Chapter 68: Incurable Disease and the New Chairman (5000 words) (Page 1/2)
"Hey, David, what are you doing here? Looking for a patient to treat?
This patient was brought in this morning, a homeless woman found in a condemned building.
We suspect drug overdose, but the tox screen was negative, yet she still has delusional symptoms.
Furthermore, the patient also has muscle spasms in her wrists.
We don't have a diagnosis yet, but Dr. Wells from Oncology wants us to take over this case.
House agreed."
Chase, who was coming over to receive the patient, said this while handing over the chart.
Seeing that David was unusually quiet, Chase shook his head and performed a few simple neurological tests on the patient.
"Can you feel pain?"
"Yes, I'm human, why wouldn't I feel pain?"
"Hey, quite a feisty patient. Come on, squeeze my hand.
Huh? Can't squeeze? Then try lifting your hand above your head."
Upon hearing this, the patient trembled all over, trying with difficulty to lift her hand above her head. But when it reached her shoulder, the patient suddenly lost strength, and her arm dropped limply.
Then her whole body went into convulsions.
Chase immediately noticed this:
"She's seizing, get me some Ativan."
Taking the sedative David handed him, Chase said while administering it:
"Check her blood glucose."
David took the glucometer and expertly pressed it onto the patient's finger:
"Blood sugar is 38."
"D50, IV push, now!"
After a brief resuscitation, the patient's condition finally stabilized and she gradually regained consciousness.
Chase wiped the sweat from his forehead and smiled helplessly at David:
"Looks like another complicated case."
But Chase still didn't get a reply from David. Feeling that something was wrong, he asked in confusion:
"What's wrong? Why are you so down today? Is it because of Pete?
I heard he was always targeting you, so his death should actually be a relief for you."
David sighed deeply and motioned with his eyes for Chase to talk outside.
Only after Chase closed the door to the isolation room did David speak with a heavy tone:
"I think I know what disease she has."
Chase raised an eyebrow. Knowing the patient's diagnosis should be a good thing, but David's expression didn't seem relieved at all.
"Yeah?"
David added in a grave tone:
"Rabies. Symptomatic rabies."
"What?!"
Chase's sudden increase in volume caused people nearby to look over. Chase then realized he had been out of line.
He lowered his voice and said softly:
"You can't just throw that diagnosis around. If it's symptomatic rabies, the mortality rate is practically one hundred percent.
In the past twenty years, there have been fewer than ten survivors worldwide."
To be honest, David didn't want this either. He came here to save people, not to pronounce death sentences.
But with current medical technology, symptomatic rabies is essentially incurable!
In other words, no matter how hard they try, the patient lying inside will die within 3-6 days.
"Did you notice the scars on her body?
In my experience, they look very much like bat bites.
You also said she's homeless.
People with homes who are bitten by animals go to the hospital for post-exposure prophylaxis.
But homeless people might not realize the danger, and without anyone to care for them, they don't get medical intervention.
Let's test her saliva for viral RNA, we'll know the result soon."
After hearing David's words, Chase also fell silent.
No matter when, it's never easy to calmly face a patient's death.
But what needs to be done must still be done.
Chase, as instructed, used a sterile swab to collect the patient's oral secretions and took it to the lab.
Then he watched Cameron's procedure nervously, hoping the result would be negative.
House also arrived quickly after hearing about it. He glanced at Cameron who was running the test and asked David:
"How certain are you?"
"Eighty to ninety percent. Besides the bite marks on her body, she's also photophobic, and her pharyngeal muscles spasm when she hears running water—hydrophobia.
Also, when I looked at the chart just now, I found that she was also experiencing confusion, clearly already having hallucinations.
Considering that homeless people often shelter in abandoned buildings and tunnels, it's very possible that bat colonies are present.
And bats are one of the primary vectors of rabies."
House nodded, indicating his approval of David's deduction.
Then he limped over to Cameron's side and looked at the computer screen.
The peak on the graph output by the RT-PCR analyzer was quickly matched.
Undoubtedly, rabies virus.
Looking at the confirmed result, Chase also understood why David was feeling down.
For an intern, the psychological pressure of having to give up on a patient is immense.
However, logically speaking, David should be used to seeing death, given his connections to the Continental Hotel.
Regardless, Chase still patted David's shoulder and comforted him:
"This isn't your fault. If there was even the slightest chance to cure her, we would definitely try our best to save her."
House also sighed, then said:
"Isolate her in a negative pressure room, dim the lights to avoid external light and sound stimulation.
Use soft restraints to prevent her from suddenly becoming violent and harming others or herself.
Try treating her with interferon-alpha, ribavirin, and high doses of human rabies immunoglobulin.
At this point, we can only do our best and hope for a miracle."
After speaking, House shook his head and left.
Even House had no solution for symptomatic rabies.
The atmosphere in the lab was also oppressive.
David was full of frustration. Today's patient had symptomatic rabies, which meant his efforts today were essentially futile in terms of extending life.
Just as David was thinking of going to the emergency department to see if there was a chance to take in another patient, a nurse suddenly delivered a notice from Cuddy.
Cuddy requested all available doctors to come to the conference room.
David realized that something significant had happened, otherwise all available doctors wouldn't be suddenly summoned.
On the way to the conference room, Chase quietly approached David and shared the gossip he had heard.
"I heard the hospital received a massive private donation, and Cuddy decided to let the donor serve as Chairman of the Board.
I wonder if this new chairman will be reasonable."
David's expression changed slightly upon hearing this news. He instantly understood what had happened.
Simply put, this hospital had been taken over by a corporate investor.
"Hey, capitalism is all about profit. Do you think he'll be reasonable?
Salaries, benefits, and patient care will inevitably be cut, and there might even be layoffs.
If Cuddy really allows that, I can only say she's short-sighted.
The final outcome for this hospital won't be good."
Chase was stunned for a moment:
"It wouldn't be that bad, would it? I heard he wants to invest in pharmaceutical research to benefit humanity.
He shouldn't interfere too much with clinical operations."
David smiled and said no more. He then pushed open the conference room door and chose the most inconspicuous corner to stand in.
As an intern, his status in the conference room was the lowest, so naturally there was no seat for him.
The people with seats were the department heads and everyone from diagnostics.
From this, one could see the importance of the diagnostics department in this hospital.
And sitting next to Cuddy, who occupied the head position, was an obese African American man who looked like he weighed at least 300 pounds.
This guy looked like he had squeezed himself into an ill-fitting suit, to the point where he couldn't even button his jacket.
This awkward attire made him look uncomfortable no matter how you looked at it.
It was like someone completely out of touch trying to fit in by wearing expensive clothes.
While David was observing him, David also noticed that this man was staring at him.
How strange—among so many people present, this guy didn't look at those who would be his future subordinates, but instead singled him out from the crowd?
Could it be that he had some personal grudge with this obese man?
But David was very certain that he had never seen this man before today.
If he had seen him, David would definitely remember.
After all, people of this size are not common.
Just as David was thinking, Cuddy scanned the conference room, and seeing that most people had arrived, she stood up and said:
"Today, something has happened that will affect the future development of our hospital.
An investor has contributed 100 million dollars to Princeton-Plainsboro!
It's rare for a private donation to have such an impact on a large and complex institution like a teaching hospital.
Of course, this substantial donation comes with a condition—the donor will become Chairman of the Board.
I believe this is a reasonable request. He has the right to oversee how we utilize his 100 million dollars.
Now, let's welcome our new Chairman, Edward Vogler."
Cuddy led the applause, and the people in the conference room also politely clapped.
Edward also stood up from his chair.
I have to say, people of large stature really command presence when they stand up.
The conference room fell silent.
Then Edward talked about his successful pharmaceutical investments in his career, and also discussed his plans and expectations.
In short, David was drowsy listening to it. This kind of corporate speech, devoid of any highlights or passion, was honestly great for inducing sleep.
Just as David's eyelids were heavy and about to close, he suddenly heard Edward raise his voice and emphasize:
"...So we must build our hospital into a world-class medical institution, second to none!
Under this goal, I want all of us to work together!
From now on, everything will be significantly different!
I announce that everyone's performance bonuses will be increased by fifty percent!
But corresponding to the rewards is that there will be no slackers in my hospital!
If there are, I will report them to the medical board and terminate them, ensuring they can never practice medicine again!"
After saying these impactful words, David immediately felt a burning gaze directed at him.
David's sleepiness was instantly dispelled.
Good God, is this Edward targeting me specifically?
David frowned and began to recall where he had offended this financial backer.
After much thought, David could only think of two candidates: Foreman and Pete.
The defeated Foreman obviously did not have the connections to know a donor who could casually invest one hundred million dollars.
Then it can only be Pete, who had been deeply involved with the Continental Hotel for years.
So, this obese man named Edward is also connected to the Continental Hotel? Or... the High Table?
David would not forget that the High Table has twelve seats, and the Tarasov organization was just one of them.
The guy in front of him without a tattoo on the back of his hand is obviously from another faction.
He just doesn't know how deep this guy's friendship with Pete was, and to what extent he would retaliate for Pete's death.
In short, David understood that he had one more serious problem.
While David was thinking, the conference room was already filled with enthusiastic applause.
At present, they don't understand the character of this new chairman, but the fifty percent increase in performance bonuses has truly won everyone over.
For the sake of money, at least today they are enthusiastically supporting this new chairman.
As for the warning about slackers at the end, no one paid attention.
In their eyes, this Edward seemed more like a wealthy benefactor than a ruthless corporate raider.
After the meeting, Cuddy suddenly stopped Chase and David.
Then, after giving them a look to watch what they say, she turned to introduce them to Edward:
"This is Dr. Chase, our hospital's youngest board-certified attending. Next to him is intern David, who has received praise from many attendings.
They are both doctors with excellent clinical skills. They handled the emergency admission this morning."
Edward nodded. Without others present, his face was completely devoid of the smile he had during his speech.
This is the true face of a corporate executive.
His kindness, his smile, his warmth were all performance for the masses.
But now, in this office where he has absolute authority, he no longer needs to pretend.
Edward directly questioned David and Chase in a condescending tone:
"I heard that homeless woman couldn't even afford the co-pay, but you are using expensive pharmaceuticals on her?
Now that her condition is stable, why haven't you discharged her?
We have already provided emergency stabilization and fulfilled our EMTALA obligations. Subsequent treatment is not covered under emergency medical law.
Moreover, I know these homeless people. They just want to fake illness and get free meals at the hospital.
You two go and discharge her immediately!"
As soon as these words came out, not only did Chase's face change drastically, but even Cuddy's expression soured.
However, Edward didn't care. As he spoke, he opened the patient's chart on the computer.
Then his brow furrowed even more.
"Symptomatic rabies? With all due respect, even though I'm not a physician, is there even a point in treating this disease?
She is already terminal! What are you still using? Interferon-alpha, ribavirin, and high doses of human rabies immunoglobulin?
Are you really doctors? Don't you know common medical knowledge that even I know?
Or are you simply not concerned about who is paying for these medications?
You can't do this. You will never be able to make this hospital financially viable.
Who made the diagnosis? House? Who is he? Get him in here!"
Cuddy glanced at the two, signaling them not to speak yet. She forced a smile and said:
"Dr. House should be in the clinic at this time.
For this patient, I think out of humanitarian concerns, we should try our best to save her.
What if there's a chance?"
Edward sneered:
"There will be no miracle. Can't you just give her normal saline?
What does a homeless person know about the difference between interferon-alpha and saline?
Even an intern might not understand. David, do you understand this?"
Seeing Edward call his name, David replied coolly:
"If you suspect my credentials are fraudulent, you can report it to the medical board.
But please do not insult me with such a patronizing question."
Being lightly rebuffed by David, Edward was obviously very displeased. He looked at Cuddy:
"Are all the interns in your hospital like this? No professional courtesy at all.
He didn't even bother to address me as Chairman!
Or is it that the diagnostics department has this kind of undisciplined culture?
So House is the head of diagnostics, right? He's in the clinic now? Fine, I'll go and see what kind of person he is.
They say you can judge soldiers by their commander. Hmph."
Edward stood up from his executive chair and looked at David provocatively.
His purpose was very clear—he just wanted to make an example.
First, use the case of a homeless patient to severely reprimand the doctors in diagnostics and damage their morale.
Then, use David's "disrespect" as an excuse to go after House.
He had already thoroughly researched House's personality.
Now he was just pretending not to know.
According to the information Pete had sent before his death, House at this time would be avoiding clinic duty, hiding somewhere slacking off.
So he would use this as grounds to fire House first, which would leave David without protection.
At that time, David would be at his mercy, and he could slowly deal with him.
This would also be repaying Pete's favor.
But unfortunately, Pete would not be able to witness his brilliant operation.
Edward directly ignored Cuddy's attempts to stop him and strode towards the clinic.
Cuddy, who was about to continue trying to intercede, suddenly saw Edward stop.
Because Edward pointed at the guy in a glass-walled office who had his feet propped on the desk and was constantly playing with a oversized tennis ball, and asked:
"Who is that person?"
Cuddy, seeing House slacking off so blatantly, could only try to deflect:
"He is one of our many physicians."
But it was clear that Edward was not going to let this go:
"Oh? Don't doctors all wear white coats? Why isn't he wearing one?"
Cuddy continued, trying her best not to reveal House's identity:
"He's a bit... unconventional."
Edward narrowed his eyes. Of course, he knew this person was House.
He just wanted to see how long Cuddy would try to cover for him.
"Oh? What's so unconventional about him?"
Cuddy thought she had successfully diverted Edward's attention. She exhaled and said:
"He is our most outstanding diagnostician here, so he has somewhat of an eccentric personality, but he can solve many complex and rare diseases for us.
Therefore, this can be considered special accommodation for exceptional talent."
"Oh, so he is the House who raised an insubordinate intern like David, right?
It seems exactly as I expected. House is as lazy as I imagined.
My hospital does not need such an undisciplined doctor. I will convene the board of directors to terminate him!"
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