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王白水

白水房

志闲少欲,心安不惧 泛中医论坛https://forum.beginner.center/
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A030 Recording a Surgical Lecture

On Wednesday, I attended a lecture by Dr. Wang Guang, the head of the surgery department, on the differential diagnosis of acute abdomen. I won't go into the specific knowledge points, but I will record some key points.

Preparation#

First, Dr. Wang asked us to clarify the concept of acute abdomen. He emphasized that any confirmed diagnosis must meet the concept. There is no need for further investigation in surgery. A diagnosis must be given upon discharge.

Extensive#

Then, Dr. Wang posed a question that he asks every year during student interviews:

"A young male patient suddenly experiences upper abdominal pain. Regardless of internal medicine or surgery, what diseases can you think of?"

Dr. Wang prompted us to start with the distribution of nerves. Unfortunately, I had completely forgotten. Dr. Wang sighed and turned to the next page where he listed his answer. It filled an entire page with at least twenty disease names, covering various aspects, many of which I couldn't think of. And this was only a part of it; the other half was not written in the PowerPoint.

Dr. Wang said:

"During interviews, I can tell a student's level and whether they have a general idea just by listening to a couple of sentences. Think about this question outside of class. If you can answer it completely, it means your level in internal medicine and surgery has reached a certain level."

I hope that in three years, I will be able to come up with fifty disease names.

Speed#

Dr. Wang mentioned that in surgery, when there is bleeding, it sprays out and there is no time to transfuse blood. It is necessary to quickly find the source of bleeding and stop it. This kind of work experience makes every surgeon appear energetic and efficient.
Last night, it was raining in Beijing. Just as I was about to leave the subway station to go back to school, I saw that the rain was getting heavier. I had two choices: either hurry and walk, knowing that every second delayed would make it more difficult, or wait until the rain subsided. I gathered information and checked the weather forecast. It was predicted to continue raining, and it wouldn't stop in the short term. I made a judgment and decided not to wait, but to leave quickly. I calmly executed my decision. Since I was already outside, even though my shoes and pants were wet, I had to hurry back. I paid attention to puddles and slopes along the way, even though I was in a hurry, I still had to be steady.

At that moment, I felt as if I had become Dr. Wang. I was proud of my decisive and calm actions.

Confidence and Responsibility#

Dr. Wang shared a case with us. Sometimes, the symptoms and examination results of a disease may contradict each other. He asked us what we should do in such a situation: trust ourselves or trust the report?

Dr. Wang could see our dilemma and told us to believe in ourselves because surgeons are the ones ultimately responsible. If something goes wrong, no one, including the lab technicians, will take the blame for us. It's our own responsibility, our own judgment, and we must believe in ourselves.

At that time, I felt like I understood. However, during the outpatient clinic on Saturday, I almost made a mistake. The clinic was busy, and Dr. Wang asked me to handle a patient. As part of the routine, I pulled up the patient's previous medical records to prepare for reference. It was a fracture, and there was no previous treatment plan, so I couldn't copy it. I asked a senior colleague what to do, but he was also busy and told me to follow the procedure for joint injections. I was confused, but in the end, I didn't say that it was a fracture and not arthritis. Instead, I thought that my senior colleague had seen this patient before. I ended up writing a prescription for a joint injection. Before saving it, Dr. Wang came back and saw that I had made a mistake. He quickly corrected it.

It's my own responsibility! It was at that moment that I truly internalized this.

Others#

Dr. Wang also mentioned:

"In the future, when you specialize in your own field, you will have plenty of time to explore and study, just like me, who has been in surgery for forty years. But the opportunity to switch specialties is rare, and you won't have it again in the future."

In addition, a certain director of internal medicine once said:

"The biggest regret of my life is not going to the surgery operating room when I switched specialties. I never had the chance to go again."

Internal medicine has brought me balance, while surgery has taught me precision, decisiveness, and calmness. I hope everyone will seek knowledge extensively and not form biases against any particular field based on stereotypes.

Finally, you can also listen to the program we recorded a few days ago to hear how a neurosurgeon views traditional Chinese medicine and Western medicine:
Vol.6: A Conversation with a Neurosurgeon in a Traditional Chinese Medicine Hospital

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