Path of Medicine With a System

No matter how hard it is, the disadvantages of poor English are still reflected. Basically, I have passed several rounds in the past two years, but there is really a difference between self-study and teacher teaching. If there is something you don't understand in college, you can ask the teacher. And self-study is not enough, you can only explore and make up your own brain. But self-study is also good, that is, deep understanding and strong personal insights.

Not to mention English, there is a lack of environment, and Zhang Fan has never paid much attention to this thing. After two years of smooth sailing, the director of endocrinology, Di, suddenly woke up with a basin of cold water. A college student, an ordinary college student, who has a car and a house in less than two years, should be proud, but is Zhang Fan ordinary? It's not ordinary, so at this moment Zhang Fan hastily threw away the little bit of pride that had just sprouted, there is still a long way to go!

Endocrinology is too complicated, a disease is a research direction, and it is a department that is both integrated and scattered. Breathing, digestion, and the heart are all conditioned and continuous from top to bottom, and the knowledge points are coherent and interrelated, but endocrine is not, jumping, and each secretory organ has its own set Run programs, and functions. It can be said that an organ is actually a separate subject.

Although the journal Director Di gave Zhang Fan is not a top-ranked journal in the world, it still has a professional depth in endocrinology, and Zhang Fan has no time for half of it. Language is really a stumbling block for a subject. Zhang Fan spent three-sevenths of his time translating, and not much time for studying. The study of foreign language books and periodicals this time finally made Zhang Fan make up his mind to conquer English!

On the weekend, Zhang Fan and Shao Hua finally found time to go shopping for three or four hours, "You are working too hard, you don't usually drink tea and coffee, but I found out yesterday that the coffee and tea leaves I bought for you were gone. More than half of it! This is really not good, you are a doctor yourself, you should be very clear."

"Time is a bit tight, and the journal is all in English. There is really no way, hey! I regret it!"

"What's wrong?" Zhang Fan successfully diverted Shao Hua's attention away. He also knew that this was not good, but what could he do? This is not a matter of competing with anyone, but Zhang Fan competing with himself again!

"Back then, I took medical English as an elective in college. I didn't study it on purpose. As a result, I didn't even find any professional information books. This medical word is too ridiculous. Sometimes there are only two words in a paragraph, and these two words can't be looked up. to the appropriate translation!"

"Then what should we do?" Shao Hua snuggled into Zhang Fan's arms, the weather became colder, and the relationship between the two became more and more intimate. Now Shao Hua could barely agree to Zhang Fan's touch, cough cough cough! Please fill in the details!

"There is no good way, I can only check the information little by little. How is your recent review? Don't put too much pressure on yourself, take the test if you can, and forget it if you fail the test. I can still support my family. " Zhang Fan smelled the fragrance of Shao Hua's hair, a faint smell of lavender.

Lavender,

It is usually said on TV that the Netherlands is still Finland, and there are large patches of lavender that are particularly beautiful. In fact, that’s because the photographer’s level is high. The real large area of ​​lavender is located in Chasu City, with thousands of acres of lavender planting base. Every year when lavender blooms, the blue-purple flower fields blow by the breeze, like waves in a sea of ​​flowers. , wave after wave, wearing a white dress and a light yellow straw hat, standing in the sea of ​​flowers is super beautiful! Shao Hua has such a photo, which is extremely beautiful. People support the scenery, and the scenery presents people. The mountains and rivers in the frontier are so beautiful!

I don’t know the quality of lavender essential oils and essences in the mainland, but the ones in Chasu City are good. Perfume consumption in the surrounding Stan countries is particularly large.

Especially in recent years, Huaguo's national strength has improved, and businessmen who go abroad to do business have gained a lot of confidence. The lavender essence in Chasu City directly beats the Russian essence out of the five countries of Stan! Never even thought of this kind of thing before!

When you are in the interior, you can't feel the strength of a country, but you can understand how powerful the country that protects you is when you are in the border. A large number of products are sent abroad from the port, and the five countries of Stan can only exchange with natural minerals.

Zhang Fan didn't know much about other products, but Zhang Fan knew a little about medical treatment. Even the most basic sugar and salt water in the five countries of Stan are imported from Hua, not because they cannot produce them, but because Hua is cheap! The country is slowly infiltrating, the economy comes first and the culture comes later!

The girls in Chasu City more or less use things made of lavender, such as pillows, quilts, and sachets. The most peculiar thing is that there is a young man in Chasu City, who even serve pollen when entertaining distinguished guests.

When Zhang Fan ate pollen for the first time, he thought it was sesame. This pollen looks very similar to sesame. Take a hot bag, dip it in ghee and then dip some pollen. When you eat it, the taste is different from sesame, the aroma of oil Mixed with the scent of pollen, it is very delicious, the more you chew, the more delicious it is.

"Don't worry, there is no pressure. Just flip through the books casually and maintain a coherent professional knowledge thinking. There should be no problem signing up for the exam next year!" Shao Hua said proudly.

Reading and studying should emphasize hard work, hard work and learning methods, but sometimes I have to admire some people who are talented in learning. The efficiency is really too high. Zhang Fan has no talent in learning, but his liver is good!

After resting for an afternoon on Saturday, Zhang Fan's weekend was over, because he had to go to the county for surgery on Sunday, and this time he didn't need to go to a far-away county, just a few nearby counties. Elective surgery is generally performed laparoscopically.

In the past, county hospitals could still perform operations on the appendix and gallbladder. Since the popularity of laparoscopy, these county-level surgeries have almost no operations. As soon as the patient heard that he was undergoing laparotomy, he left immediately without being transferred to another hospital.

I had surgery in the county town in the morning, three surgeries in one morning, and it was already after two o'clock in the afternoon after I finished, I didn't even drink my saliva, so I hurried to Chasu City, because Wang Yongyong was going to be discharged from the hospital today. He is recovering well. After all, he is still a young man with a vigorous body. Zhang Fan is going to explain some recovery matters, and then do a physical examination for discharge. After all, athletes are different from ordinary people. Their injuries are more serious.

Although I can't use force now, the swelling has subsided. Wang Yongyong sat in a wheelchair and thanked Zhang Fan and Ma Wentao. Now is not the time to shoot commercials, but all the early photos have been taken for comparison with the restoration. Ma Wentao's years of studying abroad are not in vain.

On Monday, the big rounds of the endocrinology department began. All the doctors, interns, trainees, transferees, and in-patients, started ward rounds under the leadership of the director and several deputy senior officials. This moment is the moment that Xueba looks forward to, and the moment that Xueba is most worried about. Check each ward by ward.

"Six-bed, male, 22 years old. With unexplained polyuria, he was admitted to the emergency department of our hospital, and then transferred to our department. After a thorough examination, the patient was initially diagnosed as diabetes insipidus." The doctor in charge of the six-bed bed Introduce the condition to the doctors who make the rounds.

"Wang Xiaoyan, go and give this patient a physical examination." Director Di started the exam. Wang Xiaoyan, a graduate of Tianjin University School of Medicine, didn't know why she didn't go to graduate school, but her foundation was solid, and her results in the medical license examination last year were only about 50 points lower than Zhang Fan's.

Examination, pay attention to a sequence. From top to bottom, from front to back, a clueless physical examination is not only easy to miss the system to be checked, but also easy to toss the patient. Therefore, a qualified physical examination should be paid attention to, rather than sticking to the books.

Wang Xiaoyan was skillful, and reported while checking, "The patient's pupils are equal in size and round, and there is no obvious abnormality. There is no obvious swelling of the neck lymph nodes, no obvious abnormalities in the heart and lungs. There is no tenderness and rebound tenderness in the abdomen, and no obvious abnormalities in the lower limbs. See obviously abnormal." After about five minutes, the inspection was over.

Director Di nodded, very standard and couldn't find any problems. When Wang Xiaoyan returned to the team, she took a special look at Zhang Fan. This was not a provocation, but a competition, a competition of skills, and a competition of spirit.

"The thirst center is that organ." Director Di turned his head and asked another male doctor who transferred to another department. The male doctor has not yet entered the state, and this question is too biased, although these particularly biased questions will not be tested in the exam.

But this is a hospital, and what we are dealing with is people, not machines. Negligence of a problem may cause irreparable damage to the patient, and the human body is a whole. Learn and understand, maybe you will encounter this kind of illness with rare knowledge points that day.

"Eh! I'm sorry, I don't know." Director Di is slightly better than Ouyang, but it's a bit hurtful. She will ignore the junior doctors she doesn't like.

"Well, go down and read the book." A simple sentence, didn't say anything about this doctor, and didn't punish him for criticizing him, but this male doctor who transferred to another department felt worse than being punished~! The same young people, the same graduates, also hope to get the attention and attention of the superior doctors.

Failure after work, failure in different schools, you can come back if you fail in school, and there are make-up exams! And after going to work, a failure may be a lost opportunity, and he has no second chance to switch to endocrine, so failure should be early!

"Doctor Zhang, tell me." Director Di turned to look at Zhang Fan.

"Hypothalamus."

"The patient's urine is of that nature, how to rescue it."

"Hypotonic. Hydrate, antidiuretic and hormone therapy if necessary."

"There are currently several theories on primary diabetes insipidus." Director Di continued to ask, this question is beyond the scope, let alone transfer doctors, even if you don't study hard, you may not be able to talk about endocrinology. .

This is the difficulty of internal medicine. The predisposing factors or causes of many diseases have not been studied clearly, and the internal medicine specialists of major hospitals will make a guess or hypothesis about this disease.

Then clinical doctors, based on the ideas of these masters, will go to the corresponding treatment, because the reason why these hypotheses are called hypotheses is because they are not universal or they still have uncertainty.

In scientific research, you can slowly experiment one by one, and study one by one, but it is not possible in clinical practice. The patient is already lying on the hospital bed, and there is no time for you to study. You have to treat others.

so what should I do now? This is the time for the doctor to consider which theory the patient's symptoms are more similar to when using these hypotheses to target medication. Although an experienced doctor can't determine the cause, he can treat the symptoms according to the symptoms. Even this kind of technology that cannot be treated by the cause requires a doctor to ponder and study for more than ten years to have this skill.

"Professor Jerome P. Kassirer of the Massachusetts Medical Society (Massachusetts Medical Society) once proposed three theories. Chinese experts have subdivided these three theories. At present, the mainstream theory is three items and five items, generally the third one. AVP (antidiuretic hormone) deficiency is the main mainstream." Zhang Fan replied.

This is the knowledge that Zhang Fangan acquired after a week. Not to mention internal medicine books, this knowledge may not be available even if he reads the textbooks for graduate students. After all, this has already transitioned from clinical to laboratory.

"Listen to your spoken English. It's too bad. If I hadn't listened carefully, I would have thought you were speaking Russian." Although it was a criticism, Director Di said it with a smile. She could see that Zhang Fan was going tried. This knowledge point, if you don't study it seriously, will definitely be ignored, because it is too small.

After Zhang Fan finished speaking, Wang Xiaoyan bit her lip, because she didn't know this knowledge, it wasn't that the director was biased, but that the director wanted to weigh Zhang Fan, Zhang Fan was already very famous among hospital directors.

Continue to check the wards, everyone. Interns and trainee doctors don't have a lot of pressure, because the director is easy to talk, even if he can't answer, he doesn't say anything! They haven't realized that this is an opportunity. If they perform well, it will be very helpful for employment in the future. It is estimated that most of the students who gave up Bird City and came to Chasu City for internships and trainees plan to come here to work after graduation.

The most stressful ones are those transfer doctors who want to stay in endocrinology. There are not many opportunities, and if you fail to grasp them, you will lose them. Life is only a few key steps. If you take the right steps, the future road may be smoother.

One morning passed, Zhang Fan and the few transfer doctors who wanted to stay in endocrinology didn't feel that the time passed so quickly. Director Di's question was too tricky, not only did he need a lot of basic memory, but he also had to have his own ideas.

What can a transfer doctor who has just been employed for two years think! But this old lady can detect whether you have intentions from a little bit of your thoughts or opinions.

It was too difficult, Zhang Fan and a few people racked their brains to answer the questions, so many questions were vague, this endocrine is really too difficult.

The last patient's ward round was over, Director Di was standing at the end of the corridor, surrounded by a group of people in white coats, tall or short, male or female, who were about to conclude.

"In our department, the most frequent patient is diabetes, and insulin is the most closely related to diabetes. Who will tell us about the pancreas today? Teach us a lesson, and don't come up if you are not sure." Director Di said standing in the crowd, she This is obviously fanning the flames.

After several hours of ward rounds, Zhang Fan and Wang Xiaoyan were the most outstanding performers. They didn't make any major mistakes, so they were evenly matched. Wang Xiaoyan has an outstanding personality, is good at studying, and has a strong personality. In the field of internal medicine, she must suppress Zhang Fan, a surgeon. This is not about people, but an attitude and a spirit. A group of internal medicine transfer doctors let an appointed surgeon show off his power in internal medicine. Others don't know how it feels, but she can't stand it.

"Director, I'm coming!" Wang Xiaoyan took a look at Zhang Fan and stood up.

"Well! Alright, let's talk about it from Dr. Wang." Usually it's Xiao Wang, but now it's Dr. Wang. At this moment, Director Di has approved Wang Xiaoyan, and Wang Xiaoyan has already gained a position in endocrine! This is the characteristic of technical units, technology speaks.

Director Di took a look at Zhang Fan when he stepped aside from seat C. Zhang Fan's personality is very contradictory. He can burst out with endless courage when he can't retreat, but he doesn't like to show off very much at ordinary times. This is his character, there is no good or bad.

Director Di’s question is very broad. What is the pancreas? If a knowledgeable endocrinologist were to talk about it, one day would probably not be enough. In terms of strengths, Wang Xiaoyan's focus and strengths are the biochemistry, pathology, and physiology of islets.

"The pancreas is a complex and simple organ. The main tissue cells of the pancreas are composed of Langerhans cells and tissue groups~~~" In 20 minutes, Wang Xiaoyan explained the pathology and physiology of the pancreas thoroughly. , Can explain the function and structure of pancreatic tissue so clearly.

"That's right. It's very concise but it can show us the world of the pancreas. Not bad." After speaking, Director Di looked at Zhang Fan who was opposite him and said, "Doctor Zhang, go up and talk about it too. Tell us about your experience with the pancreas." understand."

Wang Xiaoyan looked at Zhang Fan with provocation and expectation in her eyes. She also wanted to hear what Zhang Fan had to say about the pancreas indirectly, and most importantly, she had finished the basics of the pancreas, so she didn't know what Zhang Fan was going to say.

"He won't repeat what I said again!" Wang Xiaoyan was a little proud, after all, she was still a young man.

"Ah!" Zhang Fan really had nothing to say, Wang Xiaoyan explained it very well. Zhang Fan opened his mouth to say: When Dr. Wang spoke very comprehensively. He saw Director Di's expectant gaze and Wang Xiaoyan's provocative gaze.

Zhang Fan gritted his teeth and went up. When she crossed paths with Wang Xiaoyan, Wang Xiaoyan said quietly: "Pick up people's teeth."

Zhang Fan ignored her and didn't care about the little woman! And Zhang Fan didn't intend to repeat what she said, there's no need, since he came up, if he doesn't put something out, is he still a man!

"Dr. Wang spoke very well and taught me a lot. Dr. Wang's microscopic understanding of the pancreas is quite thorough. I don't have anything to add, so let me talk about macroscopic things." Zhang Fan said.

After saying this, other people didn't have any idea, but Wang Xiaoyan felt a little uncomfortable, "You actually said that my vision is narrow!"

Director Di also looked forward to Zhang Fan with interest. Some interns and trainees below were a little impatient. It was very simple. Wang Xiaoyan said something knowledgeable, but they couldn't understand it!

"The pancreas is located deep in the abdomen and cannot be touched from the surface of the body. It is inside the duodenum in a C-shape, and its tail extends to the left close to the spleen."

"Who doesn't know about anatomy!" Wang Xiaoyan was a little disappointed. Ordinary people in Xueba's world are incomprehensible. She expects Zhang Fan to perform extraordinary, but she does not want Zhang Fan's performance to surpass her.

After a brief introduction, Zhang Fan began to introduce the anatomy of the pancreas in detail. From the normal course of the vessels to the abnormal course, from the opening of the pancreatic duct to the special variation of the bile duct and the pancreatic duct, Zhang Fan explained in detail.

Not only Wang Xiaoyan was surprised by this statement, but even Director Di looked at it with admiration. Zhang Fan's explanation is too detailed. Come here with your own hands, too skilled.

Of course you are proficient, how can you not be proficient in general surgery after more than a year! Now it is more than enough for Zhang Fan to go to the university and give anatomy classes to the students. That’s not enough, after talking about normal functions, Zhang Fan continued to talk about some special features of abnormal functions, including how to treat them.

The best treatment for abnormal shape is surgery. Taking medicine is useless for the shape of the organs that have been established, so Zhang Fan began to show off involuntarily. Zhang Fan, who is rarely like this, can't stop the car.

First of all, what Wang Xiaoyan said was very good, and then Zhang Fan experienced a lot of endocrinology after a week of liver, so he couldn't help it. He wanted to combine the knowledge he learned in the system with his own experience.

Talking and talking, there are not many people below who can understand. Continue, "When pancreatic endocrine tumors show cachexia, there are three ways to remove them during surgery. One is~~~~" This is completely incomprehensible, even Director Di can't understand , because of the difficulty of this operation, not to mention in Chasu City, even in the capital, few people can do it.

Zhang Fan was so excited, he was so excited, he integrated his experience into the knowledge of the system, and those vague knowledge points in the past suddenly seemed to be stripped of the veil. We met naked.

This is improvement, an improvement of the self, which is better than the improvement of the system blessing. After all, the most powerful human brain is fuzzy thinking, and this way of thinking is very suitable for exploring unknown knowledge.

Once the foundation is solid to a certain extent and the quantitative change reaches a qualitative change, this is a qualitative improvement. With regard to the understanding of the pancreas, Zhang Fan can already be said to be a master in pancreatic surgery.

Talking about sex continued, Zhang Fan ignored the time and place, half an hour, an hour, two hours passed, and Ren Lina, who had undergone many years of standing training, couldn't stand up anymore.

Although I don't understand Zhang Fan's point of knowledge, I can tell that this is not nonsense. What is an intellectual, the most basic thing is to respect knowledge. At this time, no one will bother Zhang Fan. If there is a pancreatic surgeon When you hear it, you will definitely be astonished.

Finally, two and a half hours later, Zhang Fan finished speaking, and then suddenly felt something, and looked at everyone with embarrassment on his face.

The doctors including Director Di were also embarrassed because they didn't understand! Director Di coughed, cleared his throat, and said, "Yes, Dr. Zhang has a solid foundation in surgery, but he's a bit off topic, so pay attention in the future. It's easy to break up."

Director Di, who returned to the department, sat down on the sofa and rubbed his calf, "Hey! My old leg!"