Oncology Physician Life

Chapter 25 Chapter 24 Late Night Intensive Care Room

Doctors need to be extremely rational and logical when seeing a doctor.

After listening to the patient's description of the condition, the doctor needs to give a diagnosis, what kind of examination the patient needs to do, and then determine or rule out various causes, and how to treat in the next step.

Ji Han already has a wealth of experience in outpatient clinics, and now he is able to deal with all kinds of patients with ease. He still remembers the first time he went out to the clinic, because he had no experience, he couldn't grasp the key points, and could only listen to the patients. Ba's nagging went on, so it took a lot of time.

But now he has learned how to extract the most important information from patients' nagging, and make his own judgment and decision in a short time.

Doctors in public tertiary hospitals have an extremely large number of outpatients. As long as it is a day of outpatient visits, there will be patients who cannot finish seeing them all day.

At one o'clock in the afternoon, after a short break, Ji Han returned to the outpatient room.He glanced at the time, from one to five, four hours, he still has 26 patients to make an appointment, but this day's work is not complete. The Department of Internal Medicine held a disease seminar, which ended around [-]:[-] p.m. After that, I had to write a medical certificate and apply for a fund project, and I had to go to the intensive care unit at [-]:[-] p.m. There was a patient with diffuse astrocytoma, Needs intensive care.

Wei Chen only agreed to a piece of bread at noon, and was so busy writing cases that he didn’t even have time to go to the cafeteria. He is 27 years old and already has spinal and stomach problems. Even weekend rest days are allocated to various medical research On the topic, I don't even have time to exercise.

In private, he often told the interns in the hospital that they should never persuade them to study medicine when they meet junior high school students at home during the holidays.

When I didn't study medicine before, I thought that the profession of a doctor was very noble and dignified, and even an oncology doctor was a great profession. But after becoming an oncologist, Wei Chen found that what he thought was completely different.

An oncologist has endless work and endless nights. He started to suffer from androgenic alopecia at the age of 27, and his body became fat. He almost lost his personal leisure life and hobbies.

But if you really say that oncologists are so tired, why don't they resign?
Wei Chen also thought about this question, but the answer made him want to laugh, it was very abstract, just because of a dream.

Because of the dream of becoming an excellent oncologist.

When Ji Han saw the last patient, it was already 05:30 in the afternoon. He sat on the wheelchair and stretched his sore neck, and looked at Wei Chen who was already exhausted: "Why, are you tired of going out to the clinic with me?"

Wei Chen wanted to nod, but he didn't dare, but Ji Han's outpatient clinics always took longer than other oncologists, and he was very tired, both physically and psychologically.

"No wonder Tan Tan doesn't want to go out with Professor Ji. He also said that going out with Professor Ji is the most tiring of all the doctors in the department!"

Ji Han raised his eyebrows: "It seems that Tan Tan will double his number of topics this month."

Wei Chen smiled: "Mr. Ji, I found out that you love to talk to patients. You can chat with almost every patient when they sit down. Unlike other doctors who ask about their illnesses and prescribe examinations, it's like a doctor. A ruthless machine, going out to the clinic is like doing an assembly line business."

Ji Han put away his gold-rimmed glasses, and rubbed the center of his brows: "If it's a doctor from another department, I'm not qualified to say more, but the disease in the oncology department is actually very complicated. Think about it, when those patients learn that they may have When they have tumors, when they come to see a doctor, they feel so anxious, complicated, and desperate. Some family members and patients even rush from other places to sit in front of you with the last ray of hope. A doctor, but also the patient's last hope!"

"You can be business-like, with a straight face, like a ruthless machine, anyway, this patient has nothing to do with you, but you can also give them more communication, more comfort and encouragement, in your opinion, it's just talking It’s just some insignificant words, but in the eyes of patients, it is likely to give them great encouragement, and even the hope of survival! Say a few more words, and you won’t lose anything, so why not do it? ? We doctors must be compassionate."

Ji Han put away his things and was about to leave, "Do you still remember the sentence that hung on the top of the public classroom when you were in medical school?"

Wei Chen thought for a while, and suddenly realized: "To Cure Sometimes, To Relieve often, To Comfort Always. Dr. Trudeau's epitaph, sometimes to cure, sometimes to help, always to comfort."

The two walked out of the clinic side by side, and Ji Han nodded: "When we admit that medicine cannot cure all diseases or every patient, the social significance of helping and comforting patients and their families in trouble far exceeds that of "Cure", just like the slogan hung by our oncologists at the door, is it not to give patients another kind of confidence, but also to tell them that I will be with them and we will not give up on them."

Wei Chen nodded and laughed: "There is no obituary here, only struggle!"

"Yes, there is no need for obituaries here, just fight for the cause!" Ji Han patted him on the shoulder, "Wei Chen, you have to believe in yourself, you will become an excellent oncologist, so come on, be good, help the professor Finish all of today's cases and send them to my mailbox at nine o'clock tomorrow morning!"

"Ah! No, it's me again?" Wei Chen's face collapsed in an instant, "Professor Ji, I'm going to sue you for oppressing me. I'm already the hospital chief, not your intern!"

Ji Han handed him all the information, and smiled: "One day will be a teacher and a lifelong father, good boy, master treats you to fried chicken legs this week!"

At nine o'clock in the evening, Ji Han went to the intensive care unit.

Resident doctor Tan Tan, Xu Youshu, and second-line doctor Li Xiaojun are all attending. The atmosphere here is a bit depressing. Many patients are not optimistic in the intensive care unit. Family members are forbidden to enter the intensive care unit. Only the nurses are silently busy. with.

In front of the eight-bed monitor, Ji Han saw Liu Rong, a 58-year-old patient with diffuse astrocytes, who fell into a severe coma. The navigator biopsy found intraparenchymal hemorrhage, and the location of the tumor was not very good.

Li Xiaojun handed over the results of the biopsy: "During the biopsy yesterday, the biopsy needle may have touched the distal branch of the middle cerebral artery. A temporary cerebral angiography was added, and the intracranial pressure was a bit high."

Ji Han glanced at the result, nodded and said, "Give some mannitol first to lower the intracranial pressure, and ask someone to keep an eye on it at any time tonight. The patient's cerebral hemorrhage will increase at any time. If he loses consciousness, he will be sent to the operating room for craniotomy immediately." Surgery. Then explain the patient's situation to the patient's family."

After giving all orders, Ji Han walked out of the intensive care unit, just in time to run into Jiang Li.

"Why haven't you left yet?" Ji Han glanced at Jiang Li who was in a good mood.

Jiang Li suppressed the smile on his face, and was angry with him because of the introduction of DC-CIK cell therapy last time, and said in a bad tone: "When can the outside of the tumor apply for the children's subsidy fund in the hospital? Xiao Jiang Hao's condition won't last long."

Ji Han hurriedly said: "I told Director Wang of the chest surgery, first use the quota on the chest surgery, it's just a process, it takes some time for approval, and when the money arrives, Xiao Jiang Hao can have the surgery."

Jiang Li stopped in his tracks: "Ji Han, I plan to ask doctors in all departments to vote for the introduction of DK immunotherapy at the hospital meeting. I hope you can remain neutral."

Ji Han wants to persuade her, but he doesn't know how to speak. Jiang Li's only shortcoming is that he is too idealistic. Liu Chong is the chief director of the oncology department. Jiang Li will completely put himself on the opposite side of Liu Chong, which will not do her any good.

In the intensive care unit, Li Xiaojun glanced at the time. It was already late. He turned his eyes around Tan Tan and Xu Youshu, pointing to Xu Youshu: "Xiao Xu, work hard tonight and take care of this patient. What's the problem? Just talk to Tan about the report, I had an operation last night, and I hardly slept a lot, now go catch up on sleep, don’t bother me if you have nothing to do."

Xu Youshu hesitated to speak, but finally nodded without refuting.

Soon, it was eleven o'clock in the middle of the night.

Nurse Li Xiaomei came to the intensive care unit to deliver medicine. As soon as she came in, she saw Dr. Xu Youshu standing in front of the 8th bed and staring at the patient. She was shocked: "Xu Youshu, what are you doing? You scared me to death in the middle of the night. , you don’t go to rest, what are you looking at in front of the patient?”

Xu Youshu stared at the monitor. The top one was the oxygen saturation number, the middle one was the heart rate number, and the bottom one was the breathing rate.

The oxygen saturation number indicates the concentration of blood oxygen in the blood, which is an important physiological parameter of the respiratory cycle.

"Director Li asked me to look at the patient tonight. Her condition is not optimistic. During the biopsy, intracranial hemorrhage was found. If there is any change, surgery will be performed at any time tonight."

Li Xiaomei glanced at Liu Rong who was lying on the hospital bed with her eyes closed. This 58-year-old lady with gray hair already gave Xu Youshu a canned eight-treasure porridge: "Eat it at night when you are hungry."

Xu Youshu smiled at Li Xiaomei, said thank you, and continued to stare at the patient.

Soon it was one o'clock in the morning, and Xu Youshu couldn't stand it anymore. He sat on the chair and couldn't help yawning. He glanced at the patient inadvertently. I don't know if it was an illusion, but he always felt that the patient's state was not right.

He hurriedly took out the flashlight, looked at the patient's eyelids, and found that the pupil's light reflex disappeared, the whole body began to appear stiff, and the pupil continued to dilate.

Xu Youshu's head suddenly seemed to be stuffed with a hammer, and he was a little dazed. He hurriedly took out his mobile phone and sent Tan Tan a message.In less than a minute, Tan Tan ran into the intensive care unit quickly, holding a flashlight in his hand to conduct a pupil light test on the patient, exactly as Xu Youshu said.

Tan Tan's face darkened: "It should be the continuous bleeding from the outside of the middle cerebral artery. The results of the cerebral angiography have not yet come out, but we can't wait that long. Now it should be that the bleeding continues to expand, and the patient has lost basic consciousness. It will be a few minutes later." , I am afraid of patients..."

Xu Youshu became anxious: "We're going to ask Li Xiaojun to be in charge now, should we call Professor Ji? Don't we want to inform the operating room?"

Tan Tan immediately called Li Xiaojun, but no one answered the phone.

He glanced at Xu Youshu: "No one answered the phone!"

Xu Youshu panicked. With what happened last time, he now has some shadows in his heart.

Tan Tan rubbed his hands together, and immediately made a decision: "You look at the patient here, and in addition, inform the patient that the critical illness notice has been issued first, and let the patient sign it. I will call Li Xiaojun to treat it."

After speaking, the two split up.

It was only when Tan talked about the doctor's lounge that he realized that Li Xiaojun's white coat was thrown on the bed, but he didn't know where it went.Kang Jun just followed the nurse back from rounds and yawned. When he looked up, he saw Tan Tan rushing out of the doctor's lounge. He couldn't help asking, "Brother Tan, what's wrong with you?"

Tan Tan looked at Kang Jun and asked, "Have you seen Li Xiaojun taking charge?"

Kang Jun thought for a while: "It seems that Dr. Li drove away two hours ago."

"Gone?" Tan Tan was taken aback, "Where did you go?"

Kang Jun shook his head: "I don't know."

Tan Tan took out his mobile phone, his hands were trembling, and he called Li Xiaojun again, but no one answered the phone, he found out Ji Han's number, and wanted to call Ji Han, but Kang Jun hurriedly stopped him: "Brother Tan, you Forgot the lesson from last time? It’s against the rules to go directly to the third-line doctor by crossing the second line.”

Hearing Kang Jun's words, Tan Tan hesitated a bit. He was fine, but Xu Youshu managed to stay after Jiang Li's pleading. If there was any problem this time, he might really...

Tan Tan hurried back to the intensive care unit, but was stopped by Liu Rong's son before he came in.

The other party already knew about his mother's critical illness, and when he stood up from the chair, he staggered and almost fell to the ground.He hadn't closed his eyes for several days and nights, his eyeballs were bloodshot, and he was unshaven.

He grabbed the resident doctor Tan Tan: "Doctor, how is my mother? Didn't she say she was critically ill! Where is the doctor? Why hasn't the attending doctor come yet!!!"

Tan Tan was a little at a loss: "The doctor in charge, the doctor in charge, I haven't found it yet!"

"What?!" The man's voice suddenly became sharp, "Why can't the attending doctor be found? I, my mother is almost dying. You guys, what are you doing in your hospital! There is no doctor on duty at night!"

Tan Tan dared not look into the eyes of his family members. The eyes of the other party were like nails, nailing him firmly to death.

The door of the intensive care unit was suddenly opened, and nurse Li Xiaomei ran out: "Dr. Tan, the heartbeat of the 8-bed patient has stopped, and Dr. Xu is doing CPR! Why hasn't Li Xiaojun come yet?"

Liu Rong's 30-year-old son, Wang Xiaojun, trembled when he heard the nurse's words, and fell heavily on the chair. He raised his eyes high, looked at the pale wall above his head, and suppressed his crying: " My mother, my mother, she... can't do it..."

Wang Xiaojun trembled violently all over, as if a hurricane was raging in his heart.

A few nurses rushed into the intensive care unit pushing the defibrillator. Jiang Li didn't leave today because he checked the relevant operation information at the hospital at night, so he stayed in the lounge. Hearing the nurses said that there was a critically ill patient in the intensive care unit, he hurried away came in.

Tan Tan was finishing defibrillation, and the patient's electrocardiogram showed a straight line.

Jiang Li immediately pushed away the nurse in front of the hospital bed, straightened his elbows, started external compressions for the patient, and shouted loudly: "Don't surround yourself here, let the air circulate, call the second-line doctor now! Open the passageway in the operating room." , Contact the third-line doctors and prepare for surgery at any time!"

Tan Tan immediately called Ji Han. After receiving the call, Ji Han inquired about the patient's condition, rushed to the hospital immediately, and called the surgery center at the same time, ready to operate at any time.

…………

In the ICU, Jiang Li and Ji Han had taken turns to perform CPR for nearly an hour, but the electrocardiograph still showed a straight line.

Ji Han looked at Jiang Li who was sweating profusely, panted and sighed, he looked viciously at Li Xiaojun who was dodging his eyes in the crowd, walked over and grabbed Li Xiaojun by the collar and shouted: "When I leave Didn't I tell you to always observe the patient's life state!"

Li Xiaojun's face was pale. He would never have thought that the matter was so small. He had only been away for two hours, and the patient had problems. He thought it was just bleeding during a biopsy on the outside of the middle cerebral artery, which was a normal phenomenon, but he never expected... …

On the hospital bed, Jiang Li was still doing CPR repeatedly, and she said out of breath, "Don't give up, the patient's brain tumor is not very malignant, if there is bleeding outside the middle cerebral artery during the biopsy, the situation will be fine. It’s so serious! Let the patient’s family members come in, ask the old man what things and people he cares about the most, and let the son try to call his mother, the patient’s hearing should not be lost in the end!”

As soon as the door of the intensive care room was opened, the man's cries rushed up, and his son Wang Xiaojun fell on the bedside, tears streaming down his face.

Ji Han immediately said: "Is there anything your mother misses, preferably a sound, play it and let your mother listen to it, and see if it can wake your mother up!"

In a panic, Wang Xiaojun immediately took out his mobile phone: "My mother usually can't let go of her grandson the most."

Wang Xiaojun called his wife and asked his son to call him grandma.

On the phone, Wang Xiaojun's daughter-in-law seduced his son who could only speak: "Baby, you say...Grandma, I love you..."

Jiang Li was still doing CPR, and the childish voice of a child babbling came from the phone.

"Grandma... grandma, I... love... you."

In front of the hospital bed, the medical staff surrounding the patient were all staring at the electrocardiograph.

There was still a straight line on the electrocardiogram, and the piercing siren made everyone's hearts sink.

Ji Han glanced at his watch, he had been rescued for an hour, he sighed, and was about to announce the time of death, when suddenly, the beating notes of the electrocardiograph returning to sinus rhythm came over, like a stone, thrown into the In the calm and waveless deep lake, there was a huge wave in an instant, and then the huge wave resounded in everyone's heart, and it became more and more urgent.

"Ding, ding, ding, ding..."

The straight-line wave on the electrocardiogram slowly began to appear crest...

This crest represents hope.

Everyone breathed a sigh of relief.

Wang Xiaojun flung himself into his mother's arms and burst into tears: "Mom, mom..."

Ji Han looked at Jiang Li, who was sweating profusely, and immediately had his family members pulled away, ready to be pushed into the operating room.

He glanced at Jiang Li who was sweating profusely through the crowd, and the eyes of the two met in mid-air. They didn't say a word, but they seemed to have a thousand words.

At four o'clock in the morning, the lights in the operating room went out.

Ji Han came out of the operating room exhausted, and saw Jiang Li sitting in the corridor at a glance.He took two bottles of water, walked over, sat down next to Jiang Li, and handed her a bottle.

"The operation was very successful. The glioma in the brain was removed, but the patient suffered from hemorrhage outside the middle cerebral artery. If he wants to come back from the dead, he has to survive three trials."

Jiang Li knew what the three passes he had mentioned were.

Liu Rong has survived the first level, which is the scene in the intensive care unit.

The second level is the edema level. Cerebral edema will have a peak period of three to seven days.

The third level is the postoperative inflammation level.

Her hands were still trembling after unscrewing the bottle cap due to long-term external compression. She leaned back on the chair and looked at the incandescent lamp above her head.

"I saw Wang Xiaojun rushing to the bed and calling my mother, and my mind was full of my mother's shadow. If she hadn't passed away seven years ago, she should be the same age as Wang Xiaojun's mother now, but he is luckier than me because he still has Mom. So I only had one thought in my mind at the time, which was to help Wang Xiaojun keep his mother..."

Ji Han lowered his eyes and was silent for a moment: "I'm sorry, Ali, seven years ago I shouldn't have listened to our mother and concealed her illness from you..."

"I told Ji Han, it's not your fault."

Jiang Li pursed his lips and forced a smile: "Okay, you should have something to deal with, about Li Xiaojun and Tan Tan."

(End of this chapter)