White armor

Chapter 371: There is always a way out before the mountain, and the road is wider than before

The so-called other methods are minimally invasive operations such as bronchoscopic pathology.

After all, the impression left by the large open-chest surgeries in the early years, where 1000ml of blood was drawn and 1000ml of blood was drawn when the chest was closed, was too deep.

Although laparoscopic surgery has been widely used in clinical practice, so that young doctors are not able to perform "ordinary" operations, it will take some time for patients to accept this situation.

After all, surgery gives people the impression of being a bold and radical profession, and ordinary people may not have a correct understanding of surgery.

"Okay, you stay and continue communicating with the patient and his family." Feng Zixuan glanced at Luo Hao, "Xiao Luo, are you busy? Come with me to take a breath?"

"Not busy." Luo Hao smiled.

After leaving the emergency room, the two did not walk through the hospital corridor, but walked in the hospital compound.

Feng Zixuan kept making phone calls, mainly instructing his subordinates to keep an eye on online public opinion and to make sure it was discovered and resolved as soon as possible.

It can be said that the hospital has nothing to do with the patient's suicide, but no matter what the matter is, people are afraid of making a big deal out of it.

Say it doesn’t matter?

Why are you helping if you didn't hit him?
Why do patients commit suicide in hospitals? Is it because the hospitals lack medical ethics and responsibility, or is it because the medical insurance is not enough?
As for medical insurance, it is definitely enough. It doesn't matter who says it. The pot lies with the clinical doctors. It is shiny black and heavy, and it bends their backs.

After finishing his work, Feng Zixuan finally breathed a sigh of relief.

"It's really Mercury retrograde today."

"Hmm? Director Feng, do you know about Mercury retrograde?"

"Me? Why don't I know?" Feng Zixuan was obviously much more relaxed. Although his face was a little pale, there was a smile on the corner of his mouth.

Luo Hao's diagnosis may not be correct, but Feng Zixuan is willing to believe it and believes it. (It seems to be a wrong sentence, but I can't find a better description~)

"Xiao Luo, have you managed the quota issue yourself?"

"Well, it's scientific research. As long as other departments are willing to learn, I can teach them. There's no need to be so troublesome."

Feng Zixuan just smiled but did not make any comment on Luo Hao's words.

Luo Hao didn't say anything, but followed Feng Zixuan silently.

Ten seconds later, Feng Zixuan asked, "I saw that you had a consultation before. The pregnant woman had kidney problems and you and Director Pei had a very unpleasant argument."

"But you are very easygoing with Director Chen, Director Yang, and even the directors of cardiothoracic surgery and orthopedics, who you rarely interact with."

"Oh, it's indeed my fault." Luo Hao admitted directly, "Before coming to Medical University, I learned about the technical level of each department here through many channels, and the urology department is relatively poor."

"..."

Feng Zixuan thought of countless reasons, but never this one.

Now that I think about it, I have to say, it does make sense.

"If your skills are poor and you don't listen to advice, I will definitely be unhappy. But after getting to know you, I found that Director Pei is a good person. At least he is not an average person who thinks he is very good."

Feng Zixuan understood.

Sometimes Ronaldinho does things in an organized way, and sometimes he does things in a messy way, but in the end it all comes down to technique.

No matter how much his bosses train him, Luo Hao still has the heart of a young man and is still a person obsessed with technology.

Technology is close to technology.

For people with good skills, Luo Hao is willing to say a few more words and be gentler in his words; for those with poorer skills, like Pei Yingjie, Luo Hao really doesn't indulge them at all.

No wonder Pei Yingjie was hit by Luo Hao's "manifesto"-like consultation record.

His skills are average, and he insisted that it had nothing to do with his urology department. Now that Ronaldinho has caught him, why doesn't he teach him a lesson?
But these are all trivial matters, Feng Zixuan just asked and didn't care.

It's just a lesson for Pei Yingjie once, but does that old dog dare to jump out and bite people again?

"Can the patient's right lung mass be pathologically examined?"

This was the second time Feng Zixuan asked, and probably the last time.

"I can't take it out. It's too deep." Luo Hao gave an affirmative and unambiguous answer.

Since Professor Luo Haoluo said that the pathology cannot be obtained, then it really cannot be obtained, and others do not need to try.

Feng Zixuan would get a headache just thinking about if there were any unexpected events during the pathology examination.

A while ago, a child in the hospital next door had an accident during a minimally invasive tonsil surgery. The responsibility has not been determined yet, and they are in a state of panic.

The less trouble you can have, the less trouble you have. There is no need to be minimally invasive.

"Yeah." Feng Zixuan nodded.

Since it is certain that the pathology cannot be obtained, let's just go through the motions to convince the patient.

But please don't commit suicide, it's so scary.

If it is really a malignant tumor with systemic metastasis, forget it. Every year on the first and sixteenth day of the Chinese New Year, it is very common for patients with advanced cancer to commit suicide by jumping off buildings.

After the New Year and the fifteenth day of the lunar month, if you deserve to die, just die. Don't suffer this punishment.

But the patient is most likely just suffering from inflammation!

If this person really died, I guess it would be more unfair than anything else.

"This person is really true. My parents' old colleagues still do clapping dances and sing Peking opera together after retirement."

"Clapping dance? Is it the kind of activity that disturbs the neighbors? A few days ago, I saw that the violent walking groups and square dancing groups had already entered the main line. The local police went to manage it, but they were beaten away by a few uncles and aunts." Luo Hao asked.

Feng Zixuan laughed.

Even the local police are unwilling to take care of this kind of shit, and they can’t do it. In some places, the local police are just as helpless as the doctors in the hospital.

"Half a year ago, an old man suddenly got cancer, but it was discovered too late, and he died soon after. Then, one of the people in the group who was a close friend of the old man thought he had cancer, so he refused to eat or drink and refused to come to the hospital, and eventually he starved to death."

"!!!"

Luo Hao was also surprised.

Similar cases are rare.

"Another person had a persistent cough and began to suspect that he had lung cancer. No matter how he checked, nothing was wrong. I can't say it was nothing. To be more precise, it was probably nothing serious.

But because my old partner died of cancer later, I insisted that I had lung cancer. I went to the capital, but still couldn’t get a diagnosis. Now I spend most of the month in the hospital.”

"Haha, that's quite extreme." Luo Hao smiled.

"In the past, the people who worked in loading and unloading at the railway station were all illiterate and strong. But it seemed that the muscles were in their brains, and they didn't believe anything others said."

"I'll go to the respiratory department later, and you can help take a look and see the situation. If you think it's okay, I won't be in charge anymore."

Luo Hao smiled. This trust was indeed heavy.

Peking Union Medical College is the last stop for patients across the country to seek medical treatment.

Was he the last stop for the first visit to the Medical University? Judging from Feng Zixuan's expression and tone, this should be the case.

Although there is some truth in this, Luo Hao still feels a bit stressed. But this is an inevitable experience, and Luo Hao did not think about relieving himself of the pressure.

“When you get to the mountain, there will always be a way out, and the way will be wider than before.”

"?" Feng Zixuan was stunned, but soon realized that this might be a new term on the Internet.

But these words sounded auspicious, and Feng Zixuan remembered them after savoring them for a few seconds.

The two came to the Department of Respiratory Medicine, and Feng Zixuan found Director Tang of the Department of Respiratory Medicine and asked her to look at the film and make an assessment.

Then he found the medical records of his father's patients and showed them to Luo Hao, asked Luo Hao to give a diagnosis, and then went back to his own business.

The medical records of the respiratory department are written very well, unlike the medical records of the surgical department, which are completely unreadable.

Many surgeons do not write medical records or even surgical records until the patient is discharged from the hospital.

More often than not, they just copy and paste to get the job done.

There were even some patients with benign tumors whose medical records were copied and pasted with malignant tumors, which ended up causing a false alarm.

Although the medical records of the Department of Respiratory Medicine are not as good as those written by Meng Liangren, they are still pleasing to the eye.

Five years ago, the patient began to cough intermittently, feel chest tightness, and occasionally cough up yellow sputum.

The patient visited many hospitals and was once diagnosed with upper airway cough syndrome (UACS).

This is a disease similar to chronic bronchitis.

In Northeast China, the temperature difference is large, especially in winter, when the temperature difference between indoor and outdoor is at least 50 degrees Celsius, so respiratory diseases are common. Chronic bronchitis, emphysema, and the like are common in almost all people over .

However, the patient did not improve after being treated for upper airway cough syndrome for a period of time.

A chest X-ray showed that Mr. Huang had an 8mm nodule in the right middle lung field and fullness in both hila.

Further chest CT scan confirmed that there was a round non-calcified nodule with fat density in the upper segment of the right lower lobe; there were also peribronchovascular shadows in the bilateral lower lobes, right middle lobe, and lingula.

Small lung nodules will not cause frequent coughing, and the small nodules have fat shadows, so they are not considered to be malignant.

As for the presence of peribronchovascular shadows in the bilateral lower lobes, right middle lobe, and lingula, Luo Hao considered that they were related to chronic inflammation.

A bronchoscopy was then performed.

The pathological results of the bronchoalveolar lavage fluid showed that although there were no signs of cancer or other serious diseases, a large number of lipid-containing macrophages appeared, which was a manifestation of lipoid pneumonia.

Lipoid pneumonia, generally... no, most of it occurs in infants and young children with congenital diseases.

For example, premature, weak or cleft palate babies have imperfect pharyngeal reflexes. When they are fed milk, cod liver oil or paraffin oil is dripped through the nostrils, they may accidentally inhale it into the lungs and cause interstitial pneumonia.

It was quite interesting. Luo Hao slid the mouse wheel and pulled the medical record to the top to confirm the content he had just skimmed through.

The patient had a history of hypertension for more than 20 years, with the highest blood pressure at 200 mmHg; no history of coronary heart disease; and a history of rhinitis for more than 30 years.

After reading the medical records and combining them with the contents of the Union Medical College medical record database, Luo Hao had a rough guess.

However, Luo Hao was not sure what exactly caused lipoid pneumonia.

While they were still busy, Director Tang from the Respiratory Department also believed that the bronchoscope could not reach the location where the patient was located, and suggested going to the Cardiothoracic Surgery Department to consult with Director Xu, perform laparoscopic surgery, and obtain pathology data for a clear diagnosis.

Luo Hao didn't have any further opinions about the patient, it was just a fungal infection caused by raising pigeons.

As for how to make the patient believe and rekindle hope of life, that is Director Feng Zixuan's business and has nothing to do with me.

After reading the medical records, Luo Hao went to the ward to chat with the patient. With the help of affinity +3, Luo Hao chatted smoothly. After more than ten minutes, he found the cause of the disease and compared it with the medical records and the contents of the Union Medical College medical records database. With the help of AI, he got a definite diagnosis.

When I returned to the office, Feng Zixuan was not there. He was probably busy.

Luo Hao thought about it and felt that the case in front of him was special, so he picked up his phone and called Zhuang Yan.

"Senior brother~~~"

"Zhuang Yan, come to the respiratory department. There is a special patient here. Please take a look. This is considered as an annual assessment. If you can draw the correct conclusion, you will pass this year's assessment."

"Huh!" Zhuang Yan was startled. "Brother, our medical team still has an annual assessment?!"

"It's only targeting you. Don't worry, Chen Yong, Lao Liu, and Lao Meng are not targeting you."

Even through the phone, Luo Hao could hear Zhuang Yan crying and feeling heartbroken.

This statement is too direct and too targeted.

After hanging up the phone, Zhuang Yan came over soon, but she didn't come alone, Meng Liangren followed her.

It’s like a child who has been wronged and has the adults following him.

Meng Liangren had a gentle smile on his face, as if he didn't notice Luo Hao's sharp eyes.

"Take a look at this patient." Luo Hao glared at Meng Liangren, and seeing that he didn't react, he changed "you" to "you all".

Zhuang Yan sat down with a sad face and began to look through the medical records. Meng Liangren stood behind Zhuang Yan with his hands behind his back and also looked at the medical records together.

Luo Hao snapped his fingers, then realized that he was not in his own office. Erhei did not have such a strong artificial intelligence that could run across a building to let him do things.

Old Meng Xiaozhuang spent a full 30 minutes looking at the medical records. Zhuang Yan then "reported" the key points she had noticed to Meng Liangren, and Meng Liangren also followed up with improvements and additions.

Afterwards, Meng Liangren accompanied Zhuang Yan to the ward to see the patient and asked about his medical history in person.

Generally speaking, doctors don’t pay much attention to this last step, after all, they don’t have time. Objective examinations only show what they are, and asking about medical history is unlikely to yield any results.

But Luo Hao was not surprised that Meng Liangren took Zhuang Yan to ask about her medical history.

Sitting in the office, Luo Hao secretly hoped that they could come up with the correct answer.

After a while, a familiar voice was faintly heard from outside the door.

Luo Hao pricked up his ears and listened carefully. He felt a mysterious feeling as if he was eavesdropping through a wall, which he found particularly funny.

"Meng, the patient does not have a malignant tumor. This has been confirmed, but what exactly does your senior brother mean by testing me?"

"Think carefully about what habits the patient has in his life."

"Habits? No smoking, but drinking. Aspiration? But when I asked, the patient had no history of esophageal reflux."

That's right, Luo Hao smiled. A pneumonia patient could ask about esophageal reflux, so Zhuang Yan has already gotten started. There's no harm in thinking more about it.

"Indeed, there isn't. Even if there is, it shouldn't be lipoid pneumonia. You haven't seen a patient with aspiration, have you?"

"Yes, there are large shadows in the lungs."

"Yes, so this point can be ruled out." Meng Liangren didn't seem to have found the correct answer either. He was not trying to induce Zhuang Yan to draw the correct conclusion, but was also guessing.

"What else? Hypertension? Rhinitis? I think it's because the patient worked as a loader at a railway station when he was young and handled irritating items. It's similar to silicosis and pneumoconiosis, and is a work-related disease."

"It doesn't seem like it. It's been so many years. If there is any, it must be old. It doesn't show that way in the movie." Meng Liangren murmured in a low voice, as if thinking.

In Luo Hao's imagination, Meng Liangren had already stretched out his sweaty hands and subconsciously tried to touch Erhei's head.

"Edible oil, or non-edible oil, is volatile, which leads to..."

"Did you notice that the respiratory department wrote in the medical record that for lipoid pneumonia, the most important treatment is to stop the further intake of lipid substances."

"But they couldn't find the source. But this proves that, according to the specialists, the irritating oils ingested in the early years will not travel through time and space to cause illness now."

"That's strange, why?" Zhuang Yan murmured sadly.

If Luo Hao's five senses had not been digitally transformed, he really wouldn't have been able to hear what Zhuang Yan was saying.

"Well, let's go through it bit by bit." Meng Liangren pondered, "The patient has a respiratory disease. What are the possible causes? Rhinitis is definitely one of them."

“Rhinitis is an inflammation of the nasal mucosa caused by viruses, bacteria, allergens, etc., which may be caused by various physical and chemical factors or certain systemic diseases.

Among the many types, the most common is allergic rhinitis, which is caused by allergens such as dust mites, mold, pets, pollen, etc., and there is a genetic tendency. "

"Non-allergic rhinitis is caused by factors such as viruses, bacteria, irritating odors and temperature changes, and includes vasomotor rhinitis, atrophic rhinitis, hormonal rhinitis, etc."

Zhuang Yan is a graduate student from a prestigious university with solid basic skills. When it comes to rhinitis, she doesn’t even need to search the Internet and can give a standard answer immediately.

Meng Liangren didn't say anything, just listened quietly.

“The main symptoms of rhinitis include nasal congestion, sneezing, runny nose and nasal itching, but the specific manifestations can vary depending on the type of rhinitis.

The early symptoms of acute rhinitis are often dryness, burning or itching in the nose, and eventually develop into obstructive nasal sounds, decreased sense of smell, etc.

The main symptoms of chronic rhinitis are nasal congestion and increased nasal discharge, and symptoms such as headache and discomfort at the root of the nose may also occur.

If the condition is serious, the inflammation may also affect other parts of the upper respiratory tract and the lower respiratory tract, causing complications such as pharyngitis, otitis media, tracheitis, bronchitis and pneumonia. "

"Meng, this is what the book says. First of all, I have never seen pneumonia caused by rhinitis. Even if there is, it is probably very mild. Secondly, the patient's rhinitis is not very serious. It's really not serious."

"Okay, this is a questionable point. What next? It was aspiration caused by reflux esophagitis, which we have ruled out." Meng Liangren continued.

The two continued to study outside the office.

One is trained in a professional field and has a solid theoretical foundation; the other is experienced in clinical practice and is extremely meticulous.

Luo Hao listened with great interest.

They are only one step away from the correct answer, but that step is in their blind spot, so they have not yet gotten a definite answer.

It looks simple, just a thin layer of window paper, but sometimes this layer of paper is a chasm. Many people can't get over it in their lifetime.

After a while, Feng Zixuan came back with a gentle expression.

"Xiao Luo, why are you still waiting for me here? I saw Xiao Yan discussing something outside."

"Director Feng, this is your elder's condition. I have examined it and given Zhuang Yan a question as a year-end assessment."

"What?!" Feng Zixuan was surprised.

Luo Hao actually wanted Zhuang Yan to solve the problem for a patient who had not received an answer after at least two hospital-wide consultations in the Department of Respiratory Medicine.

It also serves as an end-of-year assessment.

How come it looks so formal? Feng Zixuan was surprised, then smiled. "What is the reward for the assessment?"

"Rewards, I haven't thought about it yet. I just want to know what level Zhuang Yan has reached now."

"What are the levels?" Feng Zixuan did not ask about the assessment without any reward, but curiously asked Luo Hao about his evaluation and grading of Zhuang Yan.

"It is true that medical students from other universities have poor foundations, but it is not important. The main reason is that they have seen too few rare clinical cases and their thinking is not divergent. But this is unavoidable, after all, the difference in scores in the college entrance examination is so big."

"!!!"

Feng Zixuan listened quietly to Luo Hao showing off.

However, PUMC is indeed the top one in China in this respect. More than ten years ago, during every summer vacation, a group of experts from PUMC would fly around the country, search other colleges and universities, find out the geniuses and bring them back to PUMC for interviews and postgraduate studies.

There are indeed some shady operations here, but the fact that Concord Hospital has maintained its reputation for so many years proves that most people have done the right thing.

Otherwise, even Concord, with its profound foundation, would not be able to withstand the disaster.

"Xiaozhuang has a solid foundation of knowledge, but lacks some divergent clinical thinking. He had already found the problem, but he just didn't take that step forward."

"Problem? What's the problem?" Feng Zixuan asked.

Are you talking about Zhuang Yan? You are talking about the clinical experts at the First Hospital of Medical University!
The patient in front of him, Feng Zixuan, sought consultation from the relevant departments, and even Director Shen was called over to take a look.

No one has the answer, no one knows where pneumonia came from.

Because it does not involve malignant tumors, no one cares too much about it. It is just a cough, it is not fatal.

Besides, are chronic bronchitis and emphysema rare in the Northeast? If they don’t become migratory birds and don’t go to Hainan for the winter, chronic bronchitis is a disease that almost every Northeasterner over 6 or 70 years old will suffer from.

Can……

Feng Zixuan fell into deep thought.

"Director Feng, how is the patient?"

"Send him to the trauma department first, give him a blood transfusion, and do some psychological work. Then he will be discharged and admitted to the chest department. I called Director Xu and asked him to perform the surgery."

Feng Zixuan has already arranged everything, so there are no unexpected events for the time being.

Moreover, the incident happened in the women's bathroom, and no video was released on the Internet.

Feng Zixuan expected the enemy to be lenient, but those accidents did not happen.

It can be said that this matter has been perfectly resolved. What remains is to comfort the patient, undergo surgery, and wait for pathology.

Feng Zixuan was not worried about the pathology results at all. With Luo Hao's diagnosis, there was nothing for him to worry about.

Now his attention was on the patient.

"I'll go and listen to what they discuss."

"Let's go together." Luo Hao also stood up, with a smile on his face, and walked out of the office with Feng Zixuan as warm as the spring breeze.

"That's not right. Is he fat? Some people are too fat... No, the patient is not fat, and is a little thin." Zhuang Yan's hair was about to explode from being squeezed.

Meng Liangren had a blank expression on his square face as he pondered seriously.

It seems that he has regarded Zhuang Yan's "assessment" as his own assessment, and is thinking about and checking it bit by bit.

"Senior Brother, what's going on?" Zhuang Yan asked immediately when she saw Luo Hao coming out.

Luo Hao smiled and said nothing.

"I remembered it! I said I seemed to have forgotten something!" Meng Liangren suddenly shouted loudly.

The excitement was beyond words.

(End of this chapter)