Oncology Physician Life

Chapter 76 Chapter 75 An Eight-Year-Old Liver Cancer Patient

The next morning, Ji Han had just finished the morning MDT academic meeting and was walking back from the corridor of the oncology department. Qi Song, the director of oncology surgery who was with him, looked at the shade of the park behind the hospital in surprise.

"Isn't that Professor Jiang and Dr. Gu Jun from the Thoracic Surgery Department?"

From the corner of Ji Han's eyes, he glanced at the tree-lined path in the park. Gu Jun was holding Jiang Li's messy hair behind his ears, and his movements were quite intimate.

The two stopped in front of the glass and looked under the lush tree canopy in the park. Even from a distance, they could clearly see the intimate movements of the two under the shade, like a couple in love.

Qi Song showed a clear look on his face: "I said why Gu Jun from the thoracic surgery department has always been running to our oncology department during this period of time. It turns out that this kid is a drunkard who doesn't care about drinking. Let alone, the two of them are together. It's a good match, isn't it, Professor Ji?"

"Director Qi, I'm afraid that Corey's scientific research indicators this year have not fulfilled the goals set by the chief director?"

Ji Han glanced at the two people talking and laughing in the park, and looked away, "If you have time, director, why don't you think about how to complete the task, we're going to apply for scientific research outside, but there is a problem in the hospital. The so-called 'big problem', I have an operation this afternoon, but I don't have time to accompany you here to watch other people have sex!"

"Scientific research..."

Just as Qi Song was about to speak, when he raised his head, Ji Han had already walked a long distance.He glanced at the sweet scene in the park downstairs, and looked at Ji Han's back, his expression a little confused.

"I didn't say anything? What's wrong with this kid? Why are you angry at me!"

In the park, Jiang Li saw that Gu Jun was about to reach out to help him tidy up his messy shirt collar, and took half a step back in fright.

The movements of Gu Jun's hands were in vain, and he froze in mid-air. The unnatural expression on his face was fleeting, and he smiled softly: "Why, why am I so scary? Besides, we are boyfriend and girlfriend, Isn't it normal for a boyfriend to button his girlfriend's shirt?"

Jiang Li frantically pushed aside the misplaced slit of the collar of his shirt, and said softly, "It's not good for people to see."

Gu Jun frowned. During this period of time, he always felt that the relationship between the two was abnormal.

Jiang Li always finds excuses to perfuse himself, the two seem to be incomparable to the intimacy of friends, and Jiang Li always gives him a "polite" feeling every time they go on a date for dinner or when they are alone.

This feeling made him very uncomfortable.

"Jiang Li, today is exactly one month since our relationship was established. I ordered a western restaurant that you like to eat tonight. How about..."

Before Gu Jun finished speaking, Jiang Li's cell phone in his white coat pocket rang, and it was Yang Xiaolan calling.

"Professor Jiang, the emergency surgery department needs to come here immediately. There is a special patient who may want you to take a look."

Jiang Li hung up the phone and smiled softly at Gu Jun: "Next time, next time I will treat you to dinner. I have something to do here, so I will leave first."

Gu Jun swallowed the last half of the sentence that he hadn't spoken yet, and squeezed out a smile: "Then go and get busy, I don't have anything to do here, I'll talk about it later."

Jiang Li nodded, turned around and trotted towards the emergency department.

Looking at the back of Jiang Li running away in a hurry, Gu Jun showed a disappointed look on his face, crumpled up the movie ticket in his pocket, and threw it into the trash can in the park.

emergency surgery.

When Jiang Li hurried in, Sun Renyi, the director of the emergency department, was standing in front of a boy with white rubber gloves on his hands, and kept filling his mouth with gauze.

The boy was wearing shabby casual clothes, he was young, probably not yet an adult, his mouth was opening, and his brows were wrinkled in pain.

Sun Renyi's rubber gloves were covered with blood, and the white medical gauze had just been stuffed into the boy's mouth, and was soon soaked in the blood that gushed out continuously.

Jiang Li glanced at the big beach of blood splashed on the ground, and found that the boy's mouth was severely swollen, and blood kept gushing out of the boy's mouth, while Sun Renyi kept filling the gauze to block the blood, making the boy's cheeks look like squirrels Like, bulging.

Yang Xiaolan transferred the boy's past medical history and introduced to Jiang Li: "The patient is a 17-year-old male. During military training four months ago, he experienced intermittent pain in the right side of the cheek, which gradually turned into persistent pain. It is suspected to be jaw pain. Osteosarcoma recurrence."

"Recurrence? Patient had osteosarcoma before?"

Jiang Li took the medical history and glanced at it.

Yang Xiaolan nodded: "Two years ago, the patient was diagnosed with osteosarcoma of the jaw, and he underwent surgical resection after admission. Postoperative anti-inflammation, hemostasis, swelling and other symptomatic and supportive treatments, no chemotherapy, and no signs of tumor recurrence after discharge, but Four months ago, the osteosarcoma of the jaw recurred again, and it was the second metastatic recurrence after surgery."

"Osteosarcoma of the jaw is a highly malignant tumor in medicine. At his age, there is about a 5% chance of growing on the jaw, which is usually induced by injury or radiation. For malignant tumors, it is just a simple operation, and the chance of recurrence is very high."

Sun Renyi stuffed gauze into the boy's mouth while explaining.

Jiang Li glanced at the bloody mess in the boy's mouth, frowned and asked, "Even if the osteosarcoma relapsed, it wouldn't be like this, would it?"

As she spoke, she took the penlight in the upper pocket of the white coat and took a picture of the boy's mouth, and found a deep incision on the soft palate of the boy's mouth.

"Is this a knife wound?"

Sun Renyi took off the blood-stained rubber gloves and explained: "This kid is so bold. I used a laboratory scalpel at school to cut off the tumor in my mouth abruptly, causing massive bleeding in the soft palate in the cavity. .”

Jiang Li was taken aback by Sun Renyi's words, and looked at the gentle and gentle young man in front of him. He never thought that the other party would be so courageous that he would dare to cut the tumor himself.

Yang Xiaolan added in a low voice: "He is a medical student, or the teacher at his school found out that he was bleeding from the mouth and sent him to the hospital. When he was discovered, he had just performed surgery on himself in the laboratory of the medical school. Tools such as anesthetics, surgical scissors, and scalpels were also found at the scene. The school teacher said that the child shone a flashlight on his mouth and looked in the mirror, and cut off the egg-sized sarcoma in his mouth little by little. As a result, I cut my own soft palate, and the bleeding couldn't stop."

Jiang Li glanced at the boy with low eyebrows and pleasing eyes, sighed, and said to Yang Xiaolan: "Take him to clean the wound first, and do an MRI in the mouth by the way. After the film comes out, let the radiotherapy department and tumor surgery department The doctor came to the emergency department, let's meet up."

Yang Xiaolan nodded, helped the boy with severely swollen cheeks, and walked towards the treatment room.

After Sun Renyi washed his hands, he turned around and looked at Jiang Li, and said, "Professor Jiang has no doubts?"

"What do you suspect?" Jiang Li asked curiously.

Sun Renyi smiled: "Since this boy had a second recurrence of osteosarcoma, why did he wait until the tumor grew so large that he cut it off in the school's laboratory instead of coming to the hospital for surgery?"

After thinking about it for a while, Jiang Li understood the meaning of Sun Renyi's words.

The nurse at the side didn't understand, and asked curiously, "Professor Jiang, why?"

Jiang Li sighed: "This kind of osteosarcoma is mostly composed of tumorous osteoblasts, tumorous bone-like tissue and tumor bone. Osteogenic osteosarcoma with more mature differentiation and more tumor bone is called osteosarcoma. Lower; the differentiation is more primitive or embryonic, and the tumor with less bone is called osteolytic osteosarcoma, which has a higher degree of malignancy. Like this one that grows on the jaw, it should be the type with less tumor bone, and it is easy Repeated recurrence, simple surgery can no longer be completely cured."

Just in time, Yang Xiaolan came back with the scanned film, handed it to Jiang Li, and continued: "I heard from the teacher at the boy's school that when this child was studying two years ago, he had osteosarcoma removed on the left jaw. The family's economic conditions are not very good, and the teachers and students in the school donated money to solve the problem of surgery costs. Who would have thought that just two years ago, the tumor had metastasized to the right jawbone. This child should be afraid of the cost of surgery. Too much burden, so I secretly cut out the sarcoma in the school laboratory."

Jiang Li took the film into the emergency surgery office, and pasted the film on the map reader.

After a while, the consultant doctor from the tumor surgery department also arrived.

Ji Han walked in with Xu Youshu and Shu Yusheng, two interns.

Ji Han casually glanced at Jiang Li's figure from the corner of his eye, and then found a seat in the office to sit down and read the medical history.

Jiang Li glanced at the location of the tumor recurrence on the film: "The patient's osteosarcoma metastasized and recurred for the second time. The first time was on the left jaw. Chemotherapy, but judging from this recurrence, the effect of surgery at that time may not be so ideal."

Shu Yusheng looked at the film, raised his hand, and said, "Can we use neoadjuvant chemotherapy? Do preoperative chemotherapy first, and check the tumor necrosis rate based on the resected sarcoma section to see the effect of chemotherapy before deciding whether to proceed with surgery." ?”

Ji Han shook his head: "For the chemotherapy of osteosarcoma, large doses of methotrexate, cisplatin, ifosfamide, and doxorubicin will be used. Prolonged chemotherapy will also seriously damage the child's liver and kidney functions." Influence."

Zhao Lihua, deputy director of the Radiation Therapy Department, also arrived. After hearing the suggestion from the tumor surgery department, he said, "I think we can try it. Now the patient has cut off the sarcoma on the oral and maxillary bone, and it is still uncertain whether the tumor is If it is transferred to other places, you can use drugs such as MTX (methotrexate), ADM (doxorubicin), CDP (cisplatin), VCR (vincristine), and IFO (ifosfamide) for two months of brief chemotherapy. After confirming that the patient’s liver and kidney functions are normal and that the platelets and neutrophils have returned to normal levels, it is time to decide whether to follow up with chemotherapy or surgery? After all, simple surgery is not the best for this kind of osteosarcoma that is easy to relapse and metastasize. Good plan."

Jiang Li nodded: "I agree with Director Zhao. From the perspective of this patient, the combined treatment plan of chemotherapy + surgery + postoperative chemotherapy is the best. Moreover, the purpose of chemotherapy is to improve the long-term survival rate of the patient and reduce the risk of death. The incidence of fatal distant metastases, although it has a certain toxic effect, should also consider the economic conditions of the patient's family. Solving the tumor once and for all is the best solution for this child! Avoid just cutting it off like the previous time He had sarcoma, but it recurred every two years, and finally the patient was forced by financial pressure to secretly cut off the sarcoma himself, which is a shocking thing.”

The three departments met briefly, and after confirming the treatment plan, Jiang Li asked the nurse to notify the family members in other places to come over as soon as possible, and ended the short consultation.

She glanced at Ji Han who was walking ahead without saying a word, and hurriedly chased after him.

"Why are you walking so fast?"

Jiang Li glanced at Ji Han who was expressionless, and asked, "Xiao Nan just sent me a message, asking if we want to go to her house tonight, she prepared a barbecue."

Ji Han didn't look sideways, and his expression was very cold: "I don't have time, so go and do it yourself!"

Seeing Ji Han's rather indifferent attitude, Jiang Li frowned, and muttered: "Who messed with him? How crazy is this!"

In the evening, Jiang Li made an appointment with Pei Xiaonan to have a party at her house, and after changing clothes in the office, he was about to get off work, and came to the elevator to wait, when he saw Director Zhao from the Department of Hepatobiliary Surgery leading a group of doctors, walking towards the hospital in a hurry. Run upstairs.

Head nurse Sun passed by with the doctor's order, glanced upstairs, looked at Jiang Li and said, "The patient from the hepatobiliary surgery department got lost again!"

"Lost it?" Jiang Li asked curiously.

Head Nurse Sun nodded: "Hepatobiliary Surgery admitted a special patient half a month ago. He was transferred from a hospital in Shandong. The child was only eight years old, and his stomach was as hard as a stone. His belly was swollen. When he went to the hospital for an examination, he had liver cancer. .”

"An eight-year-old patient with liver cancer?" Jiang Li couldn't help but be silent when he heard this.

Head nurse Sun sighed: "I've met that child a few times, he's so cute and mischievous, he doesn't want to stay in the ward peacefully every time, he jumps up and down, but Director Zhao from the Department of Hepatobiliary Surgery is exhausted. "

Jiang Li didn't think much, seeing the elevator coming, he walked in immediately.

In the elevator, an old man in his fifties clutched his heart, glared at his 50-year-old daughter-in-law, and blamed him face-to-face: "When you were pregnant, I advised you not to eat those messy things. You husband and wife despise me, an old lady, and don’t listen to my advice. Now the retribution is on my grandson. Such a small child will get liver cancer, which you brought from the womb. You didn’t pay attention when you were pregnant, and ate it. Those things that shouldn't be eaten made my grandson so sick at such a young age!"

The daughter-in-law was reprimanded face to face by her mother-in-law, but she was obedient and did not dare to speak out, she just sobbed choked up.

Jiang Li stood aside, looked up at the number of elevators going down, and wanted to argue with this "no common sense" mother-in-law. How could it be the mother's fault that the child had liver cancer?

But seeing the deep self-blame on the mother's face, Jiang Li resisted the impulse in his heart.

She smiled gently at the child's mother, took the initiative to hold the child's mother's hand, and said softly and firmly: "It's not your fault, you are a great mother, and the child is healthy and well. It's not your fault that you got sick, but at this time, you have to be stronger and not be defeated, you are the child's last support."

The young mother fell into deep self-blame at first, and also thought that she ate something bad when she was pregnant, which caused such a young child to get liver cancer.

But looking at the female doctor who had met several times in the elevator, and hearing her warm words of encouragement, her nose suddenly became sore: "Doctor, it's really not my fault that caused my child to have this disease? "

Jiang Li shook his young mother's cold hand, nodded solemnly: "Of course not, you have to believe what the doctor says."

The young mother forced a smile on her face, squeezed out a smile at Jiang Li, and said softly: "Thank you."

Jiang Li looked at the mother-in-law and daughter-in-law who got off the elevator, and suddenly said: "Don't worry, the child is still very young, even if he can't be operated on, he can still undergo liver transplantation. As long as the direct relatives are successfully matched, they can be transplanted to the child."

The young mother looked back at Jiang Li in the elevator, and nodded slightly at her.

Jiang Li looked at the closed elevator, and suddenly sighed in his heart.

She can understand the young mother's heart, on the one hand, she is worried about the child's illness, and on the other hand, it is the mother-in-law's constant blame and guilt towards the child.

Although what the mother-in-law said was unreasonable, and the child's illness was not directly related to what the mother ate during pregnancy, but to the young mother with a fragile heart, the mother-in-law's words were still like a knife, stabbing into the mother's heart!
If the child really passed away unfortunately, then the mother will probably live on the tip of a knife for the rest of her life because of these words.

The elevator door opened, and Jiang Li walked towards the outside of the hospital. When passing by the garden of the building, he saw an eight-year-old boy sitting on one end of a garden bench.

The boy seemed to notice Jiang Li, turned his head to make a face at Jiang Li, and laughed.

The scene here briefly dilutes the depression in Jiang Li's heart, and she is amused by the voice of this naughty child who can't help but laugh.

She recognized the child at a glance, most likely it was the special patient named Pengpeng who sneaked out from the Department of Hepatobiliary Surgery.

Jiang Li walked over, Pengpeng immediately made a silence gesture to Jiang Li, and motioned to his side.

It was only then that Jiang Li realized that there was a milky white kitten next to the little boy. He secretly took out the bread and milk in the ward and fed the kitten here.

Jiang Li patted his watermelon head: "You little naughty boy, did you sneak out because of it?"

Pengpeng hastily showed a smiling face: "Sister doctor, don't tell my mother, okay? You see Xiaobai is so pitiful. If I lose him, he will starve to death! He must have lost his mother. Without a mother , it is so pitiful!"

Jiang Li knelt down in front of him: "But if you sneak out, your grandma and mother will be anxious too!"

Pengpeng snorted coldly: "I don't want to go back. Every time my mother sees me, she will cry secretly. I don't want to make my mother sad because of me."

Jiang Li felt sore when he heard that, and said with a smile: "Then Pengpeng and the doctor should actively cooperate with the doctor to treat the illness. Only when the illness is cured can mother be happy!"

Pengpeng turned his head away: "Sister doctor, you are with those doctor uncles. You lied to me and refused to tell me what disease I have! My mother said that as long as I hang a few more bottles of water, I will be fine, but grandma is also here. I know I have cancer myself!"

Eight-year-old Pengpeng suddenly became agitated.

Jiang Li looked at the eight-year-old boy in shock, his eyes softened a lot, "Who did Peng Peng listen to?"

Pengpeng raised his head: "I secretly used my father's mobile phone to check online. I have liver cancer. It's incurable. You can't lie to me!"

"Pengpeng, you have to trust the doctors and uncles, this disease can be cured."

Just as Jiang Li was about to speak, Pengpeng's mother and grandma finally came over.

Panicked, Pengpeng stuffed the cat in his arms into Jiang Li's arms, ran out of the garden in a hurry, and did not forget to tell Jiang Li: "Sister doctor, you have to take good care of Xiaobai. Can I leave it with you temporarily?"

Although Jiang Li is allergic to cat fur, looking at Pengpeng's earnest and longing eyes, he still gritted his teeth and nodded: "Okay, I can help Pengpeng take care of it, but Pengpeng also promises me that he will treat the disease obediently. Sneak out again!"

Pengpeng bit his lip. Although he hesitated, he nodded and agreed, and then ran towards his mother.

Jiang Li looked at the little milk cat in her arms, but she was at a loss. She was allergic to animal hair, and she already felt her skin was itchy.

Just when she was at a loss, suddenly stretched out a pair of big hands from behind, and hugged the kitten in her arms.

Relieved, Jiang Li stood up and looked back, only to see Ji Han wearing a dark blue suit, holding the little milk cat in his arms.

She breathed a sigh of relief: "It's a good thing you're here, otherwise I really don't know what to do!"

Ji Han glanced at her reproachfully: "Obviously I'm allergic to cat fur, but I still pretend to be a hero and help others raise cats!"

A trace of shyness flashed across Jiang Li's face, pretending to be calm: "I'm also doing this to appease the patient!"

Ji Han didn't speak, and looked at the little milk cat in his arms: "I remember that Lao Wei's family has a dog, this kitten should be fostered in his house first!"

Jiang Li followed Ji Han, walking towards the outside of the hospital, and suddenly asked the patient in the hepatobiliary surgery department, "How is the eight-year-old liver cancer patient in the hepatobiliary surgery department?"

Ji Han glanced at her, did not hide anything, and said everything he knew: "Although the tumor on the child's liver has not metastasized, it is very malignant. Surgery cannot completely remove the lesion. Currently, the only option is liver transplantation. Both the father and the mother were matched, the father’s was unsuccessful, and the mother’s was successful, but the mother suffered from fatty liver, which failed to meet the qualified indicators in the MELD liver scoring system, and there was no suitable donor in the donor pool. The donor of..."

Jiang Li was stunned: "But now time is the most important thing for this eight-year-old child. It is necessary to find a suitable donor for transplantation before the cancer cells on the liver metastasize, otherwise..."

Ji Han: "Otherwise, once the cancer cells spread widely, this child will be sentenced to death!"

　Six thousand words, three chapters in one
　　
　
(End of this chapter)