I run a clinic in the United States

Chapter 234

Since Elena and Ava showed their superb skills in subject three last time, Murphy and Stephanie have also joined the ranks.

Then Park Soo-joo and Kim Hee-jin also came to give it a try. However, the two of them were incomparable to the four girls, so only little Yoona could challenge it.

Especially Murphy, Elena and Ava, their slender, white and onion-like jade fingers can actually bend in reverse direction. They are extremely dexterous and silky, and their hands are so versatile that no one can match them.

Even Stephanie is slightly inferior.

In fact, this is because Zhou Qiao has enhanced the physical attributes of Murphy, Elena and Ava, and their finger flexibility is different from ordinary people.Stephanie has not completed 100 times and is currently unable to optimize her physical attributes.

But Stephanie also danced very well.Especially the proud peaks and mountains tremble slightly with the rhythm of the body, which is fascinating.

The soundtrack is also quite nice, but the tempo is too fast. As a Chinese, Zhou Qiao can't hear the specific lyrics every time.

It wasn’t until I checked online that I realized the lyrics were beautifully written.

"The sword raises the grievances of the rivers and lakes, and the sleeves cover the bright moon; the leaves fall in the west wind and the flowers fade, and it is difficult to sleep under the sword; you are a passerby in the mountains and rivers, but you always sigh and say goodbye; your temples are like frost, and a cup of it is strong..."

I have to say, watching four girls dance subject three together, all of them are "hands", and they all have graceful figures, sweet and fair looks, the feeling is like extending your life.

With the victory in the heart surgery competition and the oncology brand with an academician background, the clinic's business is getting better and better, and Zhou Qiao has to continue to put recruitment on the agenda.

Especially people like Murphy and Stephanie, they should be freed from ordinary work and allowed to do more difficult things.

Even if they don't need to perform surgery, they can still sort out the previous disease course information, summarize the patterns, and write some research papers on applied medicine.Simply performing surgery without thinking will hinder future growth.

If you can concentrate on thinking carefully and researching with great concentration, you may be able to perform 3-5 difficult surgeries, which is worth the painstaking efforts of doing more than 100 surgeries!

Moreover, with the resources of Academician Domitri, if you want to submit your manuscript to the top journal of your choice, your manuscript will basically not be rejected.

Those leading journals ranked in the top 100 or top 50 are often extremely picky because they receive so many manuscripts every year that they can make them vomit. However, with so many well-known medical schools and hospitals around the world, the competition is actually very high.

Zhou Qiao and the others are a private clinic, and there is no need for professional titles or promotions. However, if the clinic wants to become the biggest and strongest, it will compete with top medical institutions such as the Cleveland Clinic and the Mayo Clinic in the future, and even far exceed them. As they grow, they need some knowledge in this area.

In addition, if Zhou Qiao personally wants to reach the top of medicine and enjoy the supreme glory of a global medical leader, he also needs to have accumulated experience in this area.

Academician Domitri's research institute is basically engaged in basic medical research, which is a category that elucidates the essential laws of life or disease, and also develops some new drugs. However, the Iris Clinic focuses on surgeries and case analysis. Mainly, it belongs to clinical research type.The two sides are actually complementary.

Basic medical research is exactly what Zhou Qiao and the others lack.

Academician Domitri also engaged in a lot of clinical work in his early years. He performed many difficult surgeries and was very accomplished in clinical aspects. Later, when he got older, he turned to basic academic research and finally won the Nobel Prize.

In terms of writing papers, whether it is in the field of applied medicine or basic research, Academician Domitri can give Zhou Qiao and others good guidance.Of course, the most important thing is the resources that Academician Domitri has.

These resources and connections cannot be created by the system.

Unfortunately, good doctors are difficult to find, especially in the United States, where the entry threshold for doctors is too high and the number of doctors is limited.So Zhou Qiao went to several interviews, but none were suitable, so he had to wait.

Mr. Huang came for a follow-up visit accompanied by his wife. He was recovering well. Then, he also brought a distant elder from his family.Her surname is also Huang, but she should be called Granny Huang.

Because this old lady is 85 years old and is a distant cousin of Mr. Huang.

Their family actually came to the United States many years ago and spread its branches here, contributing to the spread of the Chinese nation around the world.This old lady has lived in San Francisco for more than 60 years.

Grandma Huang heard that her nephew was easily cured of heart disease and lung tumors at the Iris Clinic. She also heard that she was a national champion in surgery and had a Nobel Prize-winning academician background, so she came to see him.

Accompanying Grandma Huang was one of her granddaughters, a mixed-race child in her 30s who still retains her charm.

"My grandma was diagnosed with pulmonary nodules during a physical examination two years ago. Because the nodules were not big and there was nothing particularly uncomfortable, she kept having re-examinations every six months. But when she went for a re-examination last week, But it was discovered that grandma’s lung nodules were much larger than before, reaching almost 2 centimeters. The doctor said they might be malignant, but because she still had some underlying diseases and had a nephrectomy before, she now only has one kidney. At work, the operation is more difficult and the risk is higher. We haven’t found a suitable doctor yet. I wonder if you are confident about it, Dr. Zhou?"

Zhou Qiao smiled and said: "I don't know if you have seen my competition. When I competed before, I performed heart surgery on an old man in his 90s. The old man also had various basic diseases."

As soon as these words came out, the 30-year-old mixed-race granddaughter beamed and said, "That's great. Doctor Zhou, why don't you bother."

"It's okay. Let the elderly person be admitted to the hospital first, and I will help arrange pre-operative examinations for her. Then our team will evaluate and come up with a safe surgical plan. There should be no big problem."

"Team? Was that academician involved in the evaluation?" the mixed-race granddaughter in her 30s asked, her eyes brightening.

Zhou Qiao thought to himself, how is it possible that I would trouble Academician Domitri for such a trivial matter?But he still smiled slightly and said: "Of course. I will make a video connection at that time and ask the academician to check on the condition."

Since the patient needed it, he would say something to reassure the patient's family. Anyway, even if he connected with the academician or called the other party, it would not be possible for the other party to see it, right?
Immediately, Zhou Qiao admitted Grandma Huang to the hospital and asked Ava to arrange pre-operative examination. As soon as the report came out, he summoned Murphy and Stephanie for a consultation to discuss the condition together.

This old lady's condition is indeed very difficult.

It wasn't difficult, and people didn't hesitate. I finally came to Iris Clinic, which has an academician background.

First of all, surgery is a big blow to the elderly.

It can be said that the older you are, the higher the risk.It is more difficult to perform surgery if you are over 70 years old, let alone if you are 90 or [-] years old.

Trauma, bleeding during surgery, and subsequent wound recovery are all problems.

Because there is no comparison between the elderly and young people. Young people have stronger immunity and stronger recovery capabilities.Elderly people in their 90s and [-]s, who are in their twilight years, often have to undergo surgeries and have their vitality severely damaged. They may not be able to live long without conservative treatment.

Since Zhou Qiao took over, he must do his best to do things based on the concept of being responsible for the patients.

This 83-year-old grandmother not only had a nephrectomy more than ten years ago, but now only has one kidney left on her left side. She also has basic diseases such as hypertension, diabetes, and coronary heart disease in varying degrees.

Preoperative examination showed that her creatinine level was over 300, which was the critical line for hemodialysis.

Stephanie sighed lightly and said, "Fortunately, we have Prometheus-3000 now, otherwise it would have been more difficult."

Because for this type of patient, the most important thing about surgery is how to cause little damage to her body, cause little fluctuations in the internal environment, and have a low inflammatory response. Using a surgical robot is the best choice.

Murphy curled his lips and said, "Even without a surgical robot, Zhou Qiao can achieve small fluctuations."

Stephanie: "..." Are you quarreling with me now?
She thought for a moment and then asked Zhou Qiao for help: "Qiao, I am confident in this operation. Why don't you let me do the surgery?"

She has never had tumor surgery before, but this lung nodule is not too big. She has recently studied some cases with great concentration. She has also privately asked Zhou Qiao for advice on surgery, and has also done several simulated surgeries. , I think that the progress is still great, it just needs real people to practice it.

Zhou Qiao nodded and said with a smile: "No problem."

He had used the system to see that Stephanie was currently at the pinnacle of expertise in tumor surgery. With robot assistance, she could barely reach the master level. Plus, with him guiding and sitting on the side, there would be no mistakes.

Stephanie rolled her eyes at Murphy proudly and thought to herself, if you challenge me, I will seize the opportunity for surgery first, haha.

Murphy curled his lips slightly and snorted.

Stephanie stood up to the proud peaks, unwilling to be outdone.

Seeing that there was a strong smell of gunpowder between the two women, Zhou Qiao quickly changed the topic and said: "Now let's discuss the details. How to anesthetize during the operation? How to ensure the safety of the old lady's heart and lungs during the operation? Then there may be infection, Issues such as renal insufficiency also need to be carefully considered.”

Strategically despise, tactically attach importance to.Although Zhou Qiao and others behaved relaxedly and freely, especially in front of patients and their families.However, when it comes to surgery, the three of them are actually more serious and steady.

Murphy and Stephanie also temporarily "ceasefire", and everyone began to discuss seriously.

However, as they talked, the two girls began to "roll" together again. You said something and I said something. Each of them was very competitive and wanted to overpower the other.

But this kind of thing is actually a good thing. Consultation and discussion require different voices so that the plan can be improved from all aspects and angles.Zhou Qiaoxin said that these are really his two treasure girls. With them, he can save a lot of worry and effort.It can also save some points, so that every difficult case will not have to be redeemed with points.

Now, his points are growing very quickly because he spends less and replenishes more.

But there is still a big gap between the huge value of [-] upgrades.As for the other way to upgrade, collecting ten medical seeds is still a long way to go. After all, there are only two medical seeds now, and the remaining eight are not yet known where.

Medical seeds are hard to find in the world, and I don’t even know if there are ten of them on the planet.

But this kind of thing cannot be rushed. Zhou Qiao believes that the most important thing is to live every day well, run a good career, and enjoy a high-quality life after work.

Although the three of them were highly skilled, they still spent a full hour discussing the surgical plan. They kept improving and repeatedly considered every detail of the operation, and finally formulated the plan that was most suitable for Mrs. Huang.

Includes seven or eight emergency plans for intraoperative and postoperative emergencies.

If you have enough plans, you will not panic when encountering an "accident" and can choose the most correct response as soon as possible.

At the University of California, San Francisco Medical Center, the Prometheus-3000 surgical robot is in operation again.

Stephanie was the surgeon, and under the guidance of Zhou Qiao, the operation went smoothly.

With three heads and five arms, it is precise and stable and can freely control and select angles. While removing tumors, it can protect the patient's organ functions to the greatest extent, reduce trauma and bleeding caused by surgery, and shorten the postoperative recovery period.

In addition, the Prometheus-3000 has a full 6-dimensional rotation and a 20x high-definition field of view. It can clearly see every nerve and blood vessel. It also shows strong advantages when dissecting lymph nodes. .

After the operation, the old man was arranged to be hospitalized at the University of California Medical Center because the old man was old and not suitable for being moved around.Moreover, the University of California Medical Center has complete facilities and can provide timely rescue in the event of an accident.

On the first day after the operation, Stephanie basically stayed here to guard her.After she was transferred to a general hospital, Stephanie changed to coming twice a day.After all, this is the patient she is responsible for.

On the fifth day, the old man was in good condition. When Stephanie went for ward rounds, his family asked, "Can he be discharged from the hospital?"

Because before, the old man's distant nephew, Uncle Huang, was discharged from the hospital on the fifth day despite his serious illness.

They felt that their grandmother should be similar.Although he is older, he only had a lung nodule removed, unlike Uncle Huang who had a heart surgery and a lung tumor.

Moreover, the old man's current situation is quite good. How expensive is it to live here? Every day is money.

Stephanie called Zhou Qiao and reported the situation.

Zhou Qiao pondered. In view of the strong desire of the old man and his family to be discharged from the hospital, after comprehensive consideration, he agreed to be discharged from the hospital. He just told Stephanie to tell the other party that if she feels any discomfort, come to Iris Clinic for review at any time.

Stephanie naturally gave a lot of advice and instructions, and then also mentioned some other precautions.

The old man's children also nodded repeatedly, but they didn't pay much attention to it and couldn't remember it.Because every time I go to the hospital, the doctor tells me this when I am discharged.The more I listen to it, the more it seems like it’s just that, not that important.

Perhaps out of fear of what might happen, on the ninth day, a large group of the old woman’s family members led the old woman to the Iris Clinic in a hurry.

The mixed-race granddaughter from before was also among them. As soon as she entered the hall, she shouted to Ava: "Is Dr. Zhou here? Is Dr. Zhou here? Let him come and take a look quickly. There is something wrong with my grandma!"

She was very worried. She had brought her grandma here for the operation, but now she had such a problem, and her family blamed her.

Her lack of anger was fake, and she thought to herself, that Dr. Zhou, who looks very handsome, is so unreliable. I trusted you so much in vain, and handed my grandma to you, but it ended up like this.

Before Ava could go find him, Zhou Qiao, Murphy, and Stephanie came out of the consulting room to see what was going on.

Stephanie's face turned pale and she thought to herself, I finally performed the surgery alone, why did these things happen?She was afraid of being looked down upon by Zhou Qiao and Murphy.

"Don't be anxious, don't be anxious. The old man is old, and there will inevitably be some follow-up problems after the operation. Let's check and find out the situation." Zhou Qiao quickly comforted Grandma Huang's family, and then pushed the old woman into the clinic for a detailed examination.

There were no patients at Rachel's side for the time being, so she also came over to observe.

"My grandma has chest tightness and shortness of breath, and her legs are severely swollen." Grandma Huang's mixed-race granddaughter said.She felt relieved a little when she saw that Zhou Qiao and others had good attitudes and that the examination seemed very professional.

In fact, at such an old age, it is normal to have some subsequent problems.She actually understood it, but she was too impatient before.

Zhou Qiao finished the examination and said: "The old man's situation is most likely due to poor nutritional status, which has led to an increase in pleural effusion, thus affecting the respiratory function. It's okay, it's not a big problem. I'll arrange a blood routine and chest ultrasound for her first. Check it and see the results.”

Stephanie was also a little relieved, because this situation was one of the postoperative unexpected situations in the previous surgical plan. At that time, everyone discussed what to do if this situation occurred, and they also made plans.

I thought the probability of it happening was relatively small, but who knew, it still happened.

The other party's nutritional status is poor, not because her family didn't give her good food, but because she is old and cannot absorb it well.As mentioned earlier, older people are not as good as young people.In addition to the immune system, the gastrointestinal aspect is also dying.

It is already very difficult for a dying person to stay alive.

When the test results came out, sure enough, just like Zhou Qiao's previous prediction, the blood test results showed that the old man's albumin was low, and then the pleural effusion increased.

"Dr. Zhou, I'm sorry, we were too reckless before." The mixed-race granddaughter apologized to Zhou Qiao.

Zhou Qiao waved his hand and said with a smile: "It's okay. We can understand that we are worried about the patient's health."

Immediately, the old man was arranged to be hospitalized in a community hospital, because the conditions of community hospitals are better and the old man is older and can be easily rescued in emergencies.In addition, it is also closer, only a few hundred meters away from the clinic, which is equivalent to the distance from the outpatient department to the inpatient building in large domestic hospitals, so work will not be delayed.

After all, the University of California Medical Center is too far away, and the cost is higher there.

Of course, there is another reason why it is not humane to outsiders.It's just that... the patient is older. If there is anything wrong with him, it would be worse to die in the clinic. After all, the third floor is Elena and Ava's living area.

Zhou Qiao pondered whether to simply cancel the clinic's wards and operating rooms and transform the second floor into consulting rooms and conference rooms.

If we continue to recruit doctors and nurses, the clinics on the first floor will not be enough.

Or go out and buy a house for Elena and Ava and write their names on it.The third floor of the clinic is where you take your lunch break or take a nap when you don't want to go back after working overtime.

It was still left to Stephanie to perform chest drainage tube drainage on the old man, and strengthened the nutritional support for the old woman. After treatment, the old woman's lower limb edema, chest tightness and shortness of breath improved significantly.

Due to the previous incident, Zhou Qiao did not let the old man be discharged from the hospital in a hurry this time, but continued to hospitalize him for observation.

His family members were also scared, so they naturally agreed.Then the price is slightly cheaper in community hospitals.

The old man's follow-up recovery was really poor. A few days later, due to the lack of a kidney, another situation in the previous plan came one after another. Renal insufficiency worsened acutely and blood creatinine continued to rise.

Fortunately, a response plan has been formulated before, and the medication will be adjusted according to the previous plan.

To protect the kidneys of the elderly, Zhou Qiao and the others did not use nephrotoxic analgesics and antipyretics. Instead, they used relatively safe but weak drugs and continued to monitor kidney function.

Finally, the rising trend of the grandmother's serum creatinine was alleviated and maintained at an acceptable level, and the urine output was basically normal.

However, misfortunes never come singly. Soon, problems appeared in his ECG monitoring. The bedside ECG showed paroxysmal atrial flutter and atrial tachycardia.

At the same time, the old man developed severe chest tightness and shortness of breath. The examination found that the Pro-BNP index was abnormally increased, which is a symptom of heart failure.

It was such a bad thing for the grandma and her family that they had to spend Thanksgiving in the hospital.The mixed-race granddaughter was very filial and always guarded the hospital.

　Thanks to "Cola's Chicken Wings" for the 1500-point reward.Thanks to "Western Wind" for sending Elena and Ava the chicken legs.

　　Thank you to the book friends who subscribed and voted monthly.

　　
　
(End of this chapter)