Oncology Physician Life

Chapter 58 Chapter 57

Hospital Emergency Surgery.

The attending doctor, Li Ming, led a group of residents and interns to stand ready. The ambulance from the emergency center had met the traffic police in the city and was rushing towards the hospital.

For this reason, the traffic police detachment specially dispatched police forces to open up a green life channel directly to the emergency building of the hospital within 15 minutes.

Jiang Li hurriedly led Lu Jiajia into the emergency department.

Sun Renyi, the director of emergency surgery, raised his eyebrows when he saw Jiang Li's ready attitude, and kindly reminded her: "Professor Jiang, this baby is not simple. Other hospitals have tried to drain the baby beforehand, but they used mannitol for three days. Afterwards, the blood vessels in the baby's limbs shriveled up, and there was no way to find a good vein to insert the needle. There was no way to drain the blood, let alone remove the tumor. Otherwise, if the craniotomy was forced, the hydrocephalus in the child's brain would be ejected directly. , Blow up like a balloon, not to mention the operation on an eight-month-old baby, the amount of bleeding must be huge, and the baby's blood vessels are dry, and there is no place for blood transfusion, the probability of heart failure is more than 95%..."

Jiang Li interrupted Sun Renyi: "Director Sun, if you have anything to say, just say it."

Sun Renyi took a look at the crowd around him: "Professor Jiang is so virtuous and virtuous, and I, Sun, admire him, but there is no need to accompany my future for an eight-month-old child, right? The doctors in those hospitals are not Fool, knowing that the probability of success of the operation is very low, you still insist on the operation? This is not only to gamble with the life of the child, but also with the future of the doctor. If there is no perfect solution, I advise Professor Jiang not to have the operation. "

Jiang Li understood the implication of Sun Renyi's words. The baby's situation was indeed very difficult, and it might even be worse than Jiang Li expected.

But doctors do not have the right to choose patients. It is a doctor's bounden duty to save lives and heal the wounded. No matter what the result is, she will try [-]% of her efforts.

Jiang Li ignored Sun Renyi, clapped his hands, called several residents and interns around, and said, "The situation is very critical. This child is only eight months old. The tumor almost occupied the back of the child's head, oppressing the brain. tissue, the intracranial pressure reaches a critical point, and severe obstructive hydrocephalus is produced, the brainstem tissue is displaced, and the child may be comatose and stop breathing at any time."

Jiang Li's eyes fell on the extremely young group of doctors in front of him, and he said loudly: "Now all actions must be under my command, we only have 10 minutes of preparation time, emergency surgery doctors, now get ready to push the cart and breathe Machines, heart monitors, defibrillators, ultrasound guides, and other possible instruments. After the ambulance arrives in a while, they will be directly pushed into the EICU, put on the heart monitor and ventilator, and have a set of routine blood tests and blood analysis. Standby, on the other side, Lu Jiajia from the oncology department, please contact your colleagues in the CT department, and use the mobile X-ray machine to conduct a comprehensive scan of the child's brain. The rest of the nurses will follow me and prepare for rescue. "

After the words fell, the doctors dispersed and began to take charge of their work as instructed.

12:[-] p.m.

The sirens of the riders of the traffic police detachment sounded all the way through the traffic-congested avenue in front of the hospital.

Twelve traffic police riders tightly escorted an ambulance with emergency lights on, and drove into the door of the emergency building of the hospital.

The driver of the ambulance, Lao Li, was very nervous. He had been driving an ambulance for more than ten years. Almost every time he got out of the car, it meant fighting against death. He knew that he was not driving a car, but a moving car. lifeline.

Arriving at the hospital 1 minute earlier means that the patients in the car may have an extra chance of survival.

Lao Li spotted the doctors and nurses waiting in front of the emergency surgery building, and immediately slammed on the brakes and slammed the steering wheel. The ambulance turned sharply like a spinning top, and just aligned the rear hatch with the entrance of the hospital building.

Nurse Liu Xiaomin jumped out of the car first, and shouted at the nurses and doctors in front of the building: "Hurry up, hurry up, the child has ventricular fibrillation, and his pulse is very weak now!"

The nurses and doctors who had been waiting for a long time pushed the cart over immediately.

Liu Xiaomin carried the baby incubator in her hand and put it on the stroller. The young nurse quickly and correctly removed the oxygen bottle intubation on the ambulance and put on a simple oxygen bag.

She followed the cart to the EICU ward of the emergency room, counting the seconds in her heart, and pressed the airbag in her hand every three seconds. A group of five people quickly pushed the cart and ran towards the EICU of the emergency room. .

In the distance, the door of the EICU ward was directly pushed open by Jiang Li.

The resident doctor who had been prepared for a long time immediately took the baby, which was not as big as a watermelon, out of the mobile incubator and put it into the baby incubator prepared in the ward. At the same time, the nurse on the side quickly took care of the baby. Electric monitoring, connect the current.

The nurse looked at the heart monitoring data and said to Jiang Li: "Professor Jiang, the child's intracranial blood pressure is 242/120mmHg, and the heart rate is disordered."

Jiang Li said to the nurse, "Prepare the defibrillator and inject mannitol intravenously."

The nurse took out the needle and sucked the mannitol out of the medicine bottle, but when it was time for intravenous injection, she was dumbfounded: "Professor Jiang, the blood vessels in the baby's limbs are dry, there is no place to inject the needle at all!"

Jiang Li picked up the baby's little hand and took a look. In other hospitals, in order to reduce the high pressure in the child's brain, he had injected mannitol, but he didn't expect the baby's blood vessels to dry up.

When Jiang Li was looking for a venous vessel for injection, the nurse next to the monitor hurriedly turned around and said, "Professor Jiang, the baby's obstructive hydrocephalus causes severe high pressure. If the intracranial hydrocephalus is not drained, the child may breathe at any time." Stop dying."

Jiang Li glanced at the red light on the instrument, and said to the nurse, "Contact Dr. Zhang Qihua from the anesthesiology department immediately, and prepare for the drainage of the hydrocephalus at the same time."

After speaking, Jiang Li took over the defibrillator, applied the electrode paste, and pressed lightly on the baby's chest. The baby's disordered heart rhythm finally gradually recovered to sinus rhythm.

Dr. Zhang Qihua from the anesthesiology department almost ran all the way into the EICU.

He leaned down, looked at the baby's condition, and frowned: "Professor Jiang, if the drainage of intracranial hydrocephalus is performed, anesthesia must be performed first, and mannitol must be used to reduce the pressure on the brain before drainage, but the child is now There is no longer a place where needles can be inserted, so we must first find a venous vessel that can be used to inject medicine and use it as a venous channel.”

Jiang Li looked at the nurse: "Bring the ultrasound guide, and use ultrasound guidance to find a vein for the child to inject."

The nurse immediately uses the ultrasound guide.

As time passed, the nurse holding the ultrasound guide was covered with sweat on her forehead. She looked at the time and found that it had been nearly an hour, but she still hadn't found a vein to inject a needle.

Just when the nurse was about to give up, the ultrasound guide finally responded, and a vein with a diameter of about 4 mm was found under the baby's right clavicle.

The anesthetist Zhang Qihua glanced at the faintly visible vein following the baby's breathing, and shook his head directly: "No, this vein is next to the baby's aorta. On the other hand, causing arterial hemorrhage is likely to cause heart failure, and if it is pierced into the chest cavity, it will also cause pneumothorax in the baby and cause suffocation and death."

Jiang Li also hesitated for a moment, and the nurse standing in front of the monitor anxiously reminded her: "Professor Jiang, the baby's intracranial hypertension continues to pressurize, what should I do?"

Jiang Li gritted his teeth: "I can't care too much, Doctor Zhang, you are going to administer drug anesthesia, the dose of anesthesia should be accurate to 1 milliliter, any more or less will cause a fatal blow to the baby."

Zhang Qihua nodded, then turned to look at the baby's urine volume.

One hour before anesthesia, the anesthetist must accurately calculate the dosage of the drug according to the baby's urine volume.

On the other end, Jiang Li took the needle from the nurse who hesitated to give it.

She glanced at the 4mm-diameter vein just below the collarbone on the baby's right side.

The veins come and go as the baby breathes.

When the baby exhales, the veins are exposed under the baby's thin, tender skin.

But when the baby inhales, this vein "hides" again.

Holding the long and thin needle in her hand, Jiang Li calculated in her mind that whether it was mannitol, anesthetics or other drugs, they had to be delivered into the baby's body through this vein, and she only had one chance.

Jiang Li held his breath, fixed his eyes on the baby's collarbone, and waited for the moment when the baby breathed.

"call……"

At the moment when the baby's chest fell, Jiang Li pierced the needle in his hand, and it accurately pierced into the baby's vein.

Everyone around the incubator breathed a sigh of relief.

The nurse immediately connected the needle catheter and began to deliver mannitol and anesthetic.

At the same time, Jiang Li received the brain drainage tube.

After the anesthetist completed the anesthesia, Jiang Li immediately inserted one end of the drainage tube into the baby's lateral ventricle with a minimally invasive approach, and at the same time led the drainage tube away through the skin and inserted it into the baby's abdominal cavity. The effusion is drained into the peritoneal cavity and excreted from the body.

When everything was finished, the baby's breathing finally gradually stabilized.

The instrument showed intracranial hypertension, which gradually dropped below the critical point.

Only then did Jiang Li heave a sigh of relief, looking at the time, it took almost two hours.However, she knew that this was just the beginning, and the brain tumor that everyone would face next would be more difficult and dangerous.

Jiang Li tore off the sterile clothes on his body, walked out of the EICU ward, and told the nurse: "Observe the baby's vital signs at all times, and in addition, help me contact the neurosurgery and brain surgery, and book an MDT tomorrow or the day after tomorrow (more Disciplinary diagnosis and treatment)."

The mother and grandma, who were guarding outside the ward, saw the door of the EICU ward opened, and the doctor came out, and immediately surrounded them.

Jiang Li glanced at the tears on the baby's mother's face, and comforted him: "Don't worry, the baby's life is not in danger for the time being. You should go through the hospitalization procedures here first. I have already contacted doctors from other departments for consultation and to discuss the operation plan."

The baby's mother lifted her head with sobs, her eyes were full of surprise and joy: "Doctor, you mean... would you like to help our Beibei perform surgery?"

Jiang Li nodded: "Although surgery is possible, there is still a huge risk. Even if the tumor is completely removed, if the pathological section is malignant, there is still a high possibility of recurrence. Your family members must be mentally prepared."

Zhang Xiaonan nodded again and again: "We are ready, even if there is even the slightest hope, we will not give up on this child!"

Jiang Li saw that only the mother-in-law and daughter-in-law were here, and couldn't help asking: "Is the child's father here?"

Zhang Xiaonan couldn't help but sighed: "The child's father is suing the decoration company, and the court session is held today, so he needs to come later."

"A lawsuit?" Jiang Li was taken aback.

The mother-in-law Liu Guifen looked angry: "It's all that unscrupulous decoration company who used inferior materials to decorate my son and daughter-in-law's wedding room. My daughter-in-law lived in it when she was pregnant with the child. After the child was born, she went to the hospital for an examination before she knew about the house. The air pollution here caused a tumor the size of a goose egg to grow in the brain of the child as soon as he was born, I wish I could kill these unscrupulous decoration companies and let them do nothing!"

At night, the oncology department ended a busy day and gradually returned to calm.

Wei Ran walked towards the ward in a white coat.

Wang Qiu's condition is very bad these days, Wei Ran knows in his heart that she has entered the countdown stage of her life, for Wang Qiu, he has been staying in the hospital and dare not go home.

He glanced at the wall clock in the corridor outside the ward. It was exactly 07:30, and he turned and walked into Wang Qiu's ward.

Wang Qiu's husband, Li Guangbin, had to take care of his son at home and could not come over at night. Wang Qiu was lying alone on the hospital bed.

When she saw Wei Ran coming in, she forced a smile on her face, but she didn't even have the strength to speak.

Wei Ran sat on the edge of the hospital bed, approached her, and smiled at her: "Do you feel better at night?"

Wang Qiu's voice was extremely weak: "Old Wei, you don't need to stay deliberately, you have been busy all day, go home and rest, I don't need to do anything here."

Wei Ran held Wang Qiu's hand, suppressed tears, forced a smile and nodded: "Okay, I'll leave in a while."

Wang Qiu smiled at him: "Old Wei, I only found out after I got sick that our life is actually very short, so short that we don't have time to do anything, and we may have already passed this life. I hope you don't act like that." I, too, wait until this happens before I wake up.”

Wei Ran lowered his head: "Say something stupid, you can still live, we just have to work harder..."

Wang Qiu smiled gently and said, "I'm also a doctor in the oncology department. I've been dealing with cancer for half my life. I know my own illness well. You can't lie to me."

Wei Ran's eyes were red and he didn't speak.

"Old Wei, do you still like Xiaonan?"

Hearing Wang Qiu's sudden question, Wei Ran raised his head and did not answer.

Wang Qiu shook his head: "You are always so shy. When you were in college, you liked Xiaonan, but you never dared to say it out loud. Now that you have graduated for more than ten years, neither of you has left Shanghai. Still choose to work in the same hospital, but no one is willing to confess, Old Wei, if you don’t tell me, why don’t you know, does Xiaonan like you too?”

Wei Ran smirked: "I'm afraid that if I say it out loud, it will be embarrassing for both of us, and we won't even be friends in the end."

Wang Qiu sighed, but did not continue to persuade.

She turned her head and looked at the round and big moon outside the window: "Why did I like being an oncology doctor in the first place? This job is hard, full of responsibilities, challenges and risks... At the beginning, my mother advised me that girls are still Looking for a more stable job, 60 to [-] every day, the work is not tiring, but I finally chose to be an oncologist, I think, our generation of doctors, born well, we have caught up with the most prosperous in the motherland In the era of prosperity, our generation is also the most confident generation that can overcome cancer. I fantasized that maybe when I retire at the age of [-], we will have cured most cancers, but I can’t wait. It's that day."

Wang Qiu squeezed out a smile and looked at Wei Ran: "But you know, Wei, I have never regretted becoming an oncologist for a day. If there is an afterlife, I would still choose to be an oncologist. , because I was born to be a doctor!"

Hearing that Wang Qiu seemed to be saying his last words again, Wei Ran couldn't bear the sadness, so he suppressed the sadness in his heart and bid farewell to Wang Qiu.

When returning home from get off work, he specially greeted the doctors and nurses on duty to take good care of Wang Qiu, so Wei Ran walked out of the hospital and headed home.

At night, on the roof of the attic of Wei Ran's house, the whole night sky is full of stars, and the breeze is not dry. It is rare to have such a good night.

But when the group of four got together, everyone seemed preoccupied.

Ji Han lowered his head, stared at the grilled fish on the charcoal fire with burning eyes, and suddenly said: "I have a patient named Liu Fengzhi who has a tumor in his trachea. Marry a daughter-in-law, do a job, marry a daughter-in-law for the second son, buy a house and do a job, and save enough dowry money for the younger daughter, but when the mother is sick, neither of the two sons is willing to pay for her surgery. I have been urged several times, but there is no money to pay the fee... This afternoon, the youngest daughter paid the operation fee with her savings and the dowry money given by her mother, but the two sons never showed up..."

Wei Ran was also not in a high mood: "Wang Qiu's condition has reached the point where medicine and stone can't be ignored. I went to see her today. I'm afraid the days are numbered. I still remember the scene when we met for the first time in college. She is so good. How could fate be so unfair to a girl like me!"

Jiang Li shook his head: "I also admitted a special patient today. The child is eight months old and has medulloblastoma. I suspect it is malignant. The reason for this disease is that the mother was pregnant. In order to repair the unqualified house, the unscrupulous decoration company used inferior decoration materials, which caused air pollution and caused the baby's genetic mutation. It took more than an hour to find a good one, and managed to drain the hydrocephalus, but the tumor in the child's brain was as big as a goose egg, occupying almost the entire back of the brain. grasp."

Pei Xiaonan knocked on the table and looked at the four of them: "Hey, what's wrong with you three today? It's not like your style to be so depressed. Who are we? We're a team of four in the No. [-] Tumor Hospital. How could you be overwhelmed by this difficulty? Why don’t I show mercy today and sing a song for everyone!”

The three hurriedly refused.

Ji Han shook his head like a rattle: "There's no need for this! I'm afraid I'll be even sadder after listening to it!"

Jiang Li was also frightened and quickly waved his hands: "No, no, really, I think you should eat meat, Xiao Nan!"

Wei Ran went directly to grab the microphone connected to the stereo, but it was still a step late, and Pei Xiaonan snatched it first.

The three of them sat together, looking in horror at Pei Xiaonan who was singing loudly, her voice could no longer be described as tone-deaf.

Who do I meet, what kind of dialogue will I have;
The person I am waiting for, how far in the future is he;

I hear the wind, from the subway and the sea of ​​people;

I lined up, holding the number plate of love.

……

Jiang Li sighed helplessly: "I think God is fair. He gave Xiaonan a sexy appearance, but also took away her angelic voice."

Ji Han pursed her lips: "I heard that Xiaonan always dreamed of entering the school's literature and art department when she was in college, but Director Hao of the literature and art department, after listening to Xiaonan's song, included her in the list. For this reason, Xiao Nan cursed the Minister of Literature and Art for a full year and four months, and didn't stop until the other party graduated."

Wei Ran smiled, and said: "If you can listen to Xiaonan singing at four times the speed, and listen to it as a rap, it seems that you can listen to it."

Pei Xiaonan put down the microphone, kicked the three close friends in front of her, and said angrily, "Can you three be human? I'm still here! I'm still here! I'm not deaf!"

While the four were laughing and laughing, Wei Ran suddenly received a call from the hospital. He looked very surprised. He turned his head to look at the three chasing and fighting behind him, and put down his phone.

"Just now there was a call from the special needs ward of the hospital. Wang Qiu passed away half an hour ago."

The three of them suddenly fell silent collectively.

In the night sky, a meteor pierced the sky and fell in an unknown direction.

(End of this chapter)