"Come, let's do a physical examination!" Zhang Fan didn't dwell on this issue all the time. He knew very well that when he discovered this problem, when the ward rounds were over, the department would not go through the medical records of the past five years, or at least the recent ones. Two years of medical records have been reviewed.
In the early days, medical records were records of the occurrence, development, and outcome of patients' diseases, as well as the process of examination, diagnosis, treatment, and other medical activities recorded by medical staff. When they were simple, medical records were very exciting.
Doctors will write down their own conjectures or opinions on the future development of the disease. An internal medicine medical record is a doctor's depth of understanding of the disease. Later, medical records took on a new role and became the legal basis for disputes.
Then there is nothing to read in the medical records, they are all the same, full of maybes, maybes, and unseen. The doctors, not to mention writing their own opinions, even want to ask the superior doctors and family members to sign for the treatment.
Therefore, the current medical record is just a look at the examinations pasted on it. As for the other things, they are so perfect that you can't see anything useful.
The patient is a young man, thin, and a hospital gown suitable for ordinary people looks like a loose monk's robe, but the blue and white color makes him feel like a T-Bag in a prison escape.
The cheekbones are protruding, the eye sockets are sunken, and the eyes are open, with more white eyes than black eyes. Obvious malnutrition.
"Why are you feeling unwell?" Zhang Fan asked as he began to examine his body.
"It's just that my stomach hurts! I don't want to eat." Zhang Fan nodded, used his hands together, turned his four fingers into a knife, and started touching counterclockwise with his fingertips.
"Does it hurt?"
"It doesn't hurt!"
I drove it in a circle, from left to right, and found no pain points.
Zhang Fan raised his head and looked at the patient's expression. There was no sign of pain, and then looked at the doctor in charge of the bedside.
What I mean is, I don’t have any pain in my whole abdomen, but your der actually wrote that it was suspected appendicitis, and you even invited a general surgeon for consultation. You want the general surgeon to do an operation. How did you learn this diagnosis? The biochemistry teacher gave Are you taking the diagnostic class?
"He had paroxysmal pain. There was nothing abnormal when he was not in pain. But when he was in pain, his position was passive. When the general surgeon came, he was fine. When the general surgeon left, he started to feel pain. Now he is in pain again. alright!"
The doctor in charge of the bed pouted, with an expression of aggrievedness. To be honest, the department director is afraid of Zhang Fan, but the junior doctor is not afraid of Zhang Fan. Not only was he not afraid of Zhang Fan, but he also acted like if you have the ability, don’t ask me.
The profession of doctor is very strange. If someone is obsessed with being a part-time official in a hospital, he is very easy to manage and does not need to be managed by you. He will work very hard and actively get closer to the organization. He is afraid of this kind of unrequired treatment. Have merit but seek no fault.
Anyway, I'm just a little doctor. If I don't get close to you, don't worry about me. Just pay my salary and bonus to my mother on time. I don't care about your imperial guards or your guards with swords.
Moreover, Zhang Fan is a surgeon and he is young. He is a young internal medicine doctor, so he is actually quite unconvinced. No matter how awesome your surgery is, it's still a surgical series and you don't understand anything.
Really, it’s not an exaggeration at all. People who practice medicine obviously have this experience. Surgeons suppress physicians in terms of income, and physicians will always be better than surgeons mentally.
But to be honest, the gastroenterology department of internal medicine is somewhat similar to the general surgery department of surgery. The diseases are complex and diagnosis is difficult. This department is not easy to work in.
To be specific, this thing is too difficult. First of all, the feedback of abdominal pain is inherently inaccurate. For example, a comatose patient was first sent to the hospital. The doctor said that there were no organic changes in the brain and respiratory failure. This is a matter for the respiratory department.
Then the patient came to the respiratory department. The doctor from the respiratory department looked at him and said, "Hurry and transfer him to the gastroenterology department. This is willing encephalopathy."
After being sent to the gastroenterology department, the doctor said, "Quick, check first." The family members were unhappy and scolded the gastroenterology doctor. How can you be a doctor when you have to do a check-up even if you haven't done anything?
It’s quite difficult to digest.
Gastroenterology and general surgery are very similar in appearance. General surgery can also perform laparotomy, while gastroenterology can only rely on the doctor's skills.
It is difficult to guess the human heart from the belly, and the same is true for diseases. Moreover, if you think about it carefully, the tissues and organs in the abdomen have a bit of the flavor of Yan Laoxi back in the day. They are self-contained. They usually seem to be quite honest and obey the orders of their superiors. But when this thing reaches a critical moment, it stops listening to the orders of the brain.
Not only do they not listen to the brain's orders, but they may also send troops to overthrow the brain first. For example, in patients with hepatic coma, this is because ammonia from the liver enters the brain and numbs the brain. This is not sending troops.
Zhang Fan looked at the aggrieved and complaining face of the bedside doctor, looked at the slightly embarrassed director of the gastroenterology department, and smiled softly.
He didn't talk much. If the technical unit wanted to persuade the other party with words, it was often wishful thinking, unless he used his identity to suppress the female doctor. However, Zhang Fan would not do this, because he was too unskilled.
Those who are engaged in technology are all masters who will not shed tears until they see the coffin. You can't convince her technically, and you can't use technology to make her breathless. She will always raise her mouth and say: Is this it? I’ve seen bigger ones!
Therefore, Zhang Fan smiled softly and seemed to say: It's time to show his true skills.
"Close your legs, bend your knees, take a deep breath, breathe out, let out clean air, and that's it, do it again."
The young and thin patient was squeezed by Zhang Fan's hands like a doll.
"What is this for? Will increasing the amount of exercise cause symptoms?" The doctor in charge looked at his director in confusion.
The director rolled his eyes at her, as if to say: "Ignorant and ignorant!"
Of course, Ren Li, Yan Xiaoyu and Ouyang all understand.
Zhang Fan was going to have a deep abdominal physical examination.
When CT, MRI, and DR are dominating the medical field, not to mention deep physical examinations, even ordinary physical examinations are almost falling out of favor.
Few people can see deep physical examination now, because it is not only difficult to operate, but also prone to accidents.
With advanced instruments, who would take risks?
Therefore, let alone patients, some young doctors have heard of it but have never seen it.
Ordinary examination is very particular about one detail. Four fingers, the fingertips scratch the skin, rising and falling together, like a girl between lovers first saying to take a shower, and then seducing the boy, pursing her lips and gently using four fingers. Gently scratch the boy's eight abdominal muscles.
Well, be as charming as you want.
The in-depth examination was more rough. To put it crudely, it was as if a bearded man had not seen the opposite sex for more than ten years, and then suddenly a member of the opposite sex was given to him.
Hands up!
The hands are folded together, just like artificial respiration, and then the patient's abdominal cavity rises and falls deeply. The patient's abdomen, which does not have much muscle fat, is like a squashed and bulging watermelon.
It makes people nervous just looking at it, for fear that the patient's stomach will be crushed by accident.
"Inhale, take a deep breath! Exhale, quickly, spit out, spit out desperately, quickly!" Those who don't know what they think this is doing.
The patient was so thin that his eyes almost bulged out due to the pressure from Zhang Fan. It was really not an exaggeration at all. Not only was the eyeball about to come out, but even the tongue was about to be pushed out, and the patient was a little frightened. If there were not so many doctors around him, he would definitely think that Zhang Fan was going to murder him.
It is really difficult to push your hands through the belly to a depth of about ten centimeters and still touch the organs. You must not think that you can do this just by looking at it, and then experiment with your girlfriend on the bed at night.
It would be bad if you failed to do a good physical examination and instead let your girlfriend fuck you on the bed. Making a puddle of stool is the least serious thing, but if it fails, it can lead to death. If it touches a solid organ, it will cause massive bleeding. If it touches a hollow organ, it will cause rupture and infection.
During Zhang Fan's in-depth physical examination, in the early stage of exerting force, the patient must sink quickly and vigorously as the patient exhales, and when it reaches the vicinity of the organs, the force must be quickly withdrawn.
How should I put it? It was like a bull speeding at high speed. It came at full speed. I thought it would beat the woman in front of the bull to pieces, but when it got there, the bull braked quickly and kissed the woman's lips gently. of women can’t even feel the kiss anymore!
This was the request, and Zhang Fan not only wanted to touch the organs, but also felt the abnormalities in the organs. Therefore, this kind of physical examination is too difficult.
Falling together,
Between one and the other,
The patient had a horrified expression and his eyes were open.
Then, under Zhang Fan's deep pressure more than a dozen times, the patient finally shouted: "It's right here, it's right here, it hurts right here!"
Zhang Fan was sweating. This was physical labor.
When the patient shouted, Zhang Fan immediately stopped moving, determined the position, and then made a nail mark on the skin.
The female doctor in charge of the bed was dumbfounded. Not only the female doctor in charge of the bed, but also Yan Xiaoyu was dumbfounded.
Really, for many years, it has been rare to see people using this method of physical examination, but today I finally saw it, and it was still so exciting.
Yan Xiaoyu looked at technology, while the female doctor in charge of the bed was like watching a short film for the first time. It was not why the female lead was not wearing clothes, but whether the male lead was inflated.
Too damn amazing.
From time to time, she was even worried that the patient's liver would be crushed by Zhang Fan.
"Both CT and MRI couldn't find the lesion, but the physical examination revealed it!" Yan Xiaoyu muttered to herself.
"Can the diagnosis be confirmed now?" Zhang Fan asked the doctor in charge of the bedside. The doctor in charge of the bedside changed from being unconvinced to something different.
Just like the little white rabbit seeing the big tiger, it began to tactfully say, "Dean, it seems that the dean has colonic diverticulitis!"
Forehead! Zhang Fan was speechless.
"Three days after being admitted to the hospital, I couldn't diagnose it. Not only did I try to find a way, but I also blamed the disease. Director Li, is this okay? Today, I checked out the disease. If there is another one who can't be diagnosed tomorrow, do I still need to check it out? Body?
Am I going to be the director? "
Zhang Fan didn't say he was in charge of the bedside doctor, but he couldn't let go of the director.
The director was dripping with sweat, as if he had done the heaving operation just now!
