After Li Min returned to the ward, she first walked around the ward on the twelfth floor, and only after knowing what was in her heart did she go back to the eleventh floor.After asking the nurse in charge of the class, there was no abnormality in the patient, she went to the director's office to read a book, and waited for the evening round before getting off work today.But she didn't know that the discussion was over, so Chen Wenqiang kept Director Hong of the ICU and invited him to his dean's office to talk."
Lao Hong, Xiao Li proposed an autopsy today, what do you think?""
Dean Chen, if you ask me what I think, I really had it at the beginning.I think you're too biased towards Li Min.But then I was dispelled by what you said later. ”Director Hong was blunt.Chen Wenqiang smiled and rubbed his hands and said, "A few years ago, I first watched Guan Lan and then Xie Xun participate in the director's consultation and a death discussion of this nature.Every time there is a consultation attended by the young director, they look at the problem from the point of view, well, in general, it is very special.Basically, those of us who have been clinically immersed for many years will put forward some contradictory or even contrary opinions. ”Director Hong smiled and said disapprovingly: "That's because their clinical experience is not enough." ”"You're right.Young people are inexperienced.Another is because there is no urology department in our provincial hospital, if Xiao Li had more shock secondary to G-bacillus infection caused by urinary stones, she would not insist on doing an autopsy. ”"Dean Chen, what you said is partiality."
Director Hong consciously understood Chen Wenqiang's thoughts to talk to him.He laughed and quipped, "You're obviously biased towards your students."
But don't worry, I won't worry about Xiao Li about this.In the case of a death discussion, participants were inherently allowed to express different opinions. ”Chen Wenqiang smiled and said, "That's not my personal student, that's your student who graduated from Medical University."
Lao Hong, when she saw you, her name was Teacher Hong.And the first time she saw me the year before last, she called me Director Chen.Director Chen, who has been calling for months. ”Director Hong smiled and quipped, "Dean Chen, are you doing this for a salutation?"
I know that Li Min is also called Xie Xun Teacher Xie, I heard that Xie Xun really taught her.As for Xiao Li, she called me Teacher Hong as a courtesy, I didn't give her a big lesson, nor did I teach her anything, so I naturally asked her to change her name to Director Hong. ”Chen Wenqiang looked at Director Hong's expression, pondered his thoughts and said, "Lao Hong, let me tell you something from my heart."
In today's discussion of death, I am biased towards Xiao Li.Because I want to nurture her.Because she has a certain talent in surgery, she is diligent enough, and the main thing is that she is serious enough about her work.This kind of young doctor is also what you and I hope to see more, right?
”"yes."
Director Hong nodded in agreement with Chen Wenqiang's words."
Dean Chen, if there are such seedlings in the ICU, I am willing to cultivate them.If you don't object, wait for Xiao Li to go to the ICU again, and I'll have something to ask her.Anyway, if you're not afraid of Xiao Li's disgrace, it's fine.She goes to the ICU a lot. ”"No objection.I'm sticking with you.A good doctor, relying on personal efforts alone is too slow, and he must have us as guides, and we who are willing to be the ladder to support.At least twenty or thirty years later, when we are admitted to the provincial hospital and the ICU, we will not be in a hurry.You say, don't you?
”Director Hong smiled and said, "Yes."
After entering the ICU, he was slaughtered by others, and it was impossible to get up and direct others how to rescue him. ”After laughing for a while, Director Hong said, "This patient is obese and close to 70 years old.In fact, even without an autopsy, her blood vessels are aging, and her fat deposits will be higher than those of the elderly in the same age group.From this point of view, Xiao Li's intuitive judgment is still good, and the argument of the original underlying disease can stand.Nor can her considerations be entirely wrong. ”Chen Wenqiang understood what Director Hong meant, and said honestly: "Xiao Li has been in surgery since graduation, and his working hours are short, and the cases he has seen are limited.She, the director, like Guan Lan and Xie Xun, was mentioned from the perspective of department work.Fundamentally, inexperience is what they all have in common. ”Director Hong also told the truth from his heart: "As for Xiao Li's 4-month internship in books and internal medicine, he may not even be able to do it as a resident in internal medicine.But it is already very good to be able to make your arguments stand without knowing the specific condition of the deceased.The rest of the experience is insufficient, work for a few more years, and slowly accumulate enough. ”A consensus was reached, and the atmosphere between the two was more harmonious.Director Hong, who rushed to Chen Wenqiang to come to the provincial hospital, saw that Chen Wenqiang could consider his own feelings in case of trouble, so he got closer to him.* Besides, Dr.
Wang Dazhi, who lost his beloved daughter, worked hard to lick his wounds and buried the pain of losing his daughter in his heart during the few days when he was resting at home, and returned to work with his wife Wang Qiuyun after May Day.The child is dead, but the adults still have to live, and life has to go on, and there is no possibility that they will continue to hide at home and be sad.For this reason, Dr.
Wang secretly encouraged himself, just to make more money and pay off the debt for buying a house as soon as possible - that was embezzling the money left by Wang Qiuyun's ex-husband.So Dr.
Wang returned to work on the day of Youth Day with his sadness and determination.His sadness is not only because of the loss of his beloved daughter Baozhu, but also the vague worry about his son Xiaozhi that he tries to avoid.Just after scolding Xiao Zhi a few words that day, Xiao Zhi was picked up by Yang Weihua, he never showed up again.His concern for his son made him go to the experimental primary school on the morning of the 3rd.But he saw Xiao Zhi get out of Yang Weihua's current husband's car from a distance, and happily entered the school gate with his schoolbag.At that moment, he suddenly had a bad feeling that this son had been taken away from him, and that feeling could not be driven out of his mind.That feeling seemed to remind him silently that in the more than a year since his divorce from Yang Weihua, his son's intimacy with himself was a sweet dream.Doctor Yang couldn't understand that he just said a few words to him, and he wasn't beaten like he was when he was a child, so why did he hold a grudge against himself......
His anxiety about gains and losses was also brought into his work.For example, on the first night shift after resuming work, Dr.
Yang easily discovered his inappropriateness."
Your Majesty, if you are so distracted, you can go home and rest.Otherwise, sooner or later you'll end up with medical malpractice. ”Dr.
Yang threw hemostat tongs to remind him.Dr.
Wang hurriedly collected his mind and put all his attention on the operating table.After getting off the operating table, he quickly apologized to Dr.
Yang with an apologetic face: "Old Yang, I didn't mean it just now." ”"Is it because of your little ambition?
The little one will be fine in a few days. ”"That old Yang, forget it."
Dr.
Wang couldn't go on for half of what he said, and on the morning of the 3rd, he saw his son's elated appearance......
"Forget it, when I don't have this son." ”Dr.
Yang said in a self-deprecating tone: "Children are debts.My son Xiaoyu, that day I asked him how he was getting along with Lao Li's daughter, that little bastard, he actually turned around and followed Lao Li's daughter Huang. ”Dr.
Wang opened his mouth in shock, and it was not an exaggeration to describe it as an egg stuffed in.He asked, "What's wrong with Xiaoyu?"
”"Not really.I reckon he's having too many good days.It's a good idea. ”Dr.
Yang complained to Dr.
Wang about the words he had never said to his wife, Director Luo."
You said that if he followed Zhang Zhengjie last year, and then went to Lao Bian or Lao Xu this year, would he not be like this?"
Dr.
Wang nodded in agreement with Dr.
Yang's opinion.After that, he exhaled deeply and said, "Xiao Yu has a good life."
It's not like the two of us for so many years, you have to live by people's eyes.Naturally, they won't recognize the mystery in this, and they won't understand the painstaking effort you have put in.Look at how difficult it was for me at the beginning, and so did you, let's have this opportunity to be delivered to the door, ah?
You say, don't you?
”Dr.
Yang nodded.He knows Wang Dazhi's habits, and he often cheats people inadvertently.But after more than ten years, there are so many doctors in the provincial hospital, and he can talk to Wang Dazhi.Before, it could be said that there was Lao Shi, but the kidney tumor that day made him realize the gap between the two.That friend, it's better to get along with each other.But at this point, he didn't want to say any more.It's a deep offense.He handed Wang Dazhi a cigarette and said, "Do you still apply for indicators?"
”Wang Dazhi was stunned for a moment, and then understood the meaning of Yang Weiguo's question.Thinking of Lao Lu, who was assigned to sort out the files of the radiology department, he said abruptly: "It's not born."
Not raw.So be it. ”Dr.
Yang thought that he didn't want to give birth because he was afraid that Wang Qiuyun would have another child with heart disease.But when he said this, he said, "Actually, you can ask Director Liu to show Pearl."
I saw that he and Lao Shi took Li Min to do those heart valve repair surgeries, and came back for a follow-up examination half a year after the operation, and the results were very good. ”Dr.
Yang's sincere concern made Dr.
Wang's mouth bitter.As the bitter taste swelled up, his face also showed pain, revealing the true state of his heart without concealment.If I didn't make such an excuse for the pearl, wouldn't it be a jewel......
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Alas!
Otherwise, Orb wouldn't even have a chance to see the world.Doctor Yang looked really uncomfortable when he looked at him, patted him on the shoulder and said, "King, you better go home and rest."
We can't afford the slightest mistake in Corey's current position. ”"Yes, I understand.Lao Yang. ”Their duty team is composed of three attending doctors, and the orthopedic doctor on duty is more senior than the two of them, and he is an old qualified attending doctor.But that's it, and they don't dare to take it lightly either.The two of them came out of the operating room, and it was not too early to see the time, although the postoperative patients were taken care of by intern students, but Dr.
Wang still felt that it was better for him to watch in person.So he thanked Dr.
Yang again for the reminder and went back to the general surgery ward.
*Dr.
Yang slept at home for most of the day after the night shift, and then consciously went to the kitchen to make dinner.He craned his neck to look out the window while choosing vegetables, and finally waited for his wife, Director Luo, to come back.He didn't care that the old couple of the Luo family could hear it in the living room, so he hurriedly asked Director Luo, who was changing his shoes, "How about the case discussion in the afternoon?"
”Director Luo smiled and said, "You can no longer think of Li Min's angle of thinking about the problem. ”Then Director Luo accompanied Dr.
Yang to stir-fry and told him about the death discussion in the afternoon."
Hey.Okay, you've added salt once. ”Director Luo stopped her husband from wanting to add salt, and divided the vegetables in the pot by two."
I want to be stunned.I didn't expect Li Min's luck to be so good. ”Doctor Yang sighed: "She has passed the test this time." ”"What, there are still those who can't pass the level?""
I told you that Zhang Zhengjie went off topic the first time he participated in the death discussion, and he was hung off the stage by Director Xiang.""
You can do it.However, this time Li Min proposed to do an autopsy, and I estimate that Chen Wenqiang will study medical university in the future, and include the autopsy as a necessary step after the death discussion.Whether it is true or false, right or wrong, the pathology is true. ”* And Li Min, whom the couple was talking about, had not yet gotten off work at this time, and she followed Chen Wenqiang to make a final preoperative communication with the parents of the child who was about to operate tomorrow."
Your child was originally diagnosed with a meningioma, but as I told you last night, there is a certain chance that it is not a meningioma, but a cavernous sinus cavernous hemangioma.""
That's benign, isn't it?"
The child's mother asked anxiously."
If it's a cavernous sinus hemangioma, it's benign.However, brain tumors are different from other tumors in the body, not only looking at the benign and malignant, but also looking at the location of the tumor.Tumors that are located deeply, or are in important parts, even if they are benign, have a greater impact on the human body.But this hemangioma, this tumor has a characteristic, it bleeds easily.So the surgery is particularly difficult to do. ”Chen Wenqiang explained to the patient's family very seriously: "We will do our best, but the craniotomy is already risky, and your child is more meaning to survive, so you must also be prepared." ”Whether it's a meningioma or a hemangioma, it's the same for parents of children.They believe in Chen Wenqiang and Li Min's skills, and they also believe that Chen Wenqiang and Li Min will do it well, and they are looking forward to the smooth operation now.When he went back to the doctor's office, Chen Wenqiang turned on the film reader and explained to Li Min: "Look here, although the size of the tumor given by CT and MRI is not large, the cavernous sinus segment of the internal carotid artery is almost completely surrounded by the tumor.This surgery is going to be very difficult to do, you need to rest well tonight. ”"Yes."
After Chen Wenqiang instructed Li Min, he went home with some complicated feelings.Xiao Yin has already cooked and washed the vegetables, and the stew has almost been stewed, and there is only one stir-fry left, waiting for him to enter the door and put the pot."
I'll do it."
Chen Wenqiang washed his hands and changed clothes, took off the apron around Xiao Yin's neck and hung it on himself, and Xiao Yin helped him tie the apron."
Why did you come back so late?""
The child who will have surgery tomorrow, all the tests have been completed today.""
Is there anything wrong?""
It's nothing, it's just that the surgery will be a little harder.Considered cavernous sinus cavernous hemangioma. ”"Isn't that rare?"
Xiao Yin was surprised."
Yes, the incidence is generally higher in middle-aged women.This is also the first time I have seen it in a child. ”"Are you sure?""
Hmm.I bumped into Lao Hu again before I got off work in the evening, and he agreed with me that it was not a meningioma in the saddle area. ”Chen Wenqiang moved quickly, a dish of celery fried lily color and fragrance was quickly ready, the spatula turned over, and it was put into an eight-inch flat plate with peony flowers entwined.Xiao Yin took the dishes away, and when he came back, Chen Wenqiang was already brushing the big spoon, and the tap water was so hot that the big spoon was steaming.When Xiao Yin took the rice pot away and returned to the kitchen, Chen Wenqiang had already put the big spoon upside down in the sink.Xiao Yin took the dishes and chopsticks, and Chen Wenqiang took the rag to serve the casserole, which was a chestnut stewed chicken.The two of them have lived in the south for many years, and their diet is no longer all northern tastes.Soon, a not sumptuous but nutritious dinner was put on the table.Xiao Yin didn't eat much for dinner, and when she had time, she began to continue talking about the hemangioma just now."
Are you worried that the tumor will not be easy to remove or are you worried about postoperative nerve recovery?"
Xiao Yin has focused on neurosurgery because Chen Wenqiang has been focusing on neurosurgery over the years, and she has also invested a lot of energy in neurology and surgery.Xiao Yin was not stunned."
Both.The child's disease progressed rapidly.It's just that the parents didn't ask Lao Zhao to come to me, and it is estimated that I will come to the provincial hospital for two weeks to hang the outpatient clinic, and finally arrange it according to the emergency surgery. ”"Then you did this surgery sooner or later?""
Pretty much.""
It's hard to do, so you can rest early today, and don't read a book until half past eleven.""
Okay
.
"* After a good night's sleep, Chen Wenqiang was in good spirits and arrived at Corey early.It wasn't until before the shift that he saw Director Shi."
Went to the ICU?""
Yes.I went to see the vascular replacement guy. ”"How's it going?""
Lao Liang said that he would take the patient to the general hospital today."
Director Shi didn't really want to let the patients with blood vessel replacement go.But Director Liang spoke, and he couldn't refuse.His expression fell in Chen Wenqiang's eyes, and Chen Wenqiang persuaded him: "It's okay to go to Puwai."
You have a lot of patients over there, and you don't have enough people to do the work." ”Director Shi nodded in agreement with Chen Wenqiang's opinion.Chen Wenqiang then explained to him: "Xiao Li and I have an additional operation today, and we may have to step down late, so you can take care of it more on the eleventh floor." ”"Okay."
Lu Qing saw that the two of them were chatting endlessly, so he clicked on the key, and after attracting the attention of the two, he asked, "Dean, director, let's hand over the class now?"
”"Deliver it."
When Chen Wenqiang arrived at the operating room, Director Liang was waiting for him in the dressing room."
I heard old nonsense that your hemangioma is more difficult to do today?""
yes.The tumor is not large, but the location is not good, and the internal carotid artery is almost tightly wrapped. ”"Then you should be careful.""
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Hmm.""
If you can cut it completely, you can cut it completely, and don't force it if you can't."
Director Liang was not at ease: "Don't think about the work of greed. ”"I understand.Do you have surgery today?
”"Nope.I'll come over and give you a platform. ”Chen Wenqiang's eyes were filled with gratitude."
Alright, hurry up and put on your hat, it's time to go out."
In the No. 6 operating room, Director Zhou of anesthesia came to the stage in person.Director Zhao was angry with him during this operation."
Teacher, frontotemporal incision pterygoid point approach?"
Li Min prepares to put himself in position."
Hmm."
After Li Min finished posing, Chen Wenqiang stepped forward to check the side again, and Li Min waited for him with a crossed cotton swab."
Let's draw."
Chen Wenqiang got out of the way.Director Zhou of anesthesia said, "Lao Chen, how long have you not placed a position for a patient?"
”"This kid is small, otherwise you still need me to get started.""
Don't you can't trust Xiao Li."
Chen Wenqiang smiled and said, "Old Zhou, are you too idle?"
Remember to lower your blood pressure later. ”"You don't have to look for trouble.What an old child, it's better if we don't drop or not. ”Director Liang said, "Go with your hands, I'll show you, no one can touch your child." ”"It's not bad for a while.""
Start early and end early.Go, go, go. ”Director Liang picked up Chen Wenqiang.Chen Wenqiang went to brush his hands, and Yang Weihua came in in a hand washsuit."
Director Zhou and Director Liang are all here.""
Looking for Dean Chen?""
Come and see the kid.I'm targeting a unit. ”Director Zhou smiled and reminded, "Be careful of the head nurse. ”But when Li Min came back from brushing his hands, he saw that Director Zhao of the dry clinic department was also in the operating room."
Sister Yang is here.Director Zhao, are you also looking at the surgery?
”Li Min asked while disinfecting."
I'm ready to see.But after a while, the head nurse will come in, and I will have to go out. ”That's right.There are a lot of people watching, and all of them are something that Li Min can't afford to mess with.She is not easy to talk about, Chen Wenqiang came back and immediately found out about this, he immediately said to Director Liang and the others: "You stand back, the key to this operation is to do it with a microscope, you can't see anything, you'd better not watch."
With so many people coming in, it's just a distraction for us. ”Director Liang immediately pushed Director Zhao: "Lao Zhao, you go and stand outside the door, you can't understand it."
Don't get in the way here. ”Director Zhao was unwilling to be driven away, so he dragged Director Liang and said, "We are half a catty."
Are you any better than me?
To walk together. ”Seeing the two of them like this, Yang Weihua took the lead and walked out.The head nurse of the operating room is very aware of the restrictions on the number of visitors.…… The operation began, according to the step-by-step process, Li Min took Dr.
Deng to do it first, and after opening the dura mater, Chen Wenqiang replaced Dr.
Deng and stood in the position of the chief surgeon......." pull the optic nerve apart. ”"Yes."
Li Min carefully pulled the optic nerve apart with a nerve retractor, exposing the cystic tissue on the periphery of the internal carotid artery."
Eyepieces."
The two put on eyepieces and began to carefully peel away the tumor against the internal carotid artery.This cavernous hemangioma does not have an intact blood vessel wall and is made up of sinus-like orifice of varying thickness.Specifically, like a yellowish-brown, medium-sized mulberry.Every time, in the eyes of the people standing behind Chen Wenqiang and Li Min, the instruments in their hands did not move.But every time, the caution and caution of the two of them are known only to them.More than two hours passed.Finally, the hemangioma that was entwined in the internal carotid artery was peeled out.This means that the surgery is half the battle, while avoiding the most likely intraoperative hemorrhage.The next step is to separate the hemangioma from the brain tissue.It can only be judged by the color of the brain tissue around the tumor - hemosiderosis and hyperplastic glia.At this point in the operation, not only Chen Wenqiang and Li Min, but also those who can understand it feel much easier.All that remains is to strip this "mulberry" from normal brain tissue, and then block the veins that drain it, and remove this "mulberry", which is easy to say, but difficult to do.It took Chen Wenqiang and Li Min more than two hours to finally remove the hemangioma completely.The surgery was successful."
Doctor Deng, you come to close the skull.Xiao Li, you go down and rest. ”"Hmm.Thank you, teacher. ”Li Min was not polite to Chen Wenqiang, and immediately left the operating table.From 7:15 a.m. to now, she is already feeling very tired.But she only went to sit by the wall and did not leave the No. 6 operating room, for fear that something would beckon her to come to the stage again, so she did not even take off her gloves.After waiting for another quarter of an hour, Chen Wenqiang began to suture the dura mater, and with the help of Yang Weihua, she took off her surgical gown and went to the changing room."
Xiao Li.This is the patient's family entrusting me to you and Dean Chen.I'm afraid it will affect you before the operation. ”"Sister Yang, I don't dare to accept this for Dean Chen.You can hand it over to Dean Chen.It's true. ”Li Min didn't know the background of the child, but the appearance of Director Zhao often represented another hint.The right should be a favor.She learned from Chen Wenqiang for the first time in a craniotomy.※※※※※※※※※※※※※※※※※※※※ have replaced the typo, change it tomorrow morning, good night (), the distance is a little far