Before the dura mater was opened, Director Liu shouted a pause: "Senior sister, stop first, the patient's heart rhythm is unstable." ”Li Min could only stop immediately.Director Zhou was about to leave, but when he saw this, he stopped, and he exchanged glances with Chen Wenqiang, and the meaning in those eyes was clearly - he was going to be in trouble.The internal source of this trouble, according to the current level of medical development, is still only speculation, guessing that the patient's subconscious is to resist surgery, but the clinical manifestations of the disease force him to come to the hospital for medical treatment.This state of mind may cause abnormal reactions in the central nervous system.Dr.
Deng said: "This patient has had a headache for almost a year, and he can't wait to have surgery immediately in the outpatient clinic."
Will he resist surgery?
”Director Liu was closely observing the changes in the patient's heart rhythm, and when the patient's heart rhythm was close to normal under the adjustment of her medication, she smiled and said to Dr.
Deng, "Didn't you take the psychology course?"
”Dr.
Deng nodded and said, "Compared with your and Director Li's five-year undergraduates, we have more than a dozen fewer subjects." ”Chen Wenqiang named him: "Kevin Lu, you can explain this situation with psychology." ”Lu Kaiwen, who had just arrived in the operation room with Yang Yu, was stunned for a moment before he stumbled and replied: "I think Freud's 'id', 'superego', and 'ego' should be able to explain his situation."
The 'id' deep inside him resisted the operation.The 'superego' in real life forced him to give in and come to the hospital for surgery before the headache symptoms.The contradiction between the 'id' and the 'superego' puts a lot of pressure on his 'ego'.The 'ego', which takes on the role of coordinating the 'id' and the 'superego', will show us in an exaggerated catharsis way, that is, the expression of his eagerness to have surgery in the outpatient clinic, which is the illusion of reconciling contradictions. ”Dr.
Deng was said by his list of various "I", which was a little square.It turns out that there is a gap between the junior college and the undergraduate, and there is still a "Freud", which seems to have heard of this person, is it the philosopher?"
And then?"
Chen Wenqiang asked."
And then there's the situation now.The superego could not resist the pressure of the illness and came to the hospital, so although we anesthetized him, the ego, which was detached from the coordination of the ego, took over his consciousness.I guess he used this arrhythmia to force us to give up on him. ”This conjecture sounds contradictory to the loss of consciousness of the patient after anesthesia.However, in the operating room, interns and nurses are routinely required to keep their mouths shut when they encounter risks during surgery; And Dr.
Deng was already dazed by Kevin Lu's string of "I".And his transfer procedures are being processed, and he is currently a model who is more "cowardly" than an intern and more disciplined than an instrument nurse.One dean and three directors who could speak and were qualified to speak, none of them spoke against Kevin Lu.Seeing this, Yang Yu shrank himself back and shrunk.He decided to go back and ask about all the subjects that undergraduates had offered.Whether it is an examination course or an elective course, it should be treated seriously as an examination course.The difference between myself and undergraduates is by no means a few words in that red book.
(Note: Psychology is an examination course.)Some of the examination courses and elective courses are open-book examinations. ）After Lu Kaiwen answered Dean Chen's question, he looked at Li Min and then Chen Wenqiang with doubt, and then his eyes fell on Chen Wenqiang, as if waiting for Chen Wenqiang to spit out the order to stop the operation.Can the patient's surgery be stopped?
Chen Wenqiang quietly asked the instrument nurse for hand washing water, and Yang Li hurriedly stretched out the prepared stainless steel basin to Sister Feng, the nurse on the patrol stage.Half a bottle of saline is poured into a small basin.Chen Wenqiang stood in front of the dirt basin and rinsed his gloves with great calmness.The patient had such a reaction, and his original plan to give Dr.
Deng a little more chance to operate seemed to be unworkable.Chen Wenqiang rubbed the back of his hand to make the latex gloves fit more closely with his hand.After the patient's heart rhythm was restored on the operating table, he drove the intern and Dr.
Deng down.He stepped forward to take over the position of the assistant, and then instructed Li Min: "Xiao Li, you continue."
Remember to be gentle and fast!
”"Yes."
Li Min understands that the operation must be continued, otherwise it is basically impossible to explain the 'id', 'superego', and "ego" to the patient and the patient's family.In the field of Western medicine, which requires real hammers and actual data, no one will accept their reason for stopping the operation in this way.…… The surgery is intermittent.Not only was there a problem with the heart rhythm in the middle, but there was also an increase in blood pressure, and the systolic blood pressure once soared to 180mmHg.As a result, the scalp and dura mater, which had done a good job of hemostasis, also had small oozing blood.As for abnormal brain waves, high-frequency and high-amplitude spike discharges, they occur even more frequently.Li Min followed Chen Wenqiang's instructions every step of the way, approaching the lesion as gently and quickly as possible during the time period that the patient allowed her to touch.Then, when I had to stop, I sat on a leather stool to rest.Such a difficult surgical process is something Li Min has never encountered.The operation had to go ahead.The patient presents with an unbearable headache and abnormal discharge induced by surgery, which is a very obvious symptomatic epilepsy.It is extremely cruel and unacceptable for the patient to be removed from the stage like this - the headache is not resolved, and the epilepsy appears.Chen Wenqiang pretended to smile and chat with Director Zhou, saying that in a certain year and month, when he was in charge of a meningioma in the south, he also did this to stop and stop and stop and then do the operation."
The operation, which was supposed to be done in three hours, ended up taking more than six hours."
Chen Wenqiang's embarrassed tone made Li Min frown, this operation was originally planned to take about five hours, according to the teacher, didn't it take ten hours to go out?
…… But the operation didn't actually last that long, but it also took more than eight hours.When most of the gliomas were exposed, Chen Wenqiang asked Li Min to step down and rest.Li Min sweated too much on his forehead, which was definitely not caused by the difficulty of the operation.Director Liu handed over the patient to Director Zhou to watch, and he and Sister Feng, the nurse who patrolled the stage, took Li Min out of the operating room."
Senior sister, are you okay?""
It's fine.I'll go to the bathroom first.Just lie down for a while. ”Li Min held up weakly.Sister Feng sent Li Min to the door of the bathroom and went back.Director Liu stood at the door and waited for Li Min.She sent Li Min to the dressing room bench to lie down, and found a nurse who was not on stage to guard her, and then hurried back to the No. 6 operating room.* Li Min fell asleep with her overcoat on her pillow, and she was awakened by the sound of footsteps constantly entering the locker room."
Grandma, you're awake.What's uncomfortable with it?
”Li Min opened his eyes and saw the concerned eyes of the head nurse in the operating room.Li Min touched his belly, Mu Yu was fine.She smiled and replied to the head nurse, "Well, no.What time is it?
”"It's half past five."
When the head nurse saw that she said that the child was fine, she immediately changed her expression."
Hurry up if it's okay.Go back and eat more.Saving lunch while pregnant with a child is not such a way to save money. ”Li Min, na.She slowly sat up from the bench, folded the cover, handed it to the nurse who cared for her, got up to change her clothes and went back to the neurosurgery department on the 11th floor.In the corridor on the 11th floor, there are family members delivering meals back and forth.From time to time, she nodded to the person she was greeting.When I opened the door to the director's office, the first thing that caught my eye was the thermos bucket on the table, where her lunch was placed.Li Min didn't care about anything else, stood in front of the desk and drank the chicken soup in the thermos bucket first, and then picked and ate the chicken inside......
There was food in the stomach, and the feeling of heartburn went down.After eating most of it, she felt that she had finally found herself.Lock the door and go to the nurse's office.The night nurse who had taken over told her warmly: "Dr.
Ma, they went to dinner, and Dean Chen went to the ICU." ”"Hmm.Then I'll go to the ICU. ”Li Min turned around and wanted to leave."
Director Li, your face is not good-looking, you go home and rest.Tonight is Dean Chen's night shift, and I see that he has just taken Dr.
Ma and them to check the room. ”Wen Wen persuaded Li Min with great concern.Li Min raised his hand to touch his face, smiled and said to Nuan: "I slept just now, and I didn't feel that there was anything wrong with me."
That Dean Chen worked the night shift, you quickly asked the hygienist to disinfect the duty room thoroughly, and changed the sheets and covers.When Dean Chen comes back later, you tell him that he has changed everything, and he will go to the duty room to rest. ”"Okay."
Nuan took the key and accompanied Li Min outside."
That Director Li, is it difficult to do today's surgery?""
Hmm."
Li Min agreed absentmindedly, and then told the warmth: "You asked the nurse to clean up the smell of smoke in the duty room."
Dean Chen quit smoking. ”"Okay."
Although Li Min ordered Nuan, he still wrote down the matter in his heart.I should remember to remind Dr.
Ma and Dr.
Deng not to smoke in the duty room again.Compared to the director's office on the 12th floor, Dean Chen rested on the 11th floor better for Corey.
*Li Min moved to the ICU and saw Chen Wenqiang, Director Zhou of anesthesia, and Director Hong talking in the office.She quietly changed her clothes to see Corey's two patients lying in the ICU.The patient who had surgery yesterday looked good, the oxygen mask was replaced by a low-flow oxygen inhaler with a nasal cannula, and the fluid channel on his hand was sealed.His special care was giving him nutrients in the nasogastric tube.When he saw Li Min, his eyes lit up, and he raised his hand and waved at Li Min.The nurse, who had her back to Li Min, turned around when she saw his movements."
Director Li."
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The nurse greeted Li Min."
You're working the night shift.How much did you get into?
”"It's 200ml after that."
The nurse answered Li Min's question while injecting the remaining nutrients in the syringe.Then another tube of warm water was drawn to flush the nasogastric tube."
Director Li," the patient waited for the nurse to pack up the syringe, clamp the nasogastric tube with a small bend, and then asked Li Min, who looked at the nursing record, "Director Li, when will this tube be pulled?"
I can eat on my own. ”"Not yet.Some medicines have to be given through a nasogastric tube.Hold on a little longer. ”Li Min thought about it and comforted him: "I will be able to pull it out soon."
When that's all right, I'll take you back to the 11th floor. ”The patient's eyes lit up and he pinched his eyes vigorously towards Li Min.Li Min continued to look at the day's nursing records.After reading the nursing records and changing the temporary doctor's order, the special care officer immediately took the medicine according to the doctor's instructions.Li Min nodded at the patient and said to him, "Sleep well, maybe you will be on the 11th floor when you wake up." ”Then she went to see the patient who had surgery today.He was only separated from the smoke disease by a curtain, but Li Min knew that the position was closer to the doctor on duty, and he also knew that even if the curtain was open, it meant another potential risk that could not be spoken.In other words, the patient could die at any time.The patient was lying flat on the monitoring bed, with only his facial features exposed.The tightly wrapped head, the body covered with a thin white quilt, the ECG monitor next to the bed, the EEG monitor, and the ventilator connected to the tracheal intubation brought back from the operating room, all gave Li Min a very bad feeling.She opened the operation record first, and sure enough, Dean Chen had already written the operation record.She couldn't help but feel ashamed, ashamed that she had to ask the teacher to help her complete the work.Li Min read the medical records and went to see the nursing records.When she returned the nursing records to the intensive care staff, she found Dr.
Chen standing in the patient's bed.I don't know when he came over."
Teacher.He ......"
Chen Wenqiang nodded and said to Li Min: "Let's go, go back to Corey." ”Li Min followed Chen Wenqiang to hang up the ICU robe, and the two left the ICU.In the elevator room, Chen Wenqiang said: "Xiao Li, there will be some patients in neurosurgery who will never wake up after surgery.You don't have to be too bad. ”Li Min nodded silently, she had done most of this operation, she believed that she was uncomfortable, and the teacher's heart would not be relaxed."
Teacher, the two of us did so many exercises in the laboratory the year before last for glioma surgery," Li Min took a deep breath: "I don't know if I still have to go to the laboratory to continue practicing." ”"But in terms of stabilization techniques, it's enough for you to keep this amount of surgery per week.For the rest, you can wait for the birth of the child.I told you before that you are in a special period, and you can go to the laboratory as little as you can, and you won't go if you can. ”"Uh-huh, I remember.Kevin Lu: They all go to the lab to practice by themselves. ”When the elevator arrived, Li Min followed Chen Wenqiang into the elevator.The elevator worker greeted them with a smile: "Dean Chen and Director Li, just came out of the ICU."
It's almost half past seven. ”Li Min looked at his watch meaningfully, but wasn't it, he had been delayed in the ICU for too long.From the 16th floor to the 11th floor, no one used the elevator at this time, and there was no pause in the middle, and it seemed that the moment Chen Wenqiang nodded to the elevator worker, he arrived on the 11th floor.After passing by the nurse's office, Nuan Wen saw Chen Wenqiang and Li Min come in to wash their hands, and immediately raised their voices and said, "Dean Chen, the quilt covers and sheets in the duty room have been changed, and the doors and windows have been opened just now for ventilation, you can go and rest for a while." ”Chen Wenqiang smiled at Wen Wen and said, "Then I'll go to the duty room to lie down for a while, and you can call me if you have something."
Thank you. ”Nuan came over with the key and said to Chen Wenqiang, "Dean Chen, it was arranged by Director Li.Dr.
Ma and Dr.
Deng said that they went to the duty room. ”There are 4 bunk beds in the other duty room, and Dr.
Ma and Dr.
Deng have gone over, even if Yang Yu and Lu Kaiwen are added, even if the four interns stay in Corey to sleep tonight, there are enough rest beds.Li Min waited for the warmth to finish speaking, and said to Chen Wenqiang: "Teacher, then I'll go home." ”"Good.Go back and get an early rest.Just come here at 8 a.m. tomorrow morning. ”Chen Wenqiang gently admonished Li Min."
Hmm
.
"* Li Min left the hospital with a schoolbag and a lunch box.It was getting late, and a few stars that were still bright hinted at their presence unnoticed in the distant and unfathomable sky.There is still the laughter of young people on the basketball court.The night breeze is not only gentle, but it also has just the right temperature.The crowd walking in the dormitory group is no longer holding a fan and shaking.You can even occasionally see sporadic people who wear long-sleeved shirts and are afraid of the cold.Although they rolled up their sleeves to the middle of their forearms, it also heralded the end of the summer of '92."
Xiao Li, why did you come back?"
It is the older and older people who say this.For example, Director Liu of Pediatric Surgery and Director Luo of Endocrinology."
Director Li just got off work."
This is not very familiar with Li Min.For example, the general peripheral doctor.There is also a question: "Li Min, you are still willing to go home." ”Those who dare to say such a joke are the classmates of the same grade who were assigned with her, such as Xiao Wang and Xiao Gao.Li Min always responded to these words with a smile and a nod, and her tiredness was all revealed to the people she met along the way.As for what these people will think, Li Min doesn't have the heart to pay attention.She hugged her schoolbag over her shoulders, carried the lunch box bag, and moved home unhurriedly.Li Min opened the security door of his house, and the first thing he saw was Mu Jie's slippers next to his slippers.This is Mu Jie calling Xiao Fang and informing Xiao Fang that he will come back tonight.The fragrance wafted from the kitchen, Li Min sniffled, what is fried?
Li Min put the schoolbag on the chair, carried the lunch box bag into the kitchen, and saw Xiaofang wearing an apron and cooking in front of the stove.She holds the tail of the fish in one hand and the other hand with a spatula to hold a floured fish through the oil.On the side of the board are chopped green onions, shredded ginger, minced garlic, vinegar bottles, soy sauce bottles, and sugar jars lined up in turn, and there are two large bowls of clear soup filled with most of the clear soup and one with wet starch in rice bowls."
You're going to make sweet and sour carp?""
Hmm.I'm back, Aunt Min. ”Xiao Fang uses a spatula to push the fish to the edge of the pot, so that the fish body is arched, and the back of the fish is facing down.After a while, Li Min watched her turn the fish over and fry the belly of the fish again.After that, the fish is flattened and the head is pressed into the oil with a spatula to fry it.After frying the head and tail, fry the fish tail and serve it on the prepared fish plate."
Awesome, Chef Fangji."
Li Min joked with Xiaofang and put the lunch box and thermos bucket in the pool."
Aunt Min, what time did you step down?
I called your nurse's office at 3 o'clock, and they said you hadn't been back to Corey yet. ”"I slept in the operating room.I'm almost done with the food here.Throw out the rest.I'm going to take a shower. ”"Hmm."…… When Mu Jie arrived home, Li Min was blowing his hair in the bathroom."
I'm back."
Li Min turned off the hair dryer and gave way to the sink.Mu Jie quickly washed his hands and face, grabbed the face towel, and after hugging his face twice, he was about to grab the hair dryer in Li Min's hand."
I'll blow it for you.""
Almost.You go to dinner, it's past eight o'clock. ”Li Min took a step back."
Don't make your stomach hurt."
Mu Jie didn't dare to rob Li Min, and saw that her hair was really half dry, so he gave up his plan to serve and went out to eat.Xiao Fang put the food on the table for Mu Jie, and went into the bathroom to clean up.found that Li Min's changed clothes were rarely thrown in the laundry tub."
Aunt Min, are you tired today?""
Hmm.You clean up for me, and wash my socks separately from the rest.Call me again tomorrow morning at 7 o'clock. ”"Okay."
Li Min put down the hair dryer and smeared a layer of olay oil lotion on his face.Then he went to the hall and sat down at the big table, leaning back in his chair, smiling and watching Mu Jie eat."
Eat more?"
Mu Jie asked Li Min."
Nope.Eat it yourself. ”Li Min touched the pen, opened the work notebook, and after writing the date, she drew a tombstone after the date of the day.Xiaofang came out with the laundry tub, and Mu Jie smiled and encouraged her, saying, "This sweet and sour carp is well done."
Xiaofang, you can go to the cafeteria to take charge. ”Xiao Fang pursed her lips and smiled, and entered the balcony on the other side of the kitchen, she wanted to quickly wash out Li Min's clothes and clean up the kitchen......
Then I went to help my sister take Pan Jia in the evening.Li Min looked at the tombstone behind the date and was stunned, not noticing that Mu Jie had looked at him a few times, nor did he notice that Mu Jie had finished eating.It was the sound of Mujay moving the table that alarmed her."
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Mujay, are you done eating?
Didn't you chew slowly?
”Mu Jie smiled, and said that he was really unhappy to eat today.It's just that Li Min was stunned, and he didn't mention it.In fact, when he entered the door, he found that Li Min's mood was not very high, unlike when he came back a few times before.Mu Jie moved the dining table into the kitchen, and then asked Li Min, who came in behind him, "Minmin, what is going on?"
”Li Min put his arms around Mu Jie's waist behind him and pressed his face against Mu Jie's back.Mu Jie slowly moved his steps and dragged Li Min out of the kitchen.Xiaofang washed the rice bowls, cleaned up the kitchen, and didn't care that the washing machine was still running, so she hurriedly took the key, and fled without saying hello.Mu Jie dragged Li Min back to the bedroom, turned around and hugged her and asked again: "Minmin, what did you encounter today?"
”Li Min bit his lip, held it for a while, and said in a very low mood: "The patient who operated today, he may not wake up." ”"Why?"
Mu Jie knew what Li Min needed now was someone who could listen to her.It doesn't matter if you understand it or not."
I don't know."
Li Min's mood is very bad."
Some patients after craniotomy just can't wake up for no reason."
As Li Min spoke, his eyes turned red with discomfort."
It's not that I didn't do well in the operation, and it's not that the basic conditions of this patient are too poor, but he has an unstable heart rhythm during the operation, and abnormal spikes frequently occur in EEG monitoring."
Mu Jie sat on the bed, he put his arms around his lover, and let Li Min sit on his lap.The two of them folded their hands and rested on Li Min's bulging lower abdomen."
How long did the surgery take?
When I called Xiaofang, she said you haven't been back to Corey yet. ”"I did it with Dean Chen for more than 6 hours.The rest was done by Dean Chen. ”Li Min's tears fell onto the back of Mu Jie's hand, burning Mu Jie's heart."
The preoperative examination clearly located the location and size of the glioma, and all the steps of this operation, my teacher and I strictly followed the procedure."
Mu Jie raised his hand to wipe away his lover's tears, kissed her sideburns and said, "Minmin, you and Dean Chen have done your best.You are doctors, not gods.I remember you told me that a cold kills people, don't you?
”Li Min nodded."
Do your best and then listen to the will of God.Healing the disease can't save lives.Isn't it?
If you want to be sad again, it will be difficult for yourself and make Mu Yu uncomfortable. ”Mu Jie put his arm around Li Min and whispered in her ear.Gentle kisses fell on the corners of her eyes and eyebrows one after another.When Li Min's mood calmed down, Mu Jie said, "Minmin, you're too tired today, let's lie down for a while." ”Li Min grabbed Mu Jie's shirt button and didn't move."
Well, I'll take a shower, dry my clothes, and come over to lie down with you.Good no good?
”"Hmm."
Li Min was obediently put on the bed by Mu Jie.As Muljay covered her with a quilt and closed the curtains, her eyes followed Murje.But Mu Jie didn't leave for a while, and she closed her eyes reluctantly.When Mu Jie packed everything up and returned to the bedroom, he found that Li Min's sleeping appearance was very unstable.Rapid breathing, pale face, and rapidly moving eyeballs all suggested that Li Min was in a state of panic.He knelt down on one knee on Simmons' mattress, the spring skewed his body a little, he quickly balanced his body, held his lover in his arms, and called eagerly: "Minmin, Minmin, you wake up, wake up." ”Li Min was woken up by Mu Jie.She put her arms around Mu Jie's neck and cried in a low voice: "Mu Jie, I dreamed of Director Li. ”※※※※※※※※※※※※※※※※※※※※ * That's the end of the text.I won't write a follow-up to this series in the future.,I don't know yet.。
If you write, there may be a lot of cooperation between Li Min and Liu Hong in the ICU in rotation; I don't know if I can have the courage to face kidney transplantation and liver transplantation; As for SARS, the heroic deeds of respiratory medicine and critical care medicine also require courage to face.
**When I decided to conclude the article a few days ago, I https://bbs.jjwxc.net/showmsg.php the emotion in Bishui?
board=17&boardpagemsg=5&id=1174595 Jinjiang Forum → Netizen Exchange Area→ Bishui Jiangting Theme: In the heart of every neurosurgeon, there is an epitaph that has worked hard for more than a year, rushing to the conclusion.With 3.33 million words, I don't dare to recall how I survived.Each name typed out has a lifelike image, and the personality is distinctly swirling in front of the eyes.For every name that is knocked out, there is a corresponding body of pain, and the tormented soul is reaching out for help.That sentence: At the bottom of every neurosurgeon's heart, there is an epitaph.There are patients who have never been revived because of surgery.The purpose of our whole life, in laboratory training, theoretical study, clinical practice, continuous repetition, continuous training, and continuous efforts, is to make there be fewer such patients in our inner cemetery, and there will be fewer such patients.- "The Choice of Life" Henry.
MARSH'S DESK CONTAINS RHON'S CRANIAL ANATOMY AND SURGICAL APPROACH, AND RAKSIN & UOLMAN'S ATLAS OF ACUTE NEUROSURGERY IS ALSO OUTDATED.I thought I would take these books to a second-hand bookstore and sell them.But at this moment when I want to conclude the article, I suddenly can't bear to leave these professional books in my hands that will never be useful.Which craniotomy path are these professional books that focus on neurosurgical microanatomy, and what anatomical parts can be revealed at most?
When do I need to have my zygomatic arch severed and my eye socket removed?
When I ran away, I thought I would never look at it again.But I read it, and I present it selectively to my dear readers.Thank you, thank you for being with me for more than a year.No0☆☆☆ Mingyue|b1163e3b★★★ left a message on 2020-07-1315:52:56☆☆Report*** A few days ago, I chatted with Han Shao and Tingting (daughter-in-law), talking about writing a little sweet essay (three or five hundred thousand words), writing about the love of young people across the mountains and seas, please collect if you are interested.Please support.Thank you.The tentative name "Big Hands Holding Small Hands" copywriting is sweet, sweet, sweet and sweet like drinking honey The marriage and love between the male protagonist and the female protagonist during the new crown period are cold: I turned over the mountain Tingting: I crossed the sea and the cold is less: Mom, I decided to get married The mother of the confused circle: I feel like I am still a baby!
But the answer to my son is: Baby, I'm not ready Tingting: Mom, he has all the necessary qualities, it's enough for the time being, will it be changed when it is written in September, and the distance is a little far