The road to the rise of great doctors

Chapter 34: Practicing medicine requires caution
In the morning, the Affiliated Hospital of Medical College looked vibrant under the sunlight and the bustling flow of people.

In this vibrant vitality, people laughed, cried and shouted, expressing their joy, fear, helplessness, anger, sadness and determination.

In the urology ward, under the leadership of the medical team leader and deputy chief physician Wang Peng, Zhu Guoliang and Liu Dong followed closely, forming a sharp arrow.Like the Lion King on the grassland, leading his subordinates to patrol the territory.

Every time he arrives at a new hospital bed, intern Liu Dong first hands over the corresponding medical records, and then verbally reports on the condition, the treatment received, and the subsequent arrangements and precautions.Zhu Guoliang will make up for any deficiencies.Wang Peng asked a few questions and put forward some of his own opinions from time to time.

On days other than ward rounds, the medical team leader basically answers questions and provides overall control to lower-level doctors. In addition, he also needs to meet with the patient and his family to comfort the patient's anxiety after getting sick. , helplessness and complex psychology, answer their questions from the perspective of the surgeon.Every time at this time, Liu Dong would think of that sentence and gain a deeper understanding: "Occasionally heal, often help, always comfort."

Grand rounds are completely different from ordinary rounds.The frequency of grand rounds varies in different departments. In clinical practice, the frequency is more often once a week.

Every ward round is a day of anxiety for Liu Dong and other interns, as well as residents and attending physicians.The day before the big rounds, the middle- and lower-level doctors in these medical circles will check every medical record in charge again, and will also carefully memorize the diagnostic points, test results and precautions of each patient.In a sense, the grand ward round is a "staged test."

During the ward rounds, the team is usually led by the department director, and sometimes retired old professors will participate. Every time they go to a bedside, the intern doctor respectfully hands over the medical record, and then reports the medical history, diagnosis, and treatment without writing. Plans and precautions, and the medical team leader, department director, and old professors will find "loopholes and knowledge points in the report" and then ask questions. If the intern cannot answer, the resident doctor will supplement it. If the resident doctor cannot answer, then the resident doctor will ask questions. The attending physician will make the supplement. If the attending physician cannot answer, the medical team leader, department director or senior professor will comment.Grand rounds are the most comprehensive moments for doctors in a department. Just imagine how embarrassing it is to be speechless when being asked in public when so many superiors, subordinates, and colleagues are watching.

Medicine is a profession that advocates science and technology.No matter how high your position is, if your medical skills are poor, it will be difficult to win respect!
But grand rounds are also a day that interns and residents look forward to during their growing years.Because this is the moment for each chief physician and deputy chief physician to use their knowledge to demonstrate their strength and influence.The way to show your strength is to share knowledge and experience. Just like "the cook explains the cow", the knowledge points of each disease are clearly stated in an easy-to-understand language, and some rare things in the medical field are explained. , rare complications are pointed out, and the knowledge points gained at this time are not as systematic as those from systematic reading of monographs and literature, but it is the form that most doctors absorb the most.And "expanding skills" is something that every doctor regards as a treasure.

Liu Dong's medical team did not arrange any surgery today, so he was temporarily free after completing dressing changes and medical instructions.

He reported to Zhu Guoliang and rushed to the operating room.Today, he's going in for long-awaited adrenal surgery.Liu Dong had previously obtained the permission of the surgeon Song Dachuan and the "exchange" of classmate Shan Jiajia.When you arrive at the operating room, go straight to the operating room where the adrenal patients are.

In today's operating room, Song Dachuan scheduled a total of three adrenal surgeries. The patients' diseases were adrenal Cushing's syndrome, adrenal pheochromocytoma and large non-functioning adrenal adenoma.

When he walked into the operating room, he saw Song Dachuan already waiting in the room.Unlike other surgeons who have to wait for anesthesia to begin before coming in, he comes in advance every time to carefully check the location of the disease and the results of preoperative preparations.He is mature and steady. He has heard and seen too much, and this is how he developed his cautious habits.

He turned around and saw that Liu Dong was coming over.He still liked Liu Dong, a young man who was diligent and not afraid of hardship, so he couldn't help but want to make some suggestions. "Why do we need a three-party check before surgery? Why do we need to check multiple times?" Song Dachuan asked Liu Dong.

Liu Dong replied immediately without thinking: "The overall reason is for safety. It is necessary to ensure that the information of the patient receiving treatment is accurate and not to mislead the person. This is especially important for bilateral organ surgeries."

"Yes, there is nothing trivial in medical treatment. Only by being serious can you avoid making mistakes. As the saying goes, Zhuge was cautious in his life. We must follow suit so that we can avoid medical accidents in our life."

Seeing that the anesthesia hadn't started yet, Song Dachuan couldn't help but sigh with emotion: "There are too many lessons learned from the past, not to mention those who left out gauze and surgical forceps in their stomachs. Some big-name experts are busy every day and leave the checks to others. It also happened that the wrong kidney was cut and the reputation plummeted. The patients suffered undue harm, and they also paid a painful price. These are worthy of our deep thinking."

Liu Dong gave Song Dachuan a thumbs up.He himself felt the same way. In addition to being cautious in the process, to practice medicine, you have to check the first-hand information yourself, have your own independent judgment, and you can't copy what others say.

In order to learn more, after finishing the gossip, Liu Dong pointed to the computed tomography film and asked: "Director Song, are today's operations all laparoscopic? Is this the choice?"

Song Dachuan glanced at Liu Dong, smiled, and then said: "Look, the adrenal gland is located in the upper inner part of the kidney, and its size is relatively small. The size of adenoma is even smaller. When it needs to be removed after resection, the incision does not need to be too long. And the adrenal gland The surgery can be done through the retroperitoneal approach, and laparoscopy can be used to see more clearly. Therefore, laparoscopic surgery is very well accepted by doctors."

Liu Dong nodded to express his understanding.

Song Dachuan continued: "But sometimes open surgery is also needed, and open surgery is a no-brainer. For those who have had surgery before, there may be adhesions in the surgical area; some hospitals in some places do not have laparoscopy; some doctors have never done laparoscopy, so they must use The method he is most familiar with ensures safety. Some adenomas are not found after laparoscopic exploration. Don’t think it is impossible, because the film is like seeing flowers in a fog. It seems that you can see clearly, but once the body position changes after going in, the position may also change. ”

"We have also encountered cases where a computed tomography scan looked like an adrenal adenoma, but in the end it was found to be an extragastrointestinal stromal tumor. Why, when he was lying down during the imaging examination, the tumor looked like an adrenal gland growth. . However, during the operation, I was lying on my side with my waist elevated, so I couldn’t find anything in the retroperitoneal cavity. It was only later that I discovered that the extragastrointestinal stromal tumor was on that side of the peritoneum.”

(End of this chapter)