The combination of passion and work is not only a blessing, but also a great opportunity to have a broad sky, Chen Qiren's tone is always full of anticipation when he talks about the future of radiology.
Photo/artwork by Jin-Gang Hsia
If you have a child who likes to disassemble his toys, don't scold him, he may be a future world-renowned doctor!
Chen Qiren, the vice president of Shuang He Hospital and a world authority on Ping Shan Disease, is just such a child. Ever since he was a child, he has been curious about how things are made up and how they work. Whether it's a toy or a clock, it's not the surface function that attracts him, it's the inner mechanism. He likes to use his own hands to explore the inner workings of things, so it is always difficult to escape the fate of a good thing that has been handed over to him. Chen Qiren satisfies his curiosity in the process of disassembling things gradually, and gets a sense of achievement in the process of assembling them back together.
The human body, undoubtedly, is the most complex and difficult to understand the machine, it is not difficult to understand, anatomy will become Chen Qiren in medical school, the most favorite subject, and the human body in the nervous system is more of an enigma. Apprenticeship in the hospital, the Department of Neurology impressed him y, the physician as long as the human body, and then according to the comprehensive examination of neurology, you can say something, and inferred that the patient has what disease, and the results of this inference and the results of computerized tomography scanning is not far from the results. I remember once, the teacher of a patient after neurological examination, deduced that the lesion in the lumbar spine of the third nerve, and then a computer tomography really found to be the third lumbar vertebral disc herniation, compression of the nerve, accurate as fortune-telling, so that Chen Qiren breathtaking.
In addition, the diagnosis of surgery are relatively direct, and neurology must be considered in a holistic manner motor nerves, sensory nerves, autonomic nerves and other systems, so in addition to the deep and broad learning is necessary, the reasoning mind is indispensable to deduce the lesion belongs to the path of which nerves, it must be thought, more experience, the judgment naturally faster. Therefore, with a mood of respect and admiration, coupled with a love of reasoned thinking, Chen Qiren walked into the field of neurology.
Shocked by imaging medicine
Neurology requires a lot of brain imaging, and when Chen Qiren was a resident, magnetic resonance imaging (MRI) was invented abroad. He remembers the first time he saw a magnetic resonance imaging image, he was shocked, because the image was exactly the same as the actual anatomy, and it was still a vivisection. During his internship at Chang Gung Hospital, a professor from the National Taiwan University School of Medicine would regularly come to help neurologists and radiologists with their classes, so he went to sit in on the lectures, and to his surprise, the more he listened, the more excited he became, and he felt that neuroradiology would be his passion. At the same time, he also saw the future of magnetic resonance imaging (MRI) in medical technology, so he applied to the director of NTU, who was teaching at the time, and was admitted to the Department of Radiology at NTU Hospital in 2007. At that time, there was no MRI machine in China, so Chen Qiren could only buy books to read, and it was not until the third year of his residency that NTU purchased Taiwan's first high-field magnetic resonance angiography (HFMG) machine, and at this time, he was able to put his existing knowledge into actual practice.
The training in radiology at NTU was so good that when the residents had their morning meeting every day, the attending would throw a film out and ask the residents to come up and analyze it. We had to look at a film and guess what the possibilities were because we didn't know what the pathology was, so we had to look up what the signs were based on the clues on the images, speculate on the most likely ones, and then make a list for differential diagnosis," recalls Chen Qi-ren. Since everyone on the stage has to last for 10 minutes, they have to make inferences by all means. In fact, every senior physician is so worn up, so they have trained a set of systematic thinking logic, although not necessarily every time to guess right, but because of the logic of reasonable, 100 times may guess 90 times, but if you do not follow the logic of the law, based on the intuition of jumping to think, will only be occasionally guessed right.
Being a consultant to various physicians
Because modern medical technology is so advanced, the images are so easy to access, whether in terms of resolution, stereo, or even accessibility, so clinicians are relying more and more on radiology, and the physicians would like to see the images provide information about the pathology, and even the direction of the treatment of the disease. The more the clinicians demand, the more the radiology department will want to see more films and interpret them more accurately, preferably even for pathology.
If the clinicians are the front line, the radiologists are their advisors, and the clinicians are the ones who are going to make the requests for imaging, so that they can deal with the patients more appropriately. On the other hand, the radiology department will make a report based on the support provided by the existing technology, and then **** with the discussion to solve the difficult problems.
Since radiologists have to know a lot of things to be a consultant to clinicians, their test is to be on par with clinicians in terms of knowledge, and to be absolutely on top of them in terms of image interpretation in order to gain trust. In particular, some clinicians see a lot of images and have many cases to prove that they are already very good at what they do. In order to match the clinic, and radiologists' personal time is limited, they can't be good at everything, so radiologists are now starting to go to sub-specialties. The neuroradiology subspecialty that Chen Qiren has taken is a combination of his training and experience in neurology and radiology, because every day he looks at the images of the head and reads more, so he is naturally more specialized.
Since it is a good helper for physicians, the status of radiology has also risen, like at the University of California, San Francisco Medical Center, where the radiology department will come to the attending physician to discuss the film before going to see the patient. The reason is that imaging is so convenient, and you can see many things that physicians can't see when they're out knocking around, and the relationship between doctors and patients is getting more and more tense, and now patients are asking for evidence and images all the time.
Direct patient contact interventions
From a legal perspective, radiology is one of the reasons why physicians rely on it. For example, if a patient comes to the emergency room with a head trauma and the physician thinks he's fine and discharges him, but then he comes back an hour later with a brain hemorrhage, the patient may sue the hospital for malpractice. If there is a tomography scan to prove that there is no record of bleeding before the diagnosis, the physician's responsibility can be set aside, and if there is no examination, it is difficult to clarify the legal responsibility.
Chen Qiren said, more than 20 years ago, radiology can only do diagnosis, but now the progress of instruments and equipment, so that we are no longer limited to the service clinicians, but direct contact with the patient intervention. The current situation is that after the radiology department to do imaging, and neurology, neurosurgery to discuss which treatment is the best for the patient, if you want to open the incision site is very deep, surrounded by nerves, open easy to cause damage, then the radiology department from the blood vessels to perform. Before the surgery, you need to explain to the patient how to perform the surgery and get the consent of the other party. On the day of the surgery, there are anesthesiologists to help you, so you have your own exclusive operating room, and after the surgery, you have to go into the intensive care unit and also have a neurological examination, which makes you a complete first-line service.
For example, in the vascular catheterization center at Shuang-Ho Hospital, it's a combination of neurosurgery, neurology, and radiology. If it is deep, the radiology department will do it via the vascular route, and if it is superficial, the surgery department will perform it.
Happy at work, full of fulfillment
Is it more stressful to be on the front lines? The first thing you need to do is to get your hands on some of the most popular products and services in the world," he said. He laughed and said that the film will not complain with you, but now began to see the outpatient clinic, to see a patient to put a lot of effort, not only to study the condition, but also to care about their psychological, family, economic, habits and many other factors. The patient's gratitude certainly brings a sense of fulfillment, but the more patients, the less relative time, the quality of service is also affected, but Chen Qiren for the front line still hold a positive attitude, because the whole process of participation, the understanding of the medical process and the patient's help more comprehensive.
Although he didn't choose surgery in the beginning, Chen Qiren slowly realized that he had a surgical inclination, and liked the more challenging work, because the pressure in the operating room is very high, and you have to practice being calm and collected. In fact, he also enjoys his work, he once had an operation from 12 noon to 2 o'clock in the middle of the night, but after the operation, he was only full of fulfillment, he felt that he had done a good job, and had long forgotten about the physical fatigue, just as when I was a child, after carefully comparing the parts, toys back to the mood.
Full of expectations for radiology
Chen Qiren for his work has always held a thankful, see more than the old, sick and dying, let him realize that prevention is better than cure. Over the years he has often thought, if you do not go to the step of getting sick, would it be better? He realized from many patients that modern medical treatment is not perfect, so everyone should take care of themselves, and they need to take care of themselves even more when they get older, and hypertension and diabetes are much worse than no care at all. So three years ago, Chen Qiren began to adjust the diet, the implementation of the so-called dietary supplements health, he was very happy to say, eat the right food, the essence of the spirit is really very strong, and at the same time, also began to develop the habit of running 5,000 meters every day, he said, this is very effective for stress reduction.
In the modern world of pain, Chen Qiren is a great example of happiness. He showed me that combining passion with work is not only a blessing, but also a way to have a broader sky. Whenever he talks about the future of radiology, his tone is full of anticipation. Although I have never seen Chen Qiren as a child, I believe his enthusiasm has never changed.
Chen Chi-Jen's Profile
Current: Vice President and Director of the Department of Imaging Medicine, Shuang-Ho Hospital
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This is the first time he has been in the hospital, and he has been in the hospital since the beginning.