medical simulator

After seeing Zhou Cheng, he must have known Zhou Cheng a long time ago, so he quickly led Zhou Cheng into the consulting room where the computer had been turned on a long time ago, and then said: "Dr. Zhou, I am your medical assistant. I will write to you medical records."

The voice is not as soft and waxy as the senior sister Luoli I met before, but more delicate and sweet.

Zhou Cheng blinked and said, "Thank you, but I'll write the medical records myself. You may not be able to write well for some orthopedic examinations."

Zhou Cheng directly refused, and he must do a physical examination when visiting the outpatient clinic, and the other party will definitely not.

Seeing Zhou Cheng's direct refusal, the girl froze for a moment, then nodded and said, "Okay, Doctor Zhou, let me help you maintain order."

Zhou Cheng did not refuse, and at eight o'clock, Ziyi let the first person in on time, and was still guarding the door, saying: "Just one patient and one family member come in, don't have too many people. .”

As soon as the patient came in, she closed the door, and then stood at the door, looking towards Zhou Cheng, looking rather pitiful, and her eyes were genuine, as if she really wanted to know Same.

Zhou Cheng thought for a while, then waved to her and said, "Come here and ask about the medical history."

This kind of eyes is definitely the eyes of seeking knowledge, he has seen it from Fang Yun's eyes, it is very similar, very pure!

"Okay, Doctor Zhou." Zi Yi hurriedly sat down, and then started the consultation.

"Hey, why are you uncomfortable..." Zi Yi still has the basic skills, and her voice is very sweet.

So soon the patient spoke up.

"Here, the pain is very painful. It has been in pain for a long time. I have seen many hospitals, but they all said that it is not curable. Last week, I also came here, but Director Tong said that this week, a specialist will come. So let me Let me take a look." The old man, about five or sixty years old, was talking by himself, and then pointed to his hip.

Standing next to him was his son, who patiently waited for his father to finish speaking before adding.

"Doctor Zhou, my father had seen it at the Affiliated Hospital of Shonan University before. He said it was femoral head necrosis and he needed surgery to replace the joint."

"I'll come and see, what's your opinion." He was standing, carrying a large bag of examination materials, which contained X-rays, CT, and MRI.

Ziyi stretched his neck and looked curiously. Zhou Chengcheng said, "Go ahead and ask about past history, allergies, and detailed diagnosis and treatment procedures."

Then, after focusing on the old man's plain film and various inspections, he frowned severely.

With such a collapsed femoral head, how can this old man walk to the clinic?

Chapter 3 and six forms of sentient beings!

Auxiliary examination is an important tool for judging the severity of a condition. From the tool, one can roughly infer the severity of the patient.

Zhou Cheng turned around, looked straight at Ziyi's question, and listened to the answers one by one. At the same time, he evaluated the approximate identities of the elderly and middle-aged people by their attire.

The middle-aged man is wearing a shirt, formal pants, and a watch that should be expensive. When he speaks, he is quite polite, and his cultivation is not bad. What's more, the implication is that he actually misses his father very much. Through surgery or other means, to solve the current pain.

However, the old man heard Ziyi's suggestion: "Since the professor at the Affiliated Hospital of Shonan University recommends you to have an operation, why don't you choose to have an operation?"

The old man was probably in his 60s. Hearing this, he stepped back and shook his head like a rattle: "I don't do surgery, I don't do surgery. I don't do surgery that replaces bones. "

After shaking his head, he looked at Zhou Cheng with some disappointment in his eyes, and said, "Doctor Zhou, in fact, you don't have to be embarrassed. I know my own illness very well. You just need to prescribe some medicine for me." Painkillers are enough, but I don’t want surgery.”

Zhou Chengcheng quickly answered the call, stretched out his hand to comfort him and said, "Whisper, don't get excited, let's talk slowly."

"Your condition is very serious now. Every step you take is suffering. But your situation is not complicated. After the operation, you can mostly return to normal. What do you think?"

"At your age, it should be the time when you can take care of more children and enjoy family happiness."

Zhou Cheng was puzzled. Logically speaking, the old man's family background is not bad, and his knowledge is not superficial.Moreover, the current joint replacement surgery is very mature and the curative effect is very good. Therefore, Zhou Cheng hopes to find the old man's inner nostalgia through speaking skills.

In the past, when Luo Yun worked in the outpatient clinic, he communicated with patients through different speech skills and communication methods, allowing them to make the most suitable choice for themselves.

At that time, Zhou Cheng was just a foil, unable to take the position of sitting in the clinic. Now he has to take charge of everything on his own, and he has to slowly deliberate on the way he gets along with patients.

Hearing the words, the old man was obviously moved, but he shook his head resolutely.

"I don't want to have surgery."

Only then did the middle-aged man sigh slightly, and explained in a low voice: "Doctor Zhou, it's actually like this, and it's mainly my fault."

"My mother died unexpectedly because of the operation. I used to be young and ignorant, and we young people had some complaints about the old man. Dad, can't you get out of that knot? Mother's death has nothing to do with you."

Zhou Cheng's heart moved, but he didn't interrupt.

But the old man was even more stubborn. He stood up and was about to leave: "I don't want to have surgery, I don't want to have surgery."

A little anxious, he staggered out. Seeing this, the middle-aged man hurried over to help him, with a helpless expression on his face.Ziyi didn't know how to deal with it, so he turned his head and looked at Zhou Cheng, probably asking if he should stop him.

Zhou Cheng said: "Let's sort out all the patient's examination materials and return them to them."

Zhou Cheng couldn't understand how long it took for the outpatient clinic, the past between the old man and his son, and the extent to which the middle-aged man criticized his father.Perhaps, being young and ignorant, he has complained more than once that it was his father who killed his mother.

Or maybe the old man was afraid of his wife leaving, so he didn't dare to take risks. He had a kind of fear from the heart about the operation.

After Ziyi packed up, he was ready to go out, but Zhou Cheng snatched the plain film from his hand and said, "Let me deliver it. You lead the next patient to the consulting room."

Zi Yi nodded and said yes.

Zhou Chengcheng pushed the door and chased him out, and took the registered number in his hand.

After catching up with the old man and the middle-aged man, Zhou Cheng smiled and said, "Your film has pulled the outpatient room. In addition, you can also cancel the registered number. It's a pity that it didn't help you."

The middle-aged man took Zhou Cheng's flat film bag, thanked him, and explained: "Doctor Zhou, how can I return the number I registered? I'm sorry to cause you trouble."

"Dad, let's go home, we won't have surgery. I'll listen to you, I won't force you, I'm sorry!~ But I really know I was wrong." The middle-aged man apologized to his father with red eyes.

When he was a teenager, he lacked maternal love, so during the rebellious period, he hurt his only father's love. At that time, he was still underage, so how could he know whether his father's choice was right or wrong?

Now that she has achieved success and fame, it is already too late when she wants to be filial!

Old children, old children, old people are like children, when they get along with their own children, they are cautious, and they may still be afraid of themselves. The harm done to him back then cannot be reversed...

Zhou Cheng saw that the old man's legs were still trembling slightly, which must be caused by the pain.

The necrosis of the femoral head has collapsed to such an extent that it is impossible to walk anywhere, and it is impossible to stand.

Zhou Cheng didn't continue this topic either. He is not the old man's son, nor the old man himself. If he is not good, he will be relieved. If he does not suffer from others, don't persuade others to be kind.

Zhou Cheng just said: "Hey, if you really can't stand it, you can still come to me. I won't advise you today, but in your situation, if you lack exercise in the future, you will shrink. Then he became more and more unable to move, and became paralyzed over time, and it would be too late for surgery at that time."

"I don't advise you to have an operation, but there is always a way to relieve the symptoms. You can relieve the symptoms through hospitalization and make your quality of life better."

When money is no object when a patient sees a doctor, then the problem is more difficult to solve.

The old man looked at Zhou Cheng thoughtfully, but still resolutely walked towards the elevator, apparently not wanting to turn back.

Zhou Chengcheng could only turn around and return to the consulting room.

Doctors don't knock on doors. When patients have their own attachments and choices, don't regard yourself as the savior.

After briefly ignoring the patient, Zhou Chengcheng returned to the consulting room.

The second patient was younger, about six or seven years old. He was a little boy, quite ignorant. Seeing Zhou Cheng in a white coat and Ziyi, he was very frightened and hid behind his father. timid.

The person who brought him here was a middle-aged man, very simple and honest, dressed plainly, caught the child out, and took the initiative to purse his lips and said: "Doctor, this is my son."

"I have also taken him to many hospitals, but they found nothing, and they all said that there is no cure. I heard that Changshi has a great expert here, so I wanted to take him to have a look."

As he spoke, he exposed the wrists and feet of the child in long-sleeved trousers!

Then I saw that the child's right forearm and the middle of the thigh of the left lower limb were extraordinarily slender, and there was a curved deformity.

Seeing this, Zhou Cheng realized something, put on his gloves, carefully held the forearm of his right hand, and looked at it carefully in front of his eyes: "Have you ever had a fracture?"

The middle-aged man nodded: "It's easy to fracture, and you can't even touch it. A little force will cause a fracture. I have fractured several times before."

Osteogenesis imperfecta (brittle bone disease)!

It can also be called porcelain doll disease. It mostly occurs in children. The bones are very fragile. A little external force can cause fractures. At present, there is no special treatment method...

Zi Yi was a little stunned, but also looked at it curiously.

Zhou Cheng felt a little helpless, so he said, "Let me take a look at the flat film first."

Then with the help of Zi Yi, the plain film was spread out, and it can be seen that the bone of the child's affected limb is like a bow, very slender, the bone is quite loose, and the bone marrow cavity is extremely small.

After reading it, Zhou Chengcheng asked: "How old did this start? Which hospitals have you been to before?"

"I'm about 4 years old. It's been several years. I have suffered several fractures. After each fracture, I just put a plaster cast on it. They say it's a branch fracture and it hasn't moved. I have been to the Affiliated Hospital of Shonan University and I have been to the hospitals in Guangdong Province, and they all said that it can’t be cured, so I can only pay more attention.” The middle-aged man replied.

At the same time, looking at Zhou Cheng was full of anticipation, as if he hoped that Zhou Cheng could provide a specific treatment method.

Broken branches?Oh, it's a green stick fracture.

Such a disease is prone to fractures, even spontaneous fractures, and fractures occur without doing anything.

Most of the fractures are green stick type, less displacement, less pain, faster healing, relying on subperiosteal ossification to complete, malunion is more common, limbs are often bent or angled, generally after puberty, the number of fractures gradually decreases...

Regarding this rare disease, Zhou Cheng had only heard about it before, and had never seen it in the clinic. It is estimated that he was in the ward before, so he was shaved off by the teacher in the outpatient clinic.

Zhou Cheng nodded and said: "There is indeed no better treatment for this kind of bone quality. If there is no fracture, most of them should be taken care of, and then let the child grow to puberty, usher in the second growth period, and reshape the bone." After quality, it will be better."

"However, the bones are very fragile. Maybe the heavy schoolbags you carry at school will cause fractures. It is quite troublesome for you to take care of them, but parents still need to be careful."

The middle-aged man nodded: "Yes, that's how it is. I kept him with me all the time and didn't dare to go out. Once before, on the way to school, his grandfather broke his bone while walking with him. Now it's me Send him to the classroom with his schoolbag on his back."

"Then the teacher set up a special cabinet for his schoolbag to store, and he didn't dare to bring his homework home, and he didn't dare to let him play with other children, so he was very withdrawn."

In fact, it's not that he is withdrawn, the main thing is that he also confessed that the child should not play with other people, and other parents also confessed to their children to stay away from this porcelain doll.

The child didn't speak, but looked at Zhou Cheng with a little fear. However, his eyes actually had a kind of ignorant curiosity and a kind of longing. This kind of longing eyes moved Zhou Cheng's heart.

Zhou Chengcheng said: "Actually, it is very difficult to treat this kind of disease, but there are some special auxiliary tools. Do you want to try it? It is to customize a set of braces for the child, which can assist and protect his activities. , so you can feel a little more at ease."

"There is just one problem. This brace may need to be changed every year, because the child is growing, and the cost is not low. If your family can afford it, I can give you a suggestion. If your family is already in difficulty If so, you have to worry about it yourself.”

Zhou Cheng had designed an auxiliary device similar to a wheelchair and a walking aid for that old man, not just for that old man, when he was in Shanghai.

But the practicability is not strong, but it does allow patients with fractures to get out of bed early.The cost is very expensive, and it needs to be designed by a special person.

Although this little boy has no fractures, his condition is actually more fragile than the patients with actual fractures.

If this is not a child, Zhou Chengcheng would not suggest it.

The middle-aged man was overjoyed when he heard the words: "Doctor Zhou, what is the specific use of the brace you mentioned? How much does it cost?"

"The role of the brace is to protect and provide a certain amount of support, so that his bones can avoid excessive stress, and at the same time provide a certain amount of stress to help shape the shape."

"And the cost may be a bit expensive, and a set costs more than 1 points. Because this device is aimed at only a very small number of people, it cannot be used in large quantities." Zhou Cheng also confessed truthfully.

In fact, he could give one away, but if he met a patient and gave them all, then Zhang Zhengquan's company would not have to continue. This kind of brace is originally aimed at a minority of people, needless to say the rich.

Those who have no money can also use it.

When he was in Shanghai, the old man specially asked Zhou Cheng and Zhang Zhengquan to make a special wheelchair. On the fourth day after the operation, he could go to the meeting, he could walk by himself, and he could also sit and walk, which was better than a wheelchair. When you get up, it is much more convenient and normal.

At present, the old man has been unloaded, but because it is specially made, it cannot be used by others, and it is equivalent to tens of thousands of dollars.

But for the old man, tens of thousands of dollars can buy this brace, which is worth the money.

The middle-aged man frowned tightly upon hearing this.Obviously I was intimidated by this fee, and it is five figures once a year, which is not a small amount of money.

Annual income and disposable expenses are not the same!

Seeing the middle-aged man hesitate, Zhou Cheng said again: "You can go back and think about it carefully, or you can try it for a year first. If there is no effect and it is not helpful to the child, then there will be no further orders."

"This brace is currently only known to very few people, so even if you ask other doctors, they probably don't know about it, and they can't provide you with this resource."

Most of the time, doctors can only give one suggestion. Maybe this middle-aged man will go to other places to ask. Zhou Cheng also made it clear in advance that others may not know about it.

In the end, the middle-aged man left with the contact information given by Zhou Cheng.

After the patient left, Zi Yi reminded: "Doctor Zhou, it is very dangerous to ask the patient to appoint a device manufacturer and pharmacy to buy medicine. If he reports it, there will be a lot of trouble."

"I know." Zhou Cheng nodded back.

Today, what the medical industry is strictly investigating is pharmaceutical kickbacks, especially the purchase of medicines at designated places and then getting kickbacks.

However, Zhang Zhengquan was a coward and never gave Zhou Cheng any kickbacks for so-called things, and he was not afraid of investigation.

Although there may be criticisms, as long as I sit upright, I am not afraid of others to check. The positioning of the brace is a high-end product, which is unknown to ordinary people, and Zhou Cheng will not negotiate further.

"But this patient is very special. He went to many big hospitals, but he didn't get better medical services. Maybe he will report it, but I still prefer to believe that he believes that I am kind, and his heart is also very good. .”

"Go and call, the next patient will come in." Zhou Cheng made a decision.

If it was in the past, Zhou Cheng would never do such a thing. At that time, he was still hanging around with others, and when something happened, he had to be protected by others.

But it's different now. He is an independent practitioner himself, and he is about to get a mid-level professional title. He can act upright and sit upright, so he doesn't need others to protect him.

This is the foundation and background.

Ziyi didn't dare to point fingers at Zhou Cheng, but still felt that it was very risky, but Zhou Chengcheng had made up her mind, and she could only call in the next patient.

The third outpatient was a woman in her 50s who was overweight and suffered mainly from foot pain.

Especially the soles of the feet, when standing, the pain was excruciating, but after sitting down, the pain was relieved a lot. She came here independently and was very good at talking.