This doctor has a system

Chapter 510 573. Medical Dispute
However, Dong Bo was lucky, because after the surgeon cut open the egg yolk, he found that the yolk on the right side was indeed twisted and formed a shape of a twist, but it was not necrotic.

After reduction, blood circulation gradually returned to normal.

The surgeon breathed a sigh of relief and carefully fixed the right yolk to ensure that it would not twist again. He also fixed the left yolk at the same time.

People who have problems on the right side may also have problems on the left side at some point, so it is best to fix the left side as well.

"This is called buy one get one free, no cheating for everyone."

"What do you mean? There's no charge here?" Dong Bo asked.

"You wish. We will charge you as usual."

"Then what do you call buy one get one free?" Dong Bo complained, but now he has relaxed.

He was happy with the doctor's arrangement. After all, his frequency was relatively high, the speed was relatively fast, and the force was quite strong.

Protective measures are important!
"Young man, I see you were quite nervous just now." The surgeon smiled and said, "In fact, even if one is broken, there is still another one."

"Are you so scared?"

"I'm afraid it will affect my function if I lose one." Dong Bo said honestly, "I'm not good-looking, so I'm at a disadvantage when getting along with girls. It's impossible for me to be sincere. Now I rely entirely on my body."

"You must firmly grasp this one advantage."

Gao Feng is currently reviewing the patient's condition. To be honest, this diagnosis process was really not easy.

When this happens, both doctors and patients are responsible.

Yolk torsion usually has obvious swelling and pain symptoms, and most people will tell the doctor immediately. However, the pain of the patient's yolk does not seem to be very serious, but manifests as obvious abdominal pain.

Maybe because the twisting was not serious, he did not inform the patient immediately.

There were also big problems with the doctors. Neither the emergency department doctor nor the gastroenterologist checked the patient's disease site.

If any doctor performed a comprehensive physical examination, he or she would definitely be able to discover the swollen egg yolk and quickly make a diagnosis.

But in fact, if the patient does not actively ask, most doctors will not check this private part of the patient.

Not to mention that Ma Qianqian from the Department of Gastroenterology is a female doctor.

"So physical examination still needs to be thorough." Director Hu of the General Surgery Department sighed after drinking a glass of beer.

"Yes, but now that the equipment is more advanced, many doctors don't pay much attention to this." Gao Feng said, especially in the top tertiary hospitals, doctors often prescribe a lot of tests and neglect physical examinations.

It has to be admitted that in most cases instruments work better than people and they don't lie, but no matter how detailed the examination is, it cannot replace a comprehensive physical examination.

"That's right. I feel the same way sometimes." Director Hu said, "You spend a lot of time and effort, but you don't get as much information as a single film."

Over time, you will develop a bad habit of relying on machines, but how to explain this.

Many patients come to large hospitals because the examination equipment here is more advanced.

"Doctor, give us a detailed examination."

This sentence is often heard by many doctors when they are sitting in the outpatient clinic.

The two were chatting when Li Youliang, who was in charge of pouring the wine, suddenly exclaimed.

"Isn't that Director Bu Zhengyang?" He said with a smile, "It seems like they are in love."

Bu Zhengyang was riding an electric bike with a slim girl sitting behind him. She put her arms around his waist and behaved in a very intimate manner.

Gao Feng looked carefully and found that this was Zhang Yuwei.
"Although you were a little nervous during the interview and couldn't speak, you were strong enough to finish the PPT." This sentence suddenly came to his mind.

It seems that these two people got together?
It seems that Bu Zhengyang is 5 or 6 years older than others?

shameless!
"Zhengyang!"

Bu Zhengyang was concentrating on riding his bike when he heard someone calling him. He turned around and saw Gao Feng and the other two were staring at him and Zhang Yuwei.

"Haha, the directors are eating here?" he said awkwardly.

"Director Bu, are you in love with Teacher Yuwei?" Li Youliang said with a smile.

"I haven't sent her home yet." Bu Zhengyang said.

"You still don't admit it? I see Xiao Zhang is hugging your waist." Director Hu curled his lips, "You have to wait until we catch you two kissing, right?"

This one sentence made Bu Zhengyang and Zhang Yuwei blush.

"We just talked about it." Bu Zhengyang felt a little embarrassed. At first he felt that it would not be a good idea for two people to be in the same department.

But it was obvious that the other person was interested in him, and he couldn't control himself, so he got together with her without thinking.

"I'm just about to find a time to report to you." Bu Zhengyang said to Gao Feng, "It's not very convenient for two people to be in the same department."

There are also regulations in the hospital that couples cannot be in the same department.

"Where is Xiao Zhang going?" Gao Feng asked.

"All is fine." Zhang Yuwei said with a red face.

She has worked in clinical practice for a while and was taught a few hard lessons by patients, and now she is starting to back down.

"By the way, an acquaintance of the hospital leader said he wants to see you to watch the film." Bu Zhengyang said to Gao Feng, "I'll ask him to come over early tomorrow morning."

The patient called in the morning and said he would be there in a while. Bu Zhengyang waited for him all afternoon, but he didn't arrive until 7pm.

Gao Feng was not in the department at that time. He was a little dissatisfied and told the patient to see him tomorrow.

After all, it wasn't a particularly urgent matter, but the person was still very dissatisfied and turned around and left.

"Then just ignore him." Gao Feng said. Some patients nowadays are very capable but also have bad tempers and like to be bossed around.

In the past, it was fine, and it was okay to suffer a little injustice. But with Gao Feng's current status and position, he obviously couldn't stand this.

However, he still saw the patient the next morning.

"I'm not saying that doctors should stay in the hospital." The 40-something middle-aged man said dissatisfiedly, "Why are you running around?"

"Who told you that doctors have to stay in the hospital 24 hours a day?" Gao Feng asked, "Where did you hear that?"

"What's your attitude?" The middle-aged man was a little angry. "I made a wasted trip yesterday and I didn't even mention this!"

"I told you to come in the morning, have you come yet?" Bu Zhengyang said, "I've been waiting for you for a long time, should I have a good talk with you?"

"You" The middle-aged man was silent now.

If Gao Feng wasn't in a good mood today, he really wouldn't bother to pay attention to him. What kind of person is he? It's like he owes him something.

The patient was diagnosed with lung nodules during a physical examination three months ago and had no symptoms at the time.

A chest CT scan three months later revealed that the nodule was larger than before. The doctor recommended anti-infection treatment and re-examination or direct puncture.

After one week of anti-infection, he went straight to an enhanced CT scan, which showed no change in size.

Most doctors suspected that it was malignant and recommended that he undergo a biopsy or direct removal.

It would be a lie to say that the patient was not afraid, but he was very hesitant to go straight for surgery because after all, there were still a few doctors who believed that a puncture should be done first to determine the nature of the disease, in case it turned out to be benign.

"If a piece of lung is missing for no reason, the lung function will definitely be affected."

Gao Feng looked at the film carefully. This was a very typical malignant imaging manifestation, and the possibility of invasive cancer was high.

First, the report showed significant progress during follow-up and no improvement with anti-inflammatory treatment; second, the mixed ground glass contained a high specific gravity solid component;
The lesion has obvious short and fine spicule signs, vascular signs, bronchial truncation signs, lobulation signs, and expansibility at the edge, and some levels also show contractility; finally, the internal density of this lesion is uneven, and some levels appear messy.

The most important thing is that the burrs are consistent with those of lung cancer, short, thin and sharp!
The probability of malignancy is very high.

However, imaging cannot confirm the diagnosis and is not the gold standard for diagnosis.

There are coincidences in everything. Some atypical inflammations or other diseases may also cause such lesions.

Inflammatory edema can also cause ground glass of this density.
"The probability of malignancy is very high. You can do a puncture, but direct surgical removal is best." Gao Feng gave his own advice.

The middle-aged man frowned. He had heard this many times and it was nothing new.

"Then what do you want to hear?" Gao Feng was speechless, "Do you want me to tell you that everything is fine and you can just go home and stay at ease?"

"Do you believe me when I say this?"

Of course they don't believe it, otherwise patients wouldn't go around looking for experts to look at the films.

He was just fussing unnecessarily.

In fact, even if it is a benign lesion, it is not a pity to remove it when it grows like this. Losing this lobe of lung tissue will affect lung function, but the impact is not significant.

Some people lose one lung due to tuberculosis or other diseases at a young age, but still live to be 7-80 years old.

"Can you tell me what the probability of this being malignant is?" the patient said.

"About 80%." Gao Feng said after a moment's hesitation. Although this lesion has very typical characteristics of a malignant nodule, there are several aspects that are more consistent with inflammatory changes.

"Then the probability is not very high." said the middle-aged man.

"Isn't this high?" Bu Zhengyang on the side said speechlessly.

"Other doctors said the probability of malignancy is 99%." said the middle-aged man.

"There is no difference between 99% and 80%." Gao Feng explained to him patiently, "It's best to just cut it off, so you don't have to worry about it anymore."

"Can I get a piercing first?"

"Pension can be done, but there are only two possible outcomes." Gao Feng said to him, "One, the result is malignant. There is nothing to say at this point. Surgery is required."

"Second, the result is benign, but the positive rate of puncture is only 90-95%. What if the lesion is not punctured?"

After hearing what he said, the patient became even more confused.

Gao Feng was worried about him, a grown man, but being too fussy.

It is true that the psychological state will change significantly after becoming ill, especially for lung nodules with malignant tendencies.

But it's already been three months, and it's a bit unreasonable to still be so indecisive.

But people are different, and ultimately the decision must be made by the patient himself or his family.

The patient left the general medicine ward with a troubled look on his face. Gao Feng thought the matter was over, but he didn't expect there would be a follow-up.

Five days later, Li Youliang mentioned this patient to him again.

"Do you still remember that stupid patient? The one who was nagging."

"The one with the lung nodule?"

"It was him," Li Youliang said. "Several family members went to the Department of Thoracic Surgery this morning to cause trouble and even called reporters."

A few days ago, after much hesitation, the patient finally went to the Department of Thoracic Surgery. Director Zhou of the Department of Thoracic Surgery also allowed him to undergo surgery after looking at the film.

"Do it. It's definitely vicious."

Director Zhou's words were a bit arbitrary. In fact, he usually doesn't say this, mainly because this patient is an acquaintance of Vice President Liu.

He felt that this was one of his own.

The operation went smoothly and the lesion was completely removed, but the final pathological results were beyond everyone's expectations.

(Wedge resection specimen of the right lower lobe) 2 cm from the resection margin: granulomatous inflammation (maximum diameter 0.7 cm) with necrosis, and negative resection margin.

Immunohistochemistry results: CK(-), TTF-1(-), P40(-), CD68(+), STAT-6(-), 1
(10%+)
Special staining results: PAS (-), acid-fast staining (-).

It turned out to be benign.

Director Zhou quickly told the patient the good news. The patient was happy for 3 seconds, and then his face changed.

"It's benign and you want me to have surgery?!"

"You cut off my healthy lung?"

"Black-hearted doctor!"

Director Zhou was stunned, and his brain went blank for a long time.

"No, no one can be sure it's benign before the surgery," he said angrily.

"Can't you just let me go back and observe for a while?" the patient said, "To put it bluntly, aren't you trying to make money from me?"

"I finally understand that all crows are black."

"I am a relative of Director Liu. How dare you do this? Ordinary patients will be cheated to death by you!"

"No wonder someone hacked the doctor, you deserved it!"

Director Zhou was almost angry to death. He trembled and called Vice President Liu, who was also surprised.

"Are you so unqualified?"

Vice President Liu came specially for the visit, but the patient didn't give him any face at all and scolded him with a cold face.

The situation was extremely embarrassing. Vice President Liu's face turned black and he left the ward without saying a word.

"Let it be what it is. I don't have this relative anymore."

Director Zhou was very depressed that his leader could just leave.

Several family members of this patient made a big fuss in the ward, saying they would call the police, then sue, and then asked Director Zhou to pay compensation directly.

"I'll tell you a number: 100 million!"

"That's not all. The fortune teller said I can live to 90."

"Now that I'm missing a lung, I'm definitely dying," the patient said confidently, "You'll have to pay me another 12 yuan for every year you lose."

"This is based on facts. I can show you my water flow."

His conditions are undoubtedly a fantasy. Director Zhou has never seen such an outrageous condition in all his years of work. The key point is that the other party’s academic qualifications are not low.

People from the Medical Education Department came to communicate with him several times, but to no avail.

The patient even found a reporter, and the thoracic surgery ward was as lively and bustling as the Chinese New Year these two days.

Finally, the hospital got angry, and at the instruction of Vice President Liu, the security guards took ruthless action, and the family members finally calmed down.

However, when the patient was discharged from the hospital, he threatened to take legal action and make the hospital and the surgeon, Director Zhou, pay the price.

(End of this chapter)