"Cui Lao is boiling a frog in warm water. First, he'll look for you to treat the patients. Then, as long as you can't handle it, he'll give you benefits and let you work in the emergency department," Su Yun said.
Zheng Ren had also thought of the careful thoughts in this. However, with the Nobel Prize in hand, who would go to work in such a busy, tiring, and unprofitable place like the Emergency Department?
Zheng Ren just smiled and did not answer Su Yun's question.
Both of them knew in their hearts that, like Old Chief Physician Pan, Cui Lao was also indignant.
There were no newcomers in the emergency department, but they had to exist. They could only desperately burn their remaining life force to barely hold on.
If he did his best, he would die in the end.
But was the power of an individual useful?
It was completely useless. Even at the age of seventy or eighty, Cui Lao insisted on lecturing all over the country.
However, to improve the treatment of emergency department doctors and other issues would cause a chain reaction. This kind of thing was not something that an academician of the Chinese Academy of Engineering could decide.
It sounded like an academician, but it was just a signboard. If it was useful, then it was useful. It was truly useless.
Let hospitals and society regulate themselves? How much would he have to pay in order to improve?
A while ago, the matter of beating and scolding the bus driver was taken seriously. Now, the person who beat and scolded the bus driver had been sentenced for endangering public safety.
But when it came to medical treatment, the situation was even more complicated.
'Forget it. I'm just a junior doctor.' Zheng Ren smiled sheepishly.
Along the way to the emergency department, Chief Resident Zhou Litao was already waiting in the corridor.
He was short, his face was pockmarked, and his tanned face was stuck together with Su Yun, forming a sharp contrast.
"Boss Zheng, there's a patient whose symptoms don't match. Cui Lao happened to be out today and asked you to take a look," Zhou Litao greeted him and said politely.
"I don't dare, I don't dare," Zheng Ren immediately replied. "I don't deserve Cui Lao's love."
Zhou Litao smiled and said a few polite words before bringing Zheng Ren to Cui Lao's consultation room.
After entering the door, Zheng Ren saw an old man with white hair and beard sitting in the consultation room, asking questions.
"Hello, Cui Lao." Zheng Ren bowed deeply to express his respect.
"Yes, Little Zheng, come and take a look at this patient." Cui Lao nodded. "Litao, tell Little Zheng about the patient's condition."
Zhou Litao then said, "The patient came to our hospital for treatment because of intermittent epigastric pain for a day, accompanied by nausea and vomiting. The patient had been smoking for more than30 years and had a history of hypertension.
Luo Huoxi was treated and his blood pressure was well controlled. "
"The patient's abdomen has no swelling, no bowel pattern, no peristaltic waves, no skin scars, and no varicose veins on the abdominal wall.
There was deep tenderness in the upper abdomen without rebound pain or muscle tension. Liver and spleen were not involved. Murphy's sign was negative. No obvious mass was palpated. Abdominal percussion showed drumming sound, no percussion pain in liver, spleen and kidneys, negative mobile dullness and faint bowel sound.
No abnormal vascular murmur was heard. "
"B-scan ultrasonography shows mild fatty liver, the rest is negative. However, the patient complained of severe pain, and Cui Lao determined that it might be an aortic or mesenteric artery dissection. He was preparing to perform a 64-row CTA. "
Zheng Ren understood that there were probably still patients waiting for a call on the 64th row, so they asked him to take a look during the interval.
This was definitely Cui Lao's intention.
While listening to Zhou Litao's description of the patient's medical history, Zheng Ren saw that the System's panel was bright red.
Isolated superior mesenteric artery dissectionIIb
Type A, high blood pressure, and several other diagnoses appeared in front of him.
'It's quite a troublesome disease,' Zheng Ren thought.
Vascular dissection was very troublesome. From Cui Heming's aortic dissection to the patient in front of him, if it was a lower-level hospital, they would be admitted to the hospital or the outpatient clinic for observation with abdominal pain.
If the diagnosis was not made in time, once the dissection ruptured, death would be waiting for the patient.
Especially in small and medium-sized hospitals, the misdiagnosis rate was quite high when encountering this kind of disease.
As for Cui Lao, he had basically confirmed the diagnosis of the disease with just a physical examination. This level and experience were not to be underestimated.
Zheng Ren nodded and began to examine the patient.
Just as Zhou Litao had said, the patient's abdominal tenderness was not obvious. There was some deep tenderness, but it was not important.
The physical examination showed that the tenderness was very light, but the patient's face was pale and he was sweating profusely from the pain. This was a self-reported serious condition.
The so-called physical symptoms did not match. This was the situation.
After Zheng Ren finished the physical examination, he took a look at the emergency B-scan and the test results. The patient could be said to be very healthy. Other than the intense pain, there were very few positive indicators.
"Cui Lao, I think the possibility of mesenteric artery dissection is higher," Zheng Ren said. "You can choose to do a 64-row CTA examination or interventional radiography to confirm the diagnosis and surgery."
"What about conservative treatment?"
"Well … conservative treatment depends on the opinion of the patient's family. I'm from a surgical background, so I'm not very supportive of conservative treatment. This is because whether it's an isolated mesenteric artery dissection or a concurrent aortic dissection, once conservative treatment occurs, if the dissection suddenly ruptures at night, it will cause greater damage to the patient, "Zheng Ren said.
He also knew that his attitude belonged to the more radical kind.
Surgeons were generally more radical. If a problem could be solved with surgery, why would they keep Dark Thunder by their side?
Of course, for an isolated mesenteric artery dissection, the cure rate of conservative treatment was also very high. Zheng Ren knew this.
However, Cui Lao only asked for his opinion, so Zheng Ren also expressed his inner thoughts.
Cui Lao looked at Zheng Ren and then said lightly, "Can you perform the patient's surgery?"
"I'm fine with matching the general surgery department," Zheng Ren said. "I'll try my best to minimize the patient's damage."
"Alright, you and Litao take the patient to do the examination. Let me know when they're done." After Cui Lao finished speaking, he waved his hand and gestured for them to push the patient to do a 64-row CTA.
The old man was full of vigor. Zheng Ren recalled the scene of Cui Lao pointing at Chief Kong's nose yesterday and then smiled bitterly.
It was impossible for a person in the emergency department not to be impatient. Even if it was a slow person, in the emergency department, they would soon be honed.
However, Cui Lao in front of him was very kind. He reminded Zheng Ren to pay attention to the patient's blood pressure and personally looked at the concentration and speed of the antihypertensive drugs that were pumped in. Only then did he let Zheng Ren and the others push the patient away.
"Boss Zheng, do you think the patient has an isolated dissection or a concurrent aortic dissection?" Zhou Litao asked in a low voice as they walked.
The patient's family was by his side. Without any objective evidence, everything was just an assumption. If he could keep his voice down, he would keep it down.
"From the patient's physical signs, it seems to be isolated," Zheng Ren replied. Zheng Ren replied, "The pain point is wandering. It's not like the pain point of aortic dissection that is fixed with radiation pain."
This was a reverse deduction, according to the System's panel.
Zheng Ren felt that it was very normal. The physical examination matched the diagnosis of the System panel. He reckoned that the System was right this time.
He felt that it was very normal, but in the ears of others, it was a different matter.
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