Chapter 1330 Some people are still working hard

"Yuan Zhang, if you are not satisfied with my work, please transfer me to a community outpatient clinic, or transfer me to a branch hospital. You are holding the knife like this, and I am under too much pressure. The director of the Department of Gastroenterology even cried several times Times."

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

It's not about her appearance, but her demeanor that people can't ignore. It can't be described, but there is a feeling between the eyebrows that makes men jingle. Really, a little bit. No exaggeration.

If this kind of woman reads more books and brings a bit of bookishness, really, the milk tea girl from Dongzi and various celebrities will definitely be no less than them. Moreover, the director of endocrinology feels like that kind of big house. The young master's wife.

 Because he has a son-in-law, he is tough, but because he has his parents-in-law, he is also a little weak, and he wants to show off his temper even though he is knowledgeable and sensible.

 Zhang Fan looked at her but said nothing. His expression didn't change much. Being stressed is a good thing, and being ashamed is even better. A dead pig who is afraid of honor and disgrace is not afraid of boiling water. I'm like this, what can you do to me? Come on, I'll spread my legs and stay still, what can you do to me!

“There are currently sixteen doctors in the Department of Endocrinology, five of whom work in companies. The cars they drive to work are either Audis or Mercedes-Benzes. There is also the daughter-in-law of a winery owner. After working a little overtime, she said she had low blood sugar.

 The others are either the wife of this director or the daughter-in-law of that director. What do you want me to do? I did a glucose tolerance test last time, and the results turned out to be more tiring than the other, so I didn't even get overtime pay. It’s difficult for me too. Don’t I want to be a good director?

 It’s difficult 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 lower. If you give these people less money, they really won’t move, they will just click on the button and wait for retirement. You ask her to resign, and she needs this job to support her face. After all, it seems too shameless for a powerful daughter-in-law to be a housewife.

 Zhang Fan would definitely not be happy if he was given 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 clinics and is waiting to retire. Look at you. You were among the first batch of students sent to the capital to study by Bian University. Director of Endocrinology.

I went in the same batch as you. Not to mention the distance, were Dean Yan Xiaoyu and you classmates at the time? Not to mention positions, if you look at other people’s achievements in the past few years, and then look at yourself, I think you spend more time flipping through fashion magazines than periodicals.

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

After Zhang Fan got up and left, the director of endocrinology almost cried because of the reprimand. Seeing Zhang Fan pressing the elevator button to go up to the 16th floor, the director of endocrinology said in a tearful voice: "Who the **** said that Zhang Yuan is coming to the endocrinology department?" , I’m going to tear her mouth apart today!”

When they heard that Zhang Fan was admitted to endocrinology, the directors of various internal medicine departments breathed a sigh of relief. Men and women all know that among those few strokes, the first three are the ones they are most afraid of.

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

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

“Maybe it’s because Zhang Yuan is young!”

After the director and head nurse of the Department of Gastroenterology learned that Zhang Fan had received endocrinology, they stood at the elevator door and exchanged a few words.

Then the director of the gastroenterology department took the doctors for ward rounds.

As a result, before checking a few patients, the head nurse ran over with a pale face, "Yuan Zhang is here, Yuan Zhang is here, we have arrived at the nursing station!"

The director of the Department of Gastroenterology really felt like urinating.

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

For example, if you fail in the competition within the system, you can still be transferred to a department or even a unit, but medical care is different.

Especially in Chasu, Chasu Hospital is now the only hospital. You, the department director, are really going to be fired, and you will have no place to go.

 If you are in the department and make it difficult for the new director and colleagues to carry out their work, the new director will definitely propose to the leader to ask you to leave.

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

 So, the current situation of tea plant is that it can only go up but not down. Once it comes down, it will be really embarrassing unless it is moved to another place.

 Zhang Fan clearly expressed his dissatisfaction with internal medicine at the doctors' conference. It didn't give Ouyang Renli any face, let alone Yan Xiaoyu later.

Especially when it comes to gastroenterology and endocrinology by name, in Zhang Fan’s words, you can do it, but you can’t do it and leave.

"Zhang Yuan..." The director of the Department of Gastroenterology glanced at Zhang Fan nervously and said hello.

 “Let’s continue with the ward rounds!” Zhang Fan didn’t say much.

Following behind the group of doctors, following the ward rounds, the head nurse followed Zhang Fan, secretly looking at Zhang Fan's face and trying to figure out Zhang Fan's mood.

The doctors in the Department of Gastroenterology have become active at this time. The director is afraid of Zhang Fan, but they are not afraid. Some even have to show off to stand out in front of the leader.

 So, when the director asks questions, each answer is more exciting than the last. Especially after Zhang Fan revealed that he was dissatisfied with the Department of Gastroenterology, the doctors worked hard in private.

"Abdominal pain, the doctor in charge of the bed told me how this abdominal pain occurs." In bed No. 9, the patient has chronic abdominal pain all year round and idiopathic abdominal pain.

Idiopathic, to put it bluntly, means you don’t know the cause. Anyway, you are here, and you don’t know where they come from or where they are going.

 Dr. Wu is a senior deputy chief in the Department of Gastroenterology. Because the number of senior positions in the hospital is limited, he has been suppressed in the position of deputy chief.

 In the past, I didn’t take much part in the fights in the department. Especially in the fight between drug dealers, he never cares.

Since the hospital is getting better and better, he also has ideas 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 superior physician of the doctor in charge of the bedside.

"Abdominal pain, we must first clarify the mechanism of abdominal pain. The total area of ​​epithelial cells in the gastrointestinal tract is larger than a tennis court. In such a large area, there are intricate neurons and ganglia. There are between 10 million and 10,000 neurons. Between 10,000 and 10,000, equivalent to the total number 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 current research, the development of symptoms of irritable bowel syndrome is clearly related to the enteric nerve, autonomic nerve, and central nervous system, especially when..."

 Lao Wu said that the more he felt, the more profound he became. The director of the Department of Gastroenterology turned green, but he had to pretend to listen very seriously.

The other doctors didn’t know what they thought, but Zhang Fan listened very carefully.

In a word, everyone has their own understanding of this thing, not to mention this kind of internal medicine disease, each person has his or her own opinion, and senior doctors who have studied it have a lot of clinical experience, and their own opinions are absolutely equivalent. Very powerful.

 This is what Zhang Fan needs most now. The treatment of internal medicine diseases is diversified and different from surgery.

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

  Always try to find a way to operate around the lesion. Even with current minimally invasive and interventional treatments, the ultimate target is still the disease.

 In internal medicine, it is different.

 So Zhang Fan listened carefully at the end.

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

Therefore, some patients take a certain kind of medicine and feel comfortable and comfortable in their intestines, and then recommend their medicine to another patient. As a result, the other patient cannot pass stool for a week after taking it, and even wants to stuff it in. Let me clear it out with an eel.

 Actually, this is a disease. Although it has a name, it is not actually a disease.

This disease may not kill you, but it also makes you uncomfortable. According to evidence-based medicine reports from the Golden Retriever Country, 1/6 of the people in the Golden Retriever Country have IBS (irritable bowel syndrome), and the incidence rate among women is higher than that among men. People over 60 years old are less likely to develop the disease, and 30% of patients will spontaneously disappear over time.

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

 Another special point is that people who have experienced psychological trauma in childhood are more likely to develop this symptom.

For example, constipation and bloating may not be because you are greedy but you may be suffering from irritable bowel syndrome. But you don't know.

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

Zhang Fan asked a question. After Old Wu finished speaking, Zhang Fan immediately asked a question. At this moment, everyone stood at attention and turned to look at Zhang Fan.

 Is this going to go crazy again? What’s on the minds of ordinary doctors.

Is this an eye-catcher? This is the director's idea.

"No, Golden Retriever prefers to provide psychotropic drug intervention. Although my data is relatively small and has little reference value, after I took over the first IBS patient, I found that first of all, the life span of the patient is no different from that of normal people. .

And the doctor’s comfort and explanations seem to be more effective in treating this disease than medicine. Our current treatments tend to be symptomatic. Treat constipation in case of constipation, stop diarrhea and give antispasmodic drugs in case of pain.

  But I have done a single-blind trial. After treating the patient with a placebo, I gave a lot of explanations and comfort on the sidelines, and the patient said the drug was effective! "

 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 as he left, he added: "I'm going to apply for the hospital's trial funds for this experiment. Don't do this next time!"

 “Okay!” Only he knew what Lao Wu felt in his heart. But there is hope.

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

 (End of this chapter)