Chapter 488： exchange

6 o'clock in the morning.

Zhang · Hepatobiliary Surgery · Primary attending · Tired to die · Sore body · Rather than want to get up after death · Have to get up early · Anmin, has arrived in the ward.

Previously, Zhang Anmin, like most weak chicken attendants, had non-director rounds to work at 8 or 8:30 in the morning, started rounds at 9, and then went to surgery for about half a day.

In this case, two hours before work, Zhang Anmin has enough time to change the diapers, wash the noodles, cook a rich breakfast for his wife and mother-in-law, and then leave home in the eyes of the mother-in-law.

After returning home, Zhang Anmin also had enough physical strength to make a dinner, feed the children, change diapers, and then accept the "I'm not easy" mother-in-law, then coaxed his wife, and had time to wash and take a bath to do housework.

Since Ling Ran lived in the operating area, such days, he has gradually moved away from Zhang Anmin.

The first point is that Ling Ran has a lot of questions during the operation-not many in absolute terms. However, if a surgeon is asked more than five unanswerable questions in each operation, it is embarrassing in the operating room. Almost solid.

In order to avoid such embarrassment, Zhang Anmin can only come to the operating room to check in rooms in advance, and then simulate the plan according to the patient's condition to make advance preparations.

Every day of surgery, to Zhang Anmin, it is like a director round.

However, Zhang Anmin persisted.

As a doctor, who is not nine years of compulsory education plus five years of bachelor's degree, three years of master's degree, one year of internship, three years of training and three years of hospitalization, even if it is shameful, you have to lose high-end.

On the other hand, Zhang Anmin was also willing to take the title of being bullied by Dr. Ling, and grieved for more surgery and performed surgery under the guidance of a senior doctor.

As an adult in his 30s, working hard and studying hard every day sounds good, but when it is implemented, it inevitably has to be ridiculed and discussed.

If you don't have a strong heart and a clear goal, it is very unpleasant and it is easy to give up.

When Zhang Anmin was staying at school that year, why did he have to go to class to sleep and hide in the bathroom secretly at three in the morning?

Now, Zhang Anmin feels that it is a good deal to not only learn the surgery with ease, but also get the sympathy of everyone.

As long as the housework and breakfast that can only be done in the past one and a half hours are concentrated in one hour, then coax the wife more, cheek to the mother-in-law, and the life will always pass.

"Hello, let's check the room." Zhang Anmin walked into the ward and spoke in the newly learned "Precautions for Home Inspection in the Early Morning".

The patient rolled over.

Zhang Anmin smiled, then raised his chin, and the resident doctor who came along seemed to be a pseudo-army, knocking on the bedside and shouting, "Hello, check the room."

Then, Pei Pei and the intern also stood in front of them and shouted, "Hello, round!"

This is an independent research method developed by Zhang Anmin independently, which improves the efficiency of bed inspection in the morning. The side effect is that the attitude of the awakened patient is worse.

"Check." The first patient awakened was always not so happy.

Zhang Anmin shrugged. The problem of premature ward rounds is here. If a ward round is made at 9 o'clock, the attitude of the patient and family members is very good. Most patients still have to find ways to make the attending happy.

But at 6 o'clock in the morning, there are fewer intimate patients.

"Get started." Zhang Anmin snorted.

The resident doctor said "oh" quickly, "The patient is 55 years old and complains of repeated pain in the right upper abdomen for one year, which is aggravated, and the pain persists for 2 hours before the hospital. CT shows that the gallbladder is enlarged and the intrahepatic bile duct is dilated ...

Residents with a tube bed will come earlier than the attending doctor.

Generally speaking, the minimum requirement is to come half an hour early and memorize the contents of these rounds.

When encountering severe doctors, it takes an hour or even every day to recite these specific contents, and then repeat them one bed at a time.

For residents, this is one of the pain points of early work, especially when the attendant who needs a rounds inspection at 6 o'clock, the residents must get up at 4 o'clock, rush to the hospital at 5 o'clock, and recite the information ...

The process may seem programmatic, but in hospital life, this is just the beginning of pain.

Zhang Anmin, who has become the primary attendant, can't help himself, and can't care about the life and death of the inpatient. The way to comfort the other person can only be a smooth question: "What disease do you think?"

"In terms of comprehensive CT, cholecystitis is undoubted." The hospital doctor said.

"What again?"

"Again ... is it possible to have a cyst?"

"Anyway?" Zhang Anmin has been asked a lot more recently, and he consciously needs a reverse output.

The inpatient asked me a little bit. At 6 o'clock in the morning, normal people are either Zhengxiang who sleeps, or just want to go back to bed when they don't understand, or they just want to go to bed after morning cannon, or they are full I want to go home to bed after breakfast, how about myself? How could you call someone out of the rounds?

The resident's brain filled the paste, and gave him an answer: "Or consider tumors?"

The sick patient on the bed was agitated: "Tumor? Cancer? I have cancer?"

"You don't have symptoms of cancer!" Zhang An's popular Liuqiao smoked, glaring at the hospital doctor.

Turning his head, Zhang Anmin also did not sell offense, and said to the patient: "You suspect that there is liver fluke disease, and the multiple expansion of the intrahepatic bile duct is a relatively typical symptom. This disease needs to be taken seriously, but it is related to cancer It's not an order of magnitude. With treatment, you can be discharged soon. "

Zhang Anmin looked at the patient, for fear of frightening the problem, and took the film out again, saying: "CT can see it, the state of inflammation, the edges are clear, you don't need to worry ..."

"That's liver fluke disease?" The patient breathed a little sigh of relief.

"Yes, do you know about liver fluke disease? Mainly parasites, do you usually eat sashimi?"

The patient thought for a while and said, "The kind of little Japan? I don't eat."

"It is also possible to drink raw boiled congee and undercooked barbecue." This time the voice came from the door.

Zhang Anmin felt familiar and looked back unbelievably.

"Well? Dr. Ling? Are you out?" Zhang Anmin looked at the figure standing at the door.

Because the back was facing the door, the lights in the hallway just happened to shine, so that the other side's face was full of halo and could not see clearly. However, depending on the figure, the temperament, the handsome style, Zhang Anmin certainly knew that this was Ling Ran.

No one else is possible.

Yunhua cannot exist, Changxi cannot exist, and the whole world cannot have it.

"It's okay to slip out." Ling Ran stood in the corridor of the hospital, looking like he was shopping. The open ward made Ling Ran happy when he saw it.

Several other little doctors also said helplessly.

Ling Ran smiled and nodded, then walked in again and asked, "How is the bile duct in the liver?"

"Not enough to be removed." Zhang Anmin's answer went directly to the core of the question.

Ling Ran "Oh", approached Zhang Anmin silently, asked for a medical record and looked.

On the contrary, Zhang Anmin was hesitant: "What are you?"

"I want to learn about ward rounds in hepatobiliary surgery." Ling Ran answered frankly. He has been in the operating room long enough, but he is only performing surgery, and does not involve rounds, consultations and prognosis in the ward.

Zhang Anmin looked at Ling Ran's handsome face, and the alarm bell rang in his heart.

Zhang Anmin said with vigilance: "Dr. Ling, are you going to start your cholecystectomy yourself?"

With the frequency and speed of Ling Ran's operations, Zhang Anmin was very skeptical that his main cholecystectomy would disappear.

Ling Ran just smiled and said, "I have to practice again."

Cholecystectomy is not systematic, so it is only an entry-level level. Ling Ran is not in a hurry to carry out this operation immediately. His foundation is good. After accumulating and practicing for a period of time, it will improve very quickly. At the very least, somebody has to coach him so that he can do it with quality and quantity.

Zhang Anmin's complexion changed.

This shows that Ling Ran's days of hepatobiliary surgery alone will come.

Zhang Anmin can't help complaining. The fans in the hospital are too patient. If it was divided halfway to Ling Ran ... No, he wouldn't be halfway ...

Zhang Anmin thought of this, to summon the courage of the whole body, coupled with the mental retardation in the early morning, bravely said, "Dr. Ling, our rounds of liver and gallbladder surgery cannot let you follow."

Ling Ran asked in confusion: "Why can't you see?"

"Because ... because ..." Zhang Anmin couldn't say something.

Ling Ran said naturally: "We can exchange and learn, you will take me with a cholecystectomy and I will take you with a liver resection."

Several small doctors in his treatment group were almost exhausted, and it was impossible to start learning to do liver resection immediately. There were too many prerequisites to learn.

Therefore, Ling Ran's liver resection surgery was done by himself. Lu Wenbin and others could only learn fur.

In contrast, Zhang Anmin has been undergoing hepatobiliary surgery for almost 10 years, and the prerequisites for liver resection have been met. Ling Ran also avoids the need to find a doctor in hepatobiliary surgery as an assistant when performing major surgery.

Zhang Anmin's cheeks slowly turned red

"Liver resection? Really?" Zhang Anmin asked.

"Really." Ling Ran's sincerity, the handsome ward full of suppressed breathing.

"Then ... it's settled!" Zhang Anmin swallowed, his hands were covered with sweat, and it felt like he had won a big prize.

In hepatobiliary surgery, the liver is always the first place, and it occupies an absolutely important position. In terms of complexity and importance, gall is far behind.

Zhang Anmin always wanted to have liver surgery, but he never got the chance to get started.

Hepatectomy is the top priority in liver surgery. If this is learned ... Zhang Anmin has begun to think about promotion and salary increase, and ask the nanny to rent a big house.