My Medical Skills Give Me Experience Points

Chapter 1385 550: Cause Identified—From Doubt to Belief

In the ultrasound room, Zhou Can was personally standing next to the ultrasound doctor.

What we usually call echocardiography refers to using the principle of short-wave ultrasonic ranging: pulsed ultrasound passes through the chest wall and soft tissues to measure the periodic activity of the underlying cardiac walls, ventricles, and valves. On the monitor, it is displayed as curves showing the relationship between the activity of each structure and time, and these curves are recorded by a recorder as images.

It can very well assess the size of the heart, the function of the valves, and the left ventricular ejection fraction.

What Zhou Can wanted to examine now was precisely the left ventricular ejection fraction.

"LVEF, decreased, EF 39%."

The ultrasound doctor reported the figure to Zhou Can.

"About the same left ventricular ejection fraction as in the other hospital." Zhou Can nodded, then said to the patient, "Okay, try to dorsiflex your feet, use some strength."

The patient did as instructed.

"What's the left ventricular ejection fraction now?"

"52%."

The ultrasound doctor's face was full of disbelief.

An ejection fraction of only 39% is on the low side. Not especially severe, but definitely not mild either.

The normal ejection fraction ranges between 50% and 70%.

The patient's left ventricular ejection fraction jumped directly from 39% up to 52%, which was really a bit unbelievable.

If this state could be maintained, the patient would basically be able to return to normal.

"Very good, relax, relax!"

With this, Zhou Can felt even more confident in his diagnosis and guided the patient to relax.

"Bend your lower legs!"

He once again instructed the patient to do as he said.

"What's the fraction this time?"

"46%."

"Not bad." By the time the test had reached this point, Zhou Can already basically knew where the cause of the patient's illness lay. "I'm going to squeeze your lower legs; bear with it."

After signaling the patient to straighten and relax both legs again, Zhou Can tried squeezing the patient's gastrocnemius muscles.

"How much?"

"43%, 42%."

These were the test results obtained from squeezing the left and right legs separately.

"All right, thank you for your cooperation! Print out the report, we're done here."

Zhou Can said to the ultrasound doctor.

"Dr. Zhou, is the cause of my illness really in my legs?"

"That's right, it's in your legs. I'll explain it to you when we get back to the ward!"

He couldn't keep occupying the ultrasound department's resources.

It was already past quitting time, and the doctors in the ultrasound department were essentially being forced to work overtime.

Unlike clinical departments, the work hours of technical departments are very punctual. They can clock in and out on time, and they can rest on Saturdays and Sundays. However, because of the huge service demand, departments like Ultrasound and CT operate with a shift-covering mechanism.

Also, in a large hospital like Tu Ya, the ultrasound units for Obstetrics & Gynecology and Cardiothoracic Surgery are not managed by the general technical department, but belong separately to Obstetrics & Gynecology and Cardiothoracic Surgery.

If you want to be an ultrasound doctor, getting into the ultrasound units of these two departments is generally recognized as the most promising path.

Doctors in the general ultrasound department simply have no way to break this barrier and basically spend their whole careers in that small technical circle. Their income is slightly above average, but there's no obvious upward trajectory.

Unlike doctors in clinical departments, whose work is indeed more tiring: after hours or on holidays, they can be called back to the hospital to work overtime with just one phone call.

And even after they get off work, they still have to worry about the patients under their care, praying those patients don't run into any complications.

If a patient under their care dies or something similar happens, they will definitely have to bear responsibility.

This responsibility doesn't necessarily mean paying compensation to the family or having their license revoked, but there is an evaluation system, and it has a big impact on the doctor.

If a certain doctor has, say, two patients die within three days, while the senior doctors are cursing, they'll also start keeping a close eye on this doctor and gradually marginalize him. Clinically, they will no longer give him weight.

To put it bluntly, it means his word no longer carries authority. Any orders he writes must be reviewed by a superior before being carried out, and some clinical treatment measures will likewise require approval from a superior doctor or will be executed under the direction of another doctor at the same level.

As for canceling his eligibility for awards and honors, that goes without saying.

Within the Emergency Department, Zhou Can carries a lot of weight; during clinical resuscitations, even associate chief physicians have to follow his lead.

...

Beside the temporary bed in the corridor, holding the echocardiography report in his hand, Zhou Can was explaining the cause of the patient's heart failure to him. Director Xue Yan, having heard the news, had already rushed over.

"So you really did find the cause! Impressive!"

Director Xue Yan's face was all smiles.

Every time a high-difficulty, puzzling case like this is successfully diagnosed or discharged after cure, she feels particularly happy.

As the department director, she naturally hopes her department will keep getting better.

The reputation and word-of-mouth of a department can be built to some extent by treating routine cases, but only to a limited degree. The cases with the greatest impact are still the difficult and complex ones.

"I still don't understand how my heart failure could be related to my legs?"

The patient was full of curiosity about this.

The Brother Wei his family had hired was standing beside the bed, his face full of disbelief.

He had originally thought that Zhou Can was just talking nonsense, but now, after the examination, it turned out the legs really were related to the heart failure.

"There are several powerful muscles in the legs, called the gastrocnemius muscles. Ordinary people may not know their function, but in our eyes as doctors, we call them the body's 'second heart.' Ever since our human ancestors learned to walk upright, a major defect appeared in the human body. The heart ended up further away from the ground, which made it extremely difficult for blood from the lower limbs to return to the heart."

"At the same time, it also became very hard for the blood pumped out by the heart to reach the distal ends of the lower limbs. At this point, after countless years of evolution, the gastrocnemius muscles of the legs developed the role of an auxiliary heart. Every time they contract, they can squeeze the blood in the legs and push it smoothly back to the heart. And when they relax, they create a natural suction force that draws blood in. With this cycle, they form a pumping function that's roughly similar to that of the heart."