Bai Ye has one day of follow-up time every week, while Dr. Liu has outpatient clinics all day on Wednesdays, Friday mornings and Sunday mornings.
Bai Ye simply arranged his outpatient visit to Sunday morning and stayed in the ward on weekdays.
The official rotation time of the regular training is September 20. During this period, Bai Ye basically followed Dean Liu for outpatient clinics and reading books.
Although he is a doctor in the Department of Neurology, he only really returned to his own department during his third year of graduate school. In the past two years, he may have been rotating in other departments.
How much you can learn in one day of clinic time per week depends on your knowledge reserve. Every patient is an opportunity for learning.
During this time, Bai Ye read through the books on neurology. It is no exaggeration to say that the nervous system is called the top academic subject.
As one of the most difficult clinical subjects, there is too much knowledge that needs to be mastered, and you have to remember which part of each nerve controls which part.
After Bai Ye used ten memory capsules, he finally passed the neurology department for the first time.
Coupled with this period of studying with teachers and going to outpatient clinics, Bai Ye's neurosurgery skills have reached: lv2: 2018/3000.
On September 20, Bai Ye and He Xiaoming went to the Anorectal Department together.
As a hospital integrating traditional Chinese and Western medicine, the Anorectal Department of Puze Hospital does a pretty good job. It has 60 beds and is considered a national key specialty.
In fact, traditional Chinese medicine has great advantages in anorectal medicine. Of course, some people say that this is because modern medicine does not want to engage in anorectal medicine.
But the truth is also true. The Anorectal Department of Western Hospital is not a key department. After all, there are too many surgical departments, including general surgery. There are too many such as hepatobiliary surgery, thoracic surgery, and neurological surgery. Even the Anorectal Department deals with rectal cancer.
A type of major surgery.
After handing in the class in the morning, Bai Ye and He Xiaoming were assigned to two doctors. Bai Ye's teacher was Song Jie, a deputy chief physician.
Song Jie looked at Bai Ye with a smile: "Dean Liu gave an order to our department. Your training tasks are different from others. You have to work hard."
Bai Ye was also very curious and asked: "Teacher Song, what did my instructor say?"
Song Jie chuckled: "Dean Liu asked us to treat you as a resident doctor, not a trained doctor. When you leave the hospital, you will be asked to deal with a patient alone, and then the director will personally give you a score.
"
[Ding! The training task of the Anorectal Department is to complete 50 dressing changes independently during the Anorectal Department. Obtain an exclusive dressing change package. 】
[Ding! The training task of the Anorectal Department is to follow 20 surgeries during the Anorectal Department and obtain an exclusive surgical package. 】
[Ding! As for the training tasks of the Anorectal Department, before the rotation of the Anorectal Department ends, the surgeon will complete an operation and be scored based on the surgical effect, and you will be awarded a lottery once. 】
Following several ding-ding-ding sounds, Bai Ye was stunned for a moment. He didn't expect that so many tasks were triggered.
Song Jie looked at Bai Ye in a daze and smiled: "Don't be nervous, just follow me during this period and study hard. This is not a postgraduate entrance examination for you, it is also a test for me."
Song Jie turned around and asked, "How much do you know about anorectal medicine?"
Bai Ye thought for a while: "I read the book carefully before coming here, and I have some general knowledge about anorectal medicine."
When Song Jie heard this, he nodded with satisfaction: "Good habit. Let's go. Let me change the dressing first."
After saying that, he got up and walked towards the treatment room: "Generally speaking, we change dressings first in the morning and then do ward rounds. The main patients in our department are hemorrhoids, anal fistulas, perianal abscesses, and anal fissures, which account for the main ones.
, occasionally there are some more serious cases such as rectal cancer.”
"The patient's dressing is usually changed once a day. After discharge, you can change it once a few days. You just came here today and I will give you a little help. After a week, you will start changing the dressing by yourself. In fact, it is not difficult to change the dressing. But you just came here. Today I will focus on
Emphasis on aseptic operation."
It is customary to change dressings in the morning, and all patients are ready. After Song Jie greeted the patients, he entered the treatment room and asked Bai Ye to close the door.
He took out a disposable dressing pack from the cabinet and looked at Bai Ye: "Remember, before using the dressing pack, you should check the time. Just like the shelf life of food, there are also sterilized dressing packs... outside
In the contaminated area, you can only touch the outside with your hands. After opening, the inside is a sterile area and cannot be operated directly with your hands. You can use disposable gloves. Get me gauze later and rinse the patient by the way."
Bai Ye listened to Song Jie's words carefully and kept it in mind. Although his anorectal skills were level 3, he still had to listen to the words of clinicians. In many cases, every doctor has his own clinical experience.
Song Jie currently has ten patients, seven with hemorrhoids, two with anal fistulas, and one with perianal abscess.
All require dressing changes after surgery.
Song Jie took advantage of the opportunity to explain to Bai Ye: "Hemorrhoids are the most common disease in our department. They are divided into internal hemorrhoids and external hemorrhoids. The difference is not just about the inside and outside, but there is no difference if you understand it this way. Here is a
The dentate line, above the dentate line, is internal hemorrhoids, and below it is external hemorrhoids.”
"Hemorrhoids are not a piece of flesh, but varicose veins. Above the dentate line, there is the rectal mucosa, and below it is the anal canal skin. The rectal mucosa is innervated by autonomic nerves, and the feeling is blurry, as is the pain. The skin below is rich in nerves and feels more intense.
obvious……"
Bai Ye was stunned... Yes, looking at the nervous system during this period, the rectum is indeed innervated by autonomic nerves, and the intestinal nerves are relatively independent, so some pain and certain sensations are not obvious...
Then... Bai Ye suddenly thought of some abnormal operations in some AVs in Europe, America and island countries... They are all lies, it clearly feels very vague there, okay!
Sighing, Bai Ye felt that it was terrible to be uneducated, and he could be deceived just by watching a small movie.
It has to be said that hemorrhoids account for more than 87% of anorectal diseases. No wonder there is a saying that nine out of ten people have hemorrhoids, and there are more women, especially during pregnancy and lactation, because venous return is compressed, which can easily cause hemorrhoids.
Bai Ye wore a mask and handed Song Jie gauze, scissors, etc. He was very skillful.
Looking at the cases, I found that out of the seven hemorrhoids, five were women, all in their forties, but there was also a young man who got the disease during pregnancy and was only thirty-four or five years old this year.
Song Jie has rich clinical experience, but he changes dressings quickly, and from time to time there are wails from the treatment room~
While changing the dressing, Song Jie explained to Bai Ye: "The advantages of anorectal medicine in traditional Chinese medicine are actually quite obvious. We have already recognized hemorrhoids and some common solutions in ancient times, including the current seton, which is used to control hemorrhoids.