Kawei stood by the bed and put on his outfit for the day. Just as he was about to sit down at the desk and take a look at his upcoming schedule, there was suddenly some unexplained noise outside the door. He immediately realized what was going on outside the door, and quickly stood up and walked towards the door:
"How many days has it been? You still have to check even a waiter?"
"That's an order, Doctor Carvey...you've served in the military, and you know there's nothing we can do."
Kawei opened the door, and the gloominess of the man in black passed by, and the attendant's bright voice finally sounded in his ears: "Dr. Kawei, breakfast is served downstairs. You can go downstairs to enjoy it until ten o'clock. If If you don’t have time, we can provide packaging services.”
The speech was at 9 o'clock, and Carvey had plenty of time.
But there were too many people who needed to be greeted in this hotel. He didn’t like to socialize. He was originally going to pack the food, but now he changed his mind: “Bring breakfast up.”
"I wonder what you want to eat?" The hotel attendant stood at the door and took out a small book, "Today's main item is..."
"You can do whatever you want. Don't take too much. I can't eat too much."
"OK."
The morning sunshine had not yet fully penetrated into the hotel room, so Kawei simply sorted out yesterday's harvest.
Except for the last enamel unicorn, which was bought by Eugenie for 50,000 francs, Cavell almost got rid of most of it, including three paintings, two manuscripts and a large number of domestic collections, but spent very little money.
Now that the money has been given, the items are still piled in the auction house's warehouse and can be kept for a month.
Kawei wanted to send the things back to Vienna before, but there were still many details to deal with on how and when to send them. He had just arrived in Paris not long ago, and he had a lot of things to deal with. He didn't have the time, so it was the best choice to let the other party take care of it for him.
As for other auctions related to domestic collections, they were mainly concentrated in the past few years, but now there are many fewer. Most of them will choose to collect them themselves or give them to Eugenie.
After the auction, Kawei also informed Bernard that he would be notified if there was any news in this regard...
Kawei sighed and looked up at the ceiling. He didn't know whether to be grateful that he was temporarily freed from such a trivial matter on a whim, or whether he should push himself a little more at this time to prevent him from giving up halfway.
In the final analysis, it was still not professional enough, and it was not enough for someone who only studied medicine to do such a thing.
Kawei took a deep breath, erased the unpleasantness accumulated in his mind, and focused on today's work.
When it comes to speeches, Kawi actually doesn’t attend many. Before the time travel, the talks were all about surgical procedures and some new treatment plans. I faced colleagues who had been working for many years, but today I have to face some students who have not yet graduated.
Even now, Kawei has not thought of the specific content of his speech.
"Dr. Carvey, breakfast is here."
"Uh, here we go..."
.......
The School of Medicine of the University of Paris has a long history and has provided a large number of medical talents to France and even Europe. It is one of the cornerstones of the development of modern medicine.
There is almost no free time in the lecture hall of the medical school. Half of the medical conferences in Paris are held here. There are too many medical leaders who cannot even receive invitations here. Being able to stand on the lecture stage of this medical school is enough to show that they are here. portion size.
Kawei didn't have much pressure on big scenes, but he just couldn't think of what to say to those students.
Key points for cesarean section?
How to hone surgical skills?
Or talk about the importance of vital signs and body temperature?
These are important for clinical practice, but they don't seem to be very important, because if you want to form this common sense construct in daily work, just relying on him to talk for an hour is not enough, far from enough.
They are just medical students, and most of them have not yet been exposed to clinical practice. It is too early to directly talk about clinical practice. What's more, even if you do go to a clinical internship, the doctor you follow is not you. It remains to be seen whether we will really be able to remember these things by then, and if so, how long we can persist in them, and whether it will conflict with the philosophy of teaching doctors.
On the carriage, Kawei racked his brains for a while, but after entering the venue and looking at the children about his own age in front of him, he immediately remembered his experience as a teacher when he was young.
Oh, I forgot about it...
They are still students and facing the beginning stages of their careers. What is urgently needed now is not to cram advanced medical knowledge into an empty mind, but to first learn how to learn knowledge in heavy internship work.
Kawei walked up to the podium carrying his small bag, looked at the time, and then wrote his name on the board behind him.
His appearance immediately attracted a lot of attention, and just like everyone else, the discussion focused on Kawei's nationality and age. Then a small group of people who had seen Kawei's surgery began to admire his surgical skills, and started to discuss some topics that did not belong to the medical category with another small group of skeptical people.
"It's almost time. I didn't expect so many people to come."
Kawi looked at the packed venue and said in French: "I know you have a lot to ask, but today is not the day for interviews. I have to complete a personal speech here, and I will leave the questions after the speech."
After pouring cold water on their heads, Kawei asked: "Have you all participated in hospital internships?"
Just as he had guessed, most people shook their heads, and those who did not express their opinions were mostly elderly doctors. After the audience scope was determined, Kawei began to enter today's topic: "I want to ask you, in the entire medical learning journey, which period is the most difficult?"
It is indeed a gathering of the best brains in Europe. As soon as this question arises, the correct answer also appears.
"As you know, in the long journey of medical learning, no learning curve is as steep as that of residents. There is a huge gap between interns who have just completed theoretical studies and residents who can work independently. This is also the reason why doctors Enter the most important part of his journey to success."
Kavi made his opening remarks, and from his position as a teacher, he said: "I don't know much about the internship system of Paris Medical College. The internship in Vienna didn't last long, about half a year. The content of the internship during this period is very important. , directly determines whether a graduate can quickly become a resident doctor."
At this time, there was no systematic examination for doctors, and there was no so-called physician's practicing certificate. It was more of a formal examination by the Doctors Association. As long as you pass the assessment of the Medical Doctor Association and successfully enter the Medical Doctor Association, you will be admitted.
However, the assessment itself contains very little content, and the answers are very subjective, which cannot be compared with the systematic written examination + practical assessment.
"I believe it will be easy for you to pass the medical association examination, and I am definitely not here to hear how to pass the examination." Kawei said, "What I want to say is how to truly learn the knowledge you want during the internship."
Students have different views on internships, but they all want to learn as much as possible. Unfortunately, many people use their energy in the wrong place.
"First of all, you have to position yourself right."
Kawei wrote on the board, [You are students, correct your attitude and enjoy learning]: "Students naturally focus on learning, why do you want to learn? Because you don't understand, you have to learn. So when you meet someone you don't understand, you have to learn." Just say "I don't understand" openly, then find the answer in the teacher's explanation, and report it back to the teacher to take note of it.
Those who lie about what they know to take care of their self-esteem are idiots. Clinic is not a school. Wrong feedback will make the teacher make mistakes in your judgment, and then superimpose these mistakes on the patient.
So be yourself, make sure you are energetic, set learning goals, and complete your work on time. "
Pure text preaching is always boring, even if Kawei talks about valuable personal experiences, it will reduce the quality of the speech. So after ending the first one, he introduced a typical case: "We will now use the previous female patient with abdominal pain as an example to describe what interns need to do."
Kawei wrote the medical history on the board:
[Patient, female, named Eugenie, 18 years old. Two days ago I had abdominal pain, constipation, and no vomiting. Initially, he was diagnosed with hysteria by the internal medicine department, and he was given an enema for recovery at home. The constipation was relieved, but the effect on abdominal pain was average.
The abdominal pain worsened the next day, so I consulted the internal medicine department again. After eating a piece of bread that had been left out for a long time, I was diagnosed with gastrointestinal inflammation. In addition to an enema, mercury was added to induce vomiting. The parents did not follow the instructions, but gave antimonials to continue catharsis, but the effect was still very little.
The abdominal pain did not go away on the third day, and even showed signs of worsening. Finally, he went to the surgery department, where he was diagnosed with mild hysteria and coccitis and admitted to the hospital. ]
Kawei didn't ask them how to deal with it, because they couldn't do it yet, and everything still had to start from the basics: "It may be different from the content in the theoretical classes in your medical school. If you want to find a foundation of clinical medicine, then it is The first one is definitely communication. It runs through your entire medical career, whether you are with your colleagues or patients, you need to communicate with each other.
Now this patient is admitted to the ward you manage, because the first patient was Dr. Guyon. Professor Cediyo, who has never seen the patient before, wants to ask about her situation. Who can report it? "
Reporting is naturally different from writing on the blackboard, and it is impossible to review verbally, so the key lies in how to outline a clear and complete "picture" of the patient in a short period of time.
She made the mistake that many interns are accustomed to by raising her hand first: "I would describe her as [a person who suffered from mild hysteria, had eaten some unclean food, had a small amount of diarrhea without vomiting, and had abdominal pain for two days. An 18-year-old female patient who failed to respond to herbal enemas and antimonials].”
Kawei frowned slightly as he listened, but still affirmed: "It's basically simple, but it's not enough."
After being inspired, the second person simplified the report: "What about an 18-year-old female patient who had abdominal pain for two days, diarrhea but no vomiting, and herbal enema and antimony treatment failed...?"
"It's streamlined well this time, but there are still problems."
In the eyes of medical students, this "medical history + physical signs" reporting model is a good form of expression.
But clinically, this model is not the most effective way to convey information verbally: "Your task is to extract and summarize the key content of the medical history and physical signs. You cannot be immersed in describing the complex medical history and details. It needs to be streamlined. Of course, in streamlining It’s not about streamlining for the sake of streamlining. Oversimplification will ignore some important content.”
Kawei drew several circles on the medical history board, focusing on abdominal pain.
"How many times did I mention abdominal pain in total?"
"three times."
"Does this mean that Dr. Juyong who wrote the medical history also believes that abdominal pain is the main reason for seeking medical treatment? Should you highlight the diagnosis of abdominal pain when reporting, and then..." Kawei underlined "aggravated" , “Have you ever wondered why Dr. Guyon considered abdominal pain as the main cause?”
That's when the students realized they were missing crucial information.
"If it were me, I would delete some useless information like you, such as the two internal medicine diagnoses in the middle." Kawei said, "But when expressing, the focus needs to be advanced."
[Patient female, 18 years old, developed abdominal pain two days ago and got worse...]
"This is important information related to diagnosis. Putting it in front is easier to stimulate the nerves of the person receiving the information, and it is easier to frame his thinking." Kawei explained, "After this sentence appeared, Professor Sediyo's thinking I’m basically in sync with Dr. Juyong. He only considers conditions related to abdominal pain, and will explain other information related to abdominal pain at this time.”
[… There was mild constipation, no vomiting, and herbal enemas and antimonials were ineffective. ]
.......
Just as Kawei was explaining to the medical students a reasonable and efficient way to report medical history, the Main Palace Hospital had already started preparing for the afternoon surgery.
The location was still chosen at the Second Surgery Theater, and Shanwang continued to be responsible for preparing blood. Albaran, who had helped prepare before, was squeezed into the preparation area by Kawi's three assistants.
The ratio of physiological saline, the dosage of sodium citrate, oxytocin and methylene blue, tourniquets, sutures, scalpels, hemostats, gauze, and even masks and gloves need to be prepared in advance. The key to cesarean section is speed. Any mistakes will prolong the operation time and increase the chance of failure.
"The ether and mask are all here, check if there are any air leaks."
"There are less hemostatic forceps, please give me two more."
"Tourniquet! Why isn't there a tourniquet?"
"Is there an abdominal expander here? If not, just bring two more retractors..."
The doctors repeatedly checked the preparations in the operating theater, and the two accompanying nurses also sent the women who underwent the first cesarean section to the preparation room in advance. While calming her down, he did what Kawi asked him to do, cleaning around her belly and emptying her intestines again.
All this seems to be going on step by step. The operation time, venue, equipment and drugs are determined, anesthesia is determined, the mother's physical condition is also determined, and the surgeon is even more certain.
Looking at the entire operation, the only thing uncertain now is the child in the mother's belly. And this only point of uncertainty quickly developed into a time bomb in the preparation room.
"Nurse, I..."
"What's wrong?"
"I feel a cramp in my stomach, a very obvious cramp!"
The nurse didn't care at first. Occasional uterine contractions were common, as long as they didn't form a regular pattern. But when she lifted the quilt to check the extent of the twitching, a bright red patch between her legs pierced her eyes.
