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      "body": "Congratulations @yangzhichao! You received a personal award!\n\n<table><tr><td>https://steemitimages.com/70x70/http://steemitboard.com/@yangzhichao/birthday2.png</td><td>Happy Birthday! - You are on the Steem blockchain for 2 years!</td></tr></table>\n\n<sub>_You can view [your badges on your Steem Board](https://steemitboard.com/@yangzhichao) and compare to others on the [Steem Ranking](https://steemitboard.com/ranking/index.php?name=yangzhichao)_</sub>\n\n\n###### [Vote for @Steemitboard as a witness](https://v2.steemconnect.com/sign/account-witness-vote?witness=steemitboard&approve=1) to get one more award and increased upvotes!",
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      "body": "很早之前我便申请了百度拇指医生。\n\n申请的目的主要是为了尝试一下大家所说的互联网医疗，还有就是证明我职业的合法性。\n\n因为拇指医生申请的话需要上传执业医师资格证和医师职业证书的。如果没有这两个证是无法获得拇指医生的资格。\n\n幸好我当时毕业后一年便顺利获得了执业医师资格证书。因此申请拇指医生就变得很顺利了。\n\n当时也没想着能赚多少钱，就是想尝试一下的。\n\n在申请之初我每天都会回答脑出血、脑外伤等神经外科的相关问题。后来因为工作以及打理网站的原因，就没怎么再回答问题了。\n\n前几天突然给我的银行卡汇款了120元钱。当时我还挺纳闷的，不知道这是什么钱。通过银行卡的手机银行查询，才发现是拇指医生给予的报酬。\n\n![](https://steemitimages.com/DQmTtruYC9icxHkMhJvHtDMRV9SThEaLQDqGC5PUahcrVAL/image.png)\n\n在这里不得不赞叹一下百度公司。120元钱虽然数额不大，但是也体现了对我们劳动的充分肯定。可见大公司对于细节的把握。如果在一些小公司开发的类似平台上，估计我这120元钱，早就因一些其他原因被扣除了。\n\n第二天我把这个事情告诉了我的同事们。他们看到我的酬劳，也顿时产生了兴趣。纷纷下载了拇指医生。\n\n我对于互联网执业的看法一直抱持着观望的态度。毕竟医疗行业不像是修理家电那样，有着一成不变的规则。因为人体的特殊性，导致了这个行业的特别。医生在一系列医疗行为中处于主体地位。因此单单凭借一根网线就可以看病，我觉得还是为时尚早。\n\n不过谁能预料到以后的事情呢。",
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      "author": "yangzhichao",
      "body": "有的时候是患者要求你开那些没用的药，你不开，给他解释一番吧，他还觉得你不会看病。还说哪个主任就是这么用药的，有时候被说的烦了，就随便他，想开就开了，只要不违反原则，就随他去了。",
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      "author": "runningbird",
      "body": "欢迎多来转转呀",
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      "author": "yangzhichao",
      "body": "是的，神外医生。嘻嘻，不过我是山东的",
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      "author": "liuboya",
      "body": "支持原创，你是神外？\n很希望看到你的科普…\n我猜你是东北的…哈哈",
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      "author": "yangzhichao",
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      "author": "yangzhichao",
      "body": "最近贴吧很多患者家属问我\n\n> 医生我父亲车祸昏迷二十六天，开颅手术两次，又做了气切，现在四肢能动，医生掐他耳朵他能用手去挡，头偶尔会跟着声音转，眼睛无神。打呵欠，吧唧嘴。他醒过来的几率有多少？\n\n> 超人医生，我妈4个月前第一次脑出血，后来康复到可以走了，半个月前第二次脑出血，医生说以后康复的几率就像中彩票一样。现在情况是眼睛会睁开，两只脚偶尔会动一下，但是叫她没有反应，这两天她不舒服会感到难受会嗯的发出声音，这种情况醒过来的几率大吗？\n对于这种询问几率类的问题，说实在话，我实在是不好回答。\n\n医学界只有统计结果，表示的是发生率、死亡率、治愈率等到。他们的意义主要是统计一段时间，某种疾病的治疗效果。\n\n比如在《2016年脑卒中流行病学报告》指出的\n\n脑卒中患者中，高达67.3%～80.5%的脑卒中病例归因于缺血性脑卒中（脑梗死），6.5%～19.6%为脑出血，0.8%～7.0%为蛛网膜下腔出血，2.0%～14.5%为其他类型。\n因此这种概率只局限在统计学意义层面，对于临床医疗来说只能作为一个参考，并无实际意义。\n\n进一步讲，就像你问我的，昏迷患者醒过来的几率有多大。\n\n对于一个个人来说，99%和1%没有区别。\n\n举个例子，假如一个患者醒过来的几率是99%，那还有1%的可能是仍处于[昏迷状态](http://yangzhichao.cn/244.html)。\n\n那么问题就来了，任何人也不知道当下的这个患者是属于那99%还是那1%。\n\n因此我常常说，对于一个患者个人来说，只要发生了就是100%，没有发生就是0！\n\n对于百度贴吧上咨询我的患者家属，你们的问题我确实很难回答，毕竟凡是都有例外。我建议你们最好不要把心思放在有多大几率能醒或者说有多大几率能治好这个方面，当下应做的是积极配合医生治疗，在自己的有限能力范围内尽力去做。\n\n脑出血这个疾病就是，尽人事，听天命。就好比[我们之前的一个患者](http://yangzhichao.cn/227.html)，手术做的很及时，后来又出了两次血。我们把能做的都做了，可是结果还是不好。\n\n因此，家属在心理上要有做好最坏的打算，如果真的结果不好了，心理上能够接受事实。但是也不能因此自暴自弃，在自己力所能及的情况下尽力去做，免得日后后悔。",
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    {
      "author": "yangzhichao",
      "body": "2018-1-21日是我的生日。早在这天前我的爱人花花女士就为我准备好了生日礼物。\n\n但是具体是什么我不清楚。只知道是她精心准备的一个东西。\n\n那天我正在上班，忙完之后，我和几个同事在办公室聊天。\n\n她突然出现在我的面前，面色娇羞地把礼物送给了我。\n\n一个她花了一个礼拜，做成的艺术品。\n![QQ图片20180123173442.jpg](https://steemitimages.com/DQmU2WNKt8koigVXtDNNYZqe1jkeAuEnmrtwaVCB5srALWn/QQ%E5%9B%BE%E7%89%8720180123173442.jpg)\n\n里面记录着我和她的点点滴滴，上面还写着她想对我说的话。\n\n看到这个礼物，心里暖暖地，眼睛不自觉地有些湿润。\n\n没想到她如此的细心，送给了我这么一个让我难忘的生日礼物。\n\n小的时候家人对于生日不是很看重，从小到大都没有给我买过生日礼物。\n\n真没想到我的第一个生日礼物竟是如此的贴心，让我非常感动。\n\n看着花花写的每一个字，每一句话，我都暖在心里。\n\n她为我付出了太多，总是在默默付出着。为的就是让我们两个有一个幸福的生活。\n\n今生能遇到这样一个女人，真的是我的幸运。\n\n我也不能让她失望，做最好的自己，改掉自己以前的那些坏毛病。\n\n为了自己心爱的女人，永远去奋斗下去。给她一个温暖的家，给她永久的依靠。\n\n没遇到她之前，我总以为生活就是实现自我价值，向着既定的目标前进。\n\n有了她之后，我想我就想给她幸福，让她永远幸福下去！\n\n永远爱你！\n\n![QQ图片20180123174720.jpg](https://steemitimages.com/DQmUXXmHMgbF9c4BxRDBTmuQxFD44uPpYj8szmpTRJo5jpk/QQ%E5%9B%BE%E7%89%8720180123174720.jpg)",
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  "op": [
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      "author": "yangzhichao",
      "body": "你怎么了？",
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      "parent_author": "mrtrieu",
      "parent_permlink": "so-sad",
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{
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    {
      "author": "wang-peilin",
      "body": "嗯，有些工作必须陪领导，如果实在不行的话建议换个工作",
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      "author": "yangzhichao",
      "body": "对呀，工作时间长了就越来越相信命运",
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      "author": "yangzhichao",
      "body": "大多数都不是和朋友，都是陪领导，碍于情面都是少喝一点。",
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    {
      "author": "pilgrimlife",
      "body": "> 有的时候我也很无奈，因为这个问题没法回答。\n\n人生也很无奈",
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      "author": "wang-peilin",
      "body": "酒精过敏就告诉别人啊，你酒精过敏朋友还劝你喝的话，这样的朋友就别要了。",
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      "author": "cn-naughty.boy",
      "body": "楼主的文章真是妙笔生花啊！",
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      "author": "yangzhichao",
      "body": "我酒精过敏，每次喝酒就难受得不行。\n\n对我来说，喝酒简直就是煎熬！",
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      "author": "yangzhichao",
      "body": "![](https://steemitimages.com/DQmeApw1WzmwoKGjmEkSxasjTtPjNuxA1fgxBxdaZEER8Xq/image.png)\n在脑出血吧很多患者家属都会问我病人什么时候能醒。\n\n有的时候我也很无奈，因为这个问题没法回答。\n\n首先神经系统本身就是一个很复杂的学科。涉及人类昏迷的因素有很多。而且每个人脑出血的部位也不同，诸多因素导致患者的昏迷时间没有统一的标准。\n\n而且很多脑出血患者还存在各种各样的并发症，这些并发症的治疗情况如何，我也不了解。所以回答什么时候能苏醒，这个问题真的是没办法回答。\n\n而且你们可以想一想，你的床位医生——最了解患者病情的人——都无法告诉你他何时能醒。我一个隔着屏幕的小医生，又是有怎样的本领可以预测呢？\n\n还有一点我也需要声明一下。\n\n作为一个神经外科医生，我们的治疗任务是挽救生命。\n\n首先神经系统具有不可修复的特性，脑出血把神经损伤了，那么大脑就会一直保持这个状态。\n\n我们借助手术、药物等方法，目的是挽救那些没有受到损伤的神经，或者是减少那些必定会损伤神经的影响程度。进一步控制及治疗并发症，延长患者的生存时间。\n\n至于患者何时能醒，这个只能靠患者自己。目前尚没有明确的治疗方法可以促进患者苏醒。\n\n我们把患者的生命体征维持好了，并发症治愈了，机体的各项指标恢复正常了，那么剩下了要做的就是等待他的苏醒。\n\n所以，当你们问我你的家人何时能醒的时候，我只能回答：现在不好说，还要继续治疗。",
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      "parent_author": "",
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      "title": "我的任务不是要你醒，而是救你命"
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      "author": "rivalhw",
      "body": "对的。",
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  "op": [
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      "author": "yangzhichao",
      "body": "能够打动读者是最主要的",
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{
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  "op": [
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    {
      "author": "yangzhichao",
      "body": "@@ -254,16 +254,18 @@\n %E5%B0%86%E5%81%A5%E5%BA%B7%E5%AE%9A%E4%B9%89%E4%B8%BA%0A%0A\n+%3E \n %E5%81%A5%E5%BA%B7%E4%B8%8D%E4%BB%85%E6%98%AF%E8%BA%AF%E4%BD%93%E6%B2%A1\n@@ -289,16 +289,17 @@\n %E8%89%AF%E5%A5%BD%E5%92%8C%E6%9C%89%E9%81%93%E5%BE%B7%E3%80%82%0A\n+%0A\n %E6%88%91%E6%83%B3%E5%A4%A7%E5%A4%9A%E6%95%B0%E7%9A%84%E4%BA%BA%E4%BB%AC\n",
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      "parent_author": "",
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      "permlink": "72ettw",
      "title": "你是否认为你已健康"
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{
  "block": 19060935,
  "op": [
    "comment",
    {
      "author": "yangzhichao",
      "body": "![c76ae2d26f5a1fc0a2e0015407026695.jpg](https://steemitimages.com/DQmdYhHA44yy9S5qDFEcFKcFVqq6xsZfoWeDHKHt3NuoSgY/c76ae2d26f5a1fc0a2e0015407026695.jpg)\n\n在中国人的传统观念中，认为健康就是“无病”。可是经过了家人生病的你们，现在还会这样认为吗？\n\n看看周围那些躺在病床上的人们，哪个发病之前是生病的样子？\n\n所以你还会觉得“无病”就是健康吗？\n\n现代医学将健康定义为\n\n健康不仅是躯体没有疾病，还要具备心理健康、社会适应良好和有道德。\n我想大多数的人们都仅仅是躯体没有疾病而已吧。\n\n所以我们都不是健康的人，都是亚健康。\n\n亚健康时间长了，那些潜在的危险因素逐渐积累，到达一个顶点之后就会爆发。有的人会大病一场，有的人可能就是与这个世界无缘。\n\n看看自己的家人，再想想自己，有没有感到很害怕？\n\n如果你已经在病床边服侍太久了，那么我建议你赶紧放下手头的事情，回家洗个澡，好好睡一觉。\n\n医院的事不要操心，请个护工或者让家里亲戚帮忙照顾一天。\n\n可能你觉得自己的父母很重要，但是对于你的家人来说，你的健康才是最重要的！\n\n没有过不去的坎，想要度过难关，关键在于你是否能继续坚持。\n\n良好的心态和健康的身体才是根本。不要再一筹莫展了，你已经做的够多了，把肩头的责任放一放，没人会说你的。",
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      "body": "最近事情比较多，而且上班比较劳累。每天下班之后都想着感觉休息，睡会觉。\n\n所以百度贴吧里面也很少会见到我的踪影了。\n\n而且我也开始变得没有耐心了。\n\n我想只要是做过培训或者进行知识分享的人都会遇到类似的情况吧。\n\n因为存在信息不对称，很多对你来说很简单的东西，别人却不是很了解。\n\n还记得前几天在QQ群里有个患者家属问我。长期吸氧会不会上瘾，如果不吸氧了会不会以后感觉不舒服。\n\n对于这个问题我实在是无语了。所以回答了他一句，难道我们每天都没有在吸氧吗？\n\n我想有个类似体验的人会深深地理解我的无奈和不解吧。\n\n但是事情还是要继续做下去的。我想把我的博客写好，我想实现自己那么一丢丢的理想。\n\n所以我在想，要不要换一种方式，通过在百度贴吧进行狂轰乱炸式的发帖，让大家对我的博客有一些印象，这样也许会得到一些患者内心的认可。就类似于广告那样。\n\n今天夜班没有时间，这个方案我想明天就去试试，看看效果如何。会不会达到我预期的那样呢。",
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      "body": "想必你在住院的时候生怕遇到水平不高的医生吧。\n\n这个时候你会怎么办？\n\n上网搜索这个医生的相关信息？\n\n![](https://steemitimages.com/DQmZof7JU99Ya5geUj794kdun8HVg9a26etnGYQa7zwL6ui/image.png)\n\n通过熟人找关系询问？\n\n![](https://steemitimages.com/DQmNuA5aAHKLtPharxiCBdNdeWV3nrDVs8uaXjArSGtPx14/image.png)\n\n还是直接去大医院就诊？\n\n![](https://steemitimages.com/DQme3XbozgPujjyJdm5G1zTxWpRh1F4jGWtdKYuyCPJFhYm/image.png)\n\n以上这些方法能起到一定的效果，帮助你判断这个医生的水平如何。\n\n但是，网上的信息也有假的，熟人的情报也不一定可靠，大医院也不一定就没有低水平的医生。\n\n那么怎么办呢？\n\n就没有什么好的办法了吗？我通过多年混迹职场的经验告诉大家一个小窍门，可以帮助你判断一个医生的水平如何，是不是那种滥竽充数的医生。\n\n但是注意：人类都是复杂的，我的方法也不是金标准，也有假阳性的可能，如果出现不良后果，千万别来找我哦。\n\n其实这个方法很简单，那就是看这个医生的带教水平如何。\n\n![](https://steemitimages.com/DQmfMbZvYiUZWuGoUrq3EKrjScAL6CszgbVgz6EbXU9VG7S/image.png)\n\n有的医生名头很多，什么副教授啊，什么课题组长啊，但是弄这么多的名头，最后总要实际用到病人身上，只有医术高超的人，才能看好病。\n\n因此你们在每天的查房中就可以观察到。\n\n这个医生对于学生提问的问题有没有不耐烦的现象，或者有没有答不出来的情况，如果有的问题他回答不上来，那么他是怎么解决的？是恼羞成怒对学生臭骂一通，还是随便说点糊弄过去，还是虚心接受说自己去查一查再回答？\n\n带教水平高的医生，对于理论知识的把握很深刻，因此学生的大多问题都能轻松的解答，而且有的医生还喜欢给学生讲东西。也许学生的一个问题，他能扩展到很多方面，讲半个小时也不为过。\n\n如果出现了自己解答不了的问题，他也能虚心接受，告诉学生自己去翻阅资料给他解答。而不是恼羞成怒把学生臭骂一通。\n\n毕竟学生提问的问题都很专业而且都能问道点子上，因此如果一个医生能够将学生的问题解答的很详细，那么可以证明这个医生曾经对此有过深入的研究，是个医术精湛的好医生。\n\n但是注意一点，我给大家介绍的这个方法，切不可以偏概全，并且只限用于三甲教学类医院，目前大部分二甲以下的医院都不太适用。\n\n希望我的这个小窍门能对你有所帮助。",
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      "author": "yangzhichao",
      "body": "长期以来我的博客都是以专业性的文章为主。但是偶尔自己慢慢读起来，不免觉得有些太过冷酷，没有人情味。\n\n我害怕我的读者也把我当做这样一个人。\n\n所以我开始思考，觉得有必要写东西写的平和一点。\n\n我想可能是平时经常写病历，病历所记录的内容都是很严肃刻板的缘故。所以感觉像是有了“职业病”，把写病历的语句，套用到了写文章上面。\n\n其实写病历和写文章所面对的读者不同。\n\n病历主要是一种医疗文书，用于记录和后期取证作用。\n\n而自己写的文章是给读者看的，是分享自己的思想的。\n\n不知不觉走进了这个误区。\n\n幸好发现的及时，慢慢改正也不为过。\n\n我最近在想，要不要写一些激励患者家属的文章。毕竟我的读者大多都是患者家属。\n![35b344cdc7c93a92650ec0204d12818e.jpg](https://steemitimages.com/DQmUepDbda1pgFgd22H9SSemaKUzM6Jufkg5Cyua13331sY/35b344cdc7c93a92650ec0204d12818e.jpg)\n\n可能在长期病房的服侍过程中慢慢出现了消极的心理。毕竟脑出血这个疾病无法看到未来，医生也是走一步看一步。根本无法预测以后的恢复程度，包括何时能醒。\n\n对于未来的未知以及疾病的恐惧，影响着病人及病人家属。\n\n我想给他们分享一些正能量，可能会帮助到他们。",
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      "author": "hahapp9174",
      "body": "确实是的，也许是观念的不同",
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      "author": "herlife",
      "body": "你可以加我微信  我拉你进去 微信号：ting0921ting",
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