My Medical Skills Give Me Experience Points Chapter 1385 550: Cause Identified—From Doubt to Belief

Within the specialized ultrasound room, Zhou Can was positioned attentively beside the ultrasound technician.

The procedure commonly known as echocardiography utilizes the principles of short-wave ultrasonic ranging. Pulsed ultrasound waves are transmitted through the chest wall and underlying soft tissues to capture the rhythmic movements of the heart's walls, ventricles, and valves. These dynamic activities are then visualized as graphical curves on the monitor, illustrating the relationship between structure movement and time. A recorder captures these curves, transforming them into visual images.

This technique is highly effective for assessing the dimensions of the heart, the functionality of its valves, and specifically, the left ventricular ejection fraction.

It was precisely this left ventricular ejection fraction that Zhou Can intended to evaluate.

"LVEF is down, EF is 39%," the ultrasound technician announced the figure to Zhou Can.

"The left ventricular ejection fraction is roughly the same as reported by the other hospital," Zhou Can confirmed with a nod. He then instructed the patient, "Alright, please try to dorsiflex your feet and apply some force."

The patient complied with the request.

"What is the left ventricular ejection fraction now?"

"52%."

The ultrasound technician's expression was etched with disbelief.

An ejection fraction of just 39% indicated a reduced function, not critically severe, but certainly beyond mild.

A normal ejection fraction typically falls within the range of 50% to 70%.

The patient's left ventricular ejection fraction had surged from 39% to 52%, a truly astonishing improvement.

Sustaining this level of function would practically allow the patient to return to a normal state of health.

"Excellent, relax now, relax!"

Encouraged by this positive result, Zhou Can felt more assured in his diagnosis and guided the patient to relax.

"Bend your lower legs!"

He again directed the patient to follow his instructions.

"What's the fraction this time?"

"46%."

"Not bad." By this stage of the examination, Zhou Can had largely pinpointed the source of the patient's condition. "I'm going to squeeze your lower legs; please bear with it."

After signaling the patient to straighten and relax both legs once more, Zhou Can proceeded to gently compress the patient's gastrocnemius muscles.

"How much is it?"

"43%, 42%."

These were the readings obtained from squeezing the left and right legs, respectively.

"Alright, thank you for your cooperation! Please print out the report; we are finished here," Zhou Can stated to the ultrasound technician.

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

"Precisely, it lies within your legs. I will provide a full explanation once we return to the ward!"

He recognized the need not to continue monopolizing the ultrasound department's valuable resources.

The clock had passed the standard working hours, and the staff in the ultrasound department were essentially working beyond their scheduled time.

Unlike clinical departments, technical departments adhere to very precise work schedules, allowing staff to clock in and out punctually and enjoy weekends off. However, due to the immense demand for services, departments such as Ultrasound and CT operate on a rotating shift system.

Furthermore, within a major hospital like Tu Ya, the ultrasound units serving Obstetrics & Gynecology and Cardiothoracic Surgery are not managed by the general technical department. Instead, they fall under the purview of the respective Obstetrics & Gynecology and Cardiothoracic Surgery departments.

Aspiring ultrasound technicians generally view securing a position within these two specialized departments as the most advantageous career path. Doctors in the general ultrasound department often find it challenging to transcend this limitation, spending their entire careers within that technical niche. While their income may be slightly above average, there is rarely a significant opportunity for career advancement.

In contrast, the work for physicians in clinical departments is considerably more demanding. During evenings or holidays, they may be summoned back to the hospital for overtime work with little notice. Even after their official work hours, they remain responsible for the well-being of their patients, constantly hoping they do not encounter any unforeseen complications.

Should a patient under their care pass away or experience a similar critical event, the attending physician would undoubtedly face repercussions.

These consequences might not always involve financial compensation to the family or the revocation of their medical license. However, the hospital employs an evaluation system that significantly impacts a doctor's standing. For instance, if a doctor experiences two patient deaths within a short period, while senior physicians might express frustration, they would also begin to monitor that doctor closely, gradually sidelining them professionally. Their clinical judgment would no longer carry the same weight.

In essence, their authority diminishes. Any treatment orders they issue would require review by a superior before implementation, and certain clinical treatment strategies would necessitate approval from a senior doctor or be performed under the guidance of a colleague at the same level.

As for rescinding his qualifications for awards and accolades, that was a foregone conclusion.

Within the confines of the Emergency Department, Zhou Can held considerable influence; during critical resuscitation efforts, even associate chief physicians deferred to his direction.

...

Standing beside the makeshift bed in the corridor, a report from the echocardiography in his grasp, Zhou Can elucidated the source of the patient's heart failure. Director Xue Yan, having been apprised of the situation, had already hurried to the scene.

"So, you truly identified the cause! Remarkable!"

Director Xue Yan’s countenance was wreathed in smiles.

Each instance a complex, perplexing case was successfully diagnosed or resolved through treatment brought her immense satisfaction.

As the head of the department, her earnest desire was for its continuous improvement and advancement.

The department's standing and reputation, while partially built upon the effective management of routine cases, had certain limitations. The cases that truly left a significant mark were invariably the challenging and intricate ones.

"I still cannot fathom how my heart failure could possibly be linked to my legs?"

The patient's bewilderment was palpable.

The hired consultant, referred to as Brother Wei, stood by the bedside, his expression a mask of disbelief. He had initially dismissed Zhou Can's pronouncements as mere conjecture, but now, subsequent examinations had corroborated that the patient's leg condition indeed bore a connection to his heart failure.

"The legs possess several robust muscles, known as the gastrocnemius muscles. While the average person might be unaware of their function, within the medical community, we refer to them as the body’s 'secondary heart.' Ever since our ancestors adopted an upright posture, a significant vulnerability emerged in the human physique. The heart found itself positioned further from the ground, profoundly complicating the return of blood from the lower extremities to the heart."

"Concurrently, it became exceedingly arduous for the blood expelled by the heart to reach the furthest extremities of the lower limbs. In response, through eons of evolutionary adaptation, the gastrocnemius muscles of the legs developed the crucial role of an auxiliary cardiac pump. With each contraction, they effectively compress the blood within the legs, propelling it upward towards the heart. Upon relaxation, they generate a natural suction, drawing blood inwards. This cyclical process establishes a pumping action remarkably akin to that of the heart itself."