On the weekend, at 6:20 in the morning, Chen Xi pushed open the door of the teaching room, the lights were already on.
She paused for a mont; soone was there earlier than her. Lin Yuan sat in the corner, three dical records spread in front of him, holding a pen and writing sothing in his notebook. Hearing the door, he looked up, glanced at her, nodded, and lowered his head to continue writing.
Chen Xi walked to her seat, put down her backpack, and took out her notebook. She glanced at Lin Yuan, wanted to ask sothing, but didn’t.
At 6:30, people gradually arrived. By 6:50, all twenty people were there. No one spoke, there was just the sound of pages turning and the soft rustle of pen tips across paper.
At 7:00, the door was pushed open. Yang Ping walked in, holding another stack of dical records.
He placed the dical records on the table.
"You can hand in yesterday’s clinical analysis now."
Twenty people stood up and handed over their notebooks in turn. Yang Ping took them, flipping through page by page. When he got to Lin Yuan’s, he paused, looked for a few extra seconds, then turned the page. When he reached Chen Xi’s, he looked for a long ti, then closed it and set it aside.
"Sit!"
Everyone sat down.
Yang Ping picked up the top notebook and opened it.
"Lin Yuan!"
Lin Yuan stood up.
"Your clinical analysis is written very diligently," Yang Ping said. "Diagnosis, differential diagnosis, treatnt plan, you wrote them all. However..."
He paused.
"You wrote ’possible Aortic Dissection’, why is it ’possible’? We are doctors now, the ultimate goal of analysis is a definitive diagnosis, around this conclusion we’ll develop treatnt...even if we cannot achieve a definitive diagnosis, we must co up with a response plan — further examination, symptomatic treatnt, or addressing while examining... Rember, starting now, learn to think correctly and completely, not fragnted, incomplete, or always relying on soone to help correct and perfect... Why write ’possible’?"
Yang Ping emphasized this question again.
Lin Yuan was taken aback for a mont.
"Because... because it wasn’t confird..."
"What was added to the dical record later?"
Lin Yuan thought for a mont.
"...CTA."
"What was the result of the CTA?"
"Aortic Dissection, Stanford Type A."
"Can it be diagnosed now? Why is it still ’possible’?"
Lin Yuan’s face gradually turned red.
Yang Ping looked at him without speaking, the teaching room was extrely quiet.
A few seconds later, Yang Ping spoke.
"Everyone pay attention! Learn to dynamically observe patients, do not stay fixed at one mont, this is clinical, not an exam, clinical practice will never be static like an exam, understand? Sit down!"
Lin Yuan sat down.
Yang Ping picked up another notebook.
"Chen Xi!"
Chen Xi stood up.
"Your clinical analysis is ten pages long." Yang Ping said, "From chief complaints to present illness, physical examination to auxiliary examination, diagnosis to differential diagnosis, treatnt plans to prognosis judgnt, even rehabilitation plans, all written. You even included a literature review and reflections. Notably, you incorporated the results of new tests perford on the patient after our discussion yesterday, and one result ca out at 6:05 this morning, showing that you reviewed the patient’s latest dical records on the computer first thing when you arrived in the departnt, very good!"
He looked at her.
"From a dical standpoint, you’ve written very well, but if we are more demanding, from a bio-psycho-social model standpoint, you missed sothing."
Chen Xi was stunned for a mont, then imdiately realized: "The patient’s psychological state!"
"Correct! This patient is fifty-seven years old, male, with an Aortic Dissection." Yang Ping said, "Do you know what this ans?"
Chen Xi thought for a mont.
"It ans... he could die suddenly at any ti."
"And?"
Chen Xi didn’t speak.
"It ans he is scared, terrified." Yang Ping said, "Extrely scared. You wrote about his blood pressure control plan, heart rate control plan, surgery plan, and postoperative managent plan. But have you thought about how he faces all this?"
Chen Xi lowered her head.
"Doctors don’t just treat diseases," Yang Ping said, "they treat people, managing the patient’s fear, anxiety, despair. If you only manage the disease and not the person, then you are just a surgeon, not a doctor."
He paused.
"Sit!"
Chen Xi sat down.
Yang Ping put down the notebook and looked at everyone.
"You are all Doctors, your foundational theoretical knowledge is sufficient. But theory is just theory, foundational theory is just foundational theory, people are people. Starting today, you must learn to treat disease and also learn to understand people."
"During rounds today, everyone must ask the patient one question: Do you have any other questions? Answer whatever the patient asks. If you can’t answer, note it down, research it in the evening, think it over, and tell the patient tomorrow. During the learning process, it’s not shaful to not know, but it’s shaful not to solve the problem after knowing you don’t know."
He stood up: "Later, Li Guodong will go with you."
After speaking, he left the teaching room.
The teaching room stayed quiet for a while, then soone whispered: "Asking the patient if they have any other questions? What’s difficult about that?"
No one responded.
Li Guodong walked in, clapped his hands.
"Let’s go, ti for rounds!"
The inpatient ward is on the second and third floors, with a total of eighty-six beds, all occupied by patients.
Everyone divided into small groups, Chen Xi followed the attending physician leading the team into the first ward.
The patient was an old man, seventy-two years old, with coronary heart disease and three-vessel disease, scheduled for a bypass tomorrow. He lay on the bed, and upon seeing the doctors enter, he imdiately sat up to greet them.
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