The Enhanced Doctor-Chapter 627 live questions section down
"Senior Sister Liu Yiqing, I'd like to ask. In the internship at the emergency center, how can we quickly master the skills?" the student chosen by Liu Banxia inquired.
"I'm really not sure how to answer this question," Liu Yiqing hesitated for a moment. "Take me, for example. I'm not even sure when I mastered all those skills. It was all kind of a blur; every day I was just doing one thing or another as directed by Teacher Liu. The first time I noticed some improvement was after assisting Teacher Liu in surgeries. We were split into two groups, taking turns joining him in the operating room. I never imagined I could witness so many surgeries in such a short time. I was so exhausted, I had no energy for anything else. All I was capable of was just enduring. As I endured, day by day, I arrived where I am now. I realized there were no clear boundaries or time to overthink; things just happened naturally. Every day I was either working or catching up on sleep. The first two months were the hardest, but you acclimate eventually. If I had to share any insights, I'd tell you not to slack off. But there's little chance you could; Teacher Liu wouldn't allow it. Once he found out we had completed our internship tasks in general surgery, he assigned us additional tasks in the ICU and pediatric department. So don't be fooled by any formal education plan; the tasks assigned by Teacher Liu always exceed the minimum requirements."
When she finished speaking, Liu Yiqing put down the microphone and moved to the back.
"Senior Sister Xu Yino, what kind of surgeries have you mastered so far?" another chosen student asked.
"I don't think I've actually mastered that many, mainly those related to acute abdominal conditions. Well… if I were to highlight something, it would be minimally invasive appendectomy," Xu Yino said tentatively. "But I only just grasped it, and I can only manage appendicitis that isn't too severe. If Teacher Liu were to perform the surgery, almost all types of appendicitis, as long as they haven't perforated, could be dealt with using a small incision. I haven't yet mastered other surgeries independently, but I have been involved in many level two, three, and four surgeries. In reality, if you want to be proficient in all kinds of surgeries, an internship in an emergency center might not be the best fit. The emphasis in an emergency center is on emergency patients, many of whom are trauma patients, with the occasional patient presenting with other diseases. However, these latter patients primarily come for Teacher Liu, Director Zhou, and Teacher Shi, so they account for a smaller proportion. I guess that's pretty much it; we've essentially muddled through to this point. Um… just one more thing. As Teacher Liu often says, the basics are crucial. Especially for us who perform surgeries, mastering the basics ensures a smoother process during surgery."
After finishing, Xu Yino stepped back as well.
"Okay, next patient. Oops, my mistake! Next student," Liu Banxia selected another one, laughing.
"Senior Brother Su, I'd like to ask you a question," the newly selected student said.
Su Wenhao once again walked to the podium.
"Senior Brother Su, what motivated you to stay in the emergency center? From our understanding, working in the emergency center is always extremely exhausting," the student said.
"There's no special reason; it's mainly because of Teacher Liu," Su Wenhao said, smiling. "My family's financial situation is poor, and they really wanted me to go back home to develop my career. But I felt that if I went back, I would just stagnate, with no opportunity for further development. Teacher Liu is bold. Once we pass his assessment, he's bold enough to let us undertake high-difficulty surgeries. Sometimes, we ourselves are very apprehensive, but Teacher Liu remains unfazed. If you also want to intern in the emergency center and receive guidance from Teacher Liu, my advice is: attitude is important. You need to show a willingness to learn diligently. Only then will Teacher Liu notice you and create a learning plan for you. The learning plan for each of the six of us is slightly different. The surgeries we participate in each have a different focus. Although we haven't completely mastered these surgeries, our foundations are solid. Teacher Liu places a lot of emphasis on basics. If your basics aren't up to par, don't expect further guidance. Working in the emergency center is indeed exhausting. If there's a surge of patients, you may not even have time to eat. However, in the emergency center, we do face many challenges. After successfully overcoming a challenge, we can swiftly handle any sudden issues that arise. The point is pretty much what Xu Yino said: basics are truly important. We spent quite a bit of time just mastering basic debridement and suturing. Let me offer you some advice: if you don't have the determination to persevere and are merely driven by a fleeting impulse to intern at the emergency center, you will suffer."
"Hold on, hold on! I came to promote our emergency center, and you're scaring everyone off," Liu Banxia said, sounding exasperated.
Su Wenhao shrugged. "Otherwise, it's a waste of time. The students will suffer, and you, Teacher Liu, would find it even more distressing. After careful consideration, even if faced with some difficulties, they'll grit their teeth and overcome them, right?"
Liu Banxia waved his hand. "Listen up, everyone, it's not as difficult as they make it out to be. Even though our emergency center is as challenging as a game on its highest difficulty setting, it's also quite fun every day. There's one more thing I forgot to mention, which I bet many of you have been wondering about. Remember the fecal transplant case we had at our emergency center? Regardless of whether it was a wild guess or how it was figured out, the patient's condition has improved. Before the fecal transplant, they defecated about fourteen times a day. Yesterday, the count was down to nine times. This is a success, and we plan to perform a second fecal transplant tomorrow. We hope it will have an even better effect and fully suppress the symptoms of C. difficile. Alright, the student in the eighth row, thirteenth from the left, it's your turn to ask a question. You've had your hand up from the start, so it's only right that you get this chance."
"Teacher Liu, I have a question for you. We've heard that you've diagnosed many complicated cases. What insights can you share?" the young man asked directly after grabbing the microphone.
"Well, it's slightly off-topic, but I can answer this question," Liu Banxia said with a smile. "As for insights, there isn't anything really special; it's usually just routine tests and examinations. If you want to know the key point, it is that we have to consider every symptom of the patient and every abnormal finding on the test reports. 𝘧𝓇ℯ𝑒𝓌𝑒𝑏𝓃𝘰𝘷𝘦𝘭.𝒸ℴ𝓂
"Some time ago, we had a patient with a marked lesion in the head of the pancreas, but her tumor marker screening didn't indicate cancer. So, what could we do? We had to perform a laparoscopic exploration and consider a biopsy. There are many complications from pancreatic biopsy, so we generally avoid it unless absolutely necessary. In the end, we diagnosed this patient with infiltrative pancreatitis, which can be treated with medication. I say this to boast a little about myself. When we were doing the laparoscopic exploration, we noticed some very subtle, easily overlooked signs in the patient's other organs.
"Also, a while ago, we treated a college student who had experienced rapid weight loss. The initial diagnosis was a parasitic infection, and a shadow was also found in his lungs. The conventional approach would have been a biopsy. Because it was encysted, it wasn't detected in the stool examination. However, our experienced Dr. Wang Huan promptly stopped us, suspecting echinococcosis. Even though I knew that the patient came from a pastoral area, that possibility hadn't even entered my mind. Just imagine what would have happened if I had ordered a biopsy for the patient. I don't need to spell it out; you can figure it out yourselves.
"We must be meticulous and carefully discern what information provided by the patient or their family is useful, and what might be unintentionally misleading. We can't fully trust everything a patient says, nor can we discredit them outright. We constantly face this dilemma when diagnosing patients because they aren't well-versed in medical knowledge and can't describe their symptoms using textbook definitions.
"Diagnosing illnesses isn't easy; with every patient, it's a battle of wits and resolve. Moreover, we need to be extra cautious when ordering instrumental diagnostics. Instrumental diagnostics are often the primary means by which we confirm a patient's condition. We must prescribe tests based on clear indications. Even if medical insurance covers some of it, out-of-pocket expenses can still be a heavy burden for some families.
"When I say this, many people might think it's nothing special. 'A doctor's heart is like that of a parent,' right? They'd surely think about this before ordering tests. But think about it: when there are twenty or thirty patients waiting outside the clinic, can you still maintain that same composure?
"Then there are patients for whom, even after three rounds of instrumental examinations, there's still no clear diagnosis. So, what do you do for the fourth round? It's very difficult to order that next test. This is also when disputes between doctors and patients are most likely to arise. This is very important; all of you need to think it over carefully. Because these are issues we will all face once we put on our white coats.
"Diseases these days are too insidious. People living in the north might contract diseases typically prevalent in the south. Before making a diagnosis, we might not even consider such possibilities, leading us down the wrong path. Another point is that some conditions are correlated, while others are not. When making a differential diagnosis, we need to be even more thorough.
"Diagnosing a patient is a very arduous process, and we all strive for a successful diagnosis. However, some diagnoses are very difficult to establish, requiring us to be exceptionally careful and thorough in our differentiation. We might still be unable to provide a definitive diagnosis, but we can take responsibility for every medical order we give. Because we issue them with a clear conscience, not just by adhering to routine protocols."
CLAP! CLAP! CLAP! CLAP!
Just as Liu Banxia finished his speech, a round of enthusiastic applause resounded from the audience.
