Director Fang's motivation is really high now, because he is now a person with pursuits, not an ordinary person. He has set his career goal to be the world's top general surgery expert.
This goal is still far, far away, but Director Fang feels that it will be achieved if it is achieved.
So from now on, Director Fang will demand himself according to this goal. Of course, Director Fang did not tell anyone about his ideal. He wanted to realize it quietly. Director Fang's blood boils every time he thinks of his ideal.
Now Director Fang met a patient in the outpatient clinic, Nong Tiesheng, male, 57 years old. After thyroid cancer surgery, he was complicated by recurrent laryngeal nerve damage. Now the patient has obvious hoarseness. He easily chokes when drinking water and has trouble eating.
It is very easy to choke and affect breathing.
From the medical records brought by the patient, Director Fang found that the tumor should have invaded the recurrent laryngeal nerve and its surroundings. In order to completely remove the tumor during surgery, segmental resection of the recurrent laryngeal nerve was performed.
However, the injury to the recurrent laryngeal nerve on one side does not cause such serious symptoms. Now the patient feels that it is difficult to breathe, which means that the recurrent laryngeal nerve on the other side is also damaged, but not broken. It may be a contusion at the time, or pressure from the postoperative scar.
If treatment is required, surgery is necessary. One side of the recurrent laryngeal nerve needs to be repaired, and the other side needs to be explored.
This surgery is actually nothing. It is just a routine surgery. Repairing the recurrent laryngeal nerve usually involves bridging the damaged nerve, or connecting a nerve from another place to replace the original nerve.
This patient has undergone several operations, but the operation is still difficult. Director Fang decided that it would be better to discuss it with Yang Ping. Director Fang now has different requirements for himself, and his realm is completely different from before. Every patient
He wants to perform surgeries to the best of his ability, and he even wants to try to innovate and improve surgeries.
Director Fang took the patient to the Institute of Surgery to find Yang Ping to study the condition together.
Yang Ping looked through the medical records brought by the patient and found in a thick stack that the surgery had been performed twice, and the scope of the surgery was relatively large.
The recurrent laryngeal nerve is the nerve that controls the human vocal cords. There are two left and right nerves. If it is damaged unilaterally, it will cause hoarseness and coughing when drinking water. If both sides of the recurrent laryngeal nerve have been damaged, it will cause pronunciation, eating disorders and dyspnea.
.
The protection of the recurrent laryngeal nerve is an important part of thyroid cancer surgery. The surgeon must be very careful to protect it as much as possible and prevent it from being damaged.
However, in some patients, if the tumor has seriously invaded the trachea and recurrent laryngeal nerve, in order to completely remove the tumor, the part that has been invaded by the tumor must be removed. This is called segmental resection of the recurrent laryngeal nerve.
Because the physiological function of the recurrent laryngeal nerve is very important, it cannot be left alone after resection. Otherwise, the patient may have a hoarse voice and cough when drinking water, or it may seriously affect breathing, eating and pronunciation.
If the recurrent laryngeal nerve has been segmentally resected, the recurrent laryngeal nerve needs to be repaired after surgery. There are three traditional repair methods: the simplest is to directly pull together and suture; however, some resection distances are too long and cannot be directly pulled together at all.
Other nerves can be cut to bridge the severed end of the recurrent laryngeal nerve. This is the same as coronary artery bypass grafting. The difference is that coronary artery bypass grafting bridges blood vessels, but here it bridges nerves. If the bridge distance is too far, it will lead to poor postoperative recovery.
; At this time, the phrenic nerve can be cut or the hypoglossal nerve loop can be anastomosed to the severed end of the recurrent laryngeal nerve, so that another nerve can be used to replace the original recurrent laryngeal nerve to function.
The patient brought a lot of medical records, and Yang Ping slowly flipped through the pages. Almost all the examinations had been done, and they were also included in the medical records, but there was no pathology report. Did the patient forget it?
''Why is there no pathology report?" Yang Ping handed the medical records to Director Fang.
Director Fang also looked through it again, and indeed did not find the pathology report. He just looked through it roughly and didn't pay much attention to it. He focused on looking at the discharge records.
"Who did you get this surgery in Annex 4?" Director Fang asked the patient's son Nong Zhiwen.
The Fourth Affiliated Hospital of Nandu Medical University, among the several affiliated hospitals of Nandu Medical University, was established relatively late and is not very well-known. Its strength and reputation are far inferior to those of the Affiliated Hospitals Affiliated One and Two and the Affiliated Cancer Hospital.
However, the Fourth Affiliated Hospital is also an affiliated hospital of Nandu Medical University and is a tertiary teaching hospital. It is not far behind in any case and is considered a second-tier hospital in Nandu Province.
"Director Qian!" Nong Zhiwen replied.
''Qian Lisheng?" Director Fang is very familiar with this Director Qian.
"Yes, it's Director Qian Lisheng." Nong Zhiwen confirmed.
It was his patient. If he had known he was Qian Lisheng's patient, Director Fang would never have touched him.
Because Director Qian has a bad reputation in the industry, and his skills are also notoriously poor. Of course, this is only known to people in the industry, and ordinary people don’t know it at all. Everyone outside thinks that his level is very high, because he has to shoulder a lot of responsibility.
The title of great expert or great professor.
Director Qian's surgeries are rarely smooth. As long as the surrounding doctors know, they dare not take on his patients. The probability of his thyroid cancer surgery damaging the recurrent laryngeal nerve is extremely high. Not only this surgery, but all his surgeries are rough.
It was rough, and few had good results, but this did not prevent him from continuing to be a great professor.
Director Fang was a little panicked when he met Director Qian's patient. He wanted to re-examine whether it was thyroid cancer.
This bastard sometimes operates on some benign tumors from general surgery. Many patients who have no indication for surgery and do not need surgery at all will treat them as malignant tumors. In the end, they say they are cured. The patients do not know and are grateful.
Many benign thyroid tumors only require regular thyroid color ultrasound examinations, but in the hands of Director Qian, special measures must be taken.
This guy has a lot of patients, and most of them got them through crooked means.
He once performed a da Vinci robot surgery on a patient with a small liver cyst, and ended up spending hundreds of thousands, and he was still an acquaintance of his.
Therefore, whether it is medical skills or character, Director Qian really stinks.
But he is a chief physician and a professor, and he also carries a master's degree and a doctorate with him to attend academic conferences everywhere.
"Why is there no pathology report? You have to find the pathology report. Without the pathology report, we cannot formulate a surgical plan."
Director Fang looked through it again, and there was indeed no pathology report. He just wanted to use this matter to push the patient away, because he really didn't want to touch Director Qian's patient.
Yang Ping said: "No matter what, the recurrent laryngeal nerve must be repaired. Otherwise, you should admit him to the hospital and let him find the pathology report as much as possible."
The patient and his family members immediately shed tears of gratitude when they heard this, because they visited many places in the provincial capital, and as long as they saw doctors, they initially planned to admit them to the hospital, but after looking through the medical records, they finally said that this operation was effective.
If it is difficult, it is recommended to go to the original surgical hospital or a higher-level hospital.
Now there is a place willing to take him in, and they are really grateful.
''In this case, you go and get the pathology report from Appendix 4. We must see the pathology report before we can make a surgical plan and then perform inpatient surgery." Director Fang insisted.
Pathology report?
Nong Zhiwen went through the thick medical records by himself. He didn't even know that there was such a thing as a pathology report. He just followed what the doctor said. He didn't understand what the disease was and how to treat it, so he just listened to the doctor.
''What does this thing look like? Where can I get it?" Nong Zhiwen asked.
Director Fang gestured and said: "A piece of paper with a color photo on it and a detailed diagnosis on the bottom. You can use your ID card to go to the medical records department in Attachment 4 to make a copy. If you really don't know how to do it, you can contact the surgeon at the time or
The bed doctor must be in the medical records."
"Why don't you go to Director Qian for a follow-up consultation? It would be great if you could have the recurrent laryngeal nerve repaired there. He is familiar with your situation." Director Fang couldn't help but ask curiously.
The patient had difficulty speaking, so he didn't speak. His son said: "Professor Qian is very busy, either going abroad or attending meetings, and their beds have been tight. We have been waiting for half a year, and we really can't afford to waste this time, so we have to think of other things."
Method."
"Like This!"
Director Fang probably guessed something. It's definitely not that simple. It's better not to wade into this muddy water, so as not to get yourself involved in it.
"Okay, that's it, you go get the pathology report and we'll talk about it later." Director Fang didn't want to dwell on it any longer.
Yang Ping said to the director: "When he gets the pathology report and the situation is clear, you can admit him to the hospital. This operation is probably still a bit difficult."
Director Fang hummed.
After the patient left, Director Fang immediately reminded Yang Ping: "This is Director Qian's patient. As long as he has performed surgery on the patient, no doctor in the circle dares to take over it, especially the tumor surgery he has done, which is a mess, including secondary operations."
There’s just no way to do it.”
"It's okay. We don't care what his previous condition was. As long as he trusts us and is willing to accept our diagnosis and treatment, we will do our best. As for Director Qian, we don't care about that." Yang Pingke had no intention of paying attention to Director Qian.
However, Director Fang was worried that this patient would cause trouble for Yang Ping, so he wanted to dissuade him. Director Fang also had good intentions. He felt that Yang Ping usually focused on academics and did not understand the affairs of the world, and was afraid that Yang Ping would get into trouble.
But Yang Ping is not worried about this at all. If this patient does not undergo surgery, he will always have a hoarse voice, cough when drinking water, and now has difficulty breathing. In the future, it will not only be a problem of quality of life, but may also affect his life. He has this
Ability, why not help the patient? As for who he consulted before, it has nothing to do with him. He doesn't want to care about these things.
It's just that this patient has a lot of doubts. From the various objective examinations in the medical record, it doesn't seem like thyroid cancer, but the medical record does indicate thyroid cancer. The key is the lack of a pathology report, so it's okay to look at it after getting the pathology report.
Relatively safe.
---
The patient's son, Nong Zhiwen, had no choice but to come to Annex 4 again. Because Director Qian had not left the outpatient clinic, he could not find Director Qian in the outpatient clinic, so he had to go to the ward to look for him. The doctor in the ward said that Director Qian did not come back until very late after an operation.
Nong Zhiwen then waited at the door of Director Qian's office until night. He did not go back until the security guard told him that he could not stay here, but he never saw Director Qian.
Nong Zhiwen had no choice but to return to the hospital clinic to ask Director Qian about his schedule, but everyone had already got off work, so he went to the emergency department to ask. He was not from the same department, and the emergency doctors said they didn't know. Later, an emergency doctor said
"I asked the ward for you, so I called the doctor on duty at the general surgery department, and then I found out Director Qian's schedule.
It just so happened that Director Qian was out for the outpatient clinic the next morning, and Nong Zhiwen was going to go to the outpatient clinic to see Director Qian the next day.
After finally waiting until the next day, Nong Zhiwen found Director Qian in the outpatient clinic.
"Director Qian, hello ---"
Nong Zhiwen was very polite. He came to the provincial capital from the countryside and it was not easy to see a doctor.
"You are? Why did you come in without queuing up?"
Director Qian was very impatient.
''My dad used to be your surgeon. My dad's name is Nong Tiesheng, and I am his son. That's how it is---" Nong Zhiwen explained hurriedly and handed over the discharge information.
Director Qian looked through the discharge information: "Nong Tiesheng, isn't it fine after the operation?"
"Yes, thank you, Director Qian, but now I keep choking on water, making it difficult to speak, and breathing very hard."
"Oh! For such a major surgery, the recovery will definitely be a bit slow. Let's recover slowly and see. I'm very busy now. Let's wait until I have time. There are many patients waiting for me later."
Director Qian waved his hand like a great professor.
''I only have two minutes. My father is going to Sanbo Hospital for hospitalization. The doctor looked at the medical records and said that he was missing a pathology report and asked me to get it."
"Pathology report? You can just go to the medical records room to make copies. You see, I'm quite busy."
This chapter is not over, please click on the next page to continue reading! "I have been to the medical record room, and they said that there is no pathology report in the medical record. I just checked the fee list again, and it contains the charges for pathological examination, so this examination should have been done at that time
, the people in the medical record room said they didn’t know the situation and asked me to find the doctor in charge of the bed. I contacted the doctor in charge of the bed at the time. He is now studying for a doctorate in another province and is no longer in your hospital. He asked me to come to you. You see,
excuse me."
''Looking for me? I don't directly care about the patient. How do I know where the pathology report is? I'll help you find the pathology report? I'm so busy every day, do I still want to do surgery? There must have been a copy for you at that time.
, you lost it."
''No, really, I have kept this copy of the information very well."
''Then there's nothing I can do about it. How can I find a report for you? It's been going on for so long and I have so many patients. You didn't tell me earlier, right?"
"We didn't know about the pathology report at the time. Now the doctors at Sanbo Hospital are eager to ask for it, saying that we must have the pathology report before we can make a surgical plan."
"Sanbo Hospital? What kind of doctor does he know? Why do you need this thing? If you don't have it, you won't be able to treat the disease? Who did you see at Sanbo Hospital?"
''I first saw Director Fang Nansheng, and then Director Fang took me to see Professor Yang Ping."
Director Qian's heart skipped a beat when he heard Yang Ping's name, and he couldn't help but feel chills running down his spine.
He swallowed, his attitude suddenly changed 180 degrees, and his tone became very gentle: "How do you go to Sanbo Hospital? The quality there is not good. You come to me and I will help you solve it."
"You keep saying that there are no beds. We have no choice but to go to other hospitals to find a solution. You see, my father can't speak now. He chokes when drinking water and has trouble breathing. It won't be a problem if this continues." Nong Zhiwen
Said helplessly.
"It was true that the beds were too tight before, and I was very busy. In your situation, let me think about it, let's do it this way. It is not easy for you to come to the provincial capital. I will help you think of a way and arrange beds for you. Your father is my old patient.
, I’m familiar with his situation, don’t go to Sanbo Hospital, that Yang Ping, you look so young, what do you know, you don’t even know how to do several surgeries, you must not be fooled, come here quickly, I will help you solve it
, come to me for surgery."
"I heard from patients in their hospital that Professor Yang is very powerful."
''Everything about being awesome is just bragging. Look at him. He is so young and has only graduated a few years ago. He can do a few surgeries and just write a few papers. Don't ask him for surgery. Surgery is a big deal and you can't do it casually.
, you see I performed the surgery for you, and you are recovering well now. How can other people be so energetic after cancer surgery, right? Don’t just trust others, I tell you the truth, these people are just deceiving, Sanbo Doctor is ranked among the best in the province.
Got the number? Do you have the top four with us?"
"I don't understand either. I can't help it if I'm anxious."
"How about this? You haven't gone through the admission procedures there yet? I'll say hello to you and get you a bed."
"Not yet. Okay, thank you Professor Qian."
''It's okay. I was really busy some time ago, so I can't help it. I don't know your situation. If I knew this was the case, I would definitely find a way for you. The beds are very tight now, and I have been attending a lot of academic meetings recently."
"I know! Thank you, when will I come over?"
"In this case, you call someone over now, and I will help you issue a hospitalization certificate. I will have the patient discharged from the hospital tomorrow. Once discharged, I will ask the nurse to notify you immediately. You are really filial and I am very touched."
"Where, then I won't go to Sanbo Hospital?"
''Go to Sanbo Hospital, don't listen to their lies."
"Do you still want the pathology report?"
''No, I don't know what the operation is like, so what's the use of such a piece of paper?"
