Oncology Physician Life

Chapter 53

On Monday morning, the oncology department turned over.

From seven o'clock, in the preparation room outside the ward area, more than 30 residents, interns, and regular training doctors, all wearing white coats, stood neatly inside. There is no shortage of people. Even if you ask for personal leave, you must ask the department director afterwards to explain the reason for your absence.

Wei Chen and Tan Tan are the leading doctors of two intern teams.

Xu Youshu, like other interns, has been preparing for today's handover since yesterday, because this is also a concentrated inspection by the department director.

The director of the department will randomly ask questions about the conditions of the patients in the ward, and sometimes even ask the interns to answer the questions in English. If they can’t answer the questions, they will be scolded by their own doctors at least, or they may leave a bad impression on them. , when the internship results are not satisfactory, it will be difficult for people to stay.

At a quarter past eight, Qi Song, the director of the tumor surgery department, walked in with a group of third-line professors and associate professors. Only one of them was at the level of deputy chief physician, and it was difficult to get together on weekdays.

Head nurse Sun handed over the list of wards to be checked to Qi Song. He simply flipped through it, and looked up at the young team in front of him. The youngest intern was not even over 25 years old, and he was an exchange student from Fudan Medical College. At the age of 16, he studied in a medical university majoring in molecular tumors. At the age of 20, he was recommended to Hokkaido University in Japan. It is also one of the seven imperial universities in Japan and is well-known in the field of international medicine.

You must know that the graduation thesis of Imperial University of Japan is not as easy and simple as it is in China. From the year before graduation, students have to follow their tutors to participate in various national and even international academic conferences. Before graduation defense, they have to go through 12 years. Rounds of actual combat, until you stand on the graduation defense podium, and there are 55 full professors sitting under the stage, asking you questions in turn. If you are lucky, you may only need to answer more than a dozen questions to pass smoothly, but most of the process is very difficult. difficult.

Moreover, some professors in Japan are not so friendly to Chinese students. There are various complicated reasons. Among them, some exchange students who came to Japan to study did not choose to return to China after graduation, but stayed in Japan. Some Japanese professors would be disgusted by this.

The original intention of the exchange students is to help the other party cultivate talents, but if you don't go back after you finish your studies, the other party will think that your moral character is flawed.

So this intern who returned to China at the age of only 25, when Qi Song saw that he came back from Hokkaido University, he was relieved and couldn't help showing a touch of surprise, if he found a treasure.

This tall intern boy is called Shu Yusheng, a very elegant name.

Qi Song rarely asked him about medical problems, but asked curiously: "Shu Yusheng, I want to know why you came back to China. And came to our hospital? I heard that not only the best hospital in Japan opened I want to hire you with a high salary, and even the Scripps Research Institute in the United States has offered you an olive branch. I think as long as you are a medical student, no one can refuse Scripps? After all, the other party has ten Several Nobel laureates."

Shu Yusheng was questioned face to face by the director of the department. He didn't feel flustered at all, and even smiled a little. He smiled very nicely, giving off a gentlemanly look, with two dimples showing on his cheeks.

"The reason is very simple. When I was in Japan, I met a Chinese patient who traveled across the ocean to see a doctor. He was suffering from pancreatic cancer. The domestic doctor judged that he had only three months to live. Here, he used Novartis’ latest anti-cancer drug on the market, and the cost of the drug was 75 yuan a month. Coincidentally, I met the same Chinese patient suffering from cancer, but the family conditions of the other party did not allow him to use it. Such an expensive drug, so I can only leave disappointed."

Shu Yusheng paused for a moment, then looked up at Qi Song: "This matter touched me deeply, and it was also one of the main reasons why I returned to China. It’s just a generic drug, so for those cancer patients, their lives will go on a different path. Medicine has no borders, but I think, as a doctor, there are borders. My parents also want to repay the motherland who makes my homeland hard to leave, so I am back. I believe that as long as more and more medical students like me choose to return to China for development, our domestic medical level will always have the kind of flourishing. one day."

Qi Song glanced at the professors behind him who were smiling with relief and admiration, and laughed out loud: "Unexpectedly, a patriotic and ambitious young man came to our tumor surgery department. The young man has ambition."

Shu Yusheng's generous and ingenious answers made other interns in the stratosphere even more nervous, like a shark running into a fish pond.

However, Qi Song didn't leave the right to ask questions to himself today, but handed it to Ji Han who was beside him: "Today, let us use a swollen knife to test you."

The team of interns was immediately on standby. The "Satan" doctor was not Qi Song. Some of them had a deep understanding of the other's coldness. Tan Tan still remembered that Ji Han always liked to ask tricky and weird questions when asking questions.

All eyes fell on the face of the elegant and upright professor of surgery with gold-rimmed glasses.

Ji Han glanced casually across the crowd, and landed on Shu Yusheng.

Shu Yusheng obviously also noticed that the other party was looking at him, without the slightest timidity on his face, and even took the initiative to meet Ji Han's gaze.

Ji Han's faint voice floated out: "If a patient suffers from glioma, and the tumor compresses and infiltrates the brain tissue, what kinds of focal symptoms will occur? Shu Yusheng, you answer."

"Glioma?" Shu Yusheng was stunned. He didn't expect the other party to ask about central system neuroma. This is his undergraduate major. He remembered seeing a few cases when he was reading medical records. After thinking for a while, he answered slowly. : "In the early stage, the patient will have irritation symptoms, such as focal epilepsy, and in the later stage, there will be neurological deficit symptoms, such as paralysis."

Ji Han glanced at him: "Be specific."

Xu Youshu was at the side, his heart was in his throat. Fortunately, this question was not asked to himself, but to be more specific, he couldn't answer it.

Shu Yusheng pursed his lips, suddenly remembered, and said with a smile: "If the tumor occupies the frontal lobe, the patient will have motor, language expression and mental activity disorders, such as personality changes, apathy, inattention, memory loss and other symptoms. .”

"The tumor occupies the parietal lobe, and the patient has central sensory disturbance!"

"The tumor occupies the temporal lobe. Patients may experience epilepsy, visual hallucinations, visual field defects, and sensory aphasia in the main hemisphere. Epilepsy can be an early symptom."

"The tumor occupies the occipital lobe, and the patient will experience visual disturbance."

"The tumor occupying area is in the insula, and patients will have visceral nervous system symptoms. The occupying area is different in different parts of the brain, which will affect the brain's control of various sensory functions of the human body."

Shu Yusheng answered in one go, and the eyes of all the interns fell on his proud face.

Qi Song raised his eyebrows, thinking that this kid might suffer disaster, and Doctor "Satan" would not let him off so easily.

Sure enough, Ji Han looked up at him and added, "What's the latest change in the diagnosis of glioma?"

"The latest change?" Shu Yusheng's tone froze when asked.

Ji Han didn't change his face: "You are studying tumor molecular science, CNS (central nervous system) tumors, it should be that in 2016, the WHO classified this type of CNS tumors separately into the diagnosis of CNS tumors in the molecular era, you should not know .”

Shu Yusheng suppressed the smile on his face and lowered his head: "I forgot."

Ji Han looked at the other interns, and said the answer: "IDH, H3K27M, go back and check, next time you see me, tell me the meaning of these two English terms."

Shu Yusheng nodded, and silently recited these two English nouns, thinking that he would check the textbooks when he got back.

Qi Song gave Shu Yusheng an encouragement, turned around and led them to the ward.

It just so happened that the nurses of the Department of Nuclear Medicine sent the genetic test reports of the 8-bed patients to the ward.

The 36-page report explained that a group of doctors read it in turn. Xu Youshu glanced at it and only understood the words "lung cancer", "gene", and "heterozygous polymorphism".

The genetic detection technology was only introduced into the country in the past two or three years. For this reason, the department sent several doctors to study abroad for half a year. Ji Han was one of them.

He showed the final result page of the report to the intern and explained: "The human body has many gene sequences, as many as tens of thousands, but among them, there are only a few hundred genes that cause cancer. Only when these genes mutate, people will may suffer from neoplastic disease."

Coincidentally, Jiang Li was going upstairs to prepare for the craniotomy in the afternoon, and when he passed by the ward, he met the head of the oncology surgery ward round, so he simply stood beside Xu Youshu and Tan Tan to observe, and heard what Ji Han said .

Jiang Li curled his lips, and whispered to Xu Youshu: "Smell, it seems like someone doesn't understand."

Xu Youshu touched his nose in embarrassment: "But I really don't understand."

Ji Han heard Jiang Li's voice in the crowd, and casually glanced this way, his gaze behind the gold-rimmed glasses on the bridge of his nose was very piercing.

Jiang Li stuck out his tongue.

Ji Han continued to explain on his own, his voice was very calm, but he was not angry: "The patient's gene points are normal, except for the non-frameshift insertion mutation in exon 770 of D20delinsDG in the EGFR gene, so it is basically certain The patient had EGFR-type small cell lung cancer, combined with the analysis of the patient's PET-CT film, it can be determined that it is a malignant tumor with a high incidence of bronchial mucosa."

Qi Song nodded, "So, after the operation, the patient can completely use EGFR-TKI or osimertinib for drug treatment."

Ji Han nodded: "Yes, these two anticancer drugs have more than 70% effect on this type of tumor."

Qi Song turned around and saw Jiang Li who was hiding behind the crowd, and said with a smile, "Where is Professor Jiang going?"

"Hello, Director Qi," Jiang Li nodded, "I happened to have a 5-year-old glioma patient here this afternoon. He needed a craniotomy and was planning to go upstairs for preoperative preparations."

"A five-year-old glioma patient?!" Qi Song frowned, his eyes fell on the crowd, and he said suddenly, "Professor Jiang, we just have a few new interns here, and one who came back from Hokkaido Can you take this opportunity to let our children observe this operation up close?"

Jiang Li agreed without even thinking about it: "No problem, then Director Qi, tell them to change into the sterile clothes before [-]:[-] p.m. and wait for me in the operating room."

Qi Song hurriedly said to several interns: "You are lucky today. You can watch Professor Jiang's surgery up close. You should be able to use the Da Vinci surgical robot, right?"

Jiang Li nodded: "If I cut it, I would go to Da Vinci."

(End of this chapter)