts and a large number of domestic collections, but spent very little money.

Now that the money has been given, the things are still piled up in the warehouse of the auction house and can be kept for a month.

Carvey wanted to send things back to Vienna before, but there are still many details to be dealt with as to how and when to send them.Not long after arriving in Paris, there are many things to deal with. He doesn't have the time to spare, so letting the other party take care of it is the best choice.

As for other auctions related to domestic collections, they were mainly concentrated in the past few years, and now there are many fewer auctions. Most of them will choose to collect themselves or give them to Eugenie.

After the auction, Carvey also informed Bernard, if there is any news in this regard, he will be notified.
Carvey sighed, looked up at the ceiling, and didn't know whether he should be thankful that he was temporarily separated from such a whim of trivial matters, or he had to spur himself a few more words at this time, so as not to give up halfway.

In the final analysis, he is still not professional enough, and it is still powerless for him, who only studies medicine, to do such a thing.

Carvey took a deep breath, erased the unhappiness accumulated in his mind, and focused on today's work.

When it comes to speeches, Carvey doesn't actually attend many of them.Before the time travel, what I talked about was surgical procedures and some new treatment plans, and I faced colleagues who had worked for many years, but today I have to face some students who have not yet graduated.

Even now, Carvey has not thought about the specific content of the speech.

"Dr. Carvey, breakfast is here."

"Uh, here we come."

The Faculty of Medicine of the University of Paris has a long history and has sent a large number of medical talents to France and even Europe. It is one of the cornerstones of the development of modern medicine.

There is almost no free time in the lecture hall of the medical school. Half of the medical conferences in Paris are held here. There are too many medical experts who can't even receive invitations here. Being able to stand on the podium of this medical school is enough to show that people who come here serving size.

Carvey didn't have much pressure on the big scene, but he really couldn't think of what to say to those students.

The point of cesarean section?

How to hone surgical skills?
Or talk about the importance of vital signs and body temperature?
These are very important to the clinic, but they don't seem to be very important, because in order to form this kind of common sense construction in daily work, it is not enough for him to talk for an hour, far from enough.

They are just medical students, and most of them have not been exposed to clinical practice. Is it too early to directly talk about clinical practice?What's more, even if he really went to clinical practice, the doctor he followed was not himself.At that time, whether I can really remember these things is another matter. If I really remember, how long can I last? Will it conflict with the concept of teaching doctors.

In the carriage, Carvey racked his brains for a while, but when he entered the venue and looked at the children who were about his own age, he immediately remembered his experience as a teacher when he was young.

Ah, I forgot all about it.
They are still students, facing the opening stages of their careers.What is urgently needed now is not to stuff advanced medical knowledge into empty minds, but to learn how to learn knowledge in heavy internship work.

Carvey walked up to the podium with his small bag, checked the time, and wrote his name on the board behind him.

His appearance immediately attracted a lot of attention, and like everyone else, the discussion focused on Kavi's nationality and age.Then a small group of people who saw Carvey's operation began to admire his surgical skills, and began to discuss some topics that did not belong to the medical category with another small group of skeptical people.

"It's almost time, I didn't expect so many people to come."

Carvey looked at the crowded venue and said in French: "I know you have a lot to ask, but today is not a day for interviews. I want to complete a personal speech here, and the questions will be left after the speech."

After pouring cold water on them, Carvey asked, "Have you all participated in hospital internships?"

Just as he guessed, most people shook their heads, and those who didn't make a statement were mostly elderly doctors.After the audience range was determined, Carvey began to enter today's topic: "I would like to ask you, which time period is the most difficult in the entire medical learning journey?"

As expected of the gathering of the top minds in Europe, as soon as this question appeared, the correct answer also appeared.

"As you all know, in the long medical journey, there is no learning curve as steep as that of a resident. There is a huge gap between an intern who has just completed theoretical studies and a resident who can do it alone. This is also a doctor. step into the most important part of its journey to success."

Carvey made the opening remarks, and starting from the identity of the teaching teacher, he said: "I don't know much about the internship system of the Paris Medical School. The internship in Vienna is not long, about half a year. The internship content during this period is very important. , directly determines whether a graduate can quickly become a resident doctor."

At this time, there is no systematic examination for doctors, let alone the so-called doctor's license, and more of them are the formal assessments of the medical associations.As long as you pass the examination of the Doctors Association and successfully enter the Doctors Association, you will be admitted.

However, the assessment itself has very little content, and the answers are very subjective, which cannot be compared with the systematic written test + practical operation assessment.

"I believe that it will be very easy for you to pass the examination of the Physician Association, and I am definitely not here to hear how to pass the examination." Carvey said, "What I want to talk about is how to really learn the knowledge you want during the internship process."

Students have different views on internships, but they all want to learn as much as possible. Unfortunately, many people use their energy in the wrong place.

"You have to position yourself first."

Carvey wrote on the board, [You are students, correct your attitude and enjoy learning]: "Students naturally focus on learning, why do you want to learn? You learn because you don't understand. So when you encounter someone who doesn't understand Just say "I don't understand" openly, and then find the answer in the teacher's explanation, and give it back to the teacher for you to write down.

Those who lie about what they know in order to take care of their self-esteem are idiots. Clinic is not a school. Wrong feedback will make the teacher make mistakes in your judgment, and then superimpose these mistakes on the patient.

So be yourself, keep your energy high, set your study goals, and finish your work on time. "

Lectures in plain text are always boring, and even if Carvey talks about valuable personal experience, it will reduce the quality of the speech.So after finishing the first article, he introduced a typical case: "Let's take the previous case of the female patient with abdominal pain as an example to describe what the intern doctor needs to do."

Carvey wrote the medical history on the board:
[Patient, female, named Eugene, 18 years old.Two days ago there was abdominal pain, constipation, and no vomiting.At the beginning, it was diagnosed as hysteria by the internal medicine department. When I went home, I used enemas for recuperation. The constipation was relieved, but the effect on abdominal pain was average.

The next day, the abdominal pain worsened, and I went to the internal medicine department again. Considering eating a piece of bread that had been stored for a long time, it was diagnosed as gastroenteritis, and mercury was added on the basis of an enema to induce vomiting.Parents did not follow suit, but gave antimony to continue catharsis, with little effect.

On the third day, the abdominal pain persisted, and even showed signs of aggravation. Finally, I found a surgeon, was diagnosed with mild hysteria and appendicitis, and was admitted to the hospital. ]
Carvey didn't ask them how to deal with it, because they can't do it now, and everything still needs to start from the basics: "Maybe it's different from the content of the theoretical courses in your medical school. The first thing must be communication. It runs through your entire career as a doctor, whether it is with your colleagues or patients, you need to communicate with each other.

Now this patient is admitted to the ward under your management, because Dr. Guyon was the first to see her. Professor Sedieu, who has never seen the patient, wants to inquire about her condition. Who can be in charge of reporting? "

Reporting is naturally different from blackboard writing, and verbal review cannot be done verbally, so the key lies in how to draw a clear and complete "picture" of the patient in a short time.

Raise your hand first to make a mistake that many interns are used to: "I will describe her as [a person who suffers from mild hysteria, has eaten some unclean food, has a small amount of diarrhea without vomiting, and has abdominal pain for two days. An 18-year-old female patient who failed treatment with herbal enemas and antimony].”

Carvey frowned slightly, but still gave affirmation: "Basically, it is simple, but not enough."

After being inspired, the second person condensed the report: "How about an 18-year-old female patient who had abdominal pain for two days, had diarrhea without vomiting, and herbal enema and antimony were ineffective?"

"It's been streamlined well this time, but there are still problems."

In the eyes of medical students, this "medical history + signs" reporting mode is a good form of expression.

But in clinical practice, this model is not the most effective way of verbally conveying messages: "Your task is to extract and summarize the key content in the medical history and signs, and you cannot be immersed in describing the complicated medical history and details. It needs to be streamlined. Of course, in streamlining Sometimes it’s not for the sake of simplification, over-simplification will ignore some important content.”

Carvey drew a few circles on the medical history blackboard just now, focusing on abdominal pain.

"How many times have I mentioned abdominal pain?"

"three times."

"Does this mean that Dr. Guyon, who wrote the medical history, also believes that abdominal pain is the main reason for seeing a doctor? Shouldn't you highlight the diagnosis of abdominal pain in your report, and then" Carvey underlined "aggravation", "Have you thought about it?" But why did Dr. Guyon take abdominal pain as the main cause?"

That's when the students realized they were missing key information.

"If it were me, I would delete some useless information like you, such as the two internal medicine diagnoses in the middle." Carvey said, "But when expressing, you need to put the focus in advance."

[Patient female, 18 years old, developed abdominal pain two days ago and progressively worsened.]
"These are important information related to the diagnosis, and it is easier to stimulate the nerves of the person who receives the information and frame his thinking if it is placed in the front." Carvey explained, "After this sentence appeared, Professor Cedieu's thinking It’s basically synchronized with Dr. Guyon. He only considers the situation related to abdominal pain, and he will explain other information related to abdominal pain at this time.”

[Had mild constipation, no vomiting, herbal enema and antimony did not work. ]
When Carvey was telling the medical students the reasonable and efficient way of reporting the medical history, the main palace hospital at this time had already started to prepare for the operation in the afternoon.

The location was still chosen in the Second Surgery Theater, Shanwang continued to be in charge of blood preparation, and Albaran, who had helped prepare before, was squeezed into the preparation area by Kawei's three assistants.

The ratio of normal saline, the dosage of sodium citrate, oxytocin and methylene blue, tourniquet, suture needle and thread, scalpel, hemostatic forceps, gauze, and even masks and gloves need to be prepared in advance.Cesarean section is all about speed, and any mistakes will prolong the operation time and increase the chance of failure.

"The ether and mask are all in place, check for air leaks."

"There are less hemostats, two more."

"Tourniquet! Why is there no tourniquet?"

"Is there an abdominal dilator here? If not, bring two more retractors here."

The doctors repeatedly checked the preparations in the theater, and the two accompanying nurses would also send the mothers who received the first cesarean section to the preparation room in advance.While reassuring her, he cleaned around the abdomen as Carvey asked, and then emptied her bowels again.

All of this seems to be going on step by step. The operation time, venue, equipment and medicine, anesthesia, and the physical condition of the parturient are also determined. As for the chief surgeon, it is even more certain.

Looking at the whole operation, the only thing that is uncertain now is the child in the mother's womb.And this only point of uncertainty quickly developed into a ticking time bomb in the preparation room.

"Nurse, me."

"what happened?"

"I feel my stomach throbbing, obviously throbbing!"

The nurse didn't care about it at first, and it's very common for the uterus to contract occasionally, as long as it doesn't form a regular pattern.But when she lifted the quilt to check the twitch, the bright red between her legs caught her eyes.

　The medical history report is a bit boring. I didn't want to write it at first, but considering the popular science nature of the book, introducing the key points in the report is also beneficial for readers to seek medical treatment, so I will waste some space.

　　
　
(End of this chapter)