Oncology Physician Life

Chapter 6 Chapter 05 The Boulder on the Fulcrum
After hearing what Professor Li Chunrong said, Jiang Li got up and echoed: "The incidence of this type of lung cancer is extremely low in children. In the 25 years of the United States, the children's hospital in Texas has only had more than 3000 cases of children with pleuropneumonia. For patients with cell tumors, the Nottingham City Hospital in the United Kingdom reported the surgical treatment of 7 cases of this type of children within one year, while in China, the Children’s Hospital in Guangzhou admitted 28 cases in just one year, and the BJ Children’s Hospital reported in 17 years 12 cases. In recent years, almost every year in children's hospitals across the country, there have been reports of children with pleuropulmonary blastoma. The number of patients with this type of rare childhood cancer is also increasing geometrically in China. In our country, in this The scientific research and treatment methods for this disease have not changed in almost 30 years, and scientific research is relatively lacking. Only Tianjin Cancer Hospital and Sun Yat-sen University Cancer Hospital have set up children’s tumor departments in the country, and there are relevant researches on this kind of rare childhood cancer.”

Professor Li Chunrong continued to ask: "Since Professor Jiang has researched this kind of rare childhood cancer, according to Professor Jiang's opinion, what should we do now?"

Jiang Li pondered for a moment: "The most urgent thing is to establish a guarantee for the child to breathe unobstructed, so as to buy time for the operation. My personal suggestion is to insert the catheter into the child's right chest cavity, and first drain the mass effusion that is stained with the right chest cavity to release the space in the chest cavity. , to relieve pressure on the left lung.”

Director Sun of the surgical emergency department shook his head: "Now the tumor in the child's chest is like a huge rock standing on the fulcrum. How can Professor Jiang ensure that when you pump out the tumor effusion in the right chest cavity, this huge rock can move to the hospital?" Leaning to the right? Instead of exacerbating compression to the left lung? How can you determine which direction the boulder is rolling?"

Jiang Li shook his head, "I'm not sure."

Sun Renyi smiled: "Then Professor Jiang is gambling with the child's life again?"

Professor Li Chunrong pondered for a moment: "I think since it is necessary to ensure the child's smooth breathing, the safest way is to install an ECMO (artificial heart-lung machine) for him."

Sun Renyi continued: "The cost of starting ECMO once is 7 yuan, and the cost of maintaining it for a day is around [-] yuan. We still have to consider the reasons for economic toxicity. Welfare homes cannot afford such expensive treatment costs. Our surgical emergency department The deficit expenses in this quarter have already seriously exceeded the standard, if it is free, we will not be able to get out of ECMO here."

Jiang Li watched everyone discussing and discussing, but there was no better way, and every minute that passed, Xiao Jiang Hao's danger increased by one point.She took a deep breath: "If there is no better way, then follow my way. If something goes wrong, I will be responsible!"

Sun Renyi smiled: "Professor Jiang, you haven't officially joined the job yet, right? Even if you want to do this temporary drainage operation, you shouldn't do it. Otherwise, if something happens, our emergency department can't afford it. After all, it’s still in our emergency department.”

After the words fell, Ji Han's voice suddenly came from outside the small meeting room: "I will sign this operation, and Professor Jiang Li will perform the surgery. If something goes wrong, I, Ji Han, will be in charge!"

In the conference room, a slender figure in a clean white coat walked out of the shadows, the blazing light above his head happened to pass through the glass window, and behind the man sprinkled the ground with brilliance.

Ji Han straightened the gold-rimmed glasses on the bridge of his nose, and the white coat on his body was brand new and neat, with every row of buttons tightly seamed and meticulous.

Jiang Li raised his head and met his staring eyes.

In those deep, clear but translucent eyes, it was as bright as the glimmer of light coming from under the broken leaves.

After years of separation, it has been seven years.

The appearance of him left in her memory surged in her mind, like overlapping old photos, no different.

Sun Renyi spread his hands: "Since Director Ji has said so, we will ignore this patient in the emergency department and transfer him to your tumor department. What happened has nothing to do with our surgical emergency department."

Ji Han naturally saw the clues on Sun Renyi's face. It was in line with Sun Renyi's usual style that the surgical emergency department wanted to get rid of this responsibility.

"Of course, when the head nurse goes to work at dawn, we will hand over the patient and transfer the patient to my department."

A peaceful smile appeared on Sun Renyi's face: "This is naturally the best, and it will save us a lot of trouble."

Two minutes later, in the surgical emergency room.

Ji Han looked at the little boy sitting on the hospital bed, even though he was intubated and connected to a ventilator, he could clearly hear the lung rales when he was breathing.

Ji Han stretched out his clean fingers with well-proportioned joints, and gently pressed Xiao Jiang Hao's chest, with a rare gentleness on his face, and asked, "Little friend, does it hurt here?"

Little Jiang Hao shook his head.

Ji Han smiled softly: "Relax, brother check."

Following Tan Tan, a tumor resident who came in, was shocked to see the gentle smile on Professor Ji's face, and confirmed that he was not mistaken, the sunny smile was indeed Ji Han himself.

In the past few years from intern to resident and regular training, he has never seen Ji Han smile at all. If he hadn't seen it with his own eyes, he wouldn't believe it if he was killed.

Ji Han lightly touched the swollen part of Xiao Jianghao's right chest again: "Does it hurt so much here?"

Xiao Jiang Hao frowned: "It hurt just now, but it doesn't hurt very much now."

Ji Han pressed down again, and Xiao Jianghao immediately gritted his teeth in pain from the pressure, and cried out the pain.

Ji Han's eyebrows obviously hesitated for a moment. The boy's right chest cavity was filled with tumor secretion, and almost half of the chest cavity was swollen. According to Jiang Li's operation, evacuating the tumor secretion in the right chest cavity would indeed lead to chest swelling. The mass moved, but she couldn't determine the direction of the mass's movement. If it was to the right, it would be fine, it would relieve the compression of the mass on the left lung, release the airway space of the left lung, and relieve the patient's dyspnea. Move to the left, and then continue to compress the airway of the left lung, the patient will suffocate or even die in an instant.

So, this is a double choice question.

If the effusion is not pumped, the patient may not survive tonight.

Effusion extraction is a half-choice question.

And the answer is in the hands of God, not in the hands of doctors.

Jiang Li only has a 50% chance to save this patient.

In the oncology department, 50% chance of survival sounds very high, but for this six-year-old child...

Ji Han nodded and looked at the little boy: "It's nothing serious, but now the doctor's brother and the doctor's sister are going to open a hole in your chest to pump out the fluid in your chest cavity, so that we can Little Jiang Hao can breathe normally, so you have to cooperate with your brothers and sisters for a while and don't move around..."

When Xiao Jiang Hao heard this, he looked at Ji Han nervously: "Doctor...brother doctor, is my illness very serious? Why do I need an operation? Does this operation cost a lot of money? If it costs a lot of money, then I will I won’t do it, I don’t want Grandma Dean to continue to suffer because of my illness.”

Looking at the innocent eyes of the little boy, Ji Han froze and smiled: "It's nothing, little guy, this operation doesn't cost money."

Jiang Li explained as simply as possible to the aunt of the Tongxin Welfare Institute in the ward what the risks of the operation would be. Although she doubted whether the aunt could understand, at this time, it didn't matter whether she understood or not.

(End of this chapter)