On the first day when doctors and nurses enter the hospital for internship, the teachers or leaders in charge of the internship will explicitly or implicitly tell them to learn to protect themselves.
Because the medical environment is very bad, many young doctors and nurses have done good deeds because of their kindness, but in the end they were slapped down.
Most doctors who have worked longer hours appear to be hard-hearted and ruthless.
In fact, it's just that they have become mature.
The vast majority of doctors have always been kind in their hearts, and they have always retained the benevolence that a doctor should have.
Indifference comes from being severely beaten and learning how to protect yourself.
As for the doctor's second ability - deception, this is also an essential skill for survival.
Li Jingsheng has a very upright character, but when it comes to deceiving patients and their families, he is not reserved.
Not to mention a ruthless and cunning old man like Boss Zhao.
So many patients lined up to give him money, and they also wanted to be grateful to him and praise him for his good medical skills. He had already reached the stage of deception.
At this moment, this handsome man has been initially brainwashed by him.
"My health is pretty good, I should be fine!"
Although the handsome man has been brainwashed, he still needs to be vigilant. He was obviously doubtful about what Boss Zhao said.
At this age, it is very difficult to be deceived again.
"Based on my more than 40 years of medical experience, to put it bluntly, don't be offended by Boss Chen!"
Boss Zhao looked like he was hesitating to speak.
In terms of acting skills, many movie stars may not be able to compare to Boss Zhao.
Boss Zhao can control his tone of voice, eyes, facial expressions, and body movements to the point where it is difficult to distinguish between true and false.
When Li Jingsheng first came here to open a clinic, he was pinched by Boss Zhao.
The losses I have suffered and the times I have been deceived are countless.
Now it's this handsome man's turn to be 'beaten'.
"It's okay, Boss Zhao, if you have anything to say, just say it!"
"Many diseases, especially kidney diseases, are already incurable by the time the problem is detected. Doctor Li, is that the case?"
Boss Zhao roped in Li Jingsheng as an endorser.
In this situation, it was really difficult for Li Jingsheng to avoid it.
"How should I put it? Kidney disease is divided into three stages. Many people think that only the end stage of kidney disease is uremia. In fact, from the first stage, the renal function reserve compensatory period has already begun. At this time, patients often do not have very obvious symptoms. Symptoms. Going to the hospital for examination will only show that the patient's kidney function is not very good, but the kidney's compensatory ability can meet the basic water and electrolyte balance.
At this time, the person looks fine, but if not treated in time, it will soon develop to the second stage, the uremic decompensation stage. In the second stage, various symptoms will begin to appear. At this time, the person is basically disabled. Lifelong medication cannot suppress the progression of the disease, and can only slow it down at best. "
Li Jingsheng also rarely cooperated with Boss Zhao.
I gave this 'Boss Chen' some medical knowledge about kidney disease.
To be honest, if this person was really a boss, he wouldn't go to the Sunshine Clinic and sit there for two or three hours every day.
Bosses who are doing a little better have no shortage of women at all.
Their time is the most expensive cost.
It's really despicable for 'Boss Chen' to be so shameless.
"Is kidney disease so scary? I gained some insight today."
'Boss Chen' still seemed relatively calm.
Almost most patients have this kind of luck mentality and think that they will not be so unlucky to get a serious illness.
"I also fell in love with Boss Chen, so I would like to remind you that if it were anyone else, I wouldn't even bother to open my mouth. Otherwise, if you remind me so kindly, people will think you tricked him into spending money for medical treatment!"
Boss Zhao answered very sincerely.
"Thank you, thank you! Boss Zhao mentioned before that you can judge whether you have kidney disease by touching acupuncture points. How about... help me take a look? I'll treat you to dinner then."
'Boss Chen' is still scared after all.
When he buys kidney-tonifying medicine, he must have learned some knowledge about kidney disease. And only when some symptoms appear, I will buy medicine to replenish it.
Now I heard two doctors saying that kidney disease cannot be cured.
How could he not be afraid!
"It's okay to feel it and see. I usually charge for inspections."
Boss Zhao is now more reserved.
"It's a charge, just check it for me so you can rest assured."
'Boss Chen' hesitated for two seconds, and finally decided to let Boss Zhao take a look.
"To be honest, I have practiced medicine for more than 40 years, worked in hospitals for nearly 20 years, and opened a clinic for more than 20 years. I dare not say anything else. I have never made a mistake in treating patients."
Boss Zhao was boasting as he began to examine 'Boss Chen'.
Boss Zhao is only in his fifties, so where does he have over forty years of medical experience? Have you been a doctor since you were a teenager?
It's okay to deceive laymen with this kind of talk, but insiders can see through it as soon as they hear it.
Unless Lao Zhao graduated from a medical school that year, that's another story.
Today's medical students, even if they only study for an undergraduate degree, will be in their twenties or thirties by the time they graduate from internship.
By the time you reach your fifties, you will have more than thirty years of work experience.
"Oh, it hurts, it hurts!"
Boss Zhao pressed the acupoints on 'Boss Chen's' waist, and 'Boss Chen' immediately screamed.
"Oh, I'm afraid this problem is very serious! The stronger the pain, the more serious the kidney problem is."
Boss Zhao looked serious.
Li Jingsheng almost burst out laughing. Pressing the Yaoshu point can indeed check whether there is a problem with the kidneys.
Even if the kidney shrinks to the size of a sesame seed, it won’t hurt like this!
It is all too easy for doctors to inflict pain on their patients.
What's more, he is an old man like Boss Zhao who has been running a clinic for more than 20 years. To put it more exaggeratedly, Boss Zhao will cause pain wherever the 'patient' feels pain.
In the past, those who went around selling plasters and those who used Qigong to treat diseases also used this method.
"How serious is it?"
'Boss Chen' was so painful that he was still gritting his teeth and gasping for air.
His expression was somewhat nervous.
"Don't worry, I'll look at a few other acupuncture points."
Boss Zhao checked several other acupuncture points for him with a serious look on his face.
His face became more and more solemn.
'Boss Chen' screams every time he is inspected.
He should never, never should, have any idea of Tang Ping.
If Boss Zhao is made jealous, how can he still have a good life?
"Let's go, let's go. Don't pay me any medical fees. Just treat me as a friend and help you get a free examination."
After Boss Zhao finished the inspection, he looked pitiful and solemn, shook his head, sighed and got up to leave.
'Boss Chen' put on his shoes and hurriedly chased him out.
"Hey, hey, Dr. Zhao, Dr. Zhao, how is my kidney condition? You didn't tell me after the examination, I'm worried."
"You'd better go to a big hospital and have a quick look! My diagnosis may not be accurate."
Boss Zhao is trying to get away with it.
Watching the two people leave, Li Jingsheng wondered how Boss Zhao would deal with that 'Boss Chen' next? He was just a spectator.
If Zhao really could make that man stop coming to the Sunshine Clinic, it would be a good thing for him and Tang Ping.
The clinic is a place that treats diseases and sells medicine, and it does not welcome people like this who come in and stay for a few hours when they have nothing to do.
After Li Jingsheng put a plaster on the baby, he stayed in the clinic for observation for about half an hour to confirm that the blood supply to the hand was smooth before letting the family leave with the baby.
The family members left with smiles on their faces.
They were able to achieve successful manual reduction without surgery, and they were very satisfied with the result.
And it doesn’t cost much, and you don’t have to be hospitalized, so the benefits are really not small.
The only thing they are worried about now is the later recovery.
It is estimated that when the cast is removed next time, as long as the child's right hand returns to normal, he will at least get a good review.
At that time, 10 health points will be obtained again.
"Boss, you were so handsome just now! If you have a chance in the future, teach me too!"
Xiao Gao was envious when he saw his boss easily making 600 yuan.
Moreover, the moment the child was successfully repositioned, everyone was paying attention and received countless admiring glances. That kind of glory was what Xiao Gao had only dreamed of.
"This requires a certain amount of talent. When you pass the probation period, I will teach you some medical skills depending on the situation. Work hard."
Li Jingsheng did not refuse, nor did he agree immediately.
Only when Xiao Gao's character is determined to be good will he be considered for teaching skills.
And I’m afraid I have to ask Dr. Xu about this first.
Besides, Li Jingsheng has not even started training yet, so if he is asked to accept a disciple, he is afraid that he will mislead others.
Xiao Gao returned to the counter and sold medicine honestly.
After seeing the powerful medical skills displayed by his new boss, Xiao Gao only felt that his future was brighter.
Naturally, I am more motivated.
Taking advantage of the fact that there were no customers for the time being, Xiao Gao diligently sorted out the medicines on the counter and replenished what needed to be replenished.
Tang Ping felt much more relaxed now.
However, she attaches great importance to the hygiene and disinfection of the clinic. She cleans what needs to be cleaned and disinfects what needs to be disinfected.
With the joint efforts of the two, the Sunshine Clinic has become tidier and cleaner.
The boss, Li Jingsheng, sat in front of the clinic and took the opportunity to check the changes in the property panel.
Doctor level experience increased by 50 points.
Grade: Junior attending physician 1051.5/2000.
Li Jingsheng was very surprised that treating a baby with wrist dislocation actually increased his experience points by so much.
It was the first time for me to feel the baby's bones, diagnose, perform manual reduction, and practice medicine independently.
It seems simple, but it actually improves diagnosis and treatment capabilities in many aspects.
Including improving the mentality when facing special patients.
When I first received the doctor, I saw a baby who was only half a year old. He was actually very scared. He was afraid that something would happen and instinctively wanted to push the patient out.
In the end, he went from being afraid to diagnosing and treating babies. The improvement of his character in this process was a huge growth.
It was the first time to touch the baby's bones and perform manual repositioning, which was also an important step in medical skills.
Therefore, the doctor level experience value increase by 50 points is very reasonable.
The next time I treat a baby with wrist dislocation, the level experience value will probably only increase normally.
The proficiency of bone touching technique actually increased by 10 points.
The proficiency of stretching and traction techniques and ordinary bone-setting techniques also increased by 10 points each.
Taking this business was a huge profit.
When Li Jingsheng looked at the HP column, he was dumbfounded.
In order to upgrade the pulling and stretching technique, a full 63 health points were consumed, and originally only 277 health points were left.
At this moment the number becomes 378.
This made him sigh, worrying about gains and losses. Only when there are losses can there be gains.
Originally, he wanted to save his health points to upgrade his gastrointestinal diagnosis, but when he spent the 63 health points, he felt a little reluctant.
Unexpectedly, by setting the baby's bones and resetting it, he actually earned a full 101 health points.
100 of them are definitely bonus points.
“Do one good deed every day, do one good deed every day!”
He thought silently in his mind.
Life points must be spent when they should be spent, and cannot be calculated too much.
It is meaningful to improve medical treatment and use it to save people only if the resources are put to the best possible use.
Li Jingsheng had a new understanding of the value of life.
If you calculate too much, you will easily become a 'miser'.
Now with a balance of up to 378 health points, upgrading gastrointestinal diagnosis is no longer a problem.
It can be regarded as a coincidence that made him successful.
Without too much hesitation, I directly increased my proficiency in gastroenterology diagnosis to 500 points.
The proficiency in gastroenterology was 136.7/500, which instantly increased to the minor score in gastroenterology 500.7/1000.
This diagnostic skill has finally reached the level of senior attending physicians.
He was delighted to experience the new diagnostic and treatment capabilities of gastroenterology.
If we say that at the junior attending level, I already had a hint of analyzing problems on my own and began to learn to stand alone. Now that his medical skills have risen to the level of a senior attending physician, he already has unique diagnostic and treatment capabilities.
Facing many difficult and urgent diseases in the field of gastroenterology, we have the ability to truly independently handle them.
A junior doctor can only serve as a deputy general at most, and he has to consult senior doctors on many matters.
The senior attending physician already possesses the abilities of a general in all aspects.
"Finally, we have the first diagnostic technique at the level of a senior attending physician, let's get started!"
Li Jingsheng looked forward to the stars and the moon, and was waiting for this moment.
The grandmother and mother of the baby with diarrhea must have been very anxious when they got home.
After all, the child's illness has not been cured and he is getting thinner day by day. How can a parent not be anxious?
They had not left Li Jingsheng's clinic for a long time.
If the cause of the disease is diagnosed now, there might be a chance.
After a while, they must have taken the child to another hospital to seek medical treatment.
No matter how generous you are, you can't wait at home with your child for news from a doctor in a small clinic.
Li Jingsheng took the time to analyze the cause of the baby's diarrhea again.
This time, with the addition of gastroenterology diagnostic capabilities at the senior attending level, it has obviously reached a higher level.
"The child's stool culture was negative, no fungi were found in the smear, and the pH value of the stool was 7.5..."
Some details of the inspection results that Li Jingsheng ignored came to his mind again, and this time they received his attention.
The normal pH value of stool is generally between 6.9 and 7.2.
This child's pH level is slightly higher than normal.
Generally, the pH value of a baby's stool will be around 7, and if exclusively breastfed, it can even remain between 5 and 6.
After adding complementary foods, the pH value of stool will gradually increase.
Therefore, a child’s stool pH value of 7.5 does not mean it is abnormal. At most, it means that the children basically eat complementary foods.
Li Jingsheng continued to sort out the baby's examination results.
Fortunately, he saved some time and took photos and saved some information.
Nowadays, it is quite convenient to browse directly with your mobile phone.
Otherwise, it would be impossible to just remember all the inspection data in your head.
The baby had severe abdominal bloating, which resolved after the first treatment.
But when he came for a checkup today, Li Jingsheng found that the baby had abdominal distension again.
Not particularly serious, but worth vigilance.
Thinking that the baby was eating less and less, Li Jingsheng suspected that there might be intussusception.
It was just quickly ruled out.
Because the attending physician at the People's Hospital may also have suspicions about this, he had given the child an emergency air enema and found that the intestines were unobstructed.
This indicates that there is no possibility of intestinal obstruction or intussusception.
"If you want to find out the real cause, I'm afraid you have to think from a certain height. Since intussusception and obstruction can be ruled out, the child has no other symptoms for the time being except diarrhea, reduced eating, low-grade fever, and abdominal distension. Is that right? Can we start with infectious diseases and non-infectious diseases?”
After Li Jingsheng's gastrointestinal diagnosis level improved, the benefits were huge.
He felt that he had a bit of a general style when diagnosing the cause of the disease.
"If it is an infectious disease, bacillary dysentery and intestinal amoebiasis are the primary suspects."
Because I had a stool smear and a stool culture, the results were normal.
Intestinal amoebiasis can be ruled out first.
The stool excreted by this disease is jam-colored or directly bloody. However, the color of this baby's stool is not these two colors, which can further rule out this disease.
What about the possibility of dysentery?
In the early years, many young children were infected with dysentery.
It even took the lives of some children.
This disease is notorious.
However, now that antibiotics and anti-infective drugs are quite advanced and have a complete range, this disease is no longer considered a serious illness.
If the child's stool culture is negative, this disease can basically be ruled out.
Children's hospitals, especially the People's Hospital, used a large number of anti-infective drugs on this baby, but the treatment results were very poor.
It has almost no effect.
This can also further rule out the possibility of dysentery.
"The possibility of infectious diseases has basically been ruled out. Then there is only the last possibility left, non-infectious diseases."
Li Jingsheng enjoys his current strong diagnostic capabilities.
He may not be as good as the deputy chief physician and chief physician, but compared with his past self, his current gastrointestinal diagnosis ability is no worse than that of the chief physician in a large hospital.
"Non-infectious disease, Crohn's disease? Ulcerative colitis? Food allergies?"
He racked his brains to think of non-infectious diseases that matched the symptoms, age, and condition of this baby.
Crohn's disease is very scary, has a very long course, and is currently incurable.
And its symptoms are also very strange, especially low-grade fever that lasts for a long time, coupled with diarrhea, it is very easy to associate it with this disease.
After contemplation, Li Jingsheng ruled out the disease.
One is that the baby's disease lasts about a month, which can only be regarded as a younger brother compared with the one or two years of Crohn's disease.
Also, the child did not have blood in his stool.
No obvious mass was felt during abdominal palpation.
Therefore, Li Jingsheng directly ruled out Crohn's disease.
Of the remaining two diseases, ulcerative colitis is the most common with abdominal pain, diarrhea, and blood in the stool. The baby did not have bloody stools or obvious abdominal pain.
And the disease is sudden and sudden.
High fever, mucus and bloody stools, abdominal distension, and abdominal tenderness often occur, and the age of onset is rare in infants.
This disease mostly occurs in young adults.
Clinically, ulcerative colitis occasionally occurs in children over the age of five or six.
This child is only more than seven months old, and his age and some of his symptoms are inappropriate.
Basically it can be ruled out.
That leaves only the last possibility, food allergies.
This child is eating milk from a big brand, and the quality is definitely guaranteed. But milk protein allergy is not uncommon in infants.
The baby's intestinal function is not perfect yet.
Allergy symptoms are likely to occur after repeated consumption of some allergic foods.
(End of chapter)
