Oncology Physician Life

Chapter 38 Chapter 37
Xu Youshu dozed off in a daze in the duty room, and when he opened his eyes again, it was already the morning shift time. He picked up the mobile phone on the table, and there were two messages in it, one was from the hospital office, aimed at the last time He had known about the result of the wrong medicine, so he wasn't surprised.

It's just that when the result comes out, it will be a little bit wronged.

Another message was sent from the nursing home. It was Dean Chen of the nursing home, asking him to take time to go and talk about his mother's condition in detail.

His mother suffers from Alzheimer's disease, and her condition has gradually worsened in the past two years. Sometimes she can't even recognize her dearest son, and even suffers from urinary incontinence from time to time.

Xu Youshu cheered up, and replied to the news from the dean of the nursing home, Dean Chen, promising that he would go this weekend.As soon as the mobile phone was handed out, the door of the lounge was pushed open, and several residents walked in with Tan Tan.

Fang Wei, a resident doctor of oncology surgery, was also there.

Fang Wei is two years older than him, and he is the most promising candidate for the general hospital position this year. In addition, his teacher has a relatively easy-going personality, and his life is not too bad. Such a teaching doctor.

Fang Wei was in a good mood, glanced at Xu Youshu who was sitting on the chair, and said with a smile: "Cheer up, Xiao Xu, the results of the hospital's handling have not yet come down, don't be discouraged."

Xu Youshu squeezed out a smile: "It's okay, Senior Brother Fang, I'm already mentally prepared."

The accompanying resident doctors were a little bit apologetic for him: "In the past, there were cases of wrong medicines being dispensed in our department, but as long as there were no serious consequences, at most it would be verbal criticism from the attending doctor. How could it be so serious? Must be fired?"

"What do you know? Didn't you see that Zhang and his sister-in-law were making trouble outside the hospital? Good guy, six or seven guys rushed in with sticks in their hands. If Professor Ji didn't stop him, then The thick stick hit Xiao Xu directly on the head!"

"I heard that this family extorted 400 million yuan from our hospital? Can the old Tao of the hospital recognize it?"

Fang Wei took over the words: "It is impossible to compensate so much money. After all, Tan Tan found out that he stopped the injection before he got the injection. At most, he gave some symbolic money. Isn't his wife still in our hospital for treatment?" , it is impossible for the two sides to be so rigid, it's just that Xiao Xu has become the blame."

Tan Tan didn't speak, but patted Xu Youshu's shoulder.

This action made Xu Youshu feel more at ease than any explanation. He could see that Tan Tan was a little discouraged, probably because he was emotionally affected by this matter.

In front of the oncology building, Pei Xiaonan, who was a little hungover last night, walked over with a handbag.

Yesterday I stayed at Wei Ran's house for one night, the originally ironed blouses were slightly wrinkled, and the whole person looked dusty.

Wei Ran parked the car and walked over with two glasses of iced Americano, and handed one to the other party: "I advised you not to drink so much last night, but you just want to drink it, and now you have a headache! If this makes Director Gao of your laboratory If you bump into it, you won’t be able to eat it and walk around!”

Pei Xiaonan bit her sip and took a big sip of the iced Americano. The cold coffee quickly stimulated her taste buds and made her sober up a lot: "Old Wei, you are good at everything, except that you are not so good at all. When I'm high, throw cold water on me! You shouldn't be celebrating me being single now!"

Wei Ran handed her the hangover medicine he just bought: "Here, remember to drink it, tonight is our party of four, don't forget."

"Is it Friday today?" Pei Xiaonan patted his forehead, "I'm full of brains now, no, I'll go to your lounge to sleep and give me the lounge key. "

Wei Ran took out the key from the pocket of his white coat and gave her the key. Just as he was about to send her up, his phone vibrated. It was an MDT meeting at the Thoracic Surgery Department, and he needed to attend.

Pei Xiaonan walked towards the doctor's lounge on the sixth floor, simply lifted the lid of the coffee, took a big mouthful of ice cubes, and chewed them in his mouth with a loud crackling sound. As soon as he got out of the elevator, he saw Xu Youshu, an intern doctor from the Department of Surgery. The man sat on a bench in the corner with a depressed expression.

She walked over, swept the other person's head with her hands, sat down on the bench wearily, and chuckled lightly with her bean paste-colored lips: "What's the matter, little brat? You were scolded by the attending doctor again? "

Xu Youshu's face turned a little red from Pei Xiaonan's intimate actions, and just as he was about to speak, he smelled alcohol on her body, widened his eyes, and looked at her incredulously: "Sister, how much wine did you drink yesterday? "

Pei Xiaonan was taken aback, raised his arm and sniffed: "What? Does the smell of alcohol be strong?"

Xu Youshu nodded: "I can smell it from three meters away. If Director Gao finds out about this, you will definitely be scolded!"

Pei Xiaonan smiled and said it was all right, and lowered his head to notice the intern notes in his hand, which were very careful, with different colored sticky notes for different patients' doctor's orders and precautions.

It can be seen that Xu Youshu's enthusiasm for the job of an oncologist and his dedication to knowledge can be seen.

She put her hand on his shoulder lightly, and comforted her: "Don't worry too much, maybe things will turn around? Which intern didn't make any mistakes? Everyone came from an intern step by step, that kind of A genius doctor who saves patients' lives only exists in TV dramas."

Xu Youshu was silent for a moment, his voice seemed to be muffled by cotton: "Sister Xiaonan, you don't understand how I feel right now! When I was very young, I knew that only by studying hard can I have a future. I am diligent and diligent every day, telling myself to be a good doctor who is reasonable and understands good and evil. I also thought that I would become an excellent and respected oncologist. Even when I graduated, I secretly I swore to dedicate my whole life to the oncology department..."

"So, I'm not an unreasonable person. After this incident happened, I knew that I did something wrong. Even if the patient's family wanted to sue me, I could understand. I thought about it and explained it to them. This time it was just a Accident, moreover, it did not have any effect on the patients. I even found the video and the efficacy reports of the two drugs to prove that it had no effect on the patients. They said that I deliberately replaced imported medicines with cheap medicines that were not effective, and even wanted to blackmail me. At that moment, I felt that my previous behavior was too naive and extremely stupid!"

Pei Xiaonan turned her head and looked at Xu Youshu, who was dejected in front of him. He was only in his 20s, at the time when he was full of youth and vigor, but his eyes were full of powerless despair, mixed with a cold self-mockery, laughing at how overwhelmed he was , He actually wanted ants to shake the tree, to argue right and wrong with this society, to fight for justice with those unreasonable family members of patients.

Pei Xiaonan has seen too many doctors, very good doctors, they could have shined brightly on the operating table and saved the lives of countless patients, but just once or twice, encountering unreasonable family members of patients or even crazy people ruined their lives. They ruined their lives and ruined their hopes and beliefs as doctors.

"I once had a brother who was an excellent surgeon. His hands were no less than Ji Han's. Every time he saw him, his eyes were full of light, hope, and awe of life. With such a sense of responsibility, I come to be a surgeon and even treat every patient seriously.”

"Until one time, a patient died on the operating table, but it was not his fault. The patient's family members made trouble unreasonably, thinking that he failed to save the patient. , that family member cut off his left hand holding the scalpel with a knife. From then on, he can no longer stand on the operating table. I saw that his eyes after the injury were full of shock and despair. As a doctor, he Faith has collapsed!"

Pei Xiaonan said quietly: "But Xiao Xu, you know, as long as people are alive, there must be hope. Even if you are going through a dark night, you have to believe that there are always people in this society who will risk their lives to light the lamp. He only hit you temporarily with this incident, but it can't trap you for the rest of your life."

Xu Youshu stared blankly at Pei Xiaonan who was smiling at him, his eyes suddenly turned red, and his expression became more serious: "Sister Xiaonan, I will not give up my belief in being a doctor, you are a good person!"

Pei Xiaonan smiled: "Everyone will encounter difficulties. At this time, you only need someone to gently push you one step behind, maybe this one step, you can get out of this haze!"

"Sister Xiaonan!" Xu Youshu looked at her, "I hope to become a doctor like you in the future, with a compassionate heart like a Bodhisattva."

Pei Xiaonan patted his head: "Stupid, then you have to work hard, I'm a genius student, I won't be caught up so easily."

Xu Youshu giggled and said, "I will catch up with you, and I will regard you as my idol."

Pei Xiaonan stood up, loosened his muscles and bones: "I didn't expect that you are also my little fan, okay, I'll go to sleep, otherwise I will do experiments with Lao Gao in the afternoon, and I will definitely be scolded for my smell of alcohol!"

In the MDT conference room, Zhao Zhiqiang came here early with experts from the thoracic surgery department. Today is a seminar on Zhang Qianyi's surgery and follow-up treatment plan in several departments of chest surgery, tumor surgery, tumor surgery, and radiology.

Ji Han walked in and found a place to sit down, and saw Jiang Li walking beside him.

He glanced at his watch: "Why did you come here? You don't need to go to the ward this morning?"

Holding Zhang Qianyi's diagnosis and treatment report in his hand, Jiang Li lowered his head and said, "Director Qi Songqi invited me over. After all, I have also taken over a few cases of esophageal cancer. It won't hurt to come and have a look."

After a while, Wei Ran slipped in from the side and sat beside the two of them.

Jiang Li joked: "Old Wei, how was the battle going yesterday?"

Wei Ran shook his head: "It was very tragic. She ate three catties of crayfish by herself, drank eight cans of cold beer, and vomited all over my room!"

Ji Han was amazed: "I really admire Pei Xiaonan, how did she do it as a woman, and after experiencing the dangers of this world, she still has the courage, she should be late, she should drink, and she was PUA by her boyfriend as the one who gave birth to a child Tool, the day after breaking up, continue to love so and so."

Jiang Li glanced at him: "You men will never understand us women. Time has left us women not only with eye wrinkles, but also with a strong heart! After all, who hasn't met a few scumbags in this life!"

The multidisciplinary diagnosis and treatment meeting was chaired by Qi Dahua, deputy director of the Oncology Department.

He glanced at Zhao Zhiqiang, the deputy director of thoracic surgery on his right, and said, "Let Professor Zhao first, let me introduce Zhang Qianyi's esophageal cancer to everyone."

Zhao Zhiqiang looked at Gu Jun who was beside him in the thoracic surgery department.

Gu Jun stood up, walked to the projection in the meeting room, released Zhang Qianyi's video, and introduced: "Patient Zhang Qianyi, a 34-year-old male, experienced discomforts such as obstruction of eating and swallowing, stomach distension, nausea, and vomiting three months ago, but There was no discomfort such as hemoptysis and chest pain, so I didn't pay attention to it. Recently, the symptoms aggravated. Examination in a gastrointestinal specialist hospital showed 'advanced esophageal cancer, chronic superficial gastritis, prolapse of gastric mucosa, raised gastric fundus mucosa and other lesions. To be investigated', the biopsy of the esophagus showed moderately differentiated squamous cell carcinoma of the esophagus, and no Helicobacter pylori was found. Chest CT examination showed the manifestations of esophageal cancer. After taking medicine for one month, the symptoms did not improve, and he was transferred to the Department of Thoracic Surgery of our hospital. "

Zhao Zhiqiang nodded: "Tell everyone about the patient's medical history."

Gu Jun turned over this PPT and continued to introduce the medical history: "The patient has normal bowel movements, no history of high blood pressure, diabetes, blood product transfusion, allergies, and smoking history. He has an average of 15 cigarettes a day and has quit smoking for three days. Months after admission, the examination was completed, and the preliminary plan was to surgically resect the esophageal tumor, and to induce chemotherapy in the radiology department via PICC (insertion of a central venous catheter)."

Tao Dawei from the Department of Radiology took over the conversation: "The postoperative radiotherapy and chemotherapy plan given by our radiology department is docetaxel 120mg d1, nedaplatin 130mg d2, and at the same time, protect the gastric mucosa, protect the liver, and replenish fluids. Surgery The radiotherapy plan was completed in the next 6 days, and IMRT, GTV, CTV, and PTV 60Gy/30 times were planned for treatment!"

Tao Dayong glanced at the white coats in the meeting room, and changed his voice: "However, according to the operation plan on the chest side, the tumor is not in a good position. It touches the recurrent laryngeal nerve in the upper part of the esophagus and reaches the chest cavity. If the tumor is not completely removed, chemotherapy may cause thoracic aortic rupture and bleeding, tracheoesophageal fistula and other serious adverse reactions, even life-threatening."

Qi Dahua frowned: "So, the opinion of the radiology department is that after the overall resection of the esophageal tumor, postoperative chemoradiotherapy should be performed?"

Tao Dawei nodded: "That's right. After discussing with several experts here, we still believe that the upper part of the esophagus and the recurrent laryngeal nerve of the vocal cords should all be removed, so as to maximize the clearance of the tumor."

Zhao Zhiqiang's face was not very good: "If the upper esophagus and the recurrent laryngeal nerve are all removed, the patient's vocal cords will inevitably be damaged, and even lose the ability to speak and pronounce. After all, Zhang Qianyi is a singer, and we also made it in front of the media. Guaranteed, Zhang Qianyi's vocal cords will be kept..."

Tao Dawei dismissively said: "You, Professor Zhao Da, guaranteed it to the media, not us. According to the patient's current condition, if you partially resected the esophagus outside the chest and left part of the tumor, then our radiology department can't do postoperative chemotherapy." , We can’t afford the consequences, once a patient develops tracheoesophageal fistula or thoracic aortic rupture due to residual tumor during chemotherapy, the patient’s life will be very dangerous!”

Qi Dahua listened to the quarrel between the two sides, one head and two older, he looked at Ji Han who was sitting on the chair without saying a word, his eyes lit up: "Well, Professor Ji from Zhongwai, you Do you have any good ideas?"

Hearing Qi Dahua's words, the conference room suddenly fell silent, and everyone's eyes were focused on Ji Han, who was sitting on a chair with gold-rimmed eyes and crossed his legs.

Ji Han straightened his glasses on the bridge of his nose, looked at the examination report and said: "The patient has no resistance in the neck, the jugular vein is normal, the hepatic jugular reflux sign is negative, the carotid artery pulse is normal, and there are no noises on both sides. The trachea is in the middle, and the thyroid is normal. There was no murmur in the thyroid vessels. No palpable lymph nodes in the bilateral supraclavicular region. There was no deformity in the chest, no varicose veins in the chest wall, and no tenderness in the sternum. The respiratory movement of the lungs was symmetrical, the intercostal space was normal, the chattering was symmetrical, there was no pleural friction, and no subcutaneous Crepitus. Murphy's sign was negative, the liver was not palpable, the spleen was not palpable, there was no mass in the abdomen, the liver dullness border existed, the upper liver border was located in the 5th intercostal space on the right midclavicular line, and the shifting dullness was negative. In this way, Zhang Qianyi did It belongs to the upper esophageal cancer, the tumor has spread from the esophagus of the chest to the vocal cords, and has not metastasized yet, the biggest question is, can Zhang Qianyi's vocal cords be preserved?"

Zhao Zhiqiang said in a muffled voice: "That's true, so we have done two surgical plans, both of which are partial resection of the esophageal tumor and chemotherapy and radiotherapy. If the tumor disappears, there is no need for a second operation to move the patient's recurrent laryngeal nerve... "

"Impossible!" Tao Dawei categorically vetoed, "Your extrathoracic surgery plan is too risky. If the tumor does not disappear after chemotherapy, what should we do at that time if it metastasizes to the lymph and pleura? Just because you want to preserve a vocal cord, you have to take it." The patient's life as a bet?! Or, for your face, Zhao Zhiqiang?"

"My face?" Zhao Zhiqiang looked at Tao Dawei in the radiology department with a gloomy face, "What does Director Tao mean by this? Of course we are willing to be the most convenient way to remove the vocal cords, but what will be the consequences? Tens of thousands of Zhang Qianyi fans, and the media waiting to see the excitement, can you shut their mouths?"

Tao Dawei snorted coldly: "We didn't think about this, and we didn't say what we said!"

Zhao Zhiqiang suddenly stood up from his seat and glared at Tao Dawei who was opposite him: "You are waiting to see the joke on our chest, right! I think your radiology department did it on purpose. What happens to residual tumor chemotherapy, I think it is you Tao Dawei deliberately made things difficult for us!"

Tao Dawei was also angry: "You fart, I have more than 20 years of clinical experience, and I deliberately made things difficult for you!"

"Enough!" Qi Dahua slapped the table violently, looking at the meeting room like a vegetable market, he had a severe headache, "This is the end of today's meeting, you all go back and think about the operation and treatment plan, you must get it done." Come up with a perfect plan!!!”

Jiang Li listened to the noise in the conference room, and glanced at Ji Han who was calm and calm: "Actually, you should have a solution, right?"

Ji Han raised his eyebrows, glanced at Jiang Li who was staring at him, and said coldly: "No!"

Jiang Li looked at his back suspiciously, then turned to look at Wei Ran: "Old Wei, did you see Ji Han's expression just now? His expression clearly shows that he knows the way, but why didn't he say it?"

Wei Ran sighed: "I'm afraid Ji Han won't help with this matter!"

"Why?" Jiang Li was taken aback.

Wei Ran thought for a while, but still didn't say the reason: "It's hard to talk about this matter, Ji Han won't let me talk about it."

The hesitation in Jiang Li's eyes grew stronger: "Ji Han and Zhao Zhiqiang, who is outside his chest, do you have a festive relationship?"

Wei Ran waved his hand, quickened his pace and fled Jiang Li: "Don't ask me, I don't know anything!"

(End of this chapter)