Oncology Physician Life

Chapter 59 Chapter 58 Three Coca-Cola Bottle Caps
Wang Qiu signed a body donation before his death. After his death, he will donate all available organs free of charge, and his body will be used for medical research and dissection of pancreatic cancer.

At eight o'clock in the morning, in the farewell room of the medical school, a memorial service for doctor Wang Qiu was officially held. Almost all the doctors and nurses who knew Wang Qiu went to the memorial service.

Wei Ran and Jiang Li attended the confession ceremony wearing black clothes.In the more than ten years of Wei Ran's work, he rarely participated in the memorial service of the patient, but this time the patient's identity is a bit special, not only the patient, but also a close comrade-in-arms on the front line of anti-cancer.

Although Wei Ran was very sad, when he looked at the photo of Wang Qiu's bright smile at the memorial service, he couldn't cry a single tear.

He remembered the last words Wang Qiu said to himself last night.

She said that she has never regretted choosing to be an oncology doctor in her life. If there is another life, she will still choose to be an oncology doctor.

Although Wang Qiu's life was short, she really did it, lived every day to the fullest, and fought for her beliefs and ideals.

It is a pity that Wang Qiu suffers from pancreatic cancer, and this kind of cancer makes Wei Ran feel powerless.

Pancreatic cancer is known as the "cancer king" in the medical field. It is a very malignant tumor among almost all tumors. At present, there is no good treatment method. From the perspective of existing medical methods, the treatment is not only inaccessible However, it will reduce the quality of life of patients, and even put a great financial burden on some families.

When Wang Qiu found out that he was suffering from pancreatic cancer, he approached Wei Ran, hoping that Wei Ran could help persuade her husband Li Guangbin to give up the treatment and leave the money to the children and parents, but Li Guangbin refused.

As a nuclear medicine doctor, he knew better in his heart that he would most likely end up with nothing but money, but he still insisted on trying to save his wife's life at all costs.

Wei Ran has no way to refuse Li Guangbin's request. In the choice of cancer treatment, there has always been an ethical dilemma between money and medical treatment.

In the morning, after Jiang Li attended the memorial service, he didn't have time to sort out his mood, so he immediately devoted himself to work.

She had a separate meeting with Director Fanyu of the Breast Surgery Department. After a series of examinations including PET-CT, immunohistochemistry and MRI, Fanyu told Jiang Li about a luck in misfortune, the little girl Liu Kaishi's The breast cancer did not continue to metastasize.

After Jiang Li heard this, he was completely relieved. This means that the previous surgical plan to completely remove Liu Kaishi's right breast can basically be abandoned. Breast preservation is of great significance to this teenage girl. major.

Fanyu put a lot of thought into Liu Kaishi's breast protection, because this is a rare patient with breast cancer in her teens in her more than 20 years of medical career.

She expressed her opinions one by one from Liu Kaishi's imaging, ultrasound, X-ray, MRI, PET-CT to pathology, and finally to treatment methods.

"Although it can be seen from Liu Kaishi's film that there is still a tumor in situ in the area of ​​her right breast, according to the previous operation plan, it is indeed impossible to preserve the breast, because the tumor area to be removed is relatively large, and it is difficult to maintain the breast. The appearance is not very optimistic, but I have discussed online several times with domestic breast cancer experts, and finally let us research a breast-conserving plan."

Fanyu presented the new surgical plan and zoomed in on the PPT projection: "We can make a shape after removing the tumor in the original area!"

"Molding?" Jiang Li was taken aback, she hadn't thought about this, the surgery of molding is more often used in plastic surgery for breast enlargement.

"That's right, it's shaping! We can reverse the latissimus dorsi with flaps and blood vessels after resecting the tumor in situ in the right breast, and fill in the mammary gland tissue that was removed from Liu Kaishi's right breast. It can create a new right breast shape. After all, the child is only 12 years old. I still hope that the child will not be left with any physical defects, especially what breasts mean to a woman. More or less will leave the shadow of life and low self-esteem."

Jiang Li was relieved, and Fanyu's surgical plan also solved her most worrying thing.

She smiled and thanked Fanyu: "Thank you, Director Fan, for putting so much thought into it, then we will transfer Liu Kaishi to the breast surgery department in the afternoon, and I will trouble Director Fan in the future."

After saying goodbye to Fanyu, Jiang Li immediately told Liu Kaishi the news.

The child was also very happy. After all, everyone loves beauty. Liu Kaishi is only 12 years old. If she really had a mastectomy, it would be tantamount to leaving an irreparable defect on her body.

Jiang Li is also a woman, knowing this kind of defect, what kind of test will it be for a girl like Liu Kaishi in her later life!

But this time, with the help of Director Fan of the Breast Surgery Department, it just happened to make up for the defects in the operation.

Just when Jiang Li was about to transfer Liu Kaishi to another department, Lu Jiajia hurried over.

"Mr. Jiang, why are you still here? Beibei's MDT has been arranged in the department. Professor Jiang Biyi from the Department of Neurosurgery and Professor Yu Sisi from the Department of Neurosurgery have rushed to the meeting room!"

"Jiang Biyi?" Jiang Li was taken aback.

"Yeah, I didn't expect it to be him! It's the authoritative expert on extra-brain who often appears on TV! Very famous!" Lu Jiajia nodded like a chicken pecking at rice: "It's the senior at the top of the pyramid!"

In the conference room, Tao Dayong, the vice president of the hospital office, was smiling all over his face, accompanying an old man with gray hair.

The old man is the golden signboard of the hospital. He is a 70-year-old brain surgery authority. He has retired for many years, but was hired back by the hospital as a medical consultant.

Tao Dayong did not expect that when he submitted the information of this eight-month-old medulloblastoma baby to the Department of Neurosurgery and requested MDT yesterday, Jiang Biyi happened to be in the Department of Neurosurgery.

After reading the materials, the other party insisted on attending this MDT.

Tao Dayong poured a cup of hot tea for Jiang Yuyi, and said almost flatteringly: "Mr. Jiang, you drank tea, but I never expected that you would be able to attend this MDT. With you, this child's chance of survival has increased a lot. "

"You think too highly of me. To be honest, I don't have a good solution!" Jiang Yuyi took a sip of scented tea.

Tao Dayong continued to laugh and said: "As long as Mr. Jiang is willing to work hard, there will be a solution! You are the Dinghaishenzhen of our hospital's brain surgery department!"

Jiang Yiyi took a look at Tao Dayong: "Little Tao, with your mouth, you are called Qucai if you don't go to the hospital. I remember that you were a very capable doctor in brain surgery. You were very good at suturing 2.4mm tiny brain blood vessels back then. It's a pity that you finally went to the hospital office and became a housekeeper, in charge of the medical office, dealing with trivial matters all day long, and you still enjoy it."

Tao Dayong laughed: "Mr. Jiang, I am also serving the patients. I handle all these disputes and trivial matters. Only the doctors in our hospital can go to the operating table without any worries!"

Jiang Yuyi tapped Tao Dayong with his hand: "It's still you, Vice President Tao, who is high-spirited and upright, old man, my ideological consciousness is not as high as yours."

Tao Dayong hastily made amends: "Mr. Jiang said that, but it will break me."

Just as the few people were talking, Jiang Li walked into the MDT meeting room with the materials.

The first time she came in, she saw Jiang Yuyi with white hair.

Tao Dayong was about to stand up to introduce Jiang Li, but Jiang Li walked over immediately and hugged Jiang Yuyi affectionately.

Jiang Yuyi patted Jiang Li's head lovingly: "I said girl, you don't go to see my old man when you come back, you know how chilling I am for the old man."

Jiang Li smiled: "Grandpa, what do you want me to do? I am not your granddaughter-in-law now, so how can I have the right to see you?"

Jiang Yuyi put on a serious face: "Nonsense, who said you are not my grandson-in-law, even if the people in their old Ji's family don't recognize you, but my old man recognizes you, you are my grandson-in-law!"

"Sun... grandson's daughter-in-law?" Tao Dayong was a little unresponsive, "No, Mr. Jiang, you and Professor Jiang, you..."

Jiang Li turned around and smiled: "Dean Tao may not be clear, Mr. Jiang is Ji Han's grandfather."

"Yes, I know, Mr. Jiang is Professor Ji's grandfather, but with you..." Tao Dayong said halfway, with a look of disbelief on his face, "Professor Jiang, you and Professor Ji, you two..."

"It's his ex-wife." Jiang Li looked very calm, "Ji Han and I got married after graduating from university, and within a few years, we divorced again because I went abroad to work."

Tao Dayong couldn't help being speechless, good guy, these two people still have this kind of relationship, they work together on weekdays, they don't show off, and they hide it from the whole oncology department.

Tao Dayong really did not expect that Linxing participated in an MDT today and could still eat big melons from the oncology department.

Professor Yu Sisi from the Department of Neurosurgery came late because of an impromptu meeting.

Jiang Yuyi held Beibei's MRI film, with a shocked and serious expression on his face: "It's hard to imagine that a baby who is only eight months old has a tumor in the brain with a diameter of 6 centimeters, which almost occupies the back of the brain. Half of the country."

Professor Yu Sisi of Neurosurgery also nodded in agreement: "The situation is not very optimistic. The tumor squeezed the baby's brain tissue, resulting in severe obstructive hydrocephalus. Although it was drained, doctors in many hospitals did not recommend surgery. It makes sense that the child's huge brain tumor has a very rich blood supply. Once the craniotomy is performed, the amount of bleeding will be large, and the veins of the child's limbs will be dry, so the blood transfusion must not be too fast. It can easily lead to death from heart failure.”

Jiang Yuyi thought for a moment: "I have been a doctor in brain surgery for nearly 50 years. I have never seen any kind of patients. But in recent years, I especially feel that tumors in China have shown a trend of younger age. I am very worried. An eight-month-old baby has a genetic mutation caused by air pollution, and a 6 cm diameter "goose egg" grows in his brain. I couldn't help it when I heard it outside my brain yesterday. Terrified."

Jiang Li looked at the two of them and said, "This kind of tumor is like a 'time bomb' in the baby's brain. If you don't have surgery, you will definitely die, and if you have surgery, you may die. But removing the intracranial tumor is the only way to save this baby. An eight-month-old baby's only hope!"

Jiang Yuyi agreed with Jiang Li's statement: "Xiao Jiang, you have completed the first step very well. You have found a vein for the child. Under almost impossible circumstances, you have completed the drainage of the hydrocephalus. Now we are gathered together Together, it is for the second step, how to do it, to safely remove this tumor in the child's brain!"

Professor Yu Sisi of the neurosurgery department glanced at the film: "If surgery is really needed, Professor Jiang's first problem is how to control the amount of bleeding during the operation!"

Jiang Li was silent for a moment. The question raised by Professor Yu Sisi was also a big problem that troubled her at present.

Beibei was only eight months old, and his blood vessels were dry, so he couldn't quickly transfuse blood during the operation.

The tumor body in the brain is connected to the blood supply vessels of the brain, which provides a rich blood volume to the tumor. Once the tumor is removed, it will cause massive bleeding.

Under the premise that rapid blood transfusion is not possible, the direct consequence of massive bleeding during the operation is that the baby suffers from heart failure and dies on the operating table.

It's pretty much a closed loop.

Professor Yu Sisi really didn't have a good idea, and sighed: "Bei Bei is only ten months old. If the blood loss during the operation reaches 10 milliliters, it is equivalent to 500 milliliters of adult blood loss. The blood volume of the baby's body is very small, and the bleeding during the operation If there is too much, the heart will stop beating during the operation. In addition, the blood transfusion should not be too fast, but only slowly, otherwise it will cause heart failure in the child. Therefore, the first point is that since we need surgery, we must find a way to control it. The amount of blood loss during the child's operation!"

Jiang Yuyi nodded and looked at Jiang Li: "Xiao Jiang, you need surgery, and this challenge can be said to be very difficult, because it means that you have to control the child's bleeding volume within 30 milliliters during the operation. An almost impossible task!"

Tao Dayong was silently stunned while listening: "This... how is this possible? Is this a craniotomy? How can the amount of bleeding be controlled within 30 milliliters? What is the concept of 30 milliliters? A bottle of normal eye drops, that volume , that is 30ml, right? A Coca-Cola bottle cap, the size of three Coca-Cola bottle caps, is 30ml, which is almost impossible, this is a craniotomy!"

Jiang Yuyi nodded: "So girl, think about it for yourself, this operation is not ordinary difficult, doctors are not gods, and no one can guarantee the amount of blood loss in an operation, not to mention, what you have to do is even more difficult. In a craniotomy, if the amount of bleeding is kept within the size of three Coca-Cola bottle caps, even one milliliter of blood is fatal to the baby!"

The MDT ended soon, and Jiang Li walked towards the ward area with his thoughts in mind.

In her mind, she kept simulating the scene of performing craniotomy on Bei Bei, but no matter how many times she simulated, the result was the same, that is, the baby bled too much, and finally died on the operating table due to heart failure!

She couldn't do it. During a craniotomy, the amount of bleeding was maintained at the size of three Coca-Cola bottle caps.

These three Coca-Cola bottle caps almost became a mountain pressing on Jiang Li's heart.

Unknowingly, she came to Beibei's special needs ward, but accidentally bumped into Beibei's mother, Zhang Xiaonan, who was having a fierce quarrel with her husband.

Beibei's father, Qin Zhang, faced his wife's crying and begging, and couldn't help getting angry: "What are you thinking! It's not that I don't want this child, but you also heard from the doctor that this child cannot undergo surgery! "

Zhang Xiaonan almost begged his husband: "No, no, Professor Jiang said she can perform surgery, I beg you, don't give up this child, I beg you!"

Qin Zhang took a deep breath: "Even if the child can be operated on, didn't the doctor say that various complications may occur after the operation, and this child may have some impact on health and intelligence! He is only eight months old. How long is my life? A few years, ten years, or even decades, I really don’t dare to think about it, and I don’t have the confidence to take care of a mentally handicapped child for the rest of my life! Instead of regretting it at that time, we should give up now!”

Zhang Xiaonan wept bitterly, shaking his head like a rattle.

Husband Qin Zhang firmly grabbed his wife's shoulders, stared at her face, and persuaded him: "Little man, we are still young, without this child, we can have a healthy child in the future, okay, be obedient, Let's give up and let Beibei go away with more peace of mind, shall we?"

Zhang Xiaonan opened the shackles and wailed hysterically at her husband: "No, I don't want it. I gave birth to him at ten months of pregnancy. He is only eight months old. How can you bear to let him die? ah!"

Qin Zhang's eyes were flushed, and he slammed his clenched hand against the wall: "What can I do! We haven't been to many hospitals in the past six months! You also heard from those doctors that Beibei can't have surgery. He will probably die on the operating table after the operation! I don't want, I don't want the two of us to spend our entire lives on this child!"

Zhang Xiaonan firmly grasped her husband's hand: "You said it too, the doctor just said it is possible, maybe the child will die on the operating table, maybe the child will be mentally deficient after the operation, but it is also possible that the operation can be completed smoothly, the child There is no intellectual defect!"

Qin Zhang turned his head away: "I dare not bet!"

Zhang Xiaonan beat her husband's chest hard: "You don't dare to bet, you dare not bet, you will let my son die! You bastard!"

Jiang Li listened to the quarrel between the husband and wife, but did not persuade her. She couldn't bear to see the mother's hesitation, but she couldn't protect the mother. Although she is a doctor, doctors have the highest priority before life. But she cannot make decisions for the parents of the children.

More importantly, she had no way of guaranteeing that Beibei's craniotomy would keep the amount of bleeding at the size of three Coca-Cola bottle caps.

In the oncologist's office, Fang Wei, a resident of the surgical oncology department, walked in with a medical record. Seeing that several residents and interns were there, he poured himself a cup of coffee and leaned against his desk to speak before he listened. insider information.

"Have you all heard?" Fang Wei asked, taking a sip of the hot instant coffee.

Tan Tan, a resident doctor, knocked on the medical record and ignored him.

Shu Yusheng, an intern who just arrived, asked curiously, "What did you hear?"

Fang Wei smiled: "It's the Children's Oncology Department under our Oncology Department. An eight-month-old baby with medulloblastoma was newly admitted. Today, Mr. Jiang, the authority of brain surgery, personally participated in the MDT. Professor Jiang Lijiang insisted To perform a craniotomy on this baby, because the baby is too small, excessive blood loss during the operation will cause heart failure, so, for Professor Jiang to perform this craniotomy, the blood loss must be kept within 30 milliliters!"

"Within 30ml?" Shu Yusheng looked shocked, "How is this possible? It can't be done, right? That's a craniotomy!"

Tan Tan also shook his head: "It's difficult. I heard before that the baby has been to many hospitals, and those doctors said that the operation cannot be performed."

Fang Wei nodded: "If you think about it, you know it's impossible. Craniotomy, what's the concept of bleeding volume of 30 milliliters? That's the size of three Coca-Cola bottle caps, so a small amount of bleeding, unless it's a fairy, Otherwise, a craniotomy will be performed, and the medulloblastoma connected to the blood vessels of the brain will be removed. Once the tumor is removed, the blood vessels of the brain will be disconnected, just like turning on the faucet. How can it be possible to maintain a bleeding volume of 30 ml? !"

Shu Yusheng thought for a while, and couldn't help being shocked: "So, as long as the tumor is removed by craniotomy, there is a high probability that the baby will die of heart failure due to excessive bleeding, and the baby's veins and blood vessels are dry, and it is only eight months old. There is no way to quickly transfuse blood!"

Fang Wei nodded: "You know how to operate! So, this is an endless loop. There is no way to open the head for surgery. I don't know what our female professor who came back from Anderson can do. The amount of blood loss from a craniotomy is about the size of three Coca-Cola bottle caps! I'm really curious!"

Wei Ran just happened to pass by the offices of these residents and interns with the documents. Hearing the conversation inside, he looked at the expressionless Ji Han beside him and asked, "Mr. Jiang? Isn't that your grandfather!"

Ji Han nodded: "I just read the case of the baby Jiang Li."

Wei Ran asked curiously: "Even you can't help but keep the bleeding volume at the size of three Coca-Cola bottle caps?"

Ji Han was silent for a long time, then sighed: "It's hard, I haven't thought of a way yet."

Wei Ran was taken aback: "Then Jiang Li..."

In the evening, because Wei Ran had to stay in the hospital and had a special patient to take care of, he didn't go home and stayed in Ji Han's personal lounge.

Wei Ran looked curiously at Ji Han who was sitting by the windowsill reading a book, and asked, "You didn't have surgery today, why didn't you come home after get off work?"

Ji Han was looking through the domestic and foreign case data on infant brain surgery in the past ten years, but unfortunately, he did not find a case similar to the one in Jiang Li's hands.

Just as the two were talking, the door of the ward in the lounge was pushed open, and Pei Xiaonan came in with big bags and small bags: "I bought Chen Ji pork knuckle rice today, and Jiang Jiang's favorite minced beef Soup!"

When Jiang Li came in, the three of them looked at each other, tacitly did not mention anything about the operation.

Pei Xiaonan put the pork knuckle rice and minced beef soup in front of Jiang Li, and bought her favorite shredded chicken.

Jiang Li ate the hot stewed pig's feet in big mouthfuls, and drank the beef soup with red oil floating in it, and then he took a deep breath of satisfaction.

Pei Xiaonan comforted her: "Jiang Jiang, there are some things that we can't do with our current medical methods. Isn't there a saying that nothing is difficult in this world, as long as you are willing to give up!"

Jiang Li ate his rice and drank the soup, and said vaguely: "Wrong, wrong, in my Jiang Li's dictionary, I have already picked out the two words of giving up!"

She unscrewed the caps of three Coca-Cola bottles on the table and placed them together.

Staring at the three Coca-Cola bottle caps with both eyes, he snorted coldly: "Isn't it that the amount of bleeding must be maintained at the size of three Coca-Cola bottle caps! Isn't it just three Coca-Cola bottle caps!"

She quickly finished the last bite of pig's knuckle rice in the bowl, got up and walked out.

Pei Xiaonan greeted her hurriedly: "Why are you going!"

Jiang Li waved his hand: "Go to the surgery simulation room, I won't believe in evil! I, Jiang Li, can still lose to three Coca-Cola bottle caps!"

Pei Xiaonan put down his chopsticks, glared at Wei Ran, who was eating well, and pinched him hard on the arm, causing Wei Ran to yell in pain, "Why are you pinching me!"

Pei Xiaonan threw a bottle of Coca-Cola in front of him and complained loudly: "You don't buy so many drinks! You insist on buying Coca-Cola! I think you did it on purpose, didn't you!"

Wei Ran was very wronged: "It's none of my business, you bought the rice, okay?"

Pei Xiaonan was furious, and defended herself: "I didn't think of that either! If you want to blame, you can blame the boss who sells pig's knuckle rice. He insisted on giving away Coke when selling pig's knuckle rice, he did it on purpose!"

Wei Ran glanced at Ji Han, feeling aggrieved.

Ji Han chose to ignore him: "Never try to reason with women!"

　Three chapters in one, [-] words
　　
　
(End of this chapter)