pertwk Chapter 50: The Truth Revealed Through the Examinees!
Chapter 50: The Truth Revealed Through the Examinees!
A teacher's office in the teaching building of Xiangya Medical College.
Some examiners are tallying the scores, while others are reviewing the clinical performance of trainees in different examination rooms and sessions.
More than a dozen people were gathered in front of one of the computer screens.
As the surveillance video played, the people gathered around the computer fidgeted restlessly, wiggling their hips and exchanging bewildered glances.
A few others were whispering among themselves, "Which hospital does this team belong to?"
Those who know Chen Zhuoan answered, "Xiangya First Affiliated Hospital."
Xiangya has three hospitals, and there are people from each hospital in the office, so the information needs to be accurate down to the First, Second and Third Affiliated Hospitals.
Some people explain: "Emergency room reception is generally handled on-site by resident physicians and attending physicians."
"The theoretical level of our university's doctoral students isn't necessarily inferior to that of chief residents and attending physicians, is it?"
Yes, it's not just about seeing the final result, but also about seeing who specifically came forward to treat the patient.
In any hospital, the average level is just the average level.
Some people are far above average, while others are far below average.
Some people laughed: "The problem is, this answer isn't even in the provided reference answers."
Who came up with this question?
"What is the scope of consideration?"
The person next to him chuckled as he asked, "Professor Du, are you sure you're serious?"
"Asking questions like that could offend someone!"
The answer key is right in front of you. So why are you asking the question setter what knowledge point they are testing?
Are you kidding me?
This reference answer is clearly a complex system of knowledge that blends traditional thoracic surgery, respiratory medicine, cardiology, and emergency medicine.
According to the standard answer, the first exam question was about pneumothorax combined with hemopneumothorax.
Then a clinical team is needed to have a very precise grasp of the diagnosis and treatment of pneumothorax and hemopneumothorax.
Post-operative complications related to lung re-expansion may occur in patients…
If the pathogenesis of dyspnea is not thoroughly understood, down to the root cause, it is difficult to consider that the diaphragm may also be damaged!
The diaphragm is the most crucial respiratory muscle.
Judging from the answer key, the organization that set the question probably still hasn't found the real cause of death...
However, this patient had pneumothorax, which causes breathing difficulties and carries a risk of death.
It's not to say that all patients with pneumothorax can be saved.
Just do your best.
The diagnosis was correct, and the treatment was also correct...
A ruptured diaphragm is a very rare sign.
It is an essential quality to not impose a reputation on rare cases in clinical practice.
However, not assigning blame does not mean that facts can be ignored in order to avoid responsibility or helplessness during academic discussions and reviews of death cases.
The current situation is whether or not everyone should give points to Chen Zhuoan's team!
Should we give a higher score or a lower score?
Should the score be awarded based on the diagnostic error, or should we consider that the team performed in a disguised way?
If we give them high scores, how do we correct the scoring of other teams?
"Was an autopsy performed on the patient?" An older professor looked at a few people at the Third Hospital.
A professor from the Third Hospital sniffed: "The patient's family was quite understanding; they went home after receiving the death certificate."
"Professors, I have a question to explain."
"Based on this patient's initial diagnosis, whether according to guidelines or the level of risk."
"Treating hemopneumothorax on-site is always the best solution!"
"Other considerations."
The professor pondered for a moment: "I think it's something we can learn from, but it shouldn't be taken as a rule."
"The vast majority of patients with hemopneumothorax do not happen to have diaphragmatic injury as a complication."
"So, my opinion is..."
"Give points to each team individually, and award points to the other teams according to the standard answer key."
"This team? I suggest giving them a high score as well."
The older professor asked, "Professor Du, did this patient eventually die?"
Professor Du did not evade the question: "Yes, he died during the treatment of his hemopneumothorax."
"The other contents in the reference answer are possible complications given by our Department of Thoracic Surgery after detailed derivation."
People die every day in TM's hospital.
In thoracic surgery, respiratory medicine, and cardiology, more than one person may die every day.
If no one dies in your department, it proves that the types of diseases you treat are not of high quality; those are just easy tasks.
If no one dies in the emergency room, then that would truly be the emergency room of my dreams.
It is the emergency room that patients and hospital leaders are looking forward to.
But this is not a real emergency.
……
The older professor said, "In that case, I suggest giving it 45 points. After all, it's not the reference answer, so some points should be deducted."
"The statements in the video are all supplements made by the test takers based on their own previous symptoms, and there is no actual evidence to support them."
"If we're just breaking down their diagnostic and treatment approaches, that's fine too."
"We cannot unjustifiably support the creation of something out of nothing, but we also cannot completely deny reasonable deductions about the pathogenesis."
Professor Du nodded, but he also had concerns: "Professor Chu, if the pathogenesis of this patient is really as this student described..."
"He really can save patients' lives."
"Won't giving them only 45 points affect their final grades?"
Professor Chu said, "A competition is just a competition, and results are just results."
"Being a doctor is a lifelong competition."
"The competition is never with our peers, but with those things below us, which are incurable diseases."
"In a long-distance race, there's no need to worry about short-term gains or losses."
"In fact, a score of 45 is already a high score, and it puts you in the top tier."
"If their second case performs normally, they still have a chance to make it into the top three!"
"It's settled then."
……
After the results were confirmed here, the video was also sent back to the small group chat of the Department of Thoracic Surgery at Xiangya Third Hospital.
This small group is Professor Du's working group, and it only includes the superiors of this college.
In fact, some members of the group had forgotten about this case.
Although the deaths were unusual, they were nothing compared to the number of emergency room patients.
It's okay if they forget; the exam questions and videos will help them remember.
Dying on the operating table is always a memorable experience.
Professor Du didn't criticize anything; he remained silent after posting the video.
The resident physicians and attending physicians on duty that day all spent a very long time in different places.
After reading it, both of them were filled with mixed feelings.
But there was no regret, no self-blame, and no inferiority complex.
Of course, it's impossible to be joyful or open-minded.
Being a doctor is like this: you hone your skills again and again, answer questions again and again, and refine your abilities and mindset to better face the next patient.
This isn't about deliberately causing trouble; it's an essential element of a doctor's white coat.
The patient died.
Being overly critical is definitely wrong.
But in the emergency room, you really can't be that picky...
As everyone knows, it was that candidate's logical thinking ability that was so strong that he was able to conduct a diagnosis and analysis that went straight to the heart of the matter.