I can see the status bar

Chapter 227 Misdiagnosis

Writing is a drudgery that requires quiet.With a high degree of concentration and unity of spirit and will, mechanized finger movements that last for more than several hours can produce a passable article.This job is destined to be the type of "a layman watching the excitement, an expert watching the way".After all, in modern society, everyone has written compositions when they were in school, and basically everyone can type.What's the problem?

In this regard, Sun Li'en has only one thing to say - you do what you want.

How cumbersome is the standard internal medicine case record?Just compare it with the case records of the Department of Surgery of the Fourth Central Hospital.There are "templates" for surgical case records.Generally speaking, three sentences can complete a patient's case record - the first sentence, the patient is diagnosed with XXX disease.In the second sentence, XXX was performed during the operation and the treatment was completed after the operation.In the third sentence, the patient is satisfied after the operation.Then come a set of fixed doctor's order template combinations. When the rounds are made, all that can be omitted will be omitted, and those that can be "same as before" will be written "same as before".Generally speaking, the ward round records and case records combined can write more than a hundred words, even if the surgeon is paying attention.

As for internal medicine... the average case record is 4 words per patient.It is normal to fill two pages of A[-] paper.If any trainee or intern dared to record cases in a surgical style, the director of the department would definitely spray that poor bastard so that he didn't even have the courage to stand up.According to the general opinion of physicians——"The thing written by the surgeon, is it too embarrassing to call it a case?"

Sun Lien's internal medicine teacher is an old professor in the school. When the old man was in class, the whole class who used to scold him with one sentence dared not say anything, "The difference between humans and monkeys should be that humans know how ignorant they are, while monkeys feel I understand everything myself."

The content of internal medicine is complicated, and internal medicine is indeed different from the expectations of new medical students.What everyone sees and learns from film and television works is the appearance of surgeons wearing surgical gowns, rejuvenating and saving lives.As for internal medicine... only palliative care is available, and it takes a long time to think about how to use a medicine. How can there be a handsome surgeon?In the eyes of the rookies who have just entered school, only surgeons are called "doctors".Internal medicine, probably has the same nature as a pharmacist.

The old man in internal medicine, surnamed Zhao, was already an old expert who had been retired and rehired back then.But the old man didn't know which nerve was wrong, so he gave up his good work of "hosting scientific research projects" and wanted to teach.As for doctors, especially physicians who are getting older, the most unsightly thing is the adoration of surgeons and their disdain for internal medicine by rookies.He is also a big bull in the industry and a master of surgery.People look down on internal medicine because internal medicine cannot achieve the effect of surgery performed by themselves.A group of rookies who want to play the chain of contempt like a surgeon before all their hair grows?Interns and trained doctors are the low end of the entire industry's chain of contempt!

A group of young people who have just entered school are scolded by the old professor as monkeys, and the young people are always a little unconvinced.Most of Sun Lien's classmates also felt that the old man was deliberately suppressing him to find trouble.But Sun Lien listened to this sentence.I am also a doctor, I think I have seen more diseases than I, a rookie like myself, what's wrong with calling you a monkey?As long as you don't scold your mother, take it as a good word.If you scold your mother, then pretend you didn't hear it.

Although there are psychological preparations, but also have enough ideological awareness.But Sun Lien is still suffering.Case records are not only good if you write more.Each symptom must be described accurately, and the patient's condition needs to be recorded, and it cannot be made up.Since Sun Lien decided to require his own case records according to the standards of the Association, he would find a small notebook during the usual outpatient clinics, and write down the conditions of the patients he observed in shorthand symbols on it.At the end of the consultation and when it is necessary to fill in the records, Sun Lien will look at these symbols and restore them to the patient's situation.

However, although this move sounds good, for Sun Lien, it has a fatal flaw.

He's not familiar enough with these symbols...

Unfamiliarity with symbols means that he needs to recall and compare previous cases to understand what the symbols he wrote down mean.A case record of about [-] words required Sun Lien to search for about an hour before he could finish it.

It's just terrible.

Fortunately, not many patients were diverted from other clinics today.Sun Lien was able to slowly supplement his own records.When it was almost five o'clock in the afternoon, someone knocked on the door of the ninth consulting room.It was Dr. Cao Yanhua who entered the door, followed by a middle-aged man with a painful face.

"Xiao Sun." Dr. Cao greeted Sun Li'en, and pointed to the middle-aged man behind him, "This is my second uncle, who was supposed to go to the outpatient clinic to prescribe famotidine tablets, but the outpatient clinic has already It's off work. Xiao Sun, if you have nothing to worry about right now, can you help drive it?"

Sun Lien glanced at the waiting number on his computer screen, and there was indeed a male patient surnamed Cao who complained of "acid reflux and difficulty swallowing".Dr. Cao Yanhua not only brought his second uncle to see the doctor, but also registered a number.This is the expression of "respect" for Sun Lien.Doctors usually do this kind of thing. Usually, relatives and friends of a few big-name experts consult each other but can’t get on the number, so they may change the number—please do it during the break or after work. I work overtime to see a doctor, and if you have relatives who need my help in the future, you can bring them directly.

It is human favor to bring people to see a doctor directly, but it is to save face to bring people to see a doctor by registration.Besides, they just wanted a prescription for medicine, so Sun Lien naturally had no reason to refuse.He nodded, and said to the middle-aged man with a not-so-relaxed expression, "Uncle Cao, sit down first."

The status bar hung above Uncle Cao's head, "Cao Jianguo, male, 54 years old, weakened peristalsis of esophageal smooth muscle, incompetent lower esophageal sphincter."

Sun Lien asked someone to sit in the seat in front of him without changing his face, and retrieved his previous doctor's orders and medication records from the computer.

"Have you taken the medicine for two weeks?" Sun Lien's eyebrows twitched slightly after seeing the contents of the record. "Is your stomach still sour?"

Cao Jianguo nodded, a little embarrassed and said, "Yes."

Cao Yanhua interjected, "I asked my second aunt. The old man has nothing to say, but he always forgot to take his medicine. The medicine that should have been taken last week was delayed until yesterday."

Feelings This is also an old pigeon?Sun Li'en smiled and prepared to prescribe medicine.Anyway, Lao Cao's illness was diagnosed in the Gastroenterology Department of the Fourth Central Hospital, and Cao Yanhua must have read the report.My stomach acid persisted for two weeks because I didn't take the medicine according to the doctor's advice, so it shouldn't be a big deal.

Although the prescriptions for the medicine were written, they were patients who came to him for treatment after all. According to Sun Lien's current requirements for himself, this case still had to be written in detail.So Sun Li'en asked Comrade Cao to lie on the bed in the consulting room, preparing to give him a physical examination.Cao Yanhua also knew that Sun Lien was tormenting him recently, so he didn't express any objection to this behavior, and all thought that his second uncle came to be a model for Sun Lien to practice.

The physical examination went well.The content recorded by Sun Lien in the small notebook is also gradually increasing.Those shorthand symbols with special meanings are actually designed by himself.The more you use it, the more proficient you will become.

"What do you do?" Sun Li'en was checking Cao Jianguo's nerve reflexes, and on the other hand, he was afraid that he would be too boring lying in bed, so he chatted with Cao Jianguo casually.

"A farmer." After lying down, Cao Jianguo hiccupped several times. The smell was quite smelly, which made him a little embarrassed. "I'm causing you trouble."

"Hey, what's the matter?" Sun Lien replied with a smile, "Brother Cao usually helps me a lot. A few days ago, he took over for me and took care of several patients who drank too much. As a result, Brother Cao was too busy One night, I was vomited all over."

Cao Yanhua closed his eyes in pain, and he seemed to see that middle-aged man with a serious face again - he was numb from being stared at forcibly, and then the other party vomited all over himself when he opened his mouth.This kind of experience is not only indelible in time, but even some details will become clearer with the passage of time, such as the sour smell of alcohol, such as the disgusting feeling of vomit getting into the collar of the clothes and flowing down to your back .

Dr. Cao Yanhua was busy disgusting himself, while Sun Lien began to check Cao Jianguo's hands.These are indeed the hands of an old farmer. The skin on the hands is hard and thick, and there are many calluses.

"You don't usually wear gloves when doing farm work?" Sun Li'en touched Cao Jianguo's rough hands, feeling a little emotional, "These hands are full of calluses."

"A farmer's family, how can there be so much money." Cao Jianguo laughed honestly, "You probably haven't used a hoe much in your later life. If you wear gloves, the handle of the hoe will be too slippery and you won't be able to hold it."

Sun Lien nodded thoughtfully, and then frowned again. Cao Jianguo's calluses were not only on the side of the palm, but also on the metacarpophalangeal joints on the back of the hand.

In previous novels, those with calluses in this position were all masters of punching.Sun Li'en recalled with nostalgia the martial arts novels he had read in high school.Unexpectedly, Cao Jianguo was also a hidden master.

"Doctor Cao, do you have the habit of practicing martial arts in your family?" Sun Lien said to Cao Yanhua, "Why haven't I heard you say it before?"

Cao Yanhua finally broke free from the disgusting memories, and was a little unclear about Sun Lien's question, so, "Dancing practice? What kind of dance? No one in my family can dance."

"It's not dancing, it's martial arts." Sun Li'en pointed to the back of Cao Jianguo's hand, "There are calluses on the metacarpophalangeal joints, and it takes a long time to punch them with sandbags, right?"

"No..." Cao Yanhua scratched his head, "Second Uncle, do you know martial arts?"

"No." Cao Jianguo hiccupped again, "I don't know how I got those calluses on the back of my hands. It seems that I didn't have them a few years ago."

Sun Lien frowned, it didn't fit his common sense.Anyone with calluses on their hands should know where their calluses come from.For example, the callus on his right index finger was rubbed out with a pen when he was a student.

What if these calluses, not real calluses, but a symptom?

Sun Lien glanced at the status bar above Cao Jianguo's head again.

"Cao Jianguo, male, 54 years old, weakened peristalsis of esophageal smooth muscle, insufficiency of lower esophageal sphincter, diffuse skin thickening." A reminder was added on the status bar, but this time the reminder was not common when he had other findings White, but the same black font as the status bar's own prompt.

Sun Lien's eyes widened, "No... Uncle Cao didn't have reflux esophagitis!"

(End of this chapter)