Medical road

Regardless of how he works, the disadvantages of poor English are still manifested. I have gone through several rounds of basics in the past two years, but there is a real difference between self-study and teacher teaching.If you don’t understand something at the university, you can ask the teacher.But self-study is not enough, you can only explore and make up for yourself.But self-study is also good, that is, deep understanding and strong personal opinions.

Not to mention English, lack of environment, and Zhang Fan has never paid much attention to it.After two years of smooth wind and water, the director Di of endocrinology suddenly woke up with a pot of cold water.A college student, an ordinary college student, has a car and a house in less than two years. He should be proud, but is Zhang Fan ordinary?It's not ordinary, so Zhang Fan at this moment hurriedly threw away a little bit of pride that had just sprouted, and the road was still long!

Endocrinology is too complicated, and a disease is a research direction, which is a whole and scattered department.Breathing, digestion, and heart are all conditioned and continuity from top to bottom. Knowledge points are all coherent and interrelated, while endocrine is not, jumping, and each secretory organ has its own set Run the program, and function.It can be said that an organ is actually a separate subject.

Although Director Di’s journal for Zhang Fan is not a top-ranked journal in the world, it can be said that the endocrine professional depth is still there. Zhang Fan has no time for half of the liver.Language is really a hindrance to a subject. Zhang Fan's translation took three-sevenths of the time, and there was not much time to study it.The study of foreign books and periodicals finally made Zhang Fan determined to conquer English!

On the weekend, Zhang Fan and Shao Hua finally took the time to stroll around the street for three or four hours. “You’re a bit too hard. You don’t usually drink tea and coffee. As a result, I found out yesterday that all the coffee and tea I bought for you were gone. More than half of it! This is really not good, you are a doctor yourself, you should be very clear."

"Time is a bit tight, and the journal is all in English, there is really no way, hey! I shouldn't regret it!"

"What's wrong?" Zhang Fan successfully turned Shao Hua's attention away. He also knew that this was not good, but what could he do?This is not a matter of competing with anyone, but Zhang Fan competing with himself again!

"Back then, I took medical English as an elective course in the university. I didn’t even study it. As a result, now I don’t even have a professional reference book. This medical word is too ridiculous. Sometimes there are two words in a paragraph, and these two words are still not available. To the corresponding translation!"

"What should I do then?" Shao Hua snuggled in Zhang Fan's arms. The weather got colder, and the relationship between the two became closer. Now Shao Hua can barely agree to Zhang Fan's touch, coughing!Please brainstorm for details!

"There is no good way, you can only check the information a little bit. How are you reviewing recently. Don't put too much pressure on yourself. If you can take the exam, you can take the exam. If you can't pass the exam, then forget it. I can support my family. "Zhang Fan smelled Shao Hua's hair, a faint scent of lavender.

Lavender, usually on TV, it is said that the Netherlands is still Finland, and large tracts of lavender are particularly beautiful.In fact, they are all photographers at a high level. It is true that a large area of ​​lavender is in the tea market, and there are thousands of acres of lavender planting bases. When lavender blooms every year, the blue-purple flower fields breeze like waves in a sea of ​​flowers. , Wave after wave, wearing a white dress and a light yellow straw hat, standing in the sea of ​​flowers is super beautiful!Shao Hua has such a picture, which is extremely beautiful.People are supporting the scenery, and the scenery is presenting people. The mountains and rivers of the frontier are so beautiful!

The essential oils and essences of lavender in the mainland are not known for their color, but the tea market is still good. The consumption of perfumes in several surrounding countries is particularly large. After the production of the essential oils and essences of the tea market, they go directly to the port and go abroad.

Especially in recent years, China's national strength has increased, and businessmen going abroad to do business have also gained a lot of confidence. The lavender flavor of Chasu City directly beats the flavor of Russia out of the five countries of Stanley!I couldn't even think of this kind of thing before!

You can't feel the power of a country when you are in the interior, but you know how powerful this country is to protect you in the frontier.Large quantities of products were sent abroad from the port, and the five countries of Stan could only exchange them for natural minerals.

Zhang Fan doesn't know much about other products, but Zhang Fan knows some about medical treatment.Even the most basic sugar brine in the five countries of Stan is imported from China, not because they cannot produce it, but because China is cheap!The country is slowly infiltrating, and the economy is the first and the culture is behind!

The girls in the tea city use a little lavender, pillows, quilts, and sachets.The most peculiar thing is that there is a young citizen in the tea market, and they even serve pollen when they entertain guests.

When Zhang Fan ate pollen for the first time, he thought it was sesame. This pollen looks very similar to sesame. Take a piece of heat capsule, dip it in ghee and then dip it in pollen. The taste is different from that of sesame and oil. Blended with the scent of pollen, it is particularly delicious, and the more you chew, the more delicious it is.

"Don't worry, there is no pressure, just flip through the books casually, and maintain a consistent professional knowledge thinking. There should be no problem registering for the exam next year!" Shao Hua said proudly.

Studying should emphasize hard work, hard work, and learning methods, but sometimes I have to admire some people with learning talents. The efficiency is really too high. Zhang Fan has no talent for learning, but his liver is good!

After a rest on Saturday afternoon, Zhang Fan's weekend was over, because he had to go to the county for surgery on Sundays. This time, he didn't have to go to the far county town, just in the surrounding counties.Surgery that can be performed on an optional schedule is generally laparoscopy.

In the past, county hospitals were able to perform appendix and gallbladder operations. Since laparoscopy became popular, these county-level surgeries have almost no operations.As soon as the patient heard that it was an open surgery, he left without transfer.

I had surgery in the county in the morning and three operations in the morning. After the operation, it was already more than 2 o'clock in the afternoon. I didn't even drink any saliva. I hurried to Chasu City because Wang Yongyong was going to be discharged from the hospital today.The recovery is good. After all, he is still a young man with a vigorous body. Zhang Fan is going to explain some later recovery matters, and then have a physical examination for discharge. After all, athletes are different from ordinary people, and their injuries are more serious.

Although I can't use force yet, the swelling has subsided.Wang Yongyong sat in a wheelchair and thanked Zhang Fan and Ma Wentao.This is not the time to shoot commercials, but all the previous photos have been taken for comparison with the recovery.Ma Wentao's years of studying abroad did not come for nothing.

On Monday, the large round of the Endocrinology Department began.All the doctors, intern, trainee, transfer, and in-division, started rounds under the leadership of the director and several associate professors.This moment is the moment that Xueba is looking forward to, and the moment when Xueba is most worried and afraid.One ward inspection.

"Six-bed, male, 22 years old. He was admitted to the emergency department of our hospital for unexplained polyuria, and then transferred to our department. After a complete examination, the patient was initially diagnosed with diabetes insipidus." The six-bed tube-bed doctor Introduce the condition to the doctors in the rounds.

"Wang Xiaoyan, go and do a physical examination for this patient." Director Di started the test.Wang Xiaoyan graduated from Tianjin University School of Medicine. I don't know why she didn't go to graduate school. However, she has a solid foundation, and last year's practicing doctor exam results were only about 50 points lower than Zhang Fan.

Physical examination, pay attention to a sequence.From top to bottom, from front to back, a clueless physical examination is not only easy to miss the system to be examined, but also easy to toss the patient. Therefore, a qualified physical examination is exquisite, rather than immutable according to the book.

Wang Xiaoyan was skilled in his technique and reported while checking, “The patient’s pupils on both sides are of equal size and no obvious abnormalities. There is no obvious swelling of the lymph nodes in the neck, no obvious abnormalities in the heart and lungs. The abdomen has no tenderness and rebound pain, and the legs are not See obvious abnormality." After about five minutes, the inspection was over.

Director Di nodded, very standard and couldn't find any problems.When Wang Xiaoyan returned to the team, she gave Zhang Fan a special look. This was not a provocation, but a competition, a competition of skills, and a competition of heart.

"The thirst center is that organ." Director Di turned his head and asked another male doctor who was transferred to the department. The male doctor has not yet entered the state, and this question is too biased, although these special biased questions will not be tested in the exam.

But here is a hospital, facing people rather than machines. A negligence of a problem may cause irreparable damage to the patient, and the human body is a whole, no matter how biased the knowledge points, we must try our best to go Studying and understanding, maybe I encountered such a rare condition of knowledge that day.

"Uh! I'm sorry, I don't know." Director Di is slightly better than Ouyang, but a bit hurtful. She will ignore the lower-level doctors she doesn't like.

"Well, go down and read the book." In a simple sentence, he didn't say anything about the doctor, and he didn't punish him, but this male doctor who was transferred to the department was more uncomfortable than punishment~!The same young people, the same undergraduate graduates, also hope to get the attention and attention of higher-level doctors.

The failure after work is different from the failure of the school. If the school fails, you can come again, and there are make-up exams!After going to work, a failure may be a loss of opportunity, and he does not have a second opportunity to switch to endocrine, so failure should be taken early!

"Doctor Zhang, you said." Director Di turned to look at Zhang Fan.

"Hypothalamus."

"The patient's urine is of that nature, how to rescue it."

"Hypotonic. Hydration, antidiuretic, and timely hormone therapy if necessary."

"There are currently several theories for primary diabetes insipidus." Director Di continued to ask. This question is beyond the scope. Don't talk about transferring to a doctor. Even those who don't study well in endocrinology can not be able to speak up. .

The difficulty in internal medicine lies here. The predisposing factors or causes of many diseases have not been studied clearly, and the medical doctors of major hospitals will make a guess or hypothesis about this disease.

Then, the clinician, according to these big ideas, then go to the corresponding treatment, because these hypotheses are called hypotheses because they have no commonality or uncertainty.

In scientific research, you can slowly experiment one by one, and study one by one, but not clinically. The patient is already lying in the hospital bed, and there is no time for you to study, you have to give someone treatment.

so what should I do now?This is the time to consider the doctors. According to these hypothetical medications, the patient's symptoms are more similar to which theory.Although an experienced doctor cannot determine the cause of the disease, he can treat the symptoms according to the symptoms. Even this technique that cannot be used to treat the cause requires a doctor to study and study for more than ten years to have this foundation.

"Professor Jerome P. Kassirer of the Massachusetts Medical Society (Massachusetts Medical Association) once proposed three theories. Experts in my country have broken down these three theories. The current mainstream view is three items and five items, generally the third type of AVP (antidiuretic Hormone deficiency is the main mainstream.” Zhang Fan replied.

This is the knowledge that Zhang Fangan has only obtained for a week. This knowledge is not necessarily available even if you go to read the postgraduate textbooks for internal medicine books. After all, this has already transitioned from the clinic to the laboratory.

"Listening to your spoken English is too bad. If I hadn't listened carefully, I thought you were speaking Russian." Although it was a criticism, Director Di was speaking with a smile. She could see Zhang Fan. tried.This knowledge point, if you don't study it seriously, it will definitely be ignored because it is too small.

When Zhang Fan finished speaking, Wang Xiaoyan bit her lip because she didn't know this knowledge. It was not that the director was partial, but the director wanted to weigh Zhang Fan. Zhang Fan was already very famous in the hospital director level.

Continue the rounds, everyone questions.The interns and trainee doctors are not under pressure, because the director is good at talking, even if he can't answer, he won't say anything!They haven't realized that this is an opportunity. If the performance is outstanding, it will be very helpful to employment in the future.It is estimated that most of the students who have given up Bird City to come to Chasu City for internship and traineeship plan to graduate and work here in the future.

The most stressful is still some transfer doctors who want to stay in the endocrinology.There are not many opportunities. If you can't grasp it, you will lose it. Life is just a few key steps. If you go on the right path, you will be a little smoother.

One morning passed, and neither Zhang Fan nor the few transfer doctors who wanted to stay in the endocrinologist felt that time passed so quickly.Director Di’s problem is too tricky. Not only must he have a lot of basic memory, but he must also have his own ideas.

A transfer doctor who has just been employed for two years, what ideas can he have!But this old lady can find out whether you have intentions from your little thoughts or opinions.

It's too difficult. Zhang Fan and a few people racked their brains to answer the questions, so many questions were vague. This endocrine is really too difficult.

The last patient's round was over, and Director Di stood at the end of the corridor, surrounded by a crowd of white coats, tall or short, male or female, to conclude.

"In our department, the most patients are diabetes, and the one that is most closely related to diabetes is insulin. Who will tell us about the pancreas today. Give us a lesson, don’t come up if you’re not sure." Director Di said, standing among the crowd. This is clearly fanning the flames.

After several hours of ward rounds, Zhang Fan and Wang Xiaoyan were the most prominent. The two did not make any major mistakes, and they were fairly close together.Wang Xiaoyan has a prominent personality, good study, and a strong personality. In the field of internal medicine, she must suppress Zhang Fan, a surgeon. This is not about people, but an attitude and a spirit.A group of internal medicine transfer doctors asked a designated surgeon to show off in internal medicine. Others didn't know how she felt, but she couldn't stand it.

"Director, I'm coming!" Wang Xiaoyan glanced at Zhang Fan and stood up.

"Yeah! Okay, then Dr. Wang will talk about it." It is Xiao Wang at ordinary times. Now it is Dr. Wang. At this moment, Director Di has recognized Wang Xiaoyan, and Wang Xiaoyan has a status in endocrinology!This is the characteristic of technical units, technical speaking.

When Director Di stepped away from the C position, he glanced at Zhang Fan.Zhang Fan's personality is very contradictory. He can burst out endless courage when he can't retreat, but he doesn't like to behave very much in normal times. This is his personality, no good or bad.

Director Di’s question is very broad. If a knowledgeable endocrinologist talks about pancreas, one day is probably not enough. It is estimated that Wang Xiaoyan will not finish it for one or two hours. In terms of advantages, Wang Xiaoyan's focus and advantages are the biochemistry, pathology, and physiology of pancreatic islets.

"The pancreas is a complex and simple organ. The main tissue cells of the pancreas are composed of Langerhans cell tissue groups~~~" In twenty minutes, Wang Xiaoyan explained the pathology and physiology of the pancreas transparently. This is the skill. , Can explain the function and structure of pancreatic tissue so clearly.

"Yes, it's very concise but it can show us the world of the pancreas, not bad." After speaking, Director Di looked at the opposite Zhang Fan and said: "Doctor Zhang, go up and talk. Talk about your treatment of the pancreas. understanding."

Wang Xiaoyan looked at Zhang Fan with provocation and expectation in her eyes.She also wanted to hear Zhang Fan's indirectness to the pancreas, and most importantly, she had finished talking about the basics of the pancreas, and she didn't know what Zhang Fan was going to say.

"Won't he repeat what I said!" Wang Xiaoyan was a little proud, after all, she was still a young man.

"Um!" Zhang Fan really had nothing to say, Wang Xiaoyan explained very well.Zhang Fan opened his mouth and wanted to say: When Dr. Wang said it comprehensively.He saw Director Di's expectant look and Wang Xiaoyan's provocative look.

Zhang Fan gritted his teeth and went up.When she was wrong with Wang Xiaoyan, Wang Xiaoyan whispered: "Pick up people's teeth."

Zhang Fan ignored her and didn't care about little women!And Zhang Fan didn't intend to repeat what she said, no need, since he came up, he wouldn't be a man if he didn't put something out!

"Dr. Wang spoke very well and helped me understand a lot. Dr. Wang's microscopic understanding of the pancreas is quite thorough, and I have nothing to add, so let me talk about the macroscopic things." Zhang Fan said.

When I said this, other people didn't have any thoughts, but Wang Xiaoyan felt a little uncomfortable, "I actually said that I have a narrow sense!" This is Xueba. If you can draw inferences about it, it is unknown whether Zhang Fan meant this.

Director Di also looked forward to Zhang Fan with interest. Some of the interns and trainees below are already a little impatient. It's very simple. They don't understand what Wang Xiaoyan said some knowledge!

"The pancreas is located deep in the abdomen and cannot be touched from the body surface. It presents a C-shaped duodenum, with the tail extending to the left and close to the spleen."

"Who doesn't know about anatomy!" Wang Xiaoyan was a little disappointed.The world of Xueba is incomprehensible to mortals. She expects Zhang Fan to perform extraordinary, but she does not want Zhang Fan's performance to surpass her.

After a brief introduction, Zhang Fan began to introduce the anatomy of the pancreas in detail.From the normal vascular course to the abnormally mutated course, from the opening of the pancreatic duct to the special mutation of the bile duct and pancreatic duct, Zhang Fan said in particular detail.

Not only was Wang Xiaoyan surprised, but even Director Di looked at him with admiration. Zhang Fan’s explanation was too detailed. The shape of a pancreas, from normal structure to abnormal structure, can cover almost everything in the current literature. Came with hands, too skilled.

Of course I am proficient, can I not be proficient in general surgery after more than a year!Now let Zhang Fan go to university and give students anatomy classes more than enough.That's not a big deal. After explaining the normal functions, Zhang Fan continued to talk about the special features of some abnormal functions and how to treat them.

The best treatment for abnormal morphology is surgery. The shape of the organ that has been finalized is useless to take medicine, so Zhang Fan began to show off his skills involuntarily. Usually, such Zhang Fan is a bit unable to stop the car.

First of all, Wang Xiaoyan said it very well, and then the endocrine of the liver for a week made Zhang Fan experience a lot, so he couldn't help it. He wanted to combine the knowledge learned in the system and merge his own experience.

While talking, there are not many people who can understand below.Continue, "When pancreatic endocrine tumors are in a cachectic state, there are three methods of resection during surgery, one is ~~~~" This time I can't understand it at all, even Director Di can't understand it. Because of the difficulty of this operation, not to mention it in the tea market, even in the capital, few people can do it.

Zhang Fan Balabara said, he was so excited, he was really so excited, he put his own experience and experience into the knowledge of the system, those vague knowledge points before, suddenly seemed to be stripped of the veil. See you naked.

This is improvement, an improvement of self, this improvement is better than the improvement of system blessing. After all, the most powerful thing in the human brain is fuzzy thinking. This way of thinking is very suitable for exploring unknown knowledge.

Once the foundation is solidified to a certain level and the quantitative change reaches the qualitative change, this is the improvement of quality.With regard to the understanding of the pancreas, Zhang Fan can already be said to be a master of pancreatic surgery.

Talking about sex, Zhang Fan ignored the time and the place. Half an hour, one hour, and two hours passed. Ren Lina, who had undergone many years of standing skills training, could not stand.

Although I don’t understand Zhang Fan’s knowledge points, I can understand that this is not nonsense. What is an intellectual, at the very least, is to respect knowledge. At this time, Zhang Fan has no one to bother. If there is a pancreatic surgery department After hearing it, you will definitely be shocked.

Finally, two and a half hours later, Zhang Fan finished speaking, and then suddenly felt something, and looked at everyone with embarrassment.

Doctors including Director Di also looked embarrassed because they didn't understand!Director Di coughed, cleared his throat and said, "Yes, Dr. Zhang has a solid foundation in surgery, but he is a little off topic. Pay attention to it later. It's easy to dispel."

Director Di, who returned to the department, sat on the sofa and rubbed his calf, "Hey! My old leg!"