Fear of being asked No.1: Is this disease serious? Is it serious? As a radiologist, Ding Xiaoyi most often encounters this question. After a patient has had a checkup and comes to see the film, he will almost always ask: “Is this serious?” For example, if a nodule is found in the lung, the patient will wonder if it’s a lung tumor, and it’s best if the radiologist tells him clearly. However, in most cases, different diseases may have the same manifestations, and the same disease may have different manifestations at different times, and the doctor can only make a judgment based on the manifestations at that time, which may change as the disease progresses. Some patients are very anxious about the results, but the doctors have to consult their supervisors or consult the information, so they are really in no hurry. At the same time, radiologists do not have much contact with the clinic, because they do not know the patient’s medical history and what treatments have been done before, so there is no way to give a diagnosis in the first place. No.2: Is there any risk of doing this test or treatment? As a matter of fact, any test or treatment may bring certain risks. Ding Xiaoyi once met a 35-year-old female patient, 61 days after menopause, with persistent pain in the lower abdomen for 2 days, during which she went to 4 hospitals and could not be diagnosed. Because the patient was pregnant, CT could not be done, and Ding Xiaoyi talked to the patient herself, “Medical regulations do not recommend MRI within 3 months, but given your situation, you can only take the risk, I’m afraid.” The patient finally had an MRI. The exam revealed that the left ovary was very large and was judged to be an ovarian cyst. In ultrasound for prenatal screening, it is possible to see if a fetus has a growth defect based on the thickness of the fetal nuchal neck. However, at the current level of medical care, this diagnosis is so inaccurate that further choices need to be made about whether or not to perform an amniocentesis, which in turn can cause medically induced injury or cause infectious shock. “Medical limitations similar to this are a reality that has to be accepted. Walker came across a case of twin-fetal transfusion syndrome, where the twins shared a single blood vessel for their blood supply, resulting in blood being supplied to only one child. “Which child should be preserved?” In the end, Hakan and the doctors chose to save the younger child at the expense of the older one, who might have cardiomyopathy. At 35 weeks and 4 days, the mother went into labor and gave birth to a healthy baby. Afterward, Hua Keqin thought, “If we chose to sacrifice the older child, but the younger child was not saved, would the pregnant woman and her family be able to understand? This also makes people a little afraid.” The most afraid to be asked No. 3: spent so much money, why the disease is not get better? On this point, Yang Binghui very emotional. Once, the hospital corridor posted an obituary of a doctor in the hospital, which reads “died due to treatment”, right behind them, many patients’ families are saying: “Ah? The doctor died too?” “How can a doctor die! In some patients’ concepts, doctors are omnipotent. Patients to the hospital should be cured, if the cure is not good, it must be the doctor is not dedicated or medical malpractice.” Yang Binghui said that nowadays, medical technology is very advanced, the spirit of optimism, but also infected the general public, and even many people feel that medicine is omnipotent. A survey made by Jiefang Daily on nearly 1,000 people found that 38% of the public believe that the disease did not look good is the responsibility of the doctor, 40% of the public believe that the doctor can never be misdiagnosed. But they overlooked a simple fact: you can’t pay to see all diseases, and doctors and medicine are not omnipotent. Most Fearful Question No.4: Will this disease break its roots? For Hakan, this is a difficult question to answer. This is because the number one bastion in obstetrics and gynecology medicine is the recurrence of diseases, including inflammation and tumors. Hua Keqin once met a patient who had dysmenorrhea for five years, and when examined, was found to have an ovarian chocolate cyst, which grew larger and larger with each period of abdominal pain. “If you want to cure such a disease, the only way is to do a total hysterectomy and double adnexa, but the patient was young and took conservative treatment with drugs.” Hua Keqin said without regret, “the disease has been in such a vicious circle of recurrence and surgery.” Yang Binghui said, cardiovascular and cerebrovascular disease, cancer, diabetes and other such chronic diseases, taking up 70% of China’s health resources, but it is true that all are very difficult to cure. The most afraid of being asked No.5: Why do a lot of tests, just can not find out what’s wrong? Ding Xiaoyi believes that this should be considered from two aspects, one is the clinician’s understanding of the disease or the ability to check the efficacy of the examination method is not yet in place; the second is the performance of the disease, the condition and the process of the disease, some of them in the early stage does not show, such as early gastric cancer, cervical cancer, only a very experienced doctor can see it. Hua Keqin said that the disease has insidiousness and uncertainty. She once met a 55-year-old woman with abdominal pain who first saw an internal medicine department but found no problem, only to find out that it was advanced ovarian cancer after she was transferred to a gynecologist. “For her, the best treatment period may have been missed.” Yang Binghui’s opinion is that nowadays, technology is very advanced, I’m afraid there are not many problems that can’t really be detected. If you really can’t find out, you should also consider that it’s not an organic problem, but rather caused by the psychological burden of stress. No.6: Is it “over-treatment” to do so many tests? In the survey found that 81% of the public are worried about being “over-treated”. Ding Xiaoyi said that all kinds of tests do have different characteristics and targeting, X-ray, CT, MR, DSA have their own advantages, sometimes it is necessary to use different methods. Ding Xiaoyi met a 49-year-old female patient, trauma chest X-ray examination did not find a major problem, but to the Department of Injuries after two weeks of treatment, the patient did not improve. “Further corroboration would likely require a CT and MRI.” But is an MRI always better? Of course not. For example, to deal with arthritis, the best test is generally an MRI. But Ding Xiaoyi had encountered a 57-year-old patient, shoulder joint pain for six months, after the MRI inside a large area of abnormal things, but how can not see what it is, and an additional X-ray, it was found that there is gas inside, infection. So, sometimes a single screening measure is indeed not enough, and other means must be used to find out the real cause of the disease. Besides, doctors are also afraid of being asked these questions: No.7. Is the doctor trying to shirk his responsibility when signing the consent form for the operation and talking about a lot of risks? No.8. Prof. So-and-so of such-and-such hospital said that this disease can be easily cured, but you have been treating this disease for a long time, but it is still not good? No.9. Why did you get well with the medicine last time but not at all this time? No.10. This medicine is so cheap, can it cure the disease? No.11. I took your medicine last time, but now I am worse, is it because of the medicine? No.12. I haven’t used this medicine before, how effective is it? The doctor said to the patient, “Look, we are three people – me, you, and the disease. So if you stay on my side, it will be easier for the two of us to defeat him; if you turn to his side, it will be harder for me to deal with the two of you alone.”