Chapter 629: Fear, Direct Attack
Surgery has always had extremely strict operating standards.
Internal medicine never classifies diseases into different levels. As long as you have the ability, it is completely possible for interns to treat serious diseases. However, the operating room has strict qualification requirements and a graded access system.
Resident doctors can only perform level one surgeries and at most participate in level two surgeries.
There are also preoperative evaluation, intraoperative sterile management, safety management, various strict postoperative care, etc. All medical staff have a red line that cannot be crossed, and that is the safety of the patient.
Zhou Can has extremely strong surgical skills and is proficient in almost all areas.
I am usually very careful when performing surgery on patients, so nothing goes wrong.
It was precisely because he had been doing smoothly since he started his career, coupled with his personality, that he gradually deviated from the conventional procedures during surgery and engaged in some quite risky behaviors.
So far, no problems have occurred during major operations in the emergency department, cardiothoracic surgery, or other departments.
Even if an accident occurs during the operation, Zhou Can still has director-level experience in anesthesia and critical care medicine rescue, as well as director-level pathological diagnosis and pharmacological differentiation, which are enough for him to turn the tide and rescue the patient from the hands of death at the critical moment.
People are all the same.
With strong strength and a habit of smooth sailing, people tend to be overconfident. When doing something familiar, they like to act unconventionally.
Zhou Can usually goes to other departments to help with surgeries, and basically follows the surgical plans made by others.
He is only responsible for some key parts.
If speed is a priority, it is possible that most of the operation will be completed and the remaining skin suturing and cavity closing will be left to other doctors.
He holds a very high status in the emergency department and cardiothoracic surgery department, and the chief physicians trust him highly.
This also led to the fact that his problem has never attracted anyone's attention.
It is definitely a good thing that Wu Baihe discovered Zhou Can’s problem this time.
He who knows shame is brave.
Only by recognizing our own mistakes can we make continuous progress and reduce mistakes.
"Director Wu's teaching is that I was indeed a bit willful in the past. I must correct this problem." Zhou Can saw that the teacher was criticized, and Director Wu was indeed doing it for his own good.
Be receptive to criticism and suggestions immediately.
"It is a good thing to have a proper attitude. No matter how great your ability is, you must abide by the rules. The surgical safety regulations and safety guidelines are the result of countless predecessors' experience and lessons learned through blood. Maybe it may not be reasonable in your opinion, or you think you can break these rules, but I can tell you responsibly that almost all the great doctors who get into trouble do so because they think they are so capable and confident that they can break the rules.
As a result, the final misstep led to eternal regret.
Most of those who were electrocuted were electricians, and most of those who drowned were people who could swim.”
These are harsh words, but honest advice hurts.
What you said does make sense.
"You directly probe the brainstem. What if there is no bleeding in the brainstem? Or even if there is bleeding in the brainstem, but the symptoms are mild and it is not the main cause of the patient's deep coma? The brainstem is called a life-forbidden zone. Not to mention you, a young man who has only been practicing medicine for a few years, but I, who have been working in the field of neurosurgery for decades, dare not touch it easily."
Wu Baihe scolded Zhou Can so badly that he couldn't even raise his head.
It was surprisingly quiet in the consultation room.
Although Director Lou and Doctor Xu did not say anything, they both realized the seriousness of the problem and they strongly supported Wu Baihe's opinion.
Anesthesiologist Qu Zi looked at Zhou Can with a strange look.
This was the first time she saw Zhou Can being scolded so badly.
In the past, all she heard were senior doctors, patients, and nurses praising Zhou Can.
"When performing any major surgery, you must remember to start from a safe place first and deal with the lesions that can be identified first..." Wu Baihe explained the principles of surgical sequence to Zhou Can.
"This surgery can be performed minimally invasively, and it is only suitable for minimally invasive surgery. My suggestion is to first deal with the thalamic hemorrhage and damage, and then decide whether to explore the brainstem area after observing the situation. I feel that this patient's brain blood vessels should have relatively serious sclerosis and lesions. You can take a look at the blood vessel spots on the film. Although they are not noticeable, there are a lot of them. I suspect that her brain blood vessels have relatively serious atherosclerosis."
Wu Baihe is indeed a top expert. He was able to diagnose some subtle problems that Zhou Can had not discovered.
"The patient's blood lipids are obviously high, which should be the culprit for causing arteriosclerosis. I really didn't realize that her blood vessels had such serious lesions. Director Qu, please re-evaluate the patient's surgical risks."
After hearing this, Zhou Can was slightly shocked.
Fortunately, we invited Wu Baihe to come for consultation. If we had followed his original surgical idea and directly used the brainstem area as the first stop of the operation, the consequences would have been difficult to predict.
It doesn't mean that there will definitely be danger, but at least when the patient has extensive atherosclerosis in the cerebral arteries, the safety risk of surgery will double.
He couldn't help but feel a little scared.
Every time I thought I was very strong, but in fact I still had a lot to learn.
A journey of a thousand miles begins with a single step; a river or sea is formed by the accumulation of small streams.
I have to be more humble in the future, keep learning every day, and never become proud and complacent.
"Now there is a new discovery that the patient's intracranial arteries have extensive atherosclerosis, which will increase the risk of intraoperative bleeding and the difficulty of hemostasis. However, Director Zhou's surgical skills are sufficient to significantly reduce this potential risk, so after evaluation, I believe that the operation can still be performed."
Qu Zi is also in the growth stage.
After the restructuring of the Department of Anesthesiology, she signed a one-to-one cooperation agreement with the Emergency Department.
Basically, he became the emergency department's exclusive anesthesiologist.
In fact, the people who used her the most were Zhou Can and Dr. Xu.
Currently, these two people are the only ones in the emergency department who are capable of truly conducting level 3 operations.
Doctor Tang Wangnian is striving for the title of associate senior professional. With the support of the department, it is basically a done deal. His own conditions are also good. He has basically achieved all the papers and medical achievements required for the title of associate senior professional.
The only thing missing is surgical achievement.
This is not the key to the evaluation of associate senior position, and the department will also help him smooth things over and make this happen.
Therefore, it should be no problem for him to be promoted to associate professor this year and become deputy chief physician in the field of emergency surgery.
Even after being promoted to associate professor, he still could not immediately perform level 3 surgery.
Even a less difficult level 3 surgery is not possible.
You need to practice more before you can acquire this ability.
"Director Wu, what is your opinion?"
She looked at Wu Baihe with respect in her eyes.
"Anesthesia determines life, and doctors determine illness. Isn't this a rule that has long been established in the operating room? Since you, the anesthesiologist, have said it's okay, I naturally have no objection. But there is one thing I have to tell you. You can't be too superstitious about the chief surgeon's surgical ability. Stable performance and strong surgical ability can only serve as a small part of the reference for surgical safety, and must not be the key part of the evaluation."
Director Wu is a straight man.
But he was quite gentle when treating female doctors and nurses.
Even if it was criticism, it was only euphemistic and stopped there. When he scolded Zhou Can just now, he really showed no mercy at all.
Male doctors usually take into account the psychological endurance of lesbians.
If they are scolded too harshly, they will cry.
They don’t cry in front of their female colleagues, but often cry in the bathroom or office. This is the weakness of male doctors, and no male doctor likes to make his female colleagues cry.
"clear!"
Qu Zi sticks out her tongue playfully.
She knew what Wu Baihe was referring to. He was warning her not to assume that Zhou Can's surgical skills were strong and that nothing had happened to him before, and to use this as a key factor in assessing surgical risks.
Instead, the proportion of this aspect should be reduced.
"Well... since the surgical plan has been finalized, and the anesthesia risk assessment and surgical safety assessment have also been passed, can we perform the surgery tonight while Director Wu is here?"
Zhou Can suggested.
"You are such a calculating kid! You must have come up with this idea a long time ago, right?"
Wu Baihe couldn't help but shake his head and smile bitterly.
I was always thinking about this kid, but he plotted against me instead.
"Hey, you're busy every day! It's not easy to ask you to come here, and I don't want to waste too much of your time. This patient's family is in financial difficulty, and her daughter is eager to save her mother. I thought that if the operation could be performed tonight, it would further reduce the patient's damage and save some treatment costs for the patient's family."
Zhou Can didn't shy away from what he said.
Cheng Xiaolu's father is disabled, so her income is not particularly high, probably only about 6,000 to 7,000 yuan a month.
The pharmaceutical department has been making losses for years and there is no such thing as a year-end bonus.
In fact, all companies are similar. When suffering from serious losses, it is considered good enough to be able to pay salaries, let alone year-end bonuses.
Those companies that give out million-dollar year-end bonuses, or reward cars or houses during the Chinese New Year, are all companies that have made a lot of money and use a portion of it to motivate their employees and strive to create greater success.
"I like your virtue of caring about patients and being able to sympathize with poor families and the weak. Please arrange it quickly. I have to see patients in the outpatient clinic tomorrow morning. I am old and must go home and rest early."
A rare smile appeared on Wu Baihe's face.
The look he gave Zhou Can also became much softer.
People are all made of flesh and blood.
Zhou Can always thinks of the patients and considers the financial situation of their families. His words and actions make many medical staff love and respect him from the bottom of their hearts.
With Wu Baihe's smile, the atmosphere in the consultation room suddenly became much more relaxed.
Next, we quickly talk to the family, follow the surgical procedures, and send the patient to the operating room.
When the patient was admitted to the hospital yesterday, Zhou Can explained this to the doctor in charge.
Always be prepared for surgery.
Now it comes in handy.
The patient was successfully taken to the endoscopic operating room.
…
In order to improve the safety and success rate of the operation, Wu Baihe called all his professional teams over.
It's considered temporary overtime.
Of course, this is also a good learning opportunity for those medical staff.
Following strict surgical procedures, after drilling a hole in the patient's head, the endoscopic surgery officially began, with Zhou Can as the lead surgeon, Wu Baihe and another senior neurosurgeon assisting.
Everyone else has their own duties.
The patient’s physical condition is not very good, which is the biggest risk.
Human life is sometimes particularly tenacious. During an earthquake, some people were trapped underground, with no water, no food, injuries, and unable to move. However, they managed to survive for more than a hundred hours and were finally successfully rescued.
Sometimes, human life is extremely fragile.
This is especially true in the operating room, where some patients are still alive and well before being pushed in. However, accidents occur during the operation and they eventually die in the operating room.
Many people think that it is safe to have surgery in a large hospital, but in fact it is not absolutely safe.
Take the Gastrointestinal Surgery Department of Tuya Hospital as an example. This sub-department is generally recognized as having a higher surgical safety factor and a relatively low risk. However, more than 100 patients die from surgery every year.
This does not include patients who survived more than three days after surgery.
What does it mean?
That is, after the operation, the patient may live for three days, but may die in a week, half a month, or even longer.
But the cause of death was definitely related to the surgery.
After all, any surgery involves huge risks. While removing the lesion, it can also cause serious harm and impact to the patient's body.
Take the thymus gland, for example.
In the minds of ordinary people, the thymus is a small organ that is dispensable. Few people have even heard of its name.
Moreover, in many open-chest surgeries, it is common for the thymus to be removed.
Especially cancer patients.
Generally speaking, the thymus of infants and young children is only about 10 grams, not more than 15 grams. The thymus of adults, especially men and women in their prime, is only about 20 to 30 grams, not more than 40 grams.
In old age, the thymus will degenerate and return to around 15 grams.
Such a small organ weighs less than a larger tumor.
However, the thymus is the largest immune organ in the human body.
After it is cut off, the human immune system will have serious defects, and one can easily imagine what the future holds.
Everyone knows that AIDS is terrible.
Why is it scary?
This is because it attacks the human immune system.
The reality is that some people who are unfortunately infected with AIDS are dying and extremely terrified, thinking that they will not live long. However, patients who have had their thymus or other immune organs or tissues removed do not feel any psychological pressure at all.
For example, lymph nodes, we need to cut a lot, right?
Not to mention the removal of lymph nodes during some tumor surgeries, there are also various lymph nodes that are too large to cause pain, or that are removed if the patient is worried that they may be cancer.
In fact, lymph is also an important part of the immune system.
Lymphocytes are one of the most important warriors in the human immune system.
The life of this patient is already flickering and could be extinguished at any time. In addition, the patient is relatively old, and the risks of performing a craniotomy on her now can be imagined.
Qu Zi and the anesthesia nurse were both extremely alert and did not dare to slack off for even a moment.
Zhou Can manipulated the forceps of the endoscope, carefully pushed aside some brain tissue, and went straight to the bleeding point. Because the shadow of this area was very obvious when taking a picture, he found the target location without much effort based on his experience in craniotomy.
"Director Wu, can you drain the blood first?"
"nonsense!"
Wu Baihe hated asking for instructions from all sides. In fact, with him watching and assisting, if there was really a problem, Zhou Can didn't need to ask at all.
