Among medical students, there is a popular saying: gold ophthalmology, silver surgery, exhausting obstetrics and gynaecology. Paediatrics is not worth a penny, and death does not go to the emergency department.
The emergency department is the scariest place in the hospital, because you never know what will happen to the next patient. Trauma, chest pain, stroke, poisoning, heart attack...
For Liu Hao, who had just graduated with an undergraduate degree, both the roar of the ambulance, the patient with a face as white as paper, and the thrilling and major resuscitation were too much of a thrill. At the moment, he stood in front of the lift, bewildered and at a loss.
Chen Xinan pacified the family members over there, which came over and asked him, 'Is there a film yet?'
'Just shot, the report card is not yet out.'
'Well.' Chen Xinan turned his head towards the depths of the corridor, 'I'm going to the washroom.'
Liu Hao gripped his arm, "Go back later! People are dying!"
'Don't panic.' Chen Xinan clamped his wrist with his index and middle fingers and removed it with no lightness, 'If you can't even wait for these two minutes, then even if I fly over now, it won't work.' He also smiled meaningfully after saying that.
Liu Hao looked at his back, wrinkling his face and secretly pondering.
Is this telling a hell of a joke? Or did he upset him? Thinking is concentrated, even by the lift door clamped several times did not react.
In fact, I do not blame Liu Hao sensitive, Chen Xinan's smile is really creepy.
Objectively speaking, he looks harmless. Fair short square face, glossy falling tail eyebrows. A pair of large gentle eyes, wearing a pair of half-frame myopic glasses. Thin, tall and handsome, like "someone else's child".
But there's just one problem - looking at people without focusing. Even when speaking face-to-face, his eyes never fall into each other's eyes, but fall further away. With a mysterious, ethereal, wistful look. This kind of misty with a smile, a closer look does have a few bizarre, as if the portrait in the painting moved.
In college, someone gave him the nickname: Chen Na Lisa. Chen Xinan himself is quite satisfied, thinking that the capital is elegant. When I think about it, in my hometown, he was called the only egg (not fit in).
Chen Xinan embraced the urinal, which followed Liu Hao down to the ground floor. From afar, I saw the rescue room door bustling, a group of old men are arguing with the security guard.
There were about seven or eight of them, all of them with fierce faces, banditry. One of them is a fat man with a tattoo of a Taiji Bagua formation on the back of his head. Back and forth shaking his head, like a running zebra arse.
Chen Xinan took a look at this group of oddballs, suddenly felt a few headaches. I thought that the rescue will not also tattooed a head, right? How about sewing the skin and letting the plastic surgeon come?
Push open the emergency room's big double-open iron door, the eye is a slip of blood, was stepped on and smeared everywhere.
Chen Xinan walked to the clinic desk, slowly and methodically asked: 'Which patient ah?'
The doctor raised his hand and pointed down: 'The man inside, Wang powerful cover inside.'
Wang Awesome, formerly known as Wang Danxin, is the head nurse of the Emergency Department. Doing things diligently and responsible, is to grow a pretzel mouth. From the director of the curse to the training, from the patient scolded to the family. Ten years of cursing all over the world, the dean see her go around. People send nicknames: Wang powerful.
Chen Xinan wandered to the side of Wang awesome, two hands in front of the body clasped: 'How is the person ah?' His tone was calm and relaxed. Not like in the emergency room, but like bumping into an acquaintance in the supermarket.
'The maggot toucher is here?' Wang Awesome hung up the rehydration bag and rolled his eyes, 'Very well! berber bouncing around!'
The doctor and the emergency nurse were born to be two different species. A fire fire butt are not in a hurry, a chen time point soldiers on the battlefield. And the thunder and lightning, generally can not stand slow and methodical. Wang powerful look Chen Xinan that mushroom strength, can not control to bare two sentences.
Chen Xinan is not angry, just laugh. Lift up the CT film that just arrived, viewed by the light. The patient's situation, not to mention "berber bouncing", I'm afraid it will soon be "planted rash belly up" - serious intracranial haemorrhage, obvious midline displacement.
The human brain, in fact, is not embedded in the skull, but suspended in the cerebrospinal fluid. In the event of momentary acceleration or a sharp stop, the brain will hit the skull hard. The injured brain swells and compresses the blood vessels, resulting in a poor blood supply. If the pressure isn't reduced in time, the person is gone in the blink of an eye.
So in theory, it's entirely possible to kill someone by shaking their shoulder suddenly and vigorously. The brain of a newborn baby is even softer, a parent's lift could kill.
The film in Chen Xinan's hand shows that the midline of the brain has shifted. Any further delay is likely to result in brain herniation, requiring immediate craniotomy to remove the haematoma.
He put down the film and took out the torch, wanting to check the patient's pupils. As soon as his vision hit the person on the gurney, his hand stopped.
He'd seen this man before.
No. More than seen. Rather, he had been haunted and searched for!!!!
---
It began late last year.
It was a cold, dry afternoon when a middle-aged woman came to the clinic. She had gone to the ophthalmology department for a sudden loss of vision, and it turned out to be a pituitary tumour.
It was a bit unfortunate, I thought it was an eye problem, but I didn't realise it was the brain. However, it was also fortunate because most pituitary tumours are benign and have a low probability of recurrence after removal. However, the patient's tumour was a bit too big to be cut by endonasal endoscopy, so a traditional craniotomy was needed.
When the patient and his family heard about this, they both flinched. On the one hand, it is the resistance to craniotomy, and on the other hand, it is the cost of up to 100,000 yuan.
A large family in the clinic talked for half a day, and finally said to go to the Chinese medicine side. Chen Xinan saw their attitude, thinking that it is not treated. I did not expect a month later, the patient came back. At this time, she has visual field defects, see everything with a big black hole. Under the fear of possible blindness, she was determined to have surgery.
During the evaluation stage before surgery, Chen Xinan found that her blood lipids were a bit high, so he suggested a coronary CTA to assess the risk. However, it was strongly opposed by her family - obviously there is a tumour in the brain, what is the point of checking the heart?
Probably because of their distrust of the healthcare system and financial pressure, several family members spoke very harshly. A moment said that CT has radiation, and a moment said that the doctor has a commission for prescribing CT. Chen Xinan patiently explained that not all coronary artery stenosis has symptoms, and that there is no harm in checking. And here is a public hospital, equipment is not outsourced. Open check not only no commission, open more doctors will be deducted money.
But I didn't expect the explanation to intensify the family's fear and denial. A large group of people crowded in the outpatient clinic, a moment to say that online V have exposed the inside story, do not take people as fools. A moment and then recorded a video uploaded to the network, naming him and scolding him for charging indiscriminately.
Chen Xinan originally smacked this tumour growth in general: neither academic value, nor the challenge of pleasure. The family is difficult to deal with, he is even more lazy to waste time. Put down a sentence of consequences, let them go.
I thought it was a small probability event, but the reality is so inch.
The surgery started off very smoothly and there was no abnormality in the electrocardiogram. However, just as Chen Xinan was cutting open the cerebral dura mater, the anaesthetist suddenly jumped up, 'No! The T-wave is wide!'
Chen Xinan stopped and looked at the monitor for a few seconds. He saw the T-wave getting wider and wider until it completely flipped. Immediately after that, a beep sounded and a red light flashed.
Everyone instantly entered a fighting state. Those who jumped up to do chest compressions, those who broke the ampoule of the medicine bottle, those who fired the defibrillator, those who applied conductive gel to the electrode plates, those who went out to notify the family...the atmosphere in the operating theatre was like a taut string on a bow and arrow.
'On or off defibrillation?' The assistant asked, holding up the electrode pads.
'Don't panic,' Chen Xinan was still standing in front of the patient's head, staring at the fluctuations in the ECG, 'wait a little longer.'
Half a minute later, the patient's heartbeat resumed under shadowless hand-like chest compressions. Along with the disarming of the alarm, everyone breathed a long sigh of relief under their masks.
Chen Xinan turned his head back down and joked, 'The pressure was fast enough that the King of Hell didn't even intervene.'
Everyone was amused by him. The tense atmosphere was eased and the surgery continued. However, after less than ten minutes, the beeping of the monitor sounded again. This time Chen Xinan did not choose to wait and see, and decisively commanded, 'Defibrillate.'
The assistant copied the defibrillator and shouted, 'Back off!'
Bang! The patient's body bounced violently against the sterile sheet as the current threaded through the electrode plates. But the situation didn't improve; the monitor was still a mess of small ripples.
Chen Xinan calmly repeated over the shrill beeps, 'Remove again.'
Another twitch, and the heart rate still didn't return.
'Remove again.' Panic still missing from his tone, he exchanged his weight between his two feet and glanced at the wall clock.
It was electrified four times before a pulse finally rang out.
'Sinus rhythm now!!!' The equipment nurse exclaimed excitedly, and then the room turned awfully silent again. A pair of hands were poised in mid-air and a pair of eyes looked towards the main knife.
The price of the robbery was more as if they were on thin ice. Everyone was waiting for the main knife to make a decision, to give instructions.
'No more, close the incision.' Chen Xinan said to the roving nurse, 'Call the cardiology department and do an angiogram.'
While the heart rate stabilised, the patient was pushed out of the operating room and sent directly to the cardiology department. The results of the angiogram showed coronary stenosis, with a lumen stenosis area of up to 45%. This time, the skull lifted in vain, not to mention, but also have to do a heart bypass first, at a later date to re-lift. Because of the small loss of large hospitalised in the ICU, the cost of a day is enough to do 5 times CTA.
This time the family can't stand it any more. The family can't take it anymore. The family bites because they didn't give the surgery red packet, so they intentionally treat the person to the bad, in order to send the ICU to earn money.
Although public hospitals are not afraid to make trouble, but the leadership feel that a group of people make trouble in the end is not decent, and asked to hurry to rest. At the moment of negotiation, the patient in the ICU recurrence of ventricular fibrillation. This time, however, neither electric shock nor pushing drugs were able to bring her back.
On the afternoon of the day the patient was pronounced dead, a dozen men poured into the hospital lobby and vandalised the place. By the time the police arrived, the nurses' station was in shambles.
In the end, the city medical mediation committee mediation, the hospital out of humanitarianism compensation of 500,000 yuan.
Chen Xinan because of this incident did not suffer a lot. The information has been written on a truck, and the hospital has a rule that the hospital should not be held responsible for any medical problems. And the hospital has a rule, out of medical disputes, the department to cover 70%, the doctor personally bear 30%. Deducted from the monthly performance of 3,000, deducted until the end.
Chen Xinan's back teeth are all going to bite the dust. Angry at the indisputable patient, even so inexplicably died. More angry at the mediation of this and mud type, even put the blame entirely on him.
But no matter how disturbing it was, he, as a small doctor, conceded that compromise was the least costly option. He has accepted the established facts, but did not expect this is not over.
What's more, he didn't expect that the result of this unfinished business would be to be chased by someone with a knife!