The road to the rise of great doctors

Chapter 118 brings hope and sometimes anxiety (4000+ chapters)
At 08:30 in the morning, in the conference room on the third floor of the hotel, the staff played the theme song of The Sun Also Rises after debugging the equipment, which was a bit unique.

Liu Dong signed in at the door of the conference room and then walked into the venue.He glanced around the venue and found no familiar figures such as Zhao Gang, Liang Jing, Zhang Wei, etc., so he found a seat in the middle row and sat down.

The venue has a typical conference room layout, with tables in the front three rows and name tags placed on the tables.There are two rows of seats at the back, with only seats and no tables. The chairs can pull out a small table from the side.

With his excellent eyesight, Liu Dong looked at the first three rows and found that in the first row were the name tags of the two conference chairs and several hosts.In the second row are four speakers and several panelists.The third row is the panelists participating in the meeting.In addition, there are two microphones in the first and second rows, and there is also a bottle of water, a piece of paper and a pen in each seat.

He raised his head and looked at the podium at the venue.The podium is slightly higher. There is a podium on the side near the door, decorated with flowers, with a handheld microphone and a fixed microphone. In addition, there is a computer and a laser page turner.

Liu Dong sat on the middle seat and took out his phone to read a novel for a while.He is still very interested in medical novels and feels that some of them are quite imaginative. Although some of them may be a bit intellectually confusing in terms of logic, they are still quite interesting overall.At least in terms of the relationship between men and women, it is a kind of adjustment to the daily work.The only pity is that most of them describe emergency-related departments, such as emergency departments, cardiac surgery, neurosurgery, obstetrics and gynecology, etc. These are the same departments that were adapted into film and television dramas. It feels a bit cliché, and he feels that it steals the spotlight. .

After he entered the clinic, he found that the working doctors' ideas would gradually change.

When students were students, those who studied medicine were high school science majors. After entering college, many people also have the idea of ​​"challenging advanced subjects" or the idea of ​​​​making money. Many people choose to have many surgeries, long time, and difficult to get started. departments - such as neurosurgery, cardiac surgery, etc., or choose departments that you know are particularly busy - such as obstetrics and gynecology, orthopedics, general surgery, pediatrics, geriatrics, etc. This will keep you busy and serve the people , sacrifice the small self to achieve the greater self.

After you have chosen a major and entered real work, as you grow older and experience more, especially after you get married and have children, your energy will gradually become insufficient and you will feel inadequate.Those who choose departments with fewer emergency surgeries - such as urology, nephrology, imaging, dermatology, nuclear medicine, etc. - have become particularly enviable departments. With fewer emergency surgeries, it is possible to sleep during night shifts. After all, I still had the surgery that I was supposed to have the next day, so it was a blessing to be able to sleep.In addition, I also found that there is no end to clinical work. Those who hold the idea of ​​"the busy department has great demand and can stay" are a bit like those who believed the slogan of some hospitals when applying for postgraduate applications, "fill in our hospital" , the chance of staying in the hospital is very high." After working, you may find that "a department with high cost performance" and "a top-ranked hospital in the province", if you choose it, the probability of staying will not fall into the "busy department" "Low-ranked hospital".
These are all tricks.

In your spare time, it is interesting to read these medical novels to pass the time and look for loopholes.The best thing is to read the stories of each department.

Only 5 minutes before the official start of the meeting, the participants began to arrive one after another, and the seats in the venue began to gradually fill up.

The chairman of the conference and the young and middle-aged speakers also came to the venue one after another. They greeted each other one after another, and then sat in twos and threes, whispering to each other, and bursting into laughter from time to time.Occasionally, a doctor would be alone in the front row, and people from pharmaceutical companies could be seen sitting aside and chatting for a few words. Gradually, the atmosphere in the venue became lively.

At this time, on the one hand, participants were reminded to sign in; on the other hand, the projection screen of the podium meeting began to broadcast the discovery process of targeted drugs for gastrointestinal stromal tumors - from molecular discovery in the laboratory to preclinical research such as animal testing. development, and then to the development and results of Phase I, II, and III clinical trials in human trials, as well as the achievements and honors obtained after obtaining regulatory approval for marketing - how many patients are treated every year, and how long it takes in the real world lifetime, etc.

Once the time is up, the opening video ends abruptly.

The staff at the venue handed the microphone to the chairman of the meeting, and then began the enthusiastic opening.Skilled people do not need a manuscript. Combining their own experience, introductions of participants, and the situation of the conference location, it is enough to talk for 3 minutes.
".Welcome all comrades to gather here in this picturesque season. Next, let's start the first session. The first topic brought by Dr. Li Feng, a young and middle-aged expert we are very familiar with, is gastrointestinal interstitium. Tumor’s past and present!”

The half-day schedule in the morning is generally divided into 2 periods. Each period has 2 speech topics. Each topic usually takes 20 to 30 minutes. There will be a 2-10 minute tea break between the 15 periods. .

Zhao Gang saw that the seat next to Liu Dong was empty and no one was sitting, so he hunched over and slowly moved there to sit down.

"coming?"

"Well, I came here early. Just starting now."

"Li Feng is a doctor at the Department of Gastrointestinal Oncology at Kyoto Cancer Hospital. He is very knowledgeable about gastrointestinal stromal tumors. They have a lot of patients with this type of tumor. They have rich clinical experience and have done many clinical trials. The summary is both timely and comprehensive. I listened to it once before and it benefited a lot. You can listen carefully, it will be very helpful for understanding this disease."

When Liu Dong heard that Zhao Gang praised Li Feng so much, he nodded, opened the small table attached to the seat, then took a pen in one hand and pressed the draft paper in the other, and listened carefully.

"As a fairly young tumor, gastrointestinal stromal tumors (GIST) were not officially independent from the World Health Organization's classification of gastrointestinal tumors until the millennium. Before that, it was often misdiagnosed in clinical practice. Leiomyomas and leiomyosarcoma. Although gastrointestinal stromal tumors account for one to three percent of digestive tract tumors, and there are about [-] to [-] new patients in China every year, in my opinion, this disease is not considered rare. , it can only be said to be a rare tumor.”

"At the beginning of my career, because the disease was insensitive to radiotherapy and chemotherapy, surgical resection once became the 'only' method to treat gastrointestinal stromal tumors, but only a small half of patients with primary gastrointestinal stromal tumors , can be cured by surgery, but more people will relapse and die after surgery, and the survival period is only a few months." "However, in just a few years since I started working, the situation has changed. The first target With the introduction of the drug into China, the average survival time of patients with advanced gastrointestinal stromal tumors has increased threefold, and the ten-year survival rate has reached 20.00%!"

Listening to Dr. Li Feng's sincere speech, Liu Dong could understand his emotion: a physician without any medicine is like an unarmed warrior on the battlefield, fighting with all available methods, but with limited effect. , could only face death helplessly; however, in a short period of time, from bare hands to having a spear, he could deal with it for a period of time, which greatly improved the situation where he could die at any time, and he began to change from having no choice but to Gotta have high morale.
Feeling the same, Liu Dong began to like the doctor named Li Feng, and felt that he was a good doctor with a true temperament.Liu Dong is recording key information points with a pen so that he can organize his thoughts after the meeting and help master new knowledge!

"Gastrointestinal stromal tumor is a 'new' disease that has long existed but is extremely poorly understood. It is a type of digestive tract tumor and is a rare disease internationally. It is difficult for patients to find comprehensive information to understand themselves. Disease conditions, seeking medical treatment are always full of ups and downs. The same is true for doctors. At this stage, we have increased our understanding, but the research on the diagnosis and treatment of gastrointestinal stromal tumors still mainly relies on the sharing of experience among colleagues, and we are not able to do it alone. Thin."

"Most doctors have basically zero clinical experience in understanding this rare tumor, except for some preliminary theoretical knowledge and limited foreign drug data. There are no answers to many things, which means there is little experience to learn from, which means trying and positioning , which also means there’s a lot of room for exploration.”

"So, we need to strengthen communication and sharing, gradually let everyone know about this disease, and standardize the diagnosis and treatment of this disease. In this way, we will be more convincing when we see a doctor ourselves, and we will be more confident when choosing a plan for patients. It’s more targeted. And the patients receive standardized treatment and make the most of the available weapons, so that they will benefit the most!”

Liu Dong nodded, yes, "new" and "rare" mean a lack of understanding of the disease, both by patients and doctors.After a clear diagnosis and treatment, the problems faced are temporarily solved.

However, there is another headache that is the hidden nature of gastrointestinal stromal tumors.This is a matter of diagnosis versus treatment.The early symptoms of gastrointestinal stromal tumors are mostly abdominal pain and gastrointestinal bleeding - this is similar to the symptoms of many gastrointestinal diseases, so it is difficult to detect and identify it.

When Liu Dong was riding the high-speed rail, he heard Dr. Zhao Gang mention that one of his classmates had been diagnosed with gastrointestinal stromal tumor. When he found him, "I was very surprised at the time because his stromal tumor was in the rectum and was very large. It's gone." Liu Dong was also a little emotional after hearing this, as Zhao Gang said at the time, "Although they are both doctors, his classmates had not noticed the growth of tumors before." Liu Dong's thought at the time was, "This disease , whether early screening or early diagnosis is possible, there is still a long way to go!”

The people speaking on stage were full of passion, and the people listening in the audience were also excited.

The lectures on the stage were full of useful information, and the audience listened with great enthusiasm.

Medicine is so pure sometimes. There is no one who doesn’t want to learn real skills to “save lives and heal the wounded.” Most of them either have no way to seek knowledge, or are discouraged after hitting a wall. However, when they really have the opportunity, they still raise their eyebrows. Ears, listen carefully and learn.

Regarding what Dr. Li Feng shared on the stage, “positive doctor-patient interaction brings more information, as well as feelings after taking medication and the treatment of common adverse reactions,” it caused a lot of discussion among the doctors in the audience, and they also burst into applause from time to time.
"Of course, targeted therapy drugs have brought hope. However, the disease has not been eradicated so far, and there are still many problems that need to be solved. The ultimate dilemma in the era of targeted drugs is drug resistance, and gastrointestinal stromal tumors are no exception. The same Tumor cells with different genetic mutations may coexist in tumor lesions, which means that one or several targeted drugs cannot eliminate all tumor cells. When the efficacy of drugs begins to fade, the feeling of powerlessness will approach. "

Liu Dong couldn't help but smile knowingly when he heard Li Feng saying that he was "often anxious".Anxiety stems from stress, but also from a sense of mission.

It is precisely "the urgent patient is anxious and the painful patient is in pain", so there is this kind of anxiety.

Liu Dong himself particularly understands this feeling.When he first started going to clinic, he was not too anxious.Because what he sees more is that this disease has a standard treatment plan; this disease is suitable for this kind of surgery. However, as the number of diseases he is exposed to increases, he gradually discovers that there are countless diseases that can be cured by existing treatment plans.The reason why many diseases can be cured is that they can heal themselves after meeting certain conditions. However, even if there are many ways to treat many diseases, whether they can achieve satisfactory results depends on the condition of the patient. For example, For azoospermia, the premise for obtaining sperm through microsurgery is that the whole person has sperm, but he cannot discharge it by himself, or it is immature and immature. After removal, combined with assisted reproduction counting, a satisfactory result can be achieved.But if you are relatively poor and have no seeds, then it is "hard for a clever woman to make a meal without rice."

While listening to the sharing, Liu Dong found that this kind of meeting was quite interesting.Of course, the most likely reason is that the speaker is more interesting.

In addition to the disease issues, he also shared some of his own experiences of seeing a doctor in the outpatient clinic.Doctor-patient communication "cannot be rushed". The patient is anxious, but the doctor cannot be anxious. When communicating with the patient, be patient and gentle. Don't panic yourself. Only by communicating patiently can you obtain more valuable information.

"Many times, patients and their families are under great psychological pressure. Some patients are treated confusedly no matter where they go, and no one can explain to them what is going on. If we can sit down and communicate carefully, talk about this. Explaining what the disease is, how to treat it, and answering the other person’s questions are actually quite psychologically comforting to the patient.”

Liu Dong was also very touched by this. He looked around and found that everyone was attentive and listening attentively.

Good speaker, what a treasure.And his narration also painted an image of an oncologist for Liu Dong, which seemed to partially overlap with Li Xiao's image, but was more mature and insightful. "You can have a chat with her when you go back."

(End of this chapter)