blogombal Chapter 18 Helena Murphy
Chapter 18 Helena Murphy
Fortunately, the whole afternoon went peacefully without anything unusual happening.
By five o'clock, the number of patients in the restaurant finally began to decrease visibly.
It's not that no one goes to the doctor at night, but rather that the police and security guards outside start stopping people.
Typically, conflicts are most likely to erupt or even escalate into riots towards the end.
Fortunately, this mobile clinic will last for a week, so those who couldn't get a spot outside will still have a chance, and they won't have to rush to the police cordon on the first day.
Because Chen Yisen was quick, he finished treating his last patient twenty minutes before officially leaving get off work.
Today's treatments will all be entered into the electronic medical record system and will also be included in the doctor's performance evaluation.
So even if Chen Yisen becomes free early, no one will assign their work to him.
Of course, you can't squeeze much money out of these marginalized groups of people, but from another perspective, the vast majority of them will not go to regular hospitals for treatment. In the foreseeable future, they will be "the first diagnosis is the last diagnosis". Even if they die, they will not leave much of a record in the medical system. For doctors, this is a good opportunity to improve chronic disease management and readmission rate scores.
That's right. According to the scoring criteria set by the insurance company, a treatment is considered successful as long as the same patient does not go to the hospital for the same reason again.
As for why she wasn't hospitalized—whether it was due to recovery or death—…
that's not important.
"Dr. Chen."
Chen Yisen had just finished washing his hands and came out when he heard a young woman's voice calling him from the side.
He thought another resident doctor was having trouble handling the situation, and reflexively prepared to put his mask back on.
But when she turned around, she realized it was the female medical student she had just asked to help Stacy maintain her position.
"Murphy, right?"
"That's right, Helena Murphy." The other person nodded, then leaned closer. "I still want to ask, how did you determine it was suprametrial artery syndrome?"
Chen Yisen slowed his pace: "Didn't I just say that?"
After saying that, I thought about it and realized that the other person's attention was probably on Stacy at that time.
So he repeated what he had just explained to the resident doctor.
"But this is still a verification process. Since we're verifying it, it means you already have a hypothesis." Helena persisted. "I remember reading in the book that the incidence of this disease is less than 1 in 5000, and patients severely lack typical symptoms... In fact, there are even completely opposite symptoms."
Well, I've really run into someone who's really asking all the questions.
Fortunately, Chen Yisen had also prepared another explanation.
"You've never gone hungry, have you?" He suddenly asked, changing the subject. "I mean long-term malnutrition, not the intermittent fasting that's popular now."
Helena shook her head, her blonde hair sticking to her sweaty face as she did so, prompting her to subconsciously raise her hand to tidy it up.
This scene captivated Chen Yisen, but he quickly explained, "The 1/5000 you mentioned refers to the incidence rate in healthy individuals, which is indeed very low. However, the low-income and homeless populations in the Bronx generally face chronic hunger and lack medical knowledge, making them prone to overeating after receiving food, both of which are triggering factors for SMAS."
"Prolonged hunger..." Helena's pupils visibly contracted. "Shouldn't there be social workers specifically responsible for distributing relief food..."
"Yes, there are." Chen Yisen nodded, after all, he had asked Joey to pick up a portion that morning. "But queuing to get these foods takes a long time, and you might not even get enough... Unless you're a professional homeless person, most people can't rely on this for all three meals a day."
"I see."
Seeing that the other party was no longer pursuing the issue, Chen Yisen quickened his pace, preparing to return to the rest area to relax for a while before making a quick getaway.
But as soon as they started walking, they encountered Natalia walking towards them from the opposite direction.
"It seems Dr. Chen is well-suited to working at a community clinic..."
She must have overheard what Chen Yisen said earlier, which is why she was being sarcastic.
The latter thought to himself, "You bastard, you better not let me get the chance, or you'll be in for a beating."
But his face remained expressionless as before: "Dr. Lynch, you flatter me. These are just my experiences."
Helena had already noticed the animosity between the two, and she had come with Natalia today.
I just didn't want to end my conversation with Chen Yisen like that.
So she chose to follow Chen Yisen: "Dr. Chen, I've read your paper published in the Journal of the American Medical Association..."
She was referring to the article that ignited the conflict between the original owner of this body and Natalia and others.
Because it did not receive endorsement, it was unable to successfully submit its paper to The Lancet.
Of course, the Journal of the American Medical Association is also a very high-level medical journal. To outsiders who are not familiar with it, it would be a great honor for an ordinary resident to publish such a paper.
That's why Helena used it as a starting point.
But to Natalia, it sounded like a medical student was specifically mocking her.
On the contrary, Chen Yisen seemed completely uninterested in the paper, simply grunting in response before asking, "That article shouldn't be too complicated, and the content is quite detailed. Is there anything you don't understand?"
"No, it's just... I think you're really amazing, Dr. Chen." Helena quickened her pace to catch up. "I'm about to start my fourth year of doctoral studies, and I've also chosen primary healthcare in the residency matching system..."
As he spoke, he took out his phone and showed Chen Yisen his Instagram page.
In reality, there are several levels between attending physicians and medical students, and today's shelters are, to some extent, medical settings.
According to North American custom, Helena's initiative to exchange private social media accounts in this context could be questioned as a matter of professionalism.
Fortunately, Chen Yisen was completely unfamiliar with the unspoken rules of North America.
He simply searched through the original owner's memories again and felt that Instagram's status in the West University social circle was similar to WeChat, so he decisively labeled this behavior as "getting a verified account".
The two people had just met and chatted for a bit, so it seemed reasonable for them to add each other on WeChat.
Without thinking, I took out my phone and scanned the QR code on the other party's homepage.
But Helena smiled broadly and said, "If I have any questions in the future, I hope I can ask you for advice."
Chen Yisen had already taken a quick look at the other party's account.
The content is very simple: either it conforms to the stereotypical American upper-middle-class life, or it's the exterior of medical schools and hospitals.
However, no other people, including parents and elders, appeared in any of the scenes.
Chen Yisen knew exactly how to deal with this young lady from a wealthy family who was clearly there to experience life...
"Actually, I don't have much to teach you." He put away his phone and began to show off skillfully. "That's how community healthcare work is. Usually, there aren't any really difficult or rare diseases. It's just that the conditions are too poor, and the patients are difficult to communicate with. You need more humanity than medical skills..."
Then, he silently added to himself, "But students with humanity usually find it difficult to graduate from medical school..."
Helena stared at Chen Yisen's profile, and sure enough, a look of admiration appeared on her face.
However, the answer was somewhat disjointed: "I really didn't expect that a primary care physician could make such a brilliant diagnosis..."
It's hard to say whether it was her medical skills or her looks that attracted her.
Chen Yisen also felt a bit confused, but since the other person had chosen primary healthcare internal medicine, he felt he should offer some encouragement: "From a purely medical perspective, all departments are equal..."
Helena paused for a moment after hearing this, then said quietly, "If only everyone thought that way... When I said I wanted to remove neurosurgery from the residency matching system, my mom almost went crazy with anger."
Chen Yisen: "..."
No, you should have said you could go to neurosurgery earlier!
Can they be the same?
In the US medical training system, the only mainstream form at the school level is the four-year medical doctorate, and there is no strict specialization at this stage.
What truly determines the future direction is the matching of resident physicians, as Helena just mentioned.
In terms of format, it's similar to the college entrance examination registration at the University of Tokyo, where you can select your first, second, third, and fourth choices, a two-way selection process.
Once you're matched with a department, you'll basically be stuck in that department for life.
Worried about affecting the young woman's future, Chen Yisen quickly organized his thoughts and began to try to smooth things over: "On the other hand... while departments are generally equal, neurosurgery is indeed more equal than other departments..."
This is absolutely not a lie.
While primary healthcare internal medicine is not the only career path available to community doctors, it pales in comparison to neurosurgery.
The latter has advantages in every way except for the higher tuition fees and the requirement of a full seven-year residency.
"But I don't like scalpels," Helena explained. "They feel too aggressive, and... I prefer the kind of step-by-step analysis you just went through."
Chen Yisen felt that if things continued this way, he might be reported by the other party's mother for spreading rumors, so he could only retract his words: "If you prefer diagnosis to surgery, then why not choose neurology?"
A neurologist, known as the Sherlock Holmes of the medical world.
They mainly rely on logical analysis and reasoning skills to work, and are also among the elite.
Helena's eyes lit up when she heard about neurology, but she sighed again: "I did keep neurology as an option, but... neurosurgery and neurology are different from other departments. You need to commit to a specific direction in your first year of doctoral studies, and there's a lot of prejudice against late-term converts..."
Chen Yisen had already guessed the plot: "So you initially promised to do neurosurgery, but later found out you didn't like it?"
Helena nodded: "Yes, it may be too late to switch to neurology now. We can only consider primary healthcare internal medicine as our first option."
No wonder I felt a bit off earlier. And even though I have a good foundation, I don't know a lot of common internal medicine knowledge.
After confirming that he hadn't influenced the other person's choice, Chen Yisen decided to respect their fate.
"Okay, contacting me is no problem... but if you encounter something you don't understand, I still suggest consulting your supervising doctor first."
He himself only managed to understand internal medicine through some kind of cheat code, so how could he dare to take on such a big responsibility?
Maintaining the image of a "reclusive sage who occasionally shows off but is indifferent to fame and fortune" is the right way.
Just then, the announcement that the day's work was over came from the loudspeaker.
"Alright, it's getting late, I'm going to pack up and leave work." Chen Yisen quickly packed his things and said goodbye to Helena.
The latter was left alone to watch the figure disappear through the doorway.
After a few seconds of stunned silence, Helena finally realized what she had just done.
She patted her cheeks in regret: "Helena, Helena, how could you be so direct as to ask for someone's contact information? Have you forgotten the strategy you planned? What if they think you're being unreasonable?"
But he quickly pulled out his phone again, pretending to be reluctant but actually browsing Chen Yisen's Instagram page...