top student at medical school

Upon hearing this, Hu Qingyuan suddenly realized what was going on.

With his excellent memory, he immediately said, "So that's how it is. Neuropathic arthritis, the core mechanism of which is nerve damage leading to loss of proprioception and pain sensation in the joint."

"Many patients are unaware of joint damage or overuse it, leading to inflammation, bone destruction, and joint structural collapse due to repeated microtrauma. Diabetes is the main cause; long-term high blood sugar damages peripheral nerves!"

"Why did I only think about diabetes and ignore the core mechanism?" Hu Qingyuan said with some annoyance.

He was just a hair's breadth away from the correct answer.

The patient wasn't very old, just a young middle-aged man, probably around thirty-six or thirty-seven years old, and he was a little confused when he heard this.

"What is a Charcot joint? Is it complicated?" She paused for a moment, then asked Fang Ziye.

Fang Ziye explained: "My student just said that this is a neurogenic arthropathy, which is a local functional overload caused by decreased sensory function."

"It is common in diabetes, but spinal cord injury can also lead to decreased sensory function. Any disease that affects nerve function can lead to Charcot joint disease."

"It's possible that you had spinal discomfort before, but didn't pay attention to it."

"Have you been holding the baby too much?" Fang Ziye asked with a smile.

This age is the peak period for having a second child.

Many new mothers at this age are prone to developing chronic arthritis of the lateral epicondyle of the humerus.

"I'm not married yet." The middle-aged woman's expression flickered slightly, but her tone was firm.

Fang Ziye was taken aback upon hearing this.

After carefully observing the woman again, he realized she didn't look to be thirty-six or thirty-seven years old; after dressing up, she appeared to be around thirty.

She has a good figure and a plump appearance.

Still no children at this age? Are you childless by choice? Or are you infertile?
"What do you usually do for work?" Fang Ziye asked casually after seeing that Hu Qingyuan's symptoms had weakened.

"I work in a prefecture-level city. I'm just a regular salesperson," the woman replied seriously.

"Okay, in your case, we need to do a blood test and then an MRI to determine if you have a spinal cord injury."

“There are many causes that affect nerve function… Your symptoms are probably quite severe now…” Fang Ziye said.

"Okay, doctor, you're the expert, I'll listen to you," the middle-aged woman replied politely.

After Hu Qingyuan finished the physical examination, he also looked at the plain film and CT scan from the patient's local hospital.

“Master, there are no signs of fracture, but there is roughness on the joint surfaces, which is indeed Charcot’s arthritis,” Hu Qingyuan said.

"Okay, I've already ordered all the tests for you. Here's the referral slip. Just scan the code to pay and then go to the location indicated on it."

"Qingyuan, make sure you keep good medical records..." Fang Ziye instructed.

Hu Qingyuan's theoretical reserves are becoming increasingly abundant.

Being able to remember Charcot's joint disease, a rare condition, and its common causes proves that Hu Qingyuan's memory is indeed exceptional.

Upon hearing this, Hu Qingyuan moved closer to the computer and began writing medical records based on the examination results provided by Fang Ziye.

In addition to recording the physical examination and reviewing medical images, medical record writing must also include recommendations for diagnosis, examination, and treatment.

One of the projects caught Hu Qingyuan's attention.

Four tests before blood transfusion!
Also known as epidemiological testing.

Hu Qingyuan was slightly taken aback, then thought of the important causes of Charcot's arthritis. Anything that affects nerve function can cause Charcot's arthritis.

Syphilis could also be a possibility?

Could it be that Master has doubts?
Hu Qingyuan is a normal man. Of course, he has studied with teachers from Japan. Some strange postures can damage the elbow joints...

However, the visitor was a patient, and her profession wasn't that important.

……

After politely seeing the first patient off, Hu Qingyuan didn't even ask Fang Ziye what his considerations were.

Some things, even if you have doubts, are just doubts.

For the second patient, Hu Qingyuan didn't waste any more time and handed everything over to Fang Ziye. He only needed to conduct a consultation and physical examination, while Fang Ziye was responsible for recording the examination results, writing electronic medical records, and prescribing medications...

Around 11:20 a.m., the first middle-aged woman returned for a follow-up appointment.

The blood test results came out quickly, and there was no need to queue or make an appointment for the MRI at the new hospital.

After seeing the results, Fang Ziye said very calmly, "Madam, you've seen your own blood test results, haven't you?"

"You heard my conversation with my student. Charcot's arthritis is a localized symptomatic diagnosis. Any factor that can affect the nerves can lead to Charcot's arthritis."

"The main cause of this symptom is also very direct: overuse of the joints due to sensory dysfunction leads to repeated local damage, resulting in joint destruction, deformity and dysfunction."

"The substance that you tested positive for can also cause damage."

"This is your personal privacy, but there is one thing you must do properly: if you have a boyfriend or other regular sexual partner, you must tell him and ask him to check as well."

"Otherwise, this would be illegal."

"Syphilis is not difficult to treat. All you need to do now is make an appointment with a dermatologist and get the syphilis treated first."

"Then we can consider the local issues."

The middle-aged woman seemed a little flustered, but not in a real hurry: "Doctor, if the infection is cured, will the pain here disappear?"

Fang Ziye had no doubt as to why the local hospital was not conducting an 'epidemiological investigation'!
This was not a routine non-surgical examination; when she was hospitalized at the local hospital, the primary concern was infection.

If there is an infection but no infection markers, nonspecific inflammation is the more likely cause to be considered.

Fang Ziye shook his head: "In the beginning, if it can be corrected, it can be alleviated."

"But now there's no chance."

"Once deformities and arthritis have formed, they will not recover to their original state."

"If you come back to me after your infection is cured, I can perform surgery on you. You will also need joint reconstruction."

"Stop taking other medications, they're useless. You can continue taking some nerve-nourishing medication, though."

"Did you hear that clearly?"

"I have to go to the dermatology department now!" Fang Ziye said.

After a series of changes in her expression, the middle-aged woman slunk away.

After the middle-aged woman left, Hu Qingyuan took the opportunity to ask in a low voice, "Master, is this out or not?"

Is it infidelity or... oh oh oh!

"How would I know? I'm just a doctor, not a fortune teller, and I certainly don't have clairvoyance."

"I'm only responsible for treating patients."

"Yes, you can take a closer look at this patient. Some of the diagnoses are based on local symptoms."

"Some diagnoses are direct diagnoses, so in addition to confirming the local diagnosis, we also need to infer the cause of the disease based on the local diagnosis."

“Any word a patient utters can become the basis for his diagnosis, even though most of it is useless.”

"But we need to be cautious and careful."

"You've considered cystine disease, so your knowledge base is quite impressive," Fang Ziye praised.

If Feng Junfeng and Liu Yao were to answer, they probably wouldn't think of cystine disease as a rare condition.

“Master, please stop praising me. Even the correct answer that was missed is still a wrong answer.”

"Sigh, studying medicine is so difficult," Hu Qingyuan said.

Fang Ziye smiled and suggested, "Why don't you try a different mentor? You might feel more accomplished that way."

Hu Qingyuan immediately shook his head vigorously: "No way, Master?"

"Even an idiot wouldn't choose this, so how could I be an idiot of at least level four?"

Even more ridiculous than an idiot is an idiot of four or higher.

The diseases Fang Ziye treats are indeed difficult, but the high level of difficulty makes the challenge more interesting.

He's spent his whole life dealing with fractures, doing incisions and sutures. When he encounters something tricky, he just says, "Let's go, let's go to a higher-level hospital."

That's pointless; you might as well just start your own live stream.

"Master, I'm going to call the next patient..." Hu Qingyuan happily skipped out.

Hu Qingyuan knew very well that it wasn't that he was too incompetent, but rather that his master had encountered a very wide range of cases.

There's a saying that goes, "In my master's eyes, I'm worthless, and my teacher even called me a weakling and a Teletubby."

However, once you leave my teacher's office, even if you return to the department, what should you call me?
say!

Call him a genius!
Hu Qingyuan was very confident. Even his senior brother Lan Tianluo had to give him a thumbs up and call him a genius for his professional skills!
When it comes to mathematics, my uncle is a professional.

In the medical field, in surgery, my master and I are the real professionals; you're just a bit too old, Uncle-Master… If Lan Tianluo knew that Hu Qingyuan said he was just a bit old, he'd definitely explode and start a fight…

At 1:37, Fang Ziye began his lunch break and went out to eat.

The patient from before was still at the door pleading, "Professor Fang, Professor Fang, please, please give me an extra appointment. It's really not easy for me to come all the way from Lichuan City!"

"I ran too far."

Upon hearing this, Fang Ziye nodded: "I know, are you hungry?"

The patient shook his head: "I just bought a boxed lunch from over there and just finished eating. I'm not hungry, I don't need to eat lunch."

Hu Qingyuan thought he was a complete idiot.

Fang Ziye replied, "I'm hungry. I've only drunk half a bellyful of water since I came here this morning. I've been working the whole time, and now I'm so hungry that my stomach is practically touching my belly."

"I have to see patients again at 2 o'clock sharp before I can finish seeing all the outpatients for today. It's already 1:37, oh no, 1:38." Fang Ziye took out his phone to show him.

"Please, I'm begging you, I'm also my parents' child, can't you let me have a meal?"

In one morning, there were thirty-five appointments, including follow-up appointments.

Anyone who has ever gone through an outpatient visit like this knows how unpleasant it is!
Fang Ziye's statement was reasonable and well-founded, and even the new triage nurse couldn't stand it anymore: "Brother, don't beg anymore, Professor Fang's outpatient appointments are really overloaded."

"As everyone has seen, Professor Fang has no leisure time and is always working. It is only natural for him to eat something."

"Everyone starts work at eight o'clock; who doesn't need to eat lunch?"

Upon hearing this, the middle-aged man looked troubled: "Professor Fang, but it's really not easy for me to come all this way. If I have to wait, I'll have to wait until next week."

"I told you, go see other professors first!"

“We have other professors in our department whose appointments we can book. If they don’t understand, they’ll refer the case to me. Haven’t I made myself clear enough?”

"Once someone registers for an appointment with me, we have a medical relationship, and I am responsible for them!!!"

Another patient understood and suddenly realized, "Professor Fang, can you get an appointment with anyone in your department?"

"They also send you medical cases that they don't understand?"

"Then all that waiting before was for nothing?"

“We are a large department, a team, so internal coordination is a normal thing,” Fang Ziye said.

The older woman immediately shook her head and said, "No, no, no, it wasn't like this when I went to other hospitals before. They don't offer recommendations."

"They said they wouldn't treat any illnesses that weren't within their specialty and told us to cancel our appointments immediately."

When asked about other hospitals, Fang Ziye declined to comment: "We don't have many patients here, so we help each other out. After all, our hospital isn't a top-tier one, so we're probably not as busy as those big hospitals."

"Moreover, even if you see a doctor and get a hospital admission certificate, you will still have to wait in line for a long time."

"I have to go eat... I also need to use the restroom later, so I might be a few minutes late."

"Xiao Mo, please explain this to the other patients later. Thank you for your hard work," Fang Ziye said to Cao Xiao Mo, the triage nurse.

The triage nurses in the hospital are not tenured and have a high turnover rate, so Fang Ziye was not surprised when the previous triage nurses left.

Everyone has their own life and choices.

“Okay, Professor Fang.” Cao Xiaomo nodded seriously. Although it was her first time working with Fang Ziye, she thought he was super handsome and cool.

It's just that I'm a bit older, and I'm already married...

Afternoon, three o'clock.

To Fang Ziye's surprise, the middle-aged woman who had visited him that morning returned for a follow-up appointment.

After registering for a follow-up appointment, patients are seen in the order of one follow-up appointment per outpatient visit.

"Professor Fang, Dr. Chen from the dermatology department said that my disease is not difficult to treat and that I can receive treatment while in the hospital."

"It's very difficult to book a room in the orthopedics department of our hospital. Let me come here first to get a hospital admission certificate, or follow your advice," the middle-aged woman said.

This request is perfectly reasonable.

Fang Ziye said, "If you choose surgical treatment, I can issue you a hospital admission certificate first. However, when you go to the ward, tell the patient that you are staying in Professor Wang Zongkai's group."

“I will perform the surgery for you. Our team has too many patients scheduled, and waiting in line would be too troublesome for your situation.”

"If you join Professor Wang's group, you can be admitted to the hospital in about a week, but if you join our group, you will have to wait until September or October."

The middle-aged woman asked, "Doctor, my treatment may take about a month."

“I may not be able to come to the hospital in a week.”

"Professor Fang, do I really need surgery?" Knowing that Fang Ziye was pressed for time, she asked two questions in a row.

Fang Ziye shook his head: "Surgery would be better, and it would make your future activities much easier."

"You can choose not to undergo surgery, as long as you can accept the current joint deformity and pain."

"As for booking a bed, you can make an appointment first. You don't have to come to the hospital immediately."

"You can keep it for now and continue in sequence. Just explain it to the nurses and they will make a note of it for you."

First, you have to queue up; first, you have to be admitted to the hospital. There's an order to it.

Her situation is special, and the department wouldn't be so heartless.

"Then let's have surgery..." the woman said.

Fang Ziye didn't ask why!
Hu Qingyuan had already filled out the hospital admission certificate information and gave detailed instructions: "Go to the orthopedic ward, hand the hospital admission certificate to the nurses' station, and tell them that you want to reserve this professor's bed."

"If they ask you anything, just say that Professor Fang said it himself, and that this is Professor Fang's signature, which they recognize."

"No one else can imitate this!"

There was a clever person who forged Fang Ziye's signature on a hospital admission certificate, but it was discovered...

"Okay, thank you, Professor Fang." The middle-aged woman left, her departing figure somewhat forlorn.

Fang Ziye and Hu Qingyuan then began to see patients normally.

At 6:10 p.m., Fang Ziye and his colleague finally finished their day's patient rounds.

After leaving the clinic, the two immediately went to the parking lot.

There's a very important task in the lab today, and Fang Ziye needs to go there personally.

This involves optimizing the bridging electrode, a step that Fang Ziye must personally perform.

However, as they passed through the parking lot, Hu Qingyuan and his companion overheard a somewhat familiar conversation: "I don't care if you don't want to get married, that's just how things are right now."

"I need to have surgery first, even if you don't give me the money, I still want to have the surgery."

Hu Qingyuan was extremely surprised to hear this.

He and Fang Ziye looked at each other in bewilderment.

Fang Ziye touched his nose and said, "Don't worry about other people's privacy."

"Let me tell you, don't even think about touching Xiao Tao. She's my niece. If you dare to lay a finger on her, I'll fight your whole family to the death."

“My brother and sister-in-law died early, and my parents divorced and don’t care about us. You can bully me, but if you have even the slightest ulterior motive towards Xiaotao, I will immediately expose all your embarrassing secrets.”

"Anyway, I don't expect anything anymore. You're a terrible person!"

"I'll figure out the cost of Xiaotao's follow-up treatment myself. You don't need to worry about it. I'm just an ordinary person, but I'm not a bad person..."

Fang Ziye and Hu Qingyuan walked a little further away, but they could still hear the middle-aged woman's conversation.

Sometimes, prejudice is a mountain.

Once formed, it is very difficult to change.

But occasionally, I might feel a little guilty because of my own prejudices.

"Master, I was wrong. I shouldn't have made those wild guesses," Hu Qingyuan said, bowing his head.

"Let's go. Everyone has their moments of gossip and idle chatter. When we gossip about others, we should accept their gossip about us in return."

"Our task is not to feel guilty, but to go to the lab and complete the final step of bridging the electrodes."

"Then next month, we will officially begin clinical trials of the bridging electrodes, officially announcing the routine treatment of spinal cord injury."

At this point, Fang Ziye added, "Actually, your master's social experience is also quite limited, and I have had my doubts as well."

"They were just more at ease than we were; that's what it means to have a pure heart."

Hu Qingyuan nodded: "Master, secretly gossiping a little isn't exactly a heinous crime, right?"

"Well, I also made an appointment with Brother Song Yi tonight to discuss basic theories together, so Master, you don't need to wait for me later..."

"Okay!" Fang Ziye nodded. (End of Chapter)