no traveling history in recent 3 months

It’s Dec. And It’s almost been 3 months I haven’t keep my blog. The course of internal medicine: the busiest part in internship has passed and I feel like being released from a disaster district. Following by INF, my course in Oct. is chest medicine(abbr. refers to CHE). CHE is quite a different and interesting part for me, which comprises the vital organ: lung, and respiratory mechanisms. Those diseases concerning respiration are to some extents lethal to our lives, for example, pneumonia, COPD or asthma with acute exacerbation, bronchiolitis, and interstitial lung diseases.......and so forth. My CHE visiting doctor and resident doctor are specially match that could make the near-to-death patient reversely be rescued. I sometimes seriously told myself “ lives are controlled in our therapeutic plans, and if any obstacles or mistakes happened may probably threaten to patients’ prognosis, even life. It’s quite important that we make good decisions and sharpen up our skills.

What about the GI section in Nov. you might ask. Actually, in the first one week came a catastrophic punishment inasmuch as I was found slept in a journal meeting by chief resident Dr. on one day morning, I must say thanks to my neighbor sitting next to my left side who kept trying his best arousing my attention to the lecture via touching me, kicking me, however , turn out to be a labour in vain. And the cost of sleeping is rewrite the content of the paper discussed then by hand. Totally 9 full-paged content made of size 10 alphabets left little blank at edges. Such work is sure a blockade to my receptors of forward motivation. Though frustrated and sad, I finally recovered in second week recruiting much power to prepare my first case report in GI in third week. I chose a case of a pancreatic head cancer referred from MET section with first impression of simply type 2 diabetes mellitus with poor control and thought it might be a chance to refresh myself in CR’s sights. Due to the high complexity of this case might be, I spend lots of time to prepare and presented with my MAC book. And as one slang goes ”the higher the expectancy it is, the higher you might fall down.” You must know what I’m going to say next, well , it’s truly a failure of my performance. After the morning meeting discussing my case, a strong thunder blade split me apart. Anyway, I don’t like GI as a result. Hahaha~~

Infection department

In Sep.,

I stay in infection department.

It was very special working in infection ward,

because patients almost got fever before admission,

then,

they were discharged if fever has subsided for two days.

It sounds easy and actually it is if you complete the following items:

1. confirm the source causing fever( or infection source)

2. select a proper antimicrobial agent

3. follow patient's vital sign

4. fever subside and patients regain energy

However,

it takes a long time to find out the infection sources or pathogens.

So, we cannot give antibiotics until we know the exact pathogen.

Instead,

after quickly looking the symptoms of a patient,

empiric antibiotics are ought to be given,

thus,

how to match good antibiotics to corresponding manifestations

is the most important and brain-cost thing in infection department.

There are too many kinds of antibiotics needing to be known,

there are too many pathogens needing to be studied,

there are too many diseases needing to be identified,

and I have 24 hours a days.

So far,

I feel very good and satisfied in this department,

and I hope I can keep going.

醫院生活 Day 68

耳鼻喉科のあとで、いまの僕は神経内科にいます。　神経内科にとって、一般内科と異なるシステムですよ。　その原因は僕もわかりません、本当に。神経内科にいるの第三周ですから、いろんなケースを見ました。　これまで、中風は一番多いのケースだった。　ブレーンの中で、別々の部分が中風したら、症状も異なっていますよ、それは一つ困難的な部分だと思います。　ロックインが最も特別な病気だと思っていますし、考え能力があるのに、ほかの方面、話すなど、両手と両足の動きなど、小便などは全然機能不足です。

今月は主席、バナナ、育任と一緒に働きます。　主席と僕だけ二つの先生を手伝うので、最初はちょっと忙しいだったので、苦しい気持ちを感じますし、それは実習医の一つ挑戦だけだったと思います、ところで、この一週間以来、バナナがだんだん多い仕事があって、真夜までも、仕事をやれませんでした。チームの一つメンバとして、困難にいる人を助けるのは僕たちの責任だと思います。　それは本当のチームでしょう。今日はバナナさんの誕生日だので、仲良い友達と一緒にいいレストランで晩飯を食べてお祝いました。本当に楽しかった。