Chapter 183
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The building for Yun Hua Hospital's Emergency Department was twenty-six feet tall . The reception hall was as large as the halls in high-class hotels . Even when there were plenty of people moving about, it did not feel crowded .
Whenever leaders paid a visit, Yun Hua Hospital's Emergency Department was always one of the items on their list of places to visit .
After all, while the leaders may not have understood the difficulties of internal medicine or the specializations in surgeries, they definitely knew about the importance of the Emergency Department .
The eight glass doors, which were usually pushed outwards, were now pushed inwards . The Emergency Department welcomed batches upon batches of patients who came for emergency treatment . Among them were also patients sent to them by ambulances . There were also those who walked in to receive emergency treatment, and naturally, they could not avoid receiving patients who thought they needed emergency treatment .
The resident doctors, housemen, and nurses busied themselves handling the patients, but they did so with ease .
If nothing happened in the morning, it would be a bright day for them . On mornings like that, the doctors and nurses would only run into illnesses or injuries that required them to prescribe medication or administer fluid transfusions . To medical staff working in places such as Yun Hua Hospital, these were not even considered as illnesses .
A patient who suffered from pain in his lower right abdomen was received by Doctor Zhou before he was transferred to another group .
Another patient suffering from pain in his lower left abdomen was examined by Doctor Zhou, but the doctor shook his head in disappointment .
The patient's family members were taken aback right then . They asked Doctor Zhou in a dumbfounded manner, "How is it possible that he's in critical condition the minute we transfer him to the hospital? He was still okay at home…"
"Who said he's in critical condition?" Doctor Zhou refuted while he swiftly waved his hand for a resident doctor to take over . As an experienced slacker, he had long since surpassed the age of arguing with the patients' family members .
In truth, once a person got to the age of a senior attending physician or associate chief physician, he would not lose when he quarreled seriously with others . The questions asked by the patients had been similar for the past ten years . It was just a matter of being asked by different individuals . There was already a format to answer their questions, provided that the senior doctors had enough patience of course . But normally, senior doctors were not patient enough, so they just avoided quarreling with the patients .
The resident doctor quickly received the patient . The patient's family members glared at Doctor Zhou and left the room without bothering him too much .
"Don't you have to provide some explanation?" Ling Ran rarely dealt with the patients' families . He spent most of his time working in the operating theater . He was only taught about doctor-patient problems once by Department Director Huo .
"No one can ever explain it clearly . " Doctor Zhou chuckled and said, "Did you know that in our hospital, there are scalpers who sell our consultation tickets?"
"Yes, I know that . "
"You may not have noticed one thing . Let me share a secret with you . Patients who buy expensive tickets for consultation are very obedient . They usually don't make a fuss . Do you know why?"
A plain and ugly resident doctor quietly leaned over and said, "Because they're rich?"
"No matter how rich they are, they'll be poor after consulting doctors for a period of time . " Doctor Zhou pursed his lips and said, "It actually depends on their needs, you know? So they make different requests . "
Ling Ran asked, "What kind of requests?"
"For people who spend 200 RMB or 300 RMB to buy the expensive consultation tickets, they usually want to be treated for their illness . For the hospital specialists whose appointment fees are sold at a high price, even if they don't manage to treat the patients, they can still solve some of the patients' problems . So there are fewer conflicts . But most of the people who come to the Emergency Department, and most of the patients who've made an appointment with the department's specialists, are only down with minor illnesses . Some of them may not even be sick . So, they're really just asking for medical service, get it? You'll have to observe . You have to speak nicely, and your attitude has to be good too . Our specialists have never gone through that sort of training before, so conflicts arise because of that . " Doctor Zhou smugly drew a conclusion based on the experiences he obtained over the years .
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The plain and ugly resident doctor listened very attentively . "So, will we be trained for this in the future?"
Doctor Zhou's expression immediately changed . "Are you dumb?"
"There's one more . . . " Ling Ran pointed at a patient being sent through the ambulance bay . His words shifted the duo's attention .
"He seems to be suffering from severe abdominal pain . " Doctor Zhou got up excitedly and went to receive the ambulance .
The resident doctor who was originally in charge of receiving the ambulance obediently gave up his spot when he saw Doctor Zhou approaching . Acute abdominal pain was considered a somewhat serious case in the Emergency Department . Resident doctors did not dare take over the task .
"Has she received any surgeries recently?" Doctor Zhou pressed down on the patient's abdomen a few times before he asked .
The family member who came with the patient quickly answered, "My mom received surgery for acute appendicitis last week in Yun Hua Hospital…"
"Has she had regular bowel movements?"
"She did in the beginning but stopped later on . We didn't take note of this because my mom had a mild case of constipation in the past…"
"Did she vomit?"
"No," said the family member . He turned around and asked the patient, "Mom, did you vomit?"
The old lady shook her head with great difficulty and said, "No . "
"Her abdominal sound is very weak . Let's conduct a CT scan and see . Then, do a plain radiography . Pass the result of the ultrasonography to me once you're finished . " Doctor Zhou seemed to be requesting, but he already had a medical form in his hands .
The family member watched him fill up the details and anxiously asked, "What is she down with, specifically? Can we reduce her pain first?"
"We suspect a blockage in the bowels," said Doctor Zhou after he filled out the medical form . "The blockage could lead to serious consequences . Just send her for tests first . "
After sending the old lady away, Doctor Zhou asked about her past medical history while he gave her family member a notice of surgery . This immediately made the man feel dizzy .
"How could it be so serious?" The family member held the notice of surgery in his hands . He could not believe it .
Doctor Zhou ignored him . He passed the remaining tasks to a resident doctor and got him to lead the family member away . Doctor Zhou then turned around and talked to Ling Ran, "This is a case of intestinal obstruction [1] in the elderly . I guess it's not easy to handle . Let's see if we need to perform surgery in the form of a laparotomy later . If there's a need, you can be the assistant for the surgery . "
Ling Ran thought of Yu Yuan when he heard that it was an intestinal problem . He said, "Let me call one more person up . "
Doctor Zhou did not really mind . As long as they could fit around the operating table, it did not matter how many doctors joined the surgery . If there was no need for surgery, there would no longer be a need to consider the number of surgeons required for the operation .
Yu Yuan ran down the stairs . Her face was red from the running . "Which patient has intestinal obstruction?"
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Doctor Zhou recognized Yu Yuan . He gave Ling Ran a thumbs-up . "Good idea . Why didn't I think of her? You've come up with a great proposition . "
Ling Ran then explained, "I know Yu Yuan understands colorectal surgeries very well, so I was thinking that we could just let her watch the surgery…"
"There's no need to explain . If there's a need for surgery, I'll try to give her chances to practice her skills," Doctor Zhou said firmly .
Ling Ran looked at Doctor Zhou, feeling puzzled . He asked, "Have you watched Yu Yuan in action before?"
Doctor Zhou retorted, "Have you seen any intestinal obstruction surgeries before?"
Ling Ran saw one very soon after .
Once the CT scan showed that the old lady had intestinal stenosis [2], she was pushed into the operating theater as quickly as possible . It was the most dangerous of all intestinal obstructions .
Doctor Zhou handed Ling Ran two masks . He sounded sad . "Wear it . "
Ling Ran wore the mask hesitantly .
Yu Yuan wore the mask in glee . She asked, "Am I the second assistant?"
"We'll decide after we perform the incision . " Doctor Zhou walked into the operating theater while he spoke in a solemn tone .
The nurse and the anesthetist were already in the operating theater . Their expressions were stern .
"Intestinal obstruction, stenosis . " Doctor Zhou paused for a moment before he looked at Ling Ran and said, "The patient hasn't cleared her bowels for a few days . Supposedly, she ate quite a lot . This old woman of sixty-four managed to eat two big bowls of food in one sitting . Her family is very proud of it . Let's have a look once we open her up . "
Everyone could not stand the thought of starting the operation .
Ling Ran finally realized what was going on . An idea unwittingly formed in his head .
'What am I doing?
'I only know how to perform inverted suture patterns and tension sutures .
'Why must I be curious about abdominal surgeries?'
Doctor Zhou silently performed the laparotomy .
There was a magnificent momentum . . .
Gas rose into the air . . .
And a certain smell lingered . . .
The laminar flow system in the operating theater was completely useless at that moment .
Doctor Zhou looked at Ling Ran and smiled . "There's good news and bad news . Which one do you want to hear first?"
"The good news!" Unexpectedly, Yu Yuan showed extreme cooperation . Her curiosity shone through her round, black glasses .
"The good news is, the situation isn't severe . It should be quite easy to handle," Doctor Zhou said .
"And the bad news?" Yu Yuan asked again .
"Tsk tsk," Doctor Zhou said, "Why didn't I realize that you were so obedient? The bad news… The bad news is we can't seek consultation from the General Surgery Department . We need to handle this on our own . "
"Why do you call it bad news when we're doing it ourselves?" Yu Yuan could not understand .
Doctor Zhou cackled and said, "Hang on, I'll tell you later . "
Doctor Zhou continued to examine the intestines . He stretched his neck after he finished the preliminary operation . Following that, he smiled and said, "Yu Yuan, do you know what the next step is?"
Yu Yuan had been paying full attention to the operation . "I think it should be the removal of the feces at the proximal portion of the intestines," she replied firmly .
Doctor Zhou laughed boisterously and said, "That's right . She has accumulated it for a week . There may even be previous feces that weren't completely removed through defecation . Are you happy?"
"Yes!" Yu Yuan nodded with all her might . Her round eyes sparkled behind her black-framed glasses, causing not just Doctor Zhou, but also Ling Ran and everyone else to look at her simultaneously .
"We're going to extract the feces now," Doctor Zhou faced Yu Yuan and enunciated his words clearly .
"I know . Oh, I've read a research paper on this before . It talked specifically about this . " Yu Yuan was practically bouncing on the balls of her feet . She said, "When we extract feces, don't we usually infect the abdominal cavity and the part we performed the incision? We can utilize the plastic bags used to create abdominoscopes, surgical gloves, and optical fiber cables to tie the end of the intestines . Then, we can insert another plastic bag into the intestine before we place the plastic bag we used to tie the end of the intestines . By doing so, we can push the stuff in the intestines into the plastic bag, and if there's too much, we can replace the plastic bag…"
"Why don't you do it?" Doctor Zhou quietly gave up his position as chief surgeon .
"I'll… be taking over?" Yu Yuan was instantly stunned .
"Yeah, I'll let you handle it . " Doctor Zhou felt that the surgery had lost its one and only appeal .
However, Yu Yuan was so happy that her hands shivered . She took over from Doctor Zhou and stood as the chief surgeon before she noticed Ling Ran . She quickly declined her position modestly . "Doctor Ling, why don't you take over?"
"No, you do it . " Ling Ran was very humble when he said this .
"Thank you, Doctor Ling . " Yu Yuan took a deep breath as if she had just survived a precarious situation . Her expression was slightly dark, but she did not take Ling Ran's refusal to heart .
After a while, Yu Yuan prepared a plastic bag, just as she had described earlier . Subsequently, she wrapped the plastic bag along the intestines and slowly dug out the fecal matter that was stuck in the intestine .
A palm-sized plastic bag was filled with feces the volume of two phones very soon . . .
The circulating nurse could not help but ask, "How much is still in the intestines?"
"It's still too early to say . This is just the digested portion . The granny seems to like rice a lot . " Yu Yuan laughed and said, "I'll settle the bottom part first, then I'll move on to the upper portion and push everything down . By then, it should be clean . Is that okay, Doctor Zhou?"
"Yes . " Doctor Zhou's expression was rigid .
Yu Yuan then replaced the plastic bag and continued her action of digging out the feces from the intestines .
Plastic bags that were fully filled with feces were placed in an aluminum alloy basin . The feces that slowly flowed out from the plastic bag was watery, and they could smell the odor .
"This bag contains undigested bamboo shoots . The old lady just had surgery when she ate this, but it's not suitable for her . " Yu Yuan filled up half a plastic bag before she stopped and viewed it for a few seconds . She answered her own question, "Perhaps she wanted to solve her constipation by eating bamboo shoots . But this is not the right way, right, Doctor Zhou?"
"Yes . " Doctor Zhou did not really want to talk . His eyes were staring straight ahead .
Yu Yuan continued to smile, and she said, "Okay, here's another plastic bag . "
Her tone was obviously cheerful .
"Get it done quickly . " After all, Doctor Zhou was not a specialist from the General Surgery Department .
He now regretted not asking the General Surgery Department for a consultation or just transferring the case to the department . The doctors from the General Surgery Department would be more used to what was happening right before him .
"All right, I'm going to fill up the third plastic bag . " Yu Yuan followed his instructions readily and was extremely obedient .
"The effusion here is more severe," Yu Yuan reported as she worked on the intestines .
"She has actually eaten a lot of meat! It's very difficult to digest them!
"Wow! Gas just surged out!
"I'm filling up the fourth plastic bag now!"
The only sound that could be heard in the operating theater at that moment was Yu Yuan's energetic voice . Plastic bags filled with feces had also accumulated in the huge aluminum alloy basin .
Ling Ran looked serious, dignified, level-headed, and calm as he stood in front of the operating table . He held his breath and stared straight ahead . . .
The nurses looked dejected, and their faces were filled with despair . They kept staring at Ling Ran because it was the only way they could somehow find the conviction to continue staying in the operating theater . . .