In ancient fables, there is a common profession, a farmer, both east and west. Especially in Aesop's fables, this profession is more like a mixture of two contradictions, opposite each other and closely integrated.

In the village, the farmers were good people who helped the shepherd boy twice. But after learning that they had been cheated, they chose not to help him and let the wolf take the sheep away. When they arrived, the farmers were still good people who helped the snake warm up, and in the end they were bitten to death by the snake.

The farmers in the two fables represent two extreme states of domestic doctors.

One is the former who learns from one's mistakes. Most of them are located at the bottom of the pyramid of medical care. Seniors are hospitalized, hospitalized on a total duty, attending or deputy seniors, all of which are included.

There are no interns and young people who have just been admitted to the hospital, because they are still passionate and are still in the "scamdled" stage.

After being deceived, these doctors who were beaten by society set up a high wall with the patients' families and firmly draw a clear line. They usually stand on the dry shore and look at the scenery with a noble look. Once a situation that is unfavorable to them occurs, they choose to give up, transfer to the hospital, shirk responsibility, or even give up.

Just like preventing wildfires, first burn a fireproof isolation belt with the fire yourself.

The other type is good people who advocate benevolence in medicine and philanthropy. These people are generally located in the middle and high-level positions of the pyramid. Directors of various subjects, discipline leaders, high positions all the way up, and even media and public opinion who can point fingers while watching everything can be classified as one.

No matter what the patient and family are, whether there is any mistake or not, save them first. Even if they know that the other party has a dark history, they will even deal with themselves, smash the entire department, and threaten the lives of other people in the hospital, they will have no choice but to do so.

In the end, he may have achieved his personal glory, but he used his moral values ​​that transcend the secular world and kidnapped a group of mortals who still have a bottom line of self-interest under the infinite amplification of public opinion.

If this is true, maybe one thing can be said is that it has contributed to the sublimation of human spirit.

But unfortunately, more hypocrisy is.

Qi Jing hated being a farmer in fables since he was a child, but unexpectedly, when he grew up, he had made a career that best suited this positioning.

in the country, many doctors are in these two states.

Some medical ethics are so noble that they can't help but burn all their hearts to work. In the end, this kind of saint who is one of them has become the industry standard for the public to judge this profession. Just imagine that everyone sets Einstein as the standard for normal human beings, it is probably not normal that there are few people on the earth.

This situation is not the only medical care company, teachers and police are all like this, and they are even divided into service industries.

Another doctor was as cold as a stranger. After seeing several reports of old ladies falling and striking money, he made up his mind to never help her cross the road. What would happen if such a person rushed to the front line of resistance during the relationship?

Qi Jing didn't want to stand either side, but just wanted to implement the idea conveyed by the fable: distinguishing good and evil.

The patient cannot be all snakes, it may be squirrels, or it may be a little white rabbit. In order to avoid 1% of snakes, it is not worth the effort and is contrary to the professional spirit of the doctor.

It is brainless to see a snake and hold it to keep warm. It is useless to treat other small animals as snakes.

Zhang Zhenguo was definitely a representative of the little and medium-sized shepherd boy who had been hiding the symptoms of finger muscle twitching, which brought considerable difficulties to the diagnosis. But everything should be treated separately. In Qi Jing's opinion, the stomachache and stomach swelling in the afternoon may not be fake.

Years of clinical experience have allowed Qi Jing to quickly identify the chances of a patient having sex with his family, and he has set a number of standards for this.

If you own three of them, the possibility of triggering medical disputes is as high as 30%. Once you occupy five, the probability will double. If you have two more, then medical disputes are basically a foregone conclusion, and it will only happen sooner or later.

"Four points? Which four points?" Ji Qing was a little curious.

"There are conflicts in the family relationship, I don't understand the doctor's judgment, I feel dissatisfied during the diagnosis and treatment, and the family is a low-income class." Qi Jing said as she walked, "I haven't seen anyone, but these four points have already shown that as long as there is an accident in the patient, the chance of his son's medical dispute reaches more than 40%.

Gao Jian snorted softly: "I don't know if I can see him tomorrow morning."

"Who knows?" Qi Jing spread his hands and said with a smile, "But I'm sure if there is a problem with Lao Zhang when he comes home, it will be the time for us to pay the money when he comes to the hospital."

“Is it humanitarian compensation again?”

“Absolutely.”

"Are there any other entries?" Hu Dongsheng was very interested in these.

"There are quite a few, but now is not the time to talk about his son..." As he spoke, four white coats had already arrived at Zhang Zhenguo's bedside, "Old Zhang, I'm here to see you again."

Zhang Zhenguo was obviously a little sleepy. The newspaper was placed aside, and the man lay on the pillow, facing his back to them, as if he was sleeping. He heard the voices in his ears, and he turned over and narrowed his eyes to look at the young people.

Three of them are young doctors he has come into contact with in the past two days, and they all have impressions. The other one is a little bit disgusted, but after seeing it clearly, he couldn't help but tremble in his heart: "Why are you here again..."

"I heard from my colleague that you had a stomachache in the afternoon, so I'll come to see you."

Qi Jing was very familiar with pulling a chair and sitting next to his bed, while Ji Qing and the others stood aside. It was like the gangster boss in the movie who was looking for someone to chat. The only difference was perhaps the white skin on them.

"It's just a little cramp, just like your fingers, uh~" Lao Zhang burped, couldn't help rubbing his hands, and said, "You guys have checked both the flat abdomen and ct before, isn't it nothing. Now I have a stomachache, and I even ask me to do it again. That's not reasonable."

The finger of this sentence pointed directly at Gao Jian, who advised him to review the matter in the afternoon.

Gao Jian is not a soft persimmon, so he defended: "You suddenly have abdominal symptoms. In order to eliminate the lesions of the abdominal organs, these tests must be done again. If the abdominal factors are not ruled out, how can you determine where the final problem is?"

"Okay, okay, there's nothing much, uh, I'll tell you a lot."

Old Zhang waved his hand and issued an order to expel the guest: "Anyway, I will be discharged from the hospital early tomorrow morning. My health has always been normal. There is nothing to do to check again."

After saying this, the ordinary doctor probably gave up. His complaints finally turned into four words: Whatever you want!

But Qi Jing didn't agree. The three around him naturally didn't feel anything because they had been with him for a long time. When he first established a diagnosis department, he clarified the purpose of the department, and the purpose of treating patients was the purpose but not the ultimate goal.

They only have one mind to understand how to reveal the cause of Zhang Zhenguo.

In Qi Jing's eyes, it seems that there is no problem just looking at Lao Zhang, but once he brings the surrounding environment, he will show a sense of incongruity. A lot of clinical experience tells him that this old man must have problems, big problems!

Zhang Zhenguo was a very clean old man in the morning, with a neat bed and a good spirit.

The breakfast was clean and the dishes were cleaned and hung aside in time. The garbage was emptied one night, and only a refreshing plastic bag was left beside the bed. Even if he stayed on the hospital bed, he would naturally sit up straight when he saw the person coming and be full of energy.

But now it has only been about ten hours, and the whole appearance has changed a lot.

There were a few oil stains visible to the naked eye on the bed sheets, and there were water stains spilled on the ground. I obviously didn’t eat much for dinner, and the rest were placed aside with the bowls and chopsticks, but I still didn’t clean up until now. Zhang Zhenguo is also staying on the bed now, but when he saw Qi Jing and the others lying down, he didn’t mean to get up.

There must be psychological factors, but more of them should be physical problems.

"Dimitated?" Qi Jing asked looking at him.

"No."

"Is your hands a little numb?" Qi Jing immediately put his eyes on his hands that he had been rubbing before, "It was just a pain like a needle poking."

Zhang Zhenguo quickly spread his hands and continued, "No, don't talk nonsense."

Even the three people on the side saw something wrong. Dizziness and numbness in their hands are important signs of physical problems. Once it appears, it needs to be ruled out...

"Have you tested my blood pressure?"

The three of them started their own differential diagnosis, and Qi Jing's question had arrived, and the target was naturally Gao Jian, who was present in the afternoon.

Gao Jian knew that Qi Jing was concerned about this patient, and even if all the values ​​were within the normal range, he remembered them in his mind: "I have tested it, I remember it was 130/77."

"It was not a test in the morning. What I want is in the afternoon, especially after my stomach hurts."

After Qi Jing said that, he looked at him more. Gao Jian immediately understood it and turned around and ran to the clinic: "Brother Qi, wait a moment, I'll get it now."

"Don't be idle either." Qi Jing turned around and looked at Hu Dongsheng beside him, "Go to the mining cell to borrow a B-superior beside the bed."

“B-ultrasound?”

"Yes." Qi Jing looked at Zhang Zhenguo, "Old Zhang, I don't object to doing an ultrasound, it doesn't cost much."

Zhang Zhenguo did feel dizzy and numb with his fingers, but when he thought he could hold on, he didn't say anything, just because he was afraid that he would have a higher level of examination. Now he heard that it was just a B-ultrasound, so he was considering the money in his hand, and after thinking for a while, he nodded: "Okay."

B-ultrasound is not that easy to borrow, and the heavy cell may be useful, but a blood pressure monitor is the most common thing in the emergency department.

Gao Jian brought a blood pressure monitor along the way, and also brought out two night shift interns who were resting in the clinic. Seeing Qi Jing's disgusting eyes, Gao Jian had no choice but to explain: "I just wanted to follow me, but I can't stop him."

"Test it."

The two interns knew Qi Jing's high standards and tried their best to ensure the standard of movement. They thought they were still ordinary blood pressure, but they didn't expect that the measured result scared everyone: "193/95, this is too high!"

It is definitely not a good thing to soar from normal blood pressure to such a high value in a short period of time.

Ji Qing quickly asked the intern to start a phonics: "You go to Director Hou, and you will say that Zhang Zhenguo's systolic blood pressure is 190, and then ask the electrocardiogram room to do the electrocardiogram. You, go to the head nurse of the emergency room and ask her to bring electrocardiogram and antihypertensive medicine, hurry up!"

After the interns were spread, the three young people began to differential diagnosis:

"Simply hypertension?" Qi Jing asked.

"It's impossible. It's normal for three days and no past history. It must be secondary hypertension caused by hidden diseases." Ji Qing said, "From the numerical point of view, it may be renal."

"The kidney function is normal." Gao Jian retorted, "I suspect it is a sudden cardiovascular and cerebrovascular disease."

At this time, Qi Jing no longer counted on Zhang Zhenguo, but turned around and asked a family member in the bed next door: "Has Lao Zhang vomited today?"

"No, I just don't feel very good." said an aunt, "I didn't have a chat since the afternoon."

Qi Jing nodded and looked at Ji Qing and Gao Jian: "There is only dizziness and super high blood pressure, but no vomiting or speech imperfection. It should not be a stroke, continue thinking."

"If it's not the cardiovascular system, it's a problem with the nervous system!" Gao Jian said.

“The nervous system is too wide.”

"If you don't vomit or speech, then you'll rule out your brain." Gao Jian showed his skills in neurology, "combined with his previous stubborn hiccups and abdominal discomfort..."

"spinal cord!"

"spinal cord!"

Ji Qing and Gao Jian almost spoke in unison about where the lesions might appear: "It must be the C3-C5 cervical cord that manages the hiccup reflex arc."

"What's the specific problem?"

The two of them could determine the cause of the disease, but they could never think of the real problem.

While he was at a loss, the night shift Director Hou ran over. The moment he saw Qi Jing, he couldn't help but squeezing his face a few times, and wanted to say something, but this was really not the place to scold his subordinates: "What's wrong?"

"Hypertension, dizziness, numbness, stubborn hiccups, abdominal pain."

Gao Jian summarized Zhang Zhenguo's condition with the simplest symptoms. Hou Yi frowned, turned his head and shouted at the nurse in the distance: "Come on ECG monitoring!"

"Here's here."
To be continued...