White armor

Chapter 19 Hospital-wide consultation

Ten minutes later, Lin Yuming came in, holding an enamel jar and sitting on the podium with a smile on his face.

He looked around the entire lecture theater. Most of the clinical directors were there.

Dozens of directors, deputy directors, and responsible attending physicians represent the current backbone of the mine.

People had almost arrived, and Director Li from the Department of Gastroenterology was sitting in the front row, shivering.

Lin Yuming picked up the enamel jar, blew on the tea foam, and took a sip of water.

"We're almost here, let's start the hospital-wide consultation." Lin Yuming's voice came through the microphone, buzzing in the lecture theater.

"The general surgeon will report the medical history first."

There was silence in the lecture theater.

There are a lot of consultations in the whole hospital. It is said that it is the whole hospital, but in fact three or five related departments are already too many.With so many people gathered together today, there should be... no, there must be something fishy.

Everyone knew it and craned their necks to watch the excitement.

Chen Yong stood up bravely and tried to report the medical history on the spot, but Luo Hao stood at the microphone on the podium and waved to Chen Yong.

There was no way, Chen Yong hated Luo Hao at this moment.

When he came to Mike, Chen Yong took the medical record and began to report the patient's condition.

"The patient suffered from abdominal pain and general jaundice..."

Chen Yong's hand holding the medical record trembled a little. This was caused by excitement, excitement, and excessive secretion of adrenaline in his body, not because he was afraid.

After getting started, Chen Yong calmed down, his body had adapted to the adrenaline, his hands no longer trembled, and he became more fluent in speech.

A few minutes of medical history report, concise and quite capable.

After he entered the hospital, Jiang Wenming single-handedly led him, and his basic skills were solid and reliable.

Lin Yuming was very satisfied with the medical history reported by Chen Yong. It was detailed and highlighted.If all the young doctors at the mine were like him, it would really be a promising future.

"Now that the medical history report is over, which director would like to express his or her opinion first?" Lin Yuming asked.

Director Li of the Gastroenterology Department hesitated to stand up, but as soon as she moved, she saw Wen Youren striding onto the podium next to her.

"I'm going to start the conversation by saying a few words."

Wen Youren stared at Director Li fiercely, his eyes full of disdain, as if looking at a dead person.

"I just reported the medical history, and everyone has heard that the patient had a cholecystectomy 20 years ago." Wen Youren said loudly, "Twenty years, 20 years have passed. I don't know what the gastroenterology department thought and sent the patient to the hospital. Come to our general surgery department.”

"Could it be that the patient's gallbladder will grow again in 20 years and I, Old Wen, will need to go on stage to perform another surgery?"

"Director Li! The hospital and the Municipal Health Commission have issued repeated orders not to shirk patients and to implement the first-diagnosis responsibility system. How did you do it? You didn't understand the disease, so you just pushed the patient to your brother's department?!"

The smell of gunpowder filled everyone's mouths and noses. Even the doctor with the slowest perception was looking at Director Wen in stunned silence at this moment.

This is not a hospital-wide consultation. This is clearly Wen Youren venting his personal anger.

It seems a bit excessive, some directors and responsible attending physicians thought.

But when they saw Director Lin Yuming calmly drinking tea from an enamel jar, they felt helpless.

Wen Youren was looking for an endorsement from the medical office to give the Department of Gastroenterology a good look.

Ugh.

They are all colleagues, so why bother.

"The patient has a liver abscess. I think this is the reason why the Department of Gastroenterology referred the patient to me. Director Li, please sit down first and politely listen to what I have to say." Wen Youren's words began to become wild.

He also caught a glimpse of Lin Yuming's little actions and thought that Director Lin was indulging him, so he became more and more unscrupulous.

"What to do with liver abscess? Surgery? Are you not afraid of postoperative sepsis? To treat liver abscess, puncture! Puncture!! Puncture!!!"

"In the Sanji training, every doctor must master the puncture technique. You don't have to be transferred to our general surgery department to be able to treat it. Don't say you, Li Shumei, can't do it!"

Wen Youren has already started naming people.

Director Li's face turned red and white for a while, and he almost cried out of anger.

"The patient was referred to me in the general surgery department with ulterior motives! If I go on stage to perform an operation, and the patient has a high fever and has to be admitted to the ICU after the operation, who is responsible for Li Shumei or me, Lao Wen!!"

"I am a surgical department here, and the proportion of medicines is low. The patients are likely to have complications such as sepsis and need high-level antibiotics. You are passing the trouble to others and leaving the most cost-effective patients in your gastroenterology department!"

"Shameless!!"

Wen Youren's words became more and more cruel, and he even said things that he would not normally say such as cost-effectiveness. In the end, he even cursed outright.

"I……"

Director Li of the Department of Gastroenterology wanted to refute, but there was no microphone in front of her, and her voice was like the buzz of mosquitoes in the lecture theater, so she could ignore it.

"You're kidding!" Wen Youren continued to accuse, "You are trying to blame the patient, and you have not accurately implemented the spirit of the documents of the Municipal Health Commission and the General Medical Office of the mine. You are irresponsible to the General Manager of the mine, the dean, and Director Lin. The leader is irresponsible!!”

All the directors present were dumbfounded. Everyone knew that Lao Wen had a bad temper.

But no one expected that Wen Youren would go crazy this time. With the support of the medical department, he would not mention the patient's condition at all and pointed the finger at the Department of Gastroenterology.

The conflict between the general surgery department and the gastroenterology department has been going on for a long time. Everyone knew about this, but they never expected that Wen Youren would use the hospital-wide consultation to attack the gastroenterology department.

"Director Li, please tell me about your condition." Lin Yuming interrupted Wen Youren.

If you continue talking, you may be scolded, but Lin Yuming has been controlling the rhythm.

Wen Youren looked at the short Director Li with disdain.

Director Li was so angry that his blood pressure rose. He stepped onto the podium and calmed down for a full 2 ​​minutes.

These 2 minutes were extremely embarrassing.

The lecture hall was quiet, and everyone stared at her. A few doctors who were familiar with the director of the Department of Gastroenterology wanted to stand up and say something to her, but they gave up after thinking for a long time.

"The patient's condition is very complicated. The B-ultrasound shows a liver abscess complicated by pneumobiliary tract. I think it may be caused by local inflammation."

"What kind of inflammation?" Wen Youren asked loudly, "The gallbladder has been removed and there are no clear stones in the bile duct. Where do you think the inflammation came from? It's not from liver abscess!"

"Besides, if inflammation can be solved internally, what does it have to do with surgery?!"

Wen Youren's attitude was aggressive.

Although there was no microphone, his voice was so loud that it made the director of gastroenterology breathless.

Luo Hao stood by the curtain and watched all this.

Director Li did not give a strong counterattack when facing the aggressive Wen Youren.

It seems that Director Li did not know about cesspool syndrome. She just relied on many years of clinical experience to judge that the patient might be related to the cholecystectomy 20 years ago.

But if she was asked to explain why in detail, Director Li was unable to do so.

You still have to take action yourself.

Luo Hao looked at Lin Yuming. After a while, Lin Yuming saw that Director Li had stopped talking. He was so embarrassed that his face turned red, and he also looked at Luo Hao.

Looking into each other's eyes, Luo Hao nodded.

Lin Yuming took his hand away from the enamel jar, put it under the table, and made a cutting motion.

Luo Hao nodded seriously.

"Director Li, please take a rest first. We are all colleagues in the hospital. Some minor conflicts are normal. Director Wen does not need to go online."

Wen Youren looked proud, as if he had won a big victory.

"Can anyone please talk to the director? Let's talk about the condition first." Lin Yuming was not in a hurry and looked around.

No one spoke, it was silent.

After a few seconds, Lin Yuming nodded, holding the enamel jar in both hands, "Then our medical office will give us their opinions for everyone's reference."

Ok?
The directors were stunned for a moment.

The medical office gives its opinion?
The medical office is only responsible for presiding over the whole-hospital consultation, leaving relevant departments to stop kicking the ball.

Why did the referee have to leave the game?
Luo Hao walked onto the podium, and the audience was in an uproar.

There was a time when everyone was full of expectations for this young doctor from Xiehe, but Luo Haolai had been in the mine for nearly two years and remained unknown, so that everyone had forgotten that this person existed.

Luo Hao has been a bit active recently, but the only relevant departments are obstetrics and gynecology and general surgery, and not many others know about it.

Luo Hao opened his laptop, connected the projector, and opened the ppt.

Yo!

major! !
The eyes of the directors and attending physicians in the audience lit up.

This was the behavior of the experts and professors at the annual academic conference. I didn't expect to see it in the hospital-wide consultation.

The consultation time in the whole hospital is tight, and I have never seen anyone using ppt.

This time it was really eye-opening.

"Hello everyone, directors. On behalf of the Medical Department, I will talk about this case. Please point out any deficiencies."

Luo Hao said loudly.

The smile on his face was warm, genial and sincere, like a ray of sunshine shining into everyone's heart.

The hostility that Wen Youren brought to everyone just now was swept away.

"Dr. Chen just reported the medical history, we skipped this part." Luo Hao said, "Here is the magnetic resonance cholangiopancreatography, or MRCP, that the patient had done five hours ago."

The image appears on the screen.

"Biliary-intestinal communication can be seen between the proximal duodenum and the common bile duct, and there are ill-defined low-signal filling defects in the intrahepatic and extrahepatic bile ducts..."

Luo Hao began to talk about the magnetic resonance cholangiopancreatography film.

This paragraph involves profound content in the field of imaging. Even if the people present here are directors of various departments and responsible attending physicians, the number of people who can understand it can be counted on one hand.

Let alone understand, not many people can understand Luo Hao's explanation.

"To summarize, magnetic resonance cholangiopancreatography shows the presence of intestinal contents at the choledochoduodenal anastomosis."

Intestinal contents.

Anastomosis...

After a brief moment of confusion, the directors present all frowned.

"Anastomosis? What anastomosis? The patient himself said that he had a cholecystectomy 20 years ago. Where did the anastomosis come from?" Wen Youren asked in surprise.

In an instant, countless memories emerged in Wen Youren's mind, and he realized that there might be a problem.

"Yes, the anastomosis." Luo Hao smiled slightly, "In the past history, Director Wen's description was wrong."

error!

Incorrect! !

Luo Hao bluntly pointed out that Wen Youren made a mistake! ! !
The smile on Wen Youren's face turned into ice in an instant, and it was frighteningly green. Luo Hao's words confirmed some of his guesses.

"Impossible! The patient complained that he had a cholecystectomy in our hospital 20 years ago. This is what the patient said himself!" Wen Youren shouted.

"Director Wen, please keep your voice down, this is a hospital-wide consultation." Luo Hao looked at Wen Youren calmly, "Since the surgery was performed in our mine, the medical records must be in the medical record room."

With that said, Luo Hao clicked on the computer screen to switch interfaces.

The old yellowed medical records appeared in front of everyone.

Even if it is just an image, everyone here can smell the passage of time from the handwritten medical records of that year.

Although the medical record room is there and the past medical records are on the medical record shelf, no one has ever searched for the patient's past medical records, let alone that the patient in front of him had surgery 20 years ago.

Both Li Sumei and Wen Youren missed this point.

The 2mb brains of many directors and chief physicians could not understand the contents of 10g at all, and they all went down.

Luo Hao gently slid his fingers and found the operation record written by the old director himself. "Here are the surgical records written by Guohua, the old director of our mine's general surgery department."

"I checked the handwriting and it was written by Director Guohua himself."

Write it with your own hand!

In the era of handwritten medical records, it took 20 minutes to write an operation record. The old surgical director actually wrote it by hand instead of leaving it to his doctors to do these chores.

Luo Hao's words immediately attracted the attention of the doctors.

No need to knock on the blackboard, everyone knows this is the point.

Especially Director Wen Youren Wen, he looked at the familiar handwriting in a daze.

It is indeed the old director's handwriting and cannot be faked.

The old director wrote the operation records himself, and Wen Youren knew that there must be something wrong with the operation, or that something might go wrong, without even looking at the contents.

In order to avoid accidents or unclear writing by his doctors, the old director carefully writes the surgical records himself.

The old director Guohua looked rough, but in fact he was very careful. There must be a reason why he did what he did.

Wen Youren's heart skipped a beat.

He could already smell the danger.

Look down intently.

Wen Youren felt as if he had fallen into an ice cave for an instant.

The patient did indeed undergo a cholecystectomy, but because the exploration in the book found a large number of sand-like stones in the common bile duct, the old director not only removed the gallbladder, but also performed a side-to-side common bile duct duodenal anastomosis.

if so……

Wen Youren's hair suddenly stood up.

"Side-to-side choledochoduodenal anastomosis was the surgery of the time. We can't blame the patient or a non-medical professional for saying this surgery. Generally speaking, patients only know that their gallbladder has been removed. Lost."

"The medical records are in the medical record room. I think if you have any sense of professionalism, you should take a look. What do you think, Director Wen?"

Luo Hao smiled, gentle but firm, and looked directly at Wen Youren.

!!!

Wen Youren's blood surged and he became furious.

This is a slap in the face!

Slap yourself in the face in front of the directors of all departments and responsible attending physicians in the hospital! !

Crackling.

But he couldn't refute it.

"So what if it's done? The gallbladder has been removed, what else can the surgeon do?!" Wen Youren started to mess around.

"Director Wen, speaking loudly does not mean that you are right." Luo Hao replied calmly, "Next, let's start talking about the postoperative complications of side-to-side choledochoduodenal anastomosis."

Luo Hao didn't give Wen Youren a chance to roll around like a shrew, and started talking about the postoperative complications of side-to-side choledochoduodenal anastomosis.

"The patient's diagnosis should be cesspool syndrome, also known as blind end syndrome, blind bag syndrome, and blind pit syndrome."

"On magnetic resonance images, we can also see that food residues, stones, etc. accumulate in the blind bag formed from the biliary-enteric anastomosis to the ampulla of Vater, causing a series of clinical symptoms."

"The relevant diagnostic basis is..."

"A relevant differential diagnosis is..."

Luo Hao talked eloquently on the podium.

Reasonable and well-founded.

He recounted every item as if writing a medical record.

Director Wen, who was still in a state of rage and resentment at the beginning, turned pale and his hands were trembling.

Doctors must rely on their professionalism to speak for themselves.

Before becoming a dragon, every doctor's dream is very simple - to cure diseases and save lives. (Note: This sentence comes from this chapter)

Even if he has become an evil dragon, he can only be speechless when faced with the iron-clad facts that he cannot shake.

Wen Youren thought of Luo Hao's smile and that he asked him for instructions to perform magnetic resonance cholangiopancreatography on the patient.

Scene after scene flashed through Wen Youren's mind like a revolving door before death.

He realized in a daze that he seemed to have fallen into a trap.

Looking at Director Lin on the rostrum who was drinking tea slowly with an enamel jar in his hand, and then at Luo Hao who was high-spirited and attacking him with hard facts, Wen Youren's mind went blank.

The only thing these two men have in common is that their smile hides a knife, and they have been fooled!

"Sewage pool syndrome is a typical surgical case. Now let's talk about treatment. In the past, similar patients required a second surgery..."

Luo Hao did not dwell on attacking Wen Youren, but continued to talk about the medical history.

A bloody surgery scene appeared on the projection screen.

"This is a case from 1995. There is only one picture. The surgeon published it in the Chinese Journal of Surgery."

"The treatment method at that time was surgery, but with the development of minimally invasive technology in recent years, ERCP combined with EST stone removal has replaced traditional surgery in the treatment of lower common bile duct stones."

Est?

Ercp?

Two abbreviations appear on the cast screen.

"Doctor Luo, what kind of surgery is that?" A doctor in charge sitting in the corner was fascinated and asked subconsciously.

Luo Hao seemed to have expected someone to ask questions. He slid his fingers on the computer screen and found relevant information about ercp and esd and began to briefly explain.

This time even Lin Yuming listened extremely seriously.

Luo Hao's explanations are concise and comprehensive, easy to understand and explain the profound things in a simple way.

Five minutes later, Luo Hao smiled, "That's probably it."

After finishing speaking, Luo Hao did not continue speaking, but paused for a few seconds.

"Appreciate~"

Somewhere in the corner, someone woke up from a dream and let out a long breath.

Some people have heard of ercp, some have not, but after Luo Hao's explanation, everyone realized that this surgery caused minimal trauma to the patient, and the efficacy was far superior to surgery.

Luo Hao opened a door.

The doctor behind the door saw a brand new world.

If a surgical operation is required, not to mention the trauma suffered by the patient, the changes in the anatomical structure during the second operation alone add countless difficulties to the operation.

The ercp + esd surgery can avoid this, as long as the cephalopapillary muscle is cut and the stone is removed from the basket.

The doctors present were all excited at the thought of the difficult surgical treatment becoming simpler.

Only Wen Youren is the exception.

His face was livid and he glared at Luo Hao fiercely.

"Director Wen, do you understand? If you don't understand, I can explain it again." Luo Hao said with a smile without fear in the face of Wen Youren's murderous gaze.

"!!!"

Provocation, this is pure provocation! ! !

Wen Youren clenched his fists with both hands, making a crunching sound.

"Going back to the patient we are discussing, I don't think Dr. Wen can handle the surgical operation at his level, so the medical office suggested hiring an outside expert to perform the ERCP+ESD surgery."

Take, no, come down, come!
Luo Hao didn't show any shame to Wen Youren and expressed his opinions very straightforwardly.

The key is that every word Luo Hao carries is the Medical Office. He represents the Mine General Medical Office!

Doctors who were still immersed in new technologies just now have completely woken up.

For the patients in front of us, it is not only a collision of diagnosis and treatment, but also a collision of new and old concepts.

Although ercp is no longer a new technology, it has not yet been implemented by the Institute of Mines. As far as the Institute of Mines alone is concerned, this technology can be regarded as high-end medical treatment.

"Why do you say that?!" Wen Youren squeezed out a sentence through his teeth.

Every word is as rough as a pebble, causing pain to the eardrums.

Luo Hao looked at Wen Youren thoughtfully.

"What are you looking at!" Wen Youren slapped the armrest of the chair and stood up suddenly.

He looked at Luo Hao angrily, as if he was going to rush up and punch Luo Hao in the next second.

Everyone became nervous, and some people looked at Lin Yuming.

At this time, Lin Yuming, the director of the Medical Department, should step forward to comfort Director Wen to prevent the situation from getting worse.

however.

Lin Yuming was drinking tea from an enamel jar with both hands, turning a blind eye to everything in front of him.

Luo Hao did not smile and said seriously, "Director Wen, I have overestimated you just now. Are you sure you want to know why I say that?"

Ooh!

Luo Hao's voice was not loud, but there was a microphone in front of him.

Every word falls clearly on people's ears.

Tit for tat.

There were bloodshot eyes in Wen Youren's eyes.

"Okay, then I'll tell you why. By the way, Director Wen, you'd better sit down and listen to me. If you rush up and get beaten by me... whoever sees you in the courtyard will think of you in the future. this matter."

Luo Hao paused slightly and said with a smile, "If that's the case, anyone who wants to save face will not work in the mine manager again."

"you……"

Wen Youren knew that Luo Hao was telling the truth, but the truth was difficult for him to accept.

Luo Hao opened another ppt, "Now let's look at the comparison of the difficulty, completion, and number of patient complaints in the general surgery department before and after you became the director."

"Everyone usually drinks and brags, and it doesn't matter how much they brag. We are all doctors and we know what's going on with the provincial famous doctors. It's okay to deceive ordinary people, but don't deceive yourself."

Wen Youren almost broke his teeth.

Unable to fight again and again, and refusing to listen, Wen Youren was helpless.

"I have reviewed the data in this ppt from the surgical data of general surgery in the past 25 years. There should be no doubt about it."

"In 2011, before Director Wen became the chief director of the general surgery department, the general surgery department completed about 1800 operations every year. Level 4 operations accounted for 450%, and the relative numbers of appendectomies and hernia repairs were not large."

"Among them, an average of about 30 cases of combined pancreaticoduodenectomy are completed every year."

"Since 2011, our hospital has not performed combined pancreaticoduodenectomy, and difficult level 4 surgeries have been almost zero."

"Although the decrease in the number of operations is not obvious, I checked the data and found that the 'treatment' of abdominal puncture was turned into surgery by Director Wen and reported to the hospital."

"I really don't know how Director Wen said in front of the hospital leaders when he was doing his annual summary that under his leadership, the number of surgeries in the General Surgery Department has reached a new high."

The lecture hall was eerily quiet.

Luo Hao was no longer slapping Wen Youren in the face, but pressing Wen Youren to the ground and stepping on his face with his feet.

Lin Yuming was very satisfied. He held the enamel jar in his hand and took a sip of tea happily.

(End of this chapter)