Oncology Physician Life
Chapter 7 06 70 injections of life-saving medicine
Chapter 7 Chapter 06 70 injections of life-saving medicine
In the ward of the emergency room, Ji Han glanced at Jiang Li and reconfirmed the operation procedure: "In a moment, I will talk to Tan to hold on to the child, and Dr. Zhang from the tumor department will perform local anesthesia between the ribs, while Professor Jiang will be in charge of treating the child. The right pleural cavity is opened and the fluid is pumped. Just in case, we will try our best to maintain the child's body posture during the operation to ensure that the mass will not move to the left, but there are still risks. At the moment when the right pleural effusion is evacuated, who of us There is no guarantee of the moving direction of the tumor, so are you sure you want to continue with this operation?"
Jiang Li has already put on white rubber gloves, "I, Jiang Li, have never regretted it in my dictionary. Now that I have made a decision, I have no doubts."
Soon, Ji Han and Tan Tan held Xiao Jiang Hao tightly, and the anesthetist from the tumor injected local anesthetic between his ribs.
Holding a pointed scalpel in his hand, Jiang Li opened an opening in Xiao Jianghao's right chest, and inserted a 45cm long catheter from Lu Jiajia's hand.
In an instant, a large amount of blood continuously poured into the glass container from the slender transparent tube.
Everyone held their breath at this moment.
As the right pleural effusion was emptied, everyone stared at Xiao Jianghao uneasily. No one knew whether the lump in his chest was moving to the left or to the right at this moment?
Little Jiang Hao looked at the crowd in confusion, and suddenly seemed to be greatly relieved. His breathing immediately became much easier, and even the rales in his lungs became much smaller.
Jiang Li stared at him for several minutes before the stone in his heart fell to the ground.
God was on her side this time, and the lump really tilted to the right. She did it, or she bet right.
Professor Li Chunrong also had to sigh. The success of the operation was entirely due to luck. It was just a groping in the dark. No one thought about the consequences if the tumor tilted to the left.
If it were him, he would probably take a gamble, after all, saving the child is the most important goal.
"It is true that medicine is not a perfect science. As doctors, we sometimes need some experience and more luck!" Professor Li Chunrong shook his head and smiled.
Jiang Li looked at Ji Han, and said straightforwardly, "Can you entrust me with this child's operation?"
Ji Han didn't reply, and everyone moved into the small conference room to discuss the child's follow-up surgery. Aunt Jiang from the orphanage also walked in, her face full of anxiety and helplessness.
"Among childhood cancers, leukemia ranks first, followed by nervous system tumors, followed by bone tumors. It is indeed rare for this special cancer to belong to children's lung tumors. But in recent years, people with this kind of tumor The number of children is not only in China, but also in Japan, Europe and the United States and other countries are gradually increasing."
Ji Han looked at the doctors outside the tumor, his voice was low but unquestionable, "Professor Jiang came back from Anderson and has more experience in childhood cancer research than I do. I think this operation can be handed over to Professor Jiang." Surgeon, let me help her."
Tan Tan was a little dumbfounded, what a joke, when did the "God's Hand" from the No. [-] Tumor Hospital of Fudan University help someone?
However, the resident doctor for out-of-tumor surgery raised a question: "Professor Ji, what about the cost of surgery?"
Aunt Jiang from Tongxin Welfare Institute raised her heart in her throat.
Jiang Li looked at the resident doctor and asked, "Including postoperative chemotherapy, how much will it cost?"
The resident doctor continued: "A conservative estimate, it should be between 30 and 50. It's hard to say. Let's see the tumor resection after surgery and the effect of chemotherapy."
"It takes so much money!" Aunt Jiang of the Tongxin Welfare Institute frowned, "The courtyard...the courtyard may not be able to pay so much money. In order to extend Xiao Jiang Hao's life, the old director was under pressure and gave Little Jiang Hao got an injection, and that injection cost 70 yuan, the hospital has been stretched out of funds in the past two years, and cannot afford so much medical expenses."
"70?" Jiang Li looked at Ji Han suspiciously.
"It is the specific drug needed for the treatment of spinal muscular atrophy, Nosinagen Sodium Injection, launched by the American company Biogen. It is also the first and only approved specific drug for spinal muscular atrophy in China. In 2019 Listed in China, the price of one injection is about RMB 70, and some children need six injections a year. Imported drugs like this cost less than 6 yuan, because of the monopoly of foreign technology, coupled with huge research and development time and funds, so Once on the market, the price is very expensive. The Australian government and the Japanese government have included this drug in social security, but there is no such drug in China. The centralized procurement price of the Australian government is 200 Australian dollars, which is about 11 yuan. Patients who enjoy the Australian social security have one injection. The price is about 55 yuan, and after the Japanese government includes it into social security, it is almost free, while the unit price in the United States is 280 US dollars per injection, which is more expensive than domestic ones.”
"In fact, there is another drug for the treatment of SMA, called Zolgensma. It was launched by the pharmaceutical company Novartis, priced at US$210 million per injection, and is also known as 'one of the most expensive drugs in the world.'"
Jiang Li frowned: "Is there no other way to solve the cost?"
Tan Tan's eyes brightened: "Our hospital has a children's rescue fund, maybe you can try to apply for a fund subsidy!"
Ji Han lowered his eyes and made no sound.
Sun Renyi looked at the silent people, coughed, and said: "The child is suffering from SAM type III spinal muscular atrophy. At the age of six, he had already developed symptoms of generalized muscle weakness. At present, he can no longer walk upright. He can only walk upright. Traveling in a wheelchair, if you inject special drugs every year, your life expectancy may be extended to 30 years old, but with the operating status of the Tongxin Welfare Institute, I am afraid that you cannot pay this huge amount of medical expenses, and the child's life expectancy will be greatly reduced. They may even die at any time due to respiratory muscle paralysis or systemic failure..."
Jiang Li looked at him, "What does Director Sun mean, because the child's future survival space is limited, so we have to give up the operation and let him die?"
Sun Renyi simply opened up and said: "Professor Jiang just came, and he may not know the situation in the hospital. It is true that there is a children's relief fund in the hospital, but the funds and quota are limited each year. Most of the places are given to those from outside the hospital. There are almost no places left for children with leukemia. I mean, compared with those children with leukemia, their living space is higher, and the medical resources in the hospital are limited. We should reserve resources for patients with higher living space in patients, not in patients who may lose their lives at any time."
Jiang Li seemed to be filled with righteous indignation: "Director Sun, this child is only 6 years old, even if he can only live to be 30 years old, there are still 24 years left. Yes, with our current level, this disease cannot be cured, but with With the ever-changing medical level in China and the world, who can say that we will not break through the cure for spinal muscular atrophy in the past 24 years? He is only 6 years old, and his life and future may not be grand. There are many possibilities, our children can lose their lives due to various diseases, but they cannot lose their lives because they have no money for medical treatment! Otherwise, this is the greatest tragedy of society!"
Sun Renyi shook his head: "Professor Jiang, this is the reality. Economic toxicity is the only problem in the medical field. To put it bluntly, there is only one disease in this world, and that is the disease of poverty. Professor Jiang can cure childhood cancer. Is it possible that he can cure childhood cancer?" Can 'poverty' be cured?"
"In addition, the chief director of the oncology department cooperated with saman technology company to introduce the third-generation DK immunotherapy of saman company's European and American laboratories, embezzling most of the funds in the hospital, so the children's relief fund in the hospital is even more tense."
Jiang Licai did not know the situation in the courtyard, and looked at Ji Han suspiciously.
Ji Han looked at Jiang Li, and said softly, "I'll talk to you about this matter alone later. If you want to insist on this operation, you can apply for the children's subsidy fund in the hospital."
Sun Renyi got up: "I've said everything I need to say, and it has nothing to do with our surgical emergency department. It's up to you to decide what kind of decision to make!"
…………
By the time Ji Han and Jiang Li came out of the conference room, the sky outside was already bright.
Along the direction of the corridor, bright light shines on the marble floor of the hospital through the windows, and one can see not far away at a glance, the white building is rippling with large expanses of green vegetation.
Ji Han changed his white coat, and walked towards Jiang Li by the window with two bottles of water in his hand, his tall and thin figure cast a long shadow on the ground.
He took off the blue mask under the gold-rimmed glasses frame, exposing the thin corners of his lips, handed over the mineral water in his hand, and said, "We haven't seen each other for seven years, why don't you come back to China this time?" Tell me in advance so I can pick you up at the airport."
Jiang Li said thank you, stood in front of the floor-to-ceiling windows overlooking the distant scenery of Danyi, Pudong, Shanghai, flocks of white pigeons soared past the buildings in the distance of the hospital, and then his eyes fell on the huge slogan posted on the square of the Cancer Hospital superior:
There is no need for obituaries here, only protest!
"Before the teacher went to Anderson to find me, hoping that I would return to Shanghai to develop. At that time, I was a little hesitant, but now I am glad that I made the right decision, especially after meeting Xiaojiang Hao, which made me more determined. The idea of returning to Shanghai. I was thinking just now, if we have a special drug for spinal muscular atrophy independently developed in our country, does that mean that many children like Xiao Jiang Hao will not be forced to do so in the face of money and life and death? Have you made a choice? If our country has this kind of self-developed domestic specific medicine, it may only need [-] or even [-] injections, then these children will have a grander future, and what will their lives be like? Wonderful? Medicine does have no borders, but doctors and scientific researchers do!"
Looking at the sky, Jiang Li's gaze became firmer: "The teacher's words are right, we experts who have devoted our lives to the research of childhood cancer, can't just sit still!? Are we going to wait for Lei Yifeng from the United States, Come to save our Chinese children?"
"In the past, there was no such medicine. It was a collective dilemma faced by human beings. We can blame the world if we can't save the child, but what about now?"
Jiang Li's eyes were full of firmness. She turned her head and looked at Ji Han, who was a head taller behind her, "I decided to perform this operation for little Jiang Hao. The Children's Relief Fund cannot be misappropriated by the chief director of the oncology department. As far as I know Saman's third-generation DK immunotherapy is already a cold meal that was fried in Europe and the United States more than ten years ago. Even American laboratories have declared that the experiment has failed. Why should the hospital cooperate with saman technology company to introduce it? Even at the expense of embezzling children in the hospital The cost of the rescue fund!?"
Ji Han looked away, and said softly: "You just came back, the situation in the hospital is a bit complicated, I will tell you in detail after you get hired, by the way, you haven't found a place to live yet, why don't you go home Stay here, your room has never been touched, and it still retains its original appearance..."
(Note: In December 2021, after negotiations between the National Medical Insurance Administration of China and Biogen Corporation of the United States, the special drug for the treatment of spinal muscular atrophy, Nosinagenat, will be officially included in the national medical insurance of China, and the out-of-pocket expenses may be reduced to 12. Within 10 yuan, domestic children suffering from spinal muscular atrophy have entered the era of affordable medicine, saying goodbye to the "choice of life and death".)
(End of this chapter)
In the ward of the emergency room, Ji Han glanced at Jiang Li and reconfirmed the operation procedure: "In a moment, I will talk to Tan to hold on to the child, and Dr. Zhang from the tumor department will perform local anesthesia between the ribs, while Professor Jiang will be in charge of treating the child. The right pleural cavity is opened and the fluid is pumped. Just in case, we will try our best to maintain the child's body posture during the operation to ensure that the mass will not move to the left, but there are still risks. At the moment when the right pleural effusion is evacuated, who of us There is no guarantee of the moving direction of the tumor, so are you sure you want to continue with this operation?"
Jiang Li has already put on white rubber gloves, "I, Jiang Li, have never regretted it in my dictionary. Now that I have made a decision, I have no doubts."
Soon, Ji Han and Tan Tan held Xiao Jiang Hao tightly, and the anesthetist from the tumor injected local anesthetic between his ribs.
Holding a pointed scalpel in his hand, Jiang Li opened an opening in Xiao Jianghao's right chest, and inserted a 45cm long catheter from Lu Jiajia's hand.
In an instant, a large amount of blood continuously poured into the glass container from the slender transparent tube.
Everyone held their breath at this moment.
As the right pleural effusion was emptied, everyone stared at Xiao Jianghao uneasily. No one knew whether the lump in his chest was moving to the left or to the right at this moment?
Little Jiang Hao looked at the crowd in confusion, and suddenly seemed to be greatly relieved. His breathing immediately became much easier, and even the rales in his lungs became much smaller.
Jiang Li stared at him for several minutes before the stone in his heart fell to the ground.
God was on her side this time, and the lump really tilted to the right. She did it, or she bet right.
Professor Li Chunrong also had to sigh. The success of the operation was entirely due to luck. It was just a groping in the dark. No one thought about the consequences if the tumor tilted to the left.
If it were him, he would probably take a gamble, after all, saving the child is the most important goal.
"It is true that medicine is not a perfect science. As doctors, we sometimes need some experience and more luck!" Professor Li Chunrong shook his head and smiled.
Jiang Li looked at Ji Han, and said straightforwardly, "Can you entrust me with this child's operation?"
Ji Han didn't reply, and everyone moved into the small conference room to discuss the child's follow-up surgery. Aunt Jiang from the orphanage also walked in, her face full of anxiety and helplessness.
"Among childhood cancers, leukemia ranks first, followed by nervous system tumors, followed by bone tumors. It is indeed rare for this special cancer to belong to children's lung tumors. But in recent years, people with this kind of tumor The number of children is not only in China, but also in Japan, Europe and the United States and other countries are gradually increasing."
Ji Han looked at the doctors outside the tumor, his voice was low but unquestionable, "Professor Jiang came back from Anderson and has more experience in childhood cancer research than I do. I think this operation can be handed over to Professor Jiang." Surgeon, let me help her."
Tan Tan was a little dumbfounded, what a joke, when did the "God's Hand" from the No. [-] Tumor Hospital of Fudan University help someone?
However, the resident doctor for out-of-tumor surgery raised a question: "Professor Ji, what about the cost of surgery?"
Aunt Jiang from Tongxin Welfare Institute raised her heart in her throat.
Jiang Li looked at the resident doctor and asked, "Including postoperative chemotherapy, how much will it cost?"
The resident doctor continued: "A conservative estimate, it should be between 30 and 50. It's hard to say. Let's see the tumor resection after surgery and the effect of chemotherapy."
"It takes so much money!" Aunt Jiang of the Tongxin Welfare Institute frowned, "The courtyard...the courtyard may not be able to pay so much money. In order to extend Xiao Jiang Hao's life, the old director was under pressure and gave Little Jiang Hao got an injection, and that injection cost 70 yuan, the hospital has been stretched out of funds in the past two years, and cannot afford so much medical expenses."
"70?" Jiang Li looked at Ji Han suspiciously.
"It is the specific drug needed for the treatment of spinal muscular atrophy, Nosinagen Sodium Injection, launched by the American company Biogen. It is also the first and only approved specific drug for spinal muscular atrophy in China. In 2019 Listed in China, the price of one injection is about RMB 70, and some children need six injections a year. Imported drugs like this cost less than 6 yuan, because of the monopoly of foreign technology, coupled with huge research and development time and funds, so Once on the market, the price is very expensive. The Australian government and the Japanese government have included this drug in social security, but there is no such drug in China. The centralized procurement price of the Australian government is 200 Australian dollars, which is about 11 yuan. Patients who enjoy the Australian social security have one injection. The price is about 55 yuan, and after the Japanese government includes it into social security, it is almost free, while the unit price in the United States is 280 US dollars per injection, which is more expensive than domestic ones.”
"In fact, there is another drug for the treatment of SMA, called Zolgensma. It was launched by the pharmaceutical company Novartis, priced at US$210 million per injection, and is also known as 'one of the most expensive drugs in the world.'"
Jiang Li frowned: "Is there no other way to solve the cost?"
Tan Tan's eyes brightened: "Our hospital has a children's rescue fund, maybe you can try to apply for a fund subsidy!"
Ji Han lowered his eyes and made no sound.
Sun Renyi looked at the silent people, coughed, and said: "The child is suffering from SAM type III spinal muscular atrophy. At the age of six, he had already developed symptoms of generalized muscle weakness. At present, he can no longer walk upright. He can only walk upright. Traveling in a wheelchair, if you inject special drugs every year, your life expectancy may be extended to 30 years old, but with the operating status of the Tongxin Welfare Institute, I am afraid that you cannot pay this huge amount of medical expenses, and the child's life expectancy will be greatly reduced. They may even die at any time due to respiratory muscle paralysis or systemic failure..."
Jiang Li looked at him, "What does Director Sun mean, because the child's future survival space is limited, so we have to give up the operation and let him die?"
Sun Renyi simply opened up and said: "Professor Jiang just came, and he may not know the situation in the hospital. It is true that there is a children's relief fund in the hospital, but the funds and quota are limited each year. Most of the places are given to those from outside the hospital. There are almost no places left for children with leukemia. I mean, compared with those children with leukemia, their living space is higher, and the medical resources in the hospital are limited. We should reserve resources for patients with higher living space in patients, not in patients who may lose their lives at any time."
Jiang Li seemed to be filled with righteous indignation: "Director Sun, this child is only 6 years old, even if he can only live to be 30 years old, there are still 24 years left. Yes, with our current level, this disease cannot be cured, but with With the ever-changing medical level in China and the world, who can say that we will not break through the cure for spinal muscular atrophy in the past 24 years? He is only 6 years old, and his life and future may not be grand. There are many possibilities, our children can lose their lives due to various diseases, but they cannot lose their lives because they have no money for medical treatment! Otherwise, this is the greatest tragedy of society!"
Sun Renyi shook his head: "Professor Jiang, this is the reality. Economic toxicity is the only problem in the medical field. To put it bluntly, there is only one disease in this world, and that is the disease of poverty. Professor Jiang can cure childhood cancer. Is it possible that he can cure childhood cancer?" Can 'poverty' be cured?"
"In addition, the chief director of the oncology department cooperated with saman technology company to introduce the third-generation DK immunotherapy of saman company's European and American laboratories, embezzling most of the funds in the hospital, so the children's relief fund in the hospital is even more tense."
Jiang Licai did not know the situation in the courtyard, and looked at Ji Han suspiciously.
Ji Han looked at Jiang Li, and said softly, "I'll talk to you about this matter alone later. If you want to insist on this operation, you can apply for the children's subsidy fund in the hospital."
Sun Renyi got up: "I've said everything I need to say, and it has nothing to do with our surgical emergency department. It's up to you to decide what kind of decision to make!"
…………
By the time Ji Han and Jiang Li came out of the conference room, the sky outside was already bright.
Along the direction of the corridor, bright light shines on the marble floor of the hospital through the windows, and one can see not far away at a glance, the white building is rippling with large expanses of green vegetation.
Ji Han changed his white coat, and walked towards Jiang Li by the window with two bottles of water in his hand, his tall and thin figure cast a long shadow on the ground.
He took off the blue mask under the gold-rimmed glasses frame, exposing the thin corners of his lips, handed over the mineral water in his hand, and said, "We haven't seen each other for seven years, why don't you come back to China this time?" Tell me in advance so I can pick you up at the airport."
Jiang Li said thank you, stood in front of the floor-to-ceiling windows overlooking the distant scenery of Danyi, Pudong, Shanghai, flocks of white pigeons soared past the buildings in the distance of the hospital, and then his eyes fell on the huge slogan posted on the square of the Cancer Hospital superior:
There is no need for obituaries here, only protest!
"Before the teacher went to Anderson to find me, hoping that I would return to Shanghai to develop. At that time, I was a little hesitant, but now I am glad that I made the right decision, especially after meeting Xiaojiang Hao, which made me more determined. The idea of returning to Shanghai. I was thinking just now, if we have a special drug for spinal muscular atrophy independently developed in our country, does that mean that many children like Xiao Jiang Hao will not be forced to do so in the face of money and life and death? Have you made a choice? If our country has this kind of self-developed domestic specific medicine, it may only need [-] or even [-] injections, then these children will have a grander future, and what will their lives be like? Wonderful? Medicine does have no borders, but doctors and scientific researchers do!"
Looking at the sky, Jiang Li's gaze became firmer: "The teacher's words are right, we experts who have devoted our lives to the research of childhood cancer, can't just sit still!? Are we going to wait for Lei Yifeng from the United States, Come to save our Chinese children?"
"In the past, there was no such medicine. It was a collective dilemma faced by human beings. We can blame the world if we can't save the child, but what about now?"
Jiang Li's eyes were full of firmness. She turned her head and looked at Ji Han, who was a head taller behind her, "I decided to perform this operation for little Jiang Hao. The Children's Relief Fund cannot be misappropriated by the chief director of the oncology department. As far as I know Saman's third-generation DK immunotherapy is already a cold meal that was fried in Europe and the United States more than ten years ago. Even American laboratories have declared that the experiment has failed. Why should the hospital cooperate with saman technology company to introduce it? Even at the expense of embezzling children in the hospital The cost of the rescue fund!?"
Ji Han looked away, and said softly: "You just came back, the situation in the hospital is a bit complicated, I will tell you in detail after you get hired, by the way, you haven't found a place to live yet, why don't you go home Stay here, your room has never been touched, and it still retains its original appearance..."
(Note: In December 2021, after negotiations between the National Medical Insurance Administration of China and Biogen Corporation of the United States, the special drug for the treatment of spinal muscular atrophy, Nosinagenat, will be officially included in the national medical insurance of China, and the out-of-pocket expenses may be reduced to 12. Within 10 yuan, domestic children suffering from spinal muscular atrophy have entered the era of affordable medicine, saying goodbye to the "choice of life and death".)
(End of this chapter)
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