My Medical Skills Give Me Experience Points

Chapter 1428 - 569: Assistant Lecturer, the Severe Consequences of Myocardial Necrosis (Part 2)

Director Tan has undoubtedly conducted a thorough evaluation and analysis of Zhang Qilian’s interventional surgery and its postoperative results.

He realized Zhou Can’s interventional skills have far exceeded his expectations, which sparked his interest in inviting Zhou Can to become a teacher for interventional surgeries.

This is something beneficial for both parties.

"I’d be very happy to take on this role. Teaching itself is a very enjoyable thing. I’m just a bit worried that my skills aren’t good enough and I might not teach well."

Zhou Can spoke modestly, which actually meant he had basically agreed.

It’s like visiting relatives, when giving a red envelope, people often exchange a few polite words.

Saying "Oh, no, no, that’s too much," but honestly accepting it with their hands.

The advancement of university teachers usually goes from assistant, lecturer, associate professor, to professor.

After becoming a professor, there are Level 1, Level 2, and Level 3 professors.

Among them, Level 1 professors are the highest level, often regarded as ’Pangu’ figures in a particular teaching field, with absolute authority in that area. Level 3 professors hold the lowest role among professors, but anyone who achieves this title is equally impressive.

It’s not something that just anyone can achieve.

University teaching positions have thirteen levels, just like hospital doctor positions have various levels, requiring one to step up gradually.

If your skills are lacking, your advancement will be slow.

Many university teachers may never become Level 3 professors in their lifetime, staying as lecturers until retirement is quite common.

There are even a few unlucky ones with certain flaws who may retire as an assistant.

In short, the competition in every professional field is extremely fierce.

The competent advance, while the mediocre remain in place or are eliminated.

For Zhou Can to step into a teaching position now is absolutely a wonderful thing.

Many brilliant individuals start to truly excel after the age of thirty. Starting on his educational journey before thirty will be highly beneficial for his future promotions.

Advancement in position is all about gaining an early start.

"Don’t worry about teaching well or not, everyone starts out learning to walk. The academy will definitely give you ample time and opportunity to grow, without imposing very strict demands at the start."

Director Tan reassured him.

"Alright, if you trust me that much, there’s nothing more to say. I’ll just roll up my sleeves and get to work. Everything will follow your arrangements at the time."

Zhou Can gladly accepted.

No need to be overly pretentious, because opportunities like this are hard to come by again once missed.

...

On the third day, Zhou Can was performing surgery in the emergency department when a call for help suddenly came from Cardiothoracic Surgery, asking him to come over for an emergency consultation.

Saving lives is like fighting a fire, Zhou Can handed the surgery over to his two assistants.

They now have the full ability to handle Level 1, Level 2 surgeries, and the ordinary parts of Level 3 surgeries.

For high-difficulty Level 2 surgeries and many important parts of Level 3 surgeries, Yang Zhi and Pu Dingdong still lack the ability to complete them. This is already quite fast progress.

Yang Zhi, with a good surgical foundation himself, is noticeably more capable in surgery than Pu Dingdong.

However, Pu Dingdong’s progress is very stable, consistently advancing at an even pace.

It’s still hard to predict who will be stronger or weaker in the future.

Zhou Can feels very satisfied with his two medical assistants.

It’s unrealistic to expect them to grow to Zhou Can’s level in just one or two short years.

Compared to ordinary doctors of the same level, their progress is already considered very impressive.

He quickly arrived at Cardiothoracic Surgery.

The atmosphere in the consultation room was tense.

"Three days ago, this patient underwent emergency intervention thrombus extraction surgery in our hospital’s cardiovascular department. Starting last night, they began experiencing quite noticeable symptoms of discomfort: shortness of breath, intense chest pain, and severe blood pressure drop. We are currently suspecting acute myocardial infarction with extensive myocardial ischemia leading to necrosis due to prolonged duration. The patient is currently in an extremely dangerous condition. After evaluating with several other directors, we believe the surgical risk is very high. You understand this patient’s condition the best, so we specifically invited you to join the consultation."

Director Xue Yan sat at the main seat at the consultation table.

The first seat on the left was empty, reserved specifically for Zhou Can.

The vast majority of doctors in the department regard Zhou Can as the second-in-command of Cardiothoracic Surgery.

Traditionally, the left has been a position of respect.

The chief seat on the left is usually occupied by the second-in-command.

Zhou Can took the examination materials to look over, mainly ultrasound and CT scans of the chest.

These help in identifying abnormal conditions.

"When this patient was brought in for rescue three days ago, the optimal rescue window had already been missed. During the interventional surgery, I had a bad feeling that the extent of myocardial necrosis might be very large. Now, unfortunately, it has really turned out this way."

Talking about Zhang Qilian’s condition gives Zhou Can quite a headache.

This is a real tough nut to crack.

"Based on my clinical experience, in his current state, if surgery is not performed, he will certainly die. Even if surgery is performed, the survival rate won’t exceed 50%. We have discussed two approaches. The first is to attempt surgery and assess the situation afterward. The second is to consider a direct heart transplant. Of course, finding a donor is a major issue. An artificial heart is the first choice."

Director Xue Yan provided some discussion opinions.

After listening, Zhou Can still felt very concerned.

"Both surgical methods have a certain feasibility. The key issue is that the patient has severe arterial abnormalities, with obvious atherosclerosis throughout the body. During my rounds, I found through chatting with the family that the patient has had vascular abnormalities since childhood. He has been taking medication to control it ever since. For this reason, the patient once studied in Japan specifically for methods to treat their systemic arterial vascular abnormalities."

The patient’s condition is extremely unusual.

Even for an ordinary patient, heart transplant surgery carries very high mortality risks.

Let alone for a patient with severe arterial abnormalities.

After hearing this, everyone was at a loss for what to do.

For acute myocardial infarction patients, if there is extensive necrosis, myocardial remodeling can occur, leading to heart enlargement, weakened myocardial contraction, reduced cardiac output, heart failure, lowered blood pressure, and even cardiogenic shock.

If not addressed in time, necrotic myocardium can bulge outward, possibly leading to ventricular aneurysm or papillary muscle rupture, and even heart rupture.

Because of myocardial necrosis, the infarcted myocardium becomes thin, while non-infarcted myocardium thickens, causing uncoordinated myocardial contraction, possibly resulting in mural thrombus in the left ventricle. If dislodged, it can cause embolism in the brain, kidneys, spleen, lungs, or limbs.

Therefore, when Zhou Can checked Zhang Qilian’s postoperative situation in the ward that morning, he reminded the family that the real danger zone was far from over.

He was able to successfully extract the thrombus for Zhang Qilian but couldn’t guarantee that the myocardium wouldn’t become necrotic.

Because during the thrombus extraction, some myocardium was already necrotic due to ischemia. It wasn’t discovered because the pericardium wasn’t opened.

Treatment in Western medicine often tends to be passive.

It can also be understood as a secondary version of defensive medicine.

For example, if a tumor is detected in a patient but the size isn’t large, doctors may recommend simply observing. The patient is re-examined every three or six months. If it doesn’t continue to grow, they let it be.

This is known in medicine as coexisting with the disease.

The entire philosophy of Western medical diagnosis is essentially based on this thought. It aims to extend patients’ lives as much as possible and then ease their suffering.

For instance, cancer patients are first subjected to chemotherapy or radiation therapy to control the spread of cancer cells. The goal is not to cure, but to extend the patients’ survival time.

Later, painkillers are prescribed to relieve the pain in advanced cancer stages.

Many people believe trigeminal neuralgia is the most painful, while others think childbirth is most agonizing, but compared to cancer pain, these are minor.

Cancer pain truly makes life unbearable.

Especially the pain in advanced cancer stages is enough to make one wish for death.