Six Hundred and Sixty-Seven, There Are Still People Working Hard

, the medical road is smooth

"Zhang Yuan, if you are dissatisfied with my work, you can transfer me to the community outpatient clinic, or transfer me to the branch hospital. You hold the knife like this, I am under too much pressure. The director of the gastroenterology department cried several times time."

If the director of endocrine was ten years younger, she would definitely be a somewhat enchanting young woman.

It's not about her face, but about her demeanor that people can't ignore. It's impossible to describe it, but there is a feeling between the eyes and eyebrows that makes men jingle, really, a little bit Not exaggerating.

If this kind of woman reads more books and has a bookish air, really, Dongzi's milk tea girl and various celebrities are definitely not inferior to them, and the endocrine director feels like a big mansion The son and wife in the house.

Because he has a son on his body, he is tough, but because he has his parents-in-law, he also has a little weakness, and he wants to play a little temper in his knowledge.

Zhang Fan looked at her and said nothing. His complexion didn't change much. It's a good thing to be stressed, and it's even better to be ashamed. A dead pig who is afraid of honor and disgrace is not afraid of boiling water. I am like this, what can you do to me, come on, I will spread my legs and stay still, what can you do to me!

"There are now sixteen doctors in endocrinology, and five families run companies. They drive either an Audi or a Mercedes-Benz to work. There is also a daughter-in-law of a winery owner who works a little overtime, and she says her blood sugar is low.

The others are either the wife of the director or the daughter-in-law of the director, what do you want me to do! I did a glucose tolerance test last time, and the result was more disgusting and tiring than the other, and I didn't even give overtime pay. It's hard for me too, don't I want to be a good director?

It's hard for me too! "

The objective factors she mentioned do exist.

The smaller the city, sometimes the more concentrated some characters are, and the pressure is relatively less. These people, if you give less money, they really don't move at all, they just do what they say, waiting to retire. You let her resign, and you need this job to save face. After all, it seems too embarrassing for a powerful daughter-in-law to be a housewife.

Zhang Fan would definitely not be happy if he gave too much money.

"Tell me about yourself. You have published several papers in core journals in the past few years. You are the director of endocrinology, not a doctor who runs long-term outpatient clinics and waits for retirement. Look at you. Back then, Bian University was one of the first batch sent to study in the capital. Director of Endocrinology.

I went in the same batch as you, not to mention, were Dean Yan Xiaoyu and you classmates at the time? Regardless of the position, if you look at other people's achievements in the past few years, and then look at yourself, I think you spend more time looking through fashion magazines than periodicals.

Look at your office, can you find the latest endocrinology journal? Think for yourself! "

After Zhang Fan got up and left, the director of endocrinology was about to be told to cry. Seeing Zhang Fan press the elevator up to the 16th floor, the director of endocrinology said in a crying voice: "Who the hell said Zhang Yuan would come to the endocrine department?" , I’m going to tear her mouth apart today!”

When they heard that Zhang Fan had been admitted to endocrinology, the directors of the various internal medicine departments breathed a sigh of relief. Men and women all know, just those few strokes, when he gets tired, the latter ones will be relatively loose, the most feared is the first three strokes .

Especially the director of the Department of Gastroenterology felt that she had passed the test. When she heard that Zhang Fan had entered the internal medicine building in the morning, her heart almost jumped out of her mouth. As a result, Zhang Fan went to endocrine.

"You said that Zhang Yuan is not as fierce as Dean Ou. Why do I always feel frightened when I face Zhang Yuan?"

"It's probably because Zhang Yuan is young!"

After the director of the Department of Gastroenterology and the head nurse learned that Zhang Fan had entered the endocrine system, they stood at the elevator door and said a few words casually.

Then the director of the gastroenterology department took the doctors to make rounds.

In the end, before checking a few patients, the head nurse Huarong ran over pale, "Yuan Zhang is here, Yard Zhang is here,

Already at the nursing station!"

The director of the gastroenterology department has the urge to urinate.

Everyone thinks that the system is cruel, but in fact the medical industry is even more cruel.

For example, if you fail to compete within the system, you can still transfer a department or even a unit, but medical care is different.

Especially in Chasu, now that Chasu Hospital is the only one, you are really going to be dismissed as the director of the department, and you have no place to go.

You are in the department, making it impossible for the new director and colleagues to carry out their work. The new director will definitely suggest to the leader to let you leave.

But where can you go? Go to Hua Hospital? Go to the branch? Or go to a community outpatient clinic as a clinic director?

Therefore, the current situation of the tea element is that it can only go up but not down. Once it goes down, it will be really embarrassing unless you change places.

And Zhang Fan clearly expressed his dissatisfaction with internal medicine at the doctor's conference. He didn't give Ouyang Renli face at all, let alone Yan Xiaoyu later.

In particular, he mentioned gastroenterology and endocrinology by name. In Zhang Fan's words, he is capable and cannot leave.

"Zhang Yuan..." The director of the Department of Gastroenterology glanced at Zhang Fan anxiously, and greeted him.

"Continue with the ward rounds!" Zhang Fan didn't say much.

Just behind the doctor group, followed the ward rounds, while the head nurse followed Zhang Fan, secretly watching Zhang Fan's face, trying to figure out Zhang Fan's mood.

The doctors in the Department of Gastroenterology are active at this time. The director is afraid of Zhang Fan, but they are not.

Therefore, when the director asked questions, one answer was better than the other. Especially after Zhang Fan said that he was dissatisfied with the Department of Gastroenterology, the doctors worked hard in private.

"Abdominal pain, the doctor in charge of the bed, tell me how this abdominal pain is formed." On the ninth bed, the patient has chronic abdominal pain all the year round, idiopathic abdominal pain.

Idiopathic, in fact, to put it bluntly, you just don’t know the reason. Anyway, it’s just that people are here, and you don’t know where they come from and where they are going.

Dr. Wu, a senior vice-senior in the Department of Gastroenterology, has been suppressed in the position of vice-senior because of the limited number of senior positions in the hospital.

In the past, I didn't take much part in the fights in the department. Especially in the competition of drug dealers, he will never care.

Since the hospital got better and better, he also had an idea in his mind.

When the director of the gastroenterology department asked a question, the resident doctor was about to speak, but he spoke directly, because he was the senior physician of the bed doctor.

"Abdominal pain, the mechanism of abdominal pain must first be clarified. The total area of ​​epithelial cells in the gastrointestinal tract is larger than that of a tennis court. In such a large area, there are intricate neurons and ganglia. It has between 10 million and 10,000 neurons. Between ten thousand, it is equivalent to the sum of neurons in the spinal cord.

And this is an independent nervous system, which has complex and systematic interactions with the central nervous system.

According to the current research, the development of symptoms of irritable bowel syndrome has a clear relationship with the enteric nerve, autonomic nerve, and central nervous system, especially in..."

The more old Wu Yue spoke, the more he felt, and the more he spoke, the more profound he became. The face of the director of the Department of Gastroenterology turned green, but he still had to pretend to be listening very seriously.

The other doctors didn't know what to think, but Zhang Fan listened very seriously.

Everyone has everyone's understanding of this thing, not to mention this kind of internal disease, each person has his own opinion, and this kind of senior doctor who has studied it has a lot of clinical experience, and his own experience is absolutely equivalent. It's amazing.

This is what Zhang Fan needs most now. The treatment of medical diseases is diversified, and it is not the same as surgery.

Although surgery is also said to be diversified, it is actually relatively single compared to internal medicine.

It is always around the lesion to find a way to cut the knife. Even with the current minimally invasive and interventional procedures, the ultimate goal is still the lesion.

Internal medicine is different.

So Zhang Fan listened carefully at the end.

Irritable bowel syndrome is a disease that many people have heard of. It is actually similar to cardiac syndrome. Clinically, most abdominal discomfort diseases are classified as irritable bowel syndrome.

Therefore, some patients feel comfortable after taking a certain drug, and their intestines are comfortable, and then recommend their own drug to another patient. As a result, the other patient cannot pass stool for a week after taking it, and even wants to stuff it. An eel to dredge it.

In fact, this is the disease, although it has a name, it is not actually a disease.

This disease kills you, but it also makes you uncomfortable. The evidence-based medicine of the Golden Retriever country reports that 1/6 of the people in the Golden Retriever country suffer from IBS, and the incidence rate of women is higher than that of men. People over the age of 60 have a lower incidence, and 30% of patients spontaneously disappear over time.

Moreover, what is more troublesome is that many patients with irritable bowel syndrome seldom seek medical treatment. Once they enter a tertiary hospital for treatment, 40% to 60% of the patients often have mental symptoms, especially some patients who have received medical treatment. People who are physically or sexually abused are more likely to develop severe IBS.

There is also a special point, that is, those who experienced psychological trauma in childhood are prone to this symptom.

For example, constipation and bloating, sometimes it’s not that you eat too much, maybe you are a patient with irritable bowel syndrome. But you don't know.

"What about the treatment? According to the conventional treatment, does this disease require the intervention of psychotropic drugs!"

Zhang Fan asked a question, and when Old Wu finished speaking, Zhang Fan asked the question immediately. At this moment, all the people stood at attention collectively and turned around, looking at Zhang Fan.

Is this going to go crazy again? The thoughts of ordinary doctors.

Is this right? This is the director's idea.

"No, the golden retriever country is more inclined to give psychotropic drug intervention. Although my data is relatively small and has no reference value, since I took over the first IBS patient back then, I found that the life span of the patient is no different from that of normal people. .

Moreover, the doctor's comfort and explanation seem to be more effective in the treatment of this disease than drugs. Our current treatment tends to be symptomatic. Constipation is treated for constipation, diarrhea is antidiarrheal, and antispasmodic drugs are given for pain.

But I did a single-blind test, and after treating the patient with a placebo, I gave a lot of explanation and comfort from the side, and the patient said that the drug works well! "

Doctor Wu looked at Zhang Fan and said.

"Nonsense!" Zhang Fan said softly.

When Dr. Wu heard this, his face darkened. Zhang Fan turned around and left, but when he left, he added another sentence: "This experiment is to apply for the experimental funds of the hospital, don't do it like this next time!"

"Okay!" Only he knew what Lao Wu was feeling. But there is hope.

And Zhang Fan left in a hurry because the gastroenterology department in the system was about to start testing again.