White armor

Chapter 268 The Disappearing Fishbone

Shen Zizai didn't understand, but he didn't bother about it. He turned around and went back, taking Zhuang Yan to find Meng Liangren.

"Old Meng, you will take care of Xiaozhuang from now on. If you have any problems, come to me directly. Don't keep it to yourself." Shen Zizai said it very bluntly.

The subject of his words was Lao Meng, but his eyes were always fixed on Zhuang Yan, fearing that Zhuang Yan was immature and would not understand.

Moreover, the director called the middle-aged attending physician "Lao Meng", and there was an unusual degree of intimacy in his words.

"Thank you Director Shen. I'm sorry to trouble you in the future."

"You're too polite." Shen Zizai didn't want to stay any longer, so as not to leave the impression of a bootlicker on his young doctor.

After Shen Zizai left, Zhuang Yan bowed slightly and said, "Teacher Meng, please give me more advice."

"No, no, just call me Old Meng." Meng Liangren declined quickly, "I'm not a teacher. I don't know anything. It would be great if I could become a cadaver teacher after I die."

“???” Zhuang Yan was stunned, then chuckled.

She knew Meng Liangren and had adapted to Luo Hao's medical team for a week some time ago.

But now my identity and status are different, and I am considered a newcomer in the medical team.

"Teacher Meng, I learned how to write medical records in the imperial capital. How about I try it on the new patient?" Zhuang Yan wasn't polite either.

Meng Liangren nodded.

Zhuang Yan held her breath, ready to show off her abilities as a master's student.

When asking about the medical history, almost every item was in accordance with the medical record writing standards, with no flaws.

Even Zhuang Yan herself felt quite proud.

After all, he graduated from a professional school, one of the few in the country. As long as he wants to be professional, he can do it.

Zhuang Yan is absolutely confident that this medical record can be used as a demonstration medical record in several affiliated hospitals of Peking University Health Science Center.

When she was studying for her master's degree, Zhuang Yan had a medical record that was used as a model medical record, and the level of care put into writing it was much worse than the one in front of her.

As expected, Meng Liangren also praised Zhuang Yan's medical records.

"Xiao Zhuang, your medical records are really well written. You are worthy of being a top student of Imperial Capital Medical University."

"Teacher Meng..."

"Just call me Lao Meng. I don't dare to be called a teacher. I'm not being polite. I really don't deserve the title. I'm just an experienced attending physician." Meng Liangren was humble to his core.

Zhuang Yan had no choice but to change her words.

"Meng, please give me more advice."

"Perfect!" Meng Liangren said firmly.

Zhuang Yan felt proud and she also thought that her medical records were written perfectly.

"Meng, it's already past 7 o'clock, what are you going to eat tonight?"

"Just eat something. It's getting late. Xiaozhuang, you should go home quickly."

It was Zhuang Yan's first day in the medical team. Although Luo Hao was not there, she still tried hard to leave a good impression on the team members.

And Zhuang Yan wants to demonstrate her abilities.

Writing medical records is one thing, and staying up late to work overtime is another.

It's inevitable for doctors to work overtime. They're just slaves.

She didn't go home, but ordered some food to eat with Meng Liangren.

Then, they both wrote medical records. Zhuang Yan wrote slower, but she still persisted until she finished writing the medical records of today's patients.

"We're done, let's call it a day." Meng Liangren said with a smile.

Zhuang Yan felt sleepy and looked at the time. It was already 23pm.

"Meng, I'm done with my work. I'm going back to sleep."

"Well, go ahead." Meng Liangren stood up to see Zhuang Yan off.

Zhuang Yan was stunned for a moment, "Old Meng, aren't you going home to sleep?"

"I am born to work hard, so I only need to sleep for 3 or 4 hours a day. It's still early now, so I'll go around the ward again. Professor Luo is not at home, so I have to ensure the smooth operation of the clinic."

Meng Liangren said with a smile.

Zhuang Yan felt powerless and wanted to stay up late with Meng Liangren, but she really couldn't do it anymore.

If it was just one day, it wouldn't matter, but looking at Meng Liangren's state, it was obvious that he was like this every day. Zhuang Yan was very competitive, but she had a brain and knew that she couldn't do it.

You can barely hold on for a few days, but finally give in. That will be even more embarrassing. It is better to set the rules now.

"Xiao Zhuang, go back and sleep quickly. We are slaves and shouldn't try to pua ourselves. It's meaningless." Meng Liangren said.

"What?"

Meng Liangren was also stunned for a moment, then smiled bitterly.

I am a beast of burden, but Zhuang Yan is not.

"Rest when you need to. There is always a lot of work to do in the clinic." Meng Liangren said, "Take care of your health and don't exhaust yourself. Professor Luo doesn't usually stay up late, and he is quite averse to emergency surgeries."

"Is it."

"Of course, the body is the capital of revolution." Meng Liangren sent Zhuang Yan away.

……

The next morning, Zhuang Yan got up and saw her father sitting at the table watching the news.

"Get up. Why did you come back so late yesterday?" asked Dean Zhuang.

"On the first day I go to the medical team, I always have to finish writing the medical records. I asked for it myself, and it's written quite perfectly."

Dean Zhuang smiled slightly. He knew very well what Zhuang Yan was thinking - in the future, he should say that he was Zhuang Yan's father, not Dean Zhuang's daughter.

There is a huge difference here.

Children will all have this idea to some extent, but few can actually do it. Not bringing ruin to the family is already a small achievement.

Luo Hao is very busy over there, and this kid will know how powerful he is after a while.

I ate a quick meal, washed up, and went to the hospital.

Zhuang Yan saw that Meng Liangren seemed to have not returned home and was chatting with patients in the ward.

She followed Meng Liangren, without disturbing him, but listened carefully to what Meng Liangren said.

All kinds of trivial matters in the family are meaningless to Zhuang Yan, but Meng Liangren never gets tired of them.

After finally talking to more than a dozen patients and leaving the ward, Zhuang Yan asked, "Old Meng, you didn't go home?"

"I'm back. I slept for four hours, which was enough." There was no sign of fatigue on Meng Liangren's square face.

Zhuang Yan was surprised, and although she was still a little unconvinced, she also knew that some things could not be forced.

It's all talent.

It's the handover. Luo Hao's team has no surgery for the time being. Everyone is waiting for the surgery. Zhuang Yan casually opens the medical record she wrote yesterday and prepares to appreciate it again.

This is the most perfect medical record I have ever written!
But after taking a few glances, Zhuang Yan noticed something was wrong - the medical records had been tampered with!
It was Meng Liangren! He must have secretly modified the medical records! !
Zhuang Yan felt unhappy. She was stunned for a moment and tried hard to recall and compare.

It was a full hour later that Zhuang Yan realized that the places Meng Liangren had modified later were all the necessary ones.

How could it be a standard or model medical record? In front of Meng Liangren, his medical record was full of loopholes and worthless.

"Xiao Zhuang, I went too far and changed your medical record after you left yesterday." Meng Liangren's tone was somewhat guilty, "I'm really sorry."

"..."Zhuang Yan couldn't stand Meng Liangren's politeness.

The way he talked might as well have pointed at his nose and scolded himself.

To Zhuang Yan, Meng Liangren was more like a yin and yang to herself.

"It's not that there's something wrong with what you wrote. It's that every hospital has its own habits. Our habits come from Professor Luo, and whatever he writes is what counts." Meng Liangren continued to explain.

But he didn't say too much, just kept it to the point.

Zhuang Yan nodded and returned a gentle smile, indicating that she understood.

Afterwards, Zhuang Yan tried hard to compare her memory and habits to find out the places where Meng Liangren had made modifications.

Zhuang Yan knew that it would be difficult for him to integrate into the medical team if he couldn’t even write medical records properly.

In the morning and noon, Zhuang Yan spent 6 or 7 hours studying Meng Liangren's medical records.

Although Meng Liangren speaks honestly and low-key, his medical records are really good, so good that it's outrageous.

On the first day Zhuang Yan joined Luo Hao's medical team, she was hit on the head with a silent killing stick.

3: p.m.

Shen Zizai came in hurriedly.

"Old Meng, has Xiao Luo got on the plane?" Shen Zizai asked.

"Director, Professor Luo's flight is at 5 o'clock. What do you want?"

"It's okay, emergency consultation during surgery." Shen Zizai said, "The cardiothoracic surgery department is really sick. They can't find the fish bone, and they insist that we go up and take a look."

"???"

"???"

Meng Liangren and Zhuang Yan were both stunned.

Fishbone? What does it have to do with interventional medicine?

The shallower ones are the work of otolaryngology, the deeper ones are the work of gastrointestinal endoscopy, and the ones that puncture the esophageal wall and knock down the aorta are the work of cardiothoracic surgery.

No matter what, it has nothing to do with the interventional department.

A fish bone can only damage a blood vessel. What is the interventional department doing? Angiography? The fish bone is not in the blood vessel.

"Director, can I go with you to take a look?" Zhuang Yan volunteered, eager to try.

She had just arrived at the clinic and was still fresh to everything. Moreover, Zhuang Yan had met all the directors in the hospital, so at least she was familiar with their faces.

Shen Zizai nodded slightly and took Zhuang Yan to the consultation.

Other young doctors did not dare to make this request, but she was Zhuang Yan. Meng Liangren watched from a distance and turned back to start working.

"Director, what patient?" Zhuang Yan asked as they walked.

"It was said that a patient had a fish bone stuck in his throat. Initially, he said that he didn't have any serious symptoms, only chest tightness."

"No chest pain?"

"Probably not. I just called them to ask." Shen Zizai said as he walked, "The patient was not hospitalized because of a fish bone stuck in his throat. He was hospitalized for chronic gastritis and had made an appointment for hospitalization. It was discovered by chance.

After being hospitalized, a gastroenteroscopy did not reveal any problems, but a CT scan revealed that the fish bone was stuck in the esophagus and had approached the aorta. "

"This is too dangerous!" Zhuang Yan said immediately, "When I was in school, I heard a teacher talk about a similar case. It was said that a big boss ate mandarin fish and got a fish bone stuck in his throat. He didn't trust the Mayo that was flown directly from China." (Note)
"Fei Mayo is really rich, and he is indeed a big boss." Shen Zizai smiled, with a little sarcasm in his words.

But after all, he is a patient, and the prognosis is likely to be poor, so Shen Zizai did not say more.

"I went there for three months for treatment, but no surgery was done. The teacher said that when I came back, the aorta had been corroded to a large area. We organized seven or eight hospital-wide consultations, and the teachers all thought it was incurable."

"What happened next?" Shen Zizai patiently gossiped with Zhuang Yan.

"Suddenly one day he spat out a mouthful of blood all over the wall, and then he was gone."

"Oh." Shen Zizai said calmly.

"Director Shen, what's the condition of the patient on the operating table?" Zhuang Yan just then remembered to ask.

"Oh, they said that the CT scan showed that the fish bone pierced the esophagus and entered the aorta below the tracheal bifurcation."

“!!!” Zhuang Yan was stunned.

Seeing Shen Zizai looking relaxed, she thought the patient was not seriously ill. But!

The fish bone has been stuck in the aorta, can this person still survive? I'm afraid the operating room is even prepared for extracorporeal circulation. If blood spurts out when removing the fish bone, there will be no time to sew it up... No, if that's the case, extracorporeal circulation will be useless.

Zhuang Yan fell into deep thought.

Shen Zizai saw Zhuang Yan's expression and smiled slightly.

The kid was indeed a rookie, the kind of clinician who knew a little but had little experience, and he was obviously frightened by what he said.

If Zhuang Yan did not have a solid foundation of knowledge, she would not understand how serious it was if a fish bone pierced the esophagus and entered the aorta.

If she had seen a few cases of patients dying after spitting blood on the roof, she would not have had this expression.

"Director Shen, why aren't you in a hurry?" Zhuang Yan quickened her pace, but soon found that Shen Zizai had not caught up, so she asked immediately.

It seems that Zhuang Yan is a little bit strong-willed, Shen Zizai evaluated this in his heart.

Whether she is strong or not has nothing to do with her. Let Luo Hao punish her. Others may spoil her, but Luo Hao definitely won't.

"Xiao Zhuang, if I invite you alone for this consultation, do you know what to pay attention to?"

Zhuang Yan immediately pricked up her ears and listened attentively.

"Ok?"

"Director Shen, I don't know. Please tell me." Zhuang Yan said honestly.

"This time he's looking for us for a consultation, not to see us for medical treatment." Shen Zizai said calmly.

"Quack!" Zhuang Yan made a duck-like sound from her throat.

Shen Ziyi was stunned. What did this mean?

Zhuang Yan immediately realized that something was wrong and smiled embarrassedly, "Director Shen, this is the way young people talk. What are you doing? You speak too fast. Sorry, sorry."

Shen Zizai had a smile on his face, but he sighed in his heart.

As young people, Zhuang Yan is not much younger than Luo Hao, but there are indeed problems with the way she handles things.

Every word made me unhappy.

If she didn't have a good father, I would have asked her to pack up and leave tomorrow. Even if she didn't leave, I would have ten thousand ways to make her unhappy.

But who can blame him for being born with good talents?

Although he thought so in his heart, Shen Zizai still explained, "It's a collective decision. We went to the consultation just to make up the numbers."

"???"

"Let's put it this way, they didn't notice any fish bones when they came on stage."

"Gah!" Zhuang Yan made another "Gah" sound out of habit, and immediately lowered her head after realizing what was happening. "Didn't you find the fish bone? Wasn't there one on the film?"

"Yes, that's what's strange. It was there on the film, but not after the thoracotomy. Where did the fishbone go? And I don't know if there's any problem with the aorta. The film showed a esophageal aortic fistula."

"Aorticoesophageal fistula." Zhuang Yan murmured as she thought about the diagnosis, and she began to feel unwell.

She had never heard of the diagnosis.

Shen Zizai rarely saw a similar diagnosis.

As for the fish bone, where did it go? Was it a problem with the film or the surgeon?

There are countless questions here.

Shen Zizai explained here, got on the elevator, and stopped when he saw someone without saying anything more.

The whole thing is full of inexplicable weirdness.

If it was just a common disease, it would be fine, but before the operation, it was diagnosed as aortic esophageal fistula!
The culprit is gone? Who would believe it if I told them?!

After arriving at the locker room and getting off the elevator, Shen Zizai stopped and said in a low voice, "It's a collective decision. Although we are not a related department, we still have to go and give them courage. If something goes wrong, we can not blame everyone, and we can also ask the hospital to pay great attention to it."

"..."Zhuang Yan was puzzled.

"We have invited all the experts from the departments that should be invited, and we have also invited those that shouldn't be invited. This is the level of our First Hospital of Medical University, don't you think? If something goes wrong, that's fate."

"..."

"Let's go and show some concern. In clinical work, everyone should take care of each other and not undermine each other. Everyone needs to ask for a consultation sometime."

Shen Zizai smiled and said, "Go change your clothes, and we'll meet at the door."

"it is good."

Shen Zizai changed his clothes leisurely. He was neither in a hurry nor curious.

Shen Zizai had seen all kinds of weird things in clinical practice, except that the fishbone was gone. The previously diagnosed aortic esophageal fistula probably needed to be re-diagnosed, which was nothing for an old hand like Shen Zizai.

Ga.

Shen Zizai made a "click" sound.

It is indeed the chord of the two words "gan sha" said quickly.

Young people? Shen Zizai curled his lips and said, "I am still young."

After changing clothes, Shen Zizai slowly walked out of the locker room and saw Zhuang Yan already standing at the door waiting for him.

She changed her clothes quite quickly. Shen Zizai put his hands behind his back and said, "Let's go."

Zhuang Yan said nothing and followed Shen Zizai obediently into the operating room.

The operating room was packed with people, but the usually strict head nurse did not come out to scold people and accuse them of violating sterile regulations.

"Old Shen, please take a look at the X-ray and see where the fishbone was before the operation. Then take a look at the surgical area. You are good at reading X-rays, so please help me take a look." Director Xu of the Department of Thoracic Surgery said weakly.

Shen Zizai quickened his pace after entering the room, acting rigorously and seriously, performing the whole act.

If you start to mock at this time, then you are not here to help but to cause trouble.

The film was inserted into the film viewer. It was not in the format of the First Hospital of Medical University, nor was it of the clarity of the machines in the First Hospital of Medical University. Shen Zizai knew it at a glance.

I leaned in to take a closer look and found that there was no problem with the preoperative diagnosis.

A 2cm fish bone pierced the esophagus and lodged in the aorta below the tracheal bifurcation.

The diagnosis of aortic fistula is also quite standard.

The patient was lucky. Usually in this situation, swallowing saliva would cause the fishbone to be pulled out, causing a large gap in the aorta, and the person would be killed without even a chance for rescue.

And the patient was able to survive the surgery.

There was nothing interesting in the film, so Shen Zizai turned around, pushed a director who was watching the operation off his footstool, and stood up himself.

"The film is fine, the diagnosis is fine, Old Xu, are you good enough? It's below the tracheal bifurcation."

"Well, come and see for yourself." Director Xu of the cardiothoracic surgery department sighed.

Shen Zizai looked down at the surgical area.

The tracheal bifurcation was dissected cleanly and clearly. But for this surgical dissection, I have to give a thumbs up to Director Xu's surgical skills.

The surgery was really great.

But problems also arise at the same time.

It was precisely because Director Xu of the cardiothoracic surgery department performed the operation so well, cleanly and efficiently, and with a clear surgical field, that it was easy to see at a glance whether the "damn" fishbone was there.

Shen Zizai was stunned for a moment.

I had some other guesses, but they disappeared in an instant after I saw the surgical area.

No, just no, not at all.

"Old Shen, you are good at watching movies. Can you help me take a look and see if this is the place?" Director Xu asked exhaustedly.

"Yes, the location is definitely correct. It's strange, where is the fishbone?" Shen Zizai pondered.

"Old Shen, let's develop the fishbone. I remember it should be developed."

It was obvious that Director Xu of the Department of Cardiothoracic Surgery had been driven crazy and he didn't even have the confidence to ask a question like this.

"Developed." Shen Zizai said confidently, "One side is stuck in the esophagus wall, and the other side is stuck in the aorta, that's right."

"But where are the fish bones?" Director Xu muttered to himself.

His voice was low and lost, and he was so frustrated that he felt like he was going to explode.

Shit, how would I know, Shen Zizai cursed in his heart. But Shen Zizai knew very well that no matter who was on the operating table, it would be the same, the same pain.

"Brother, are you on the plane?"

A tender voice suddenly came from the silent operating room.

Zhuang Yan!

Shen Zizai sighed.

Seeing Director Xu and the head nurse of the operating room about to curse, he quickly spoke before them, "Xiao Zhuang, go out and make a phone call. The operation is underway."

After that, Shen Zizai introduced Director Xu and the head nurse of the operating room, "This is Dean Zhuang's daughter. She just graduated with a master's degree and comes to work in our department."

Director Xu was still full of anger, and all his anger finally turned into an awkward smile, "Xiao Zhuang, who are you calling?"

"Senior Brother." Zhuang Yan listened carefully to the words on the other side and answered without thinking. Then she took a photo of the operating area, took a photo of the film on the film viewer, and clicked send.

"Brother, I've sent you the film. Please take a look at it."

Zhuang Yan imitated the tone of the experts and spoke to Luo Hao in a tender and delicate voice, as if she was acting coquettishly.

"Which senior brother?" Director Xu's smile was uglier than crying. Although he was wearing a mask, it was obvious that he was about to cry.

"Professor Luo Haoluo, my senior brother." Zhuang Yan said with some pride.

"..."

"..."

There was silence in the operating room.

Zhuang Yan heard Luo Hao say something and hung up the phone. Just as she was about to speak, she realized something was wrong and looked around timidly.

"Director Shen, what's wrong?" Zhuang Yan came close to Shen Zizai, like a child who had made a mistake. Her voice got lower and lower as she spoke, until finally it was barely audible.

"Oh, it's okay. Why did you want to call Luo Hao?" Shen Zizai asked pretending not to care.

"If there is a problem, you have to call for help. This is what my senior brother told me. When he encountered mushroom poisoning at Union Hospital, he directly called a senior brother from Nanyun Province. The senior brother said that it is not shameful to call for help when the diagnosis is unclear. It would be shameful if you really can't save face."

"Crack~"

From nowhere, a slap hit Shen Zizai's face.

Shen Zizai didn't know whether to laugh or cry.

This is indeed true, but even if it is true, it depends on the time.

Now the fishbone that was clearly visible on the film has disappeared, and the patient is lying on the operating table with his chest opened. At this moment, Luo Hao is still far away, so what's the point of calling him?

"What did Xiao Luo say?" Shen Zizai asked.

"Senior brother said, don't worry, he will come back and take care of it."

……

……

Note: This happened in 2002. I flew to Mayo Clinic, but didn't get the surgery. After three months, I came back and died in the Imperial Capital Hospital with a spit of blood.

Note 2: This medical record is from West China Hospital. This is the only similar medical record I have found. The fishbone went from the esophagus to the aorta and then inexplicably entered the aorta.

I don't understand how I got in.

(End of this chapter)