top student at medical school

Chapter 183 Request for Consultation (6k, 3 more chapters added, please subscribe)
Xue Tao had already completed the temporary pressure to stop the bleeding and handed the disinfection area over to Wang Zhongxing.

Wu Guonan looked at Peng Yuanming with a strange expression: "Both lower limbs amputated? Not even one limb can be saved?"

Peng Yuanming walked over, examined the area, and said, "Director Wu, could you take another look at the blood circulation in the lower extremities right now?"

“After a certain period of time, the proximal femoral artery will produce emboli in the distal artery, which is a reactive blood clotting process.”

“If blood cannot flow smoothly, it will clot. I’m afraid there are a lot of blood clots in the patient’s deep veins. The body’s self-protection mechanism will ensure the blood supply to the head, heart and other organs.”

"The blood vessels around the body will naturally clump together to form a blood clot."

"Even if I were to sew up the femoral artery and brachial artery right now, it wouldn't help the distal limbs!"

“Unless your orthopedics department can perform a limb-sparing surgery, it’s better to amputate the limb directly rather than dealing with the artery, in order to avoid complications due to limb necrosis later on,” Peng Yuanming suggested decisively.

Upon hearing this, everyone's expression changed.

Amputation is easy, but limb preservation surgery is difficult and is not a simple procedure.

However, Peng Yuanming was not shirking responsibility; this was simply the current situation.

"How much time has passed since the patient was injured?" Wu Guonan asked Xue Tao, the orthopedic surgeon who was the first-priority doctor to see patients.

After an injury, a blood clot will not form immediately; a certain amount of reaction time is required.

“It’s only been forty minutes since he was taken to the hospital, but we can’t be sure when the injury occurred. I heard that someone discovered the injury and then called the police,” Xue Tao replied.

"Or you could transfer to Minzu University Hospital," Peng Yuanming suggested, noticing Wu Guonan's dilemma.

“If this patient could be transferred to another hospital, he would have been transferred directly from the emergency department,” Wu Guonan said.

“Then there’s nothing I can do. I can’t perform limb-sparing surgery either.” Peng Yuanming spread his hands.

The atmosphere reached a stalemate.

After listening to the conversation of this group of people, Nie Mingxian, who was in front of the anesthesia machine, kept rolling his eyes and felt secretly irritated.

If I don't have surgery and just use medication, how much money will I lose? Will I end up having to make up for it myself?

Watching a group of people arguing pointlessly!

Nie Mingxian really wished he could just slap someone across the face—

This is the thing. If you really can't do it, why don't you try limb preservation first? If you really can't do it, why don't you temporarily switch to amputation during the operation?
In other words, he is currently an anesthesiologist and does not have the surgical authority for emergency surgery for the time being; otherwise, he would definitely have to wear surgical gowns and go on stage.

The registration of anesthesiologists is for routine anesthesia procedures, not for surgical practice.

“The patient’s vital signs are unstable right now. If we delay any longer, our anesthesiology department may not be able to save his vital signs!” Nie Mingxian urged.

Peng Yuanming looked at Nie Mingxian and implied, "Director Nie, it's not that we don't want to do it, but we have no choice right now. My suggestion is to amputate the limbs directly and save their lives first."

"If you're dead, having legs doesn't mean much."

Unfortunately, Peng Yuanming was the only person in the hospital who knew that Nie Mingxian's surgical skills were no less than Wu Xuanqi's at Minzu University Hospital. However, Nie Mingxian had become an anesthesiologist by some twist of fate.

He couldn't pass the problem on to Nie Mingxian, but limb-sparing surgery was something Wu Guonan in orthopedics had to do, but Wu Guonan definitely couldn't do it. So if he went to deal with the vascular suturing problem at this time, he would be wasting precious time and doing useless work.

“Okay! Director Huang, you are an expert in vascular surgery, I will take your advice!” Wu Guonan said decisively.

Since Peng Yuanming suggested amputation, then let's have an amputation.

Wu Guonan understood Peng Yuanming's meaning, but in the current situation, even if they called in Director Hongdu, they wouldn't be able to handle it.

Once a thrombus occurs, whether it's disseminated intravascular coagulation (DIC) or a long, thin thrombus, it's beyond the scope of the orthopedics department at Enshi Central Hospital.

No diamonds, no porcelain work.

"Director Peng, let's go talk to the patient's family together..."

five minutes later.

The family communication room is located at the entrance of the operating room.

A middle-aged man in uniform stood in front of Peng Yuanming and Wu Guonan!
He slammed his hand on the table, his face contorted with rage—

"You're saying this means we're going to amputate both hands and feet?"

Not even one will be left?

"If that's the case, even if he survives through emergency treatment, how will he live afterward?" The middle-aged man glared so fiercely that he looked like he wanted to devour Peng Yuanming and Wu Guonan.

"If you're already dead, discussing whether your hands and feet are still there is even more meaningless."

Peng Yuanming explained, "We can't hesitate or waste any more time."

"The patient's condition was already complicated. In addition to the damage to the arteries in the limbs, there was also bleeding in the internal organs and the chest and abdomen. Multiple bleeding sites can be fatal."

"In such a situation, the optimal solution is amputation to stop the bleeding and save the life."

"Even if we call a vascular surgeon to come for a consultation and surgery, the patient's current condition may not be able to hold out until then."

"Life or limbs?" Peng Yuanming was not threatened by Liu Chaodong's words at all, and his reasoning was clear and his decision was exceptionally decisive.

"I want them all!" Liu Chaodong continued pounding the table.

"Then you'll have to bear the risk of the patient losing their life at any moment during the surgery. Can you represent the patient's family?"

"Let me be clear with you, in Enshi, under the current circumstances, the only doctor who can perform limb-sparing surgery and endovascular thrombectomy is Dr. Wu Xuanqi at Minzu University Hospital."

"No other doctor can do it, and you don't need to ask. I know the situation better than you do."

"But Dr. Wu is already on the operating table for emergency surgery. Minzu University Hospital has its own emergency patients, and it will take at least two hours to get there."

"And he said on the phone that even if he came, it might not be enough..."

Peng Yuanming's words seemed to provoke the middle-aged man: "Two hours before we can leave? Who the hell did you hire? What a grand display!"

"Why didn't he wait until the person was dead before coming to collect the body?"

"He doesn't know what's going on here. Why are you telling him to come over?"

"The people here are almost dying."

"Don't you know who the person lying in the operating room is? Didn't I tell you?"

Liu Chaodong slammed his fist on the wall in anger, unable to contain his rage.

He took off his uniform cap, revealing his bald patch. Then he smashed the brim of the cap.

Peng Yuanming, however, was very experienced. After taking a deep breath, he directly took out his phone: "Family member, tell me, whose life isn't a life? Whose emergency surgery isn't a life-saving procedure?"

"Whose life is more important, whose life is more noble? Come, say it here!!!"

Peng Yuanming turned on the recording button.

“Video recording is fine too!” Peng Yuanming chose the most violent way to deal with his emotions.

The middle-aged man fell silent.

Regardless of his status, saying these words will put him on the moral high ground. He may feel that his subordinates are more important than others, but he cannot say it.

There's nothing we can do about it!

“In emergencies, severe measures must be taken.”

"Do you think we want to amputate a patient's limb? Do you think we want to create a disability?"

"If we can't do it, we'll only harm the patient!"

“Dr. Wu is currently in the operating room. We invited him to come for a consultation and surgery. Note that we invited him, not asked him to come and perform the surgery. Would Dr. Wu really leave his own patient's surgery unattended?”

"Hurry up and decide, we don't have much time to talk." Peng Yuanming put his phone down again, not really intending to record it.

"Is there no one else in Enshi besides him?"

"Do we really have to have him?" Liu Chaodong rubbed his balding scalp hard with both hands, extremely annoyed.

Everyone understands the logic, but Zhang Yu, who is lying on the operating table now, is his soldier, his nephew, and the only orphaned bloodline of his sworn brother. He is about to lose him.

"There are people, but almost none dare to do it and are capable of doing it!"

“I’m a vascular surgeon myself, but I can’t do it. In Enshi, there are only three hospitals that can handle it: Minzu University Hospital, People’s Hospital, and our Central Hospital. Minzu University Hospital and People’s Hospital even have specialized vascular surgery departments, but after calling around, I couldn’t find a single one that dared to come and perform the surgery.”

Peng Yuanming did not give Liu Chaodong a chance to waste time:
"This is not child's play, nor is it a physically demanding job. We just need someone to make up the numbers."

"If we don't amputate now, then after all the surgeries in our other departments are completed, the necrotic limbs in both lower and upper limbs will become an even more deadly death warrant!"

He has a Mediterranean expression, but his unique features mean he has very sharp attention.

He pressed further, "What do you mean by 'almost none'? Explain yourself clearly. Besides Dr. Wu, is there anyone else who can do it?"

Peng Yuanming hesitated for a moment before saying, "Yes, but he can't do it now. He's an anesthesiologist at our hospital!"

"Then what are you all standing here for? Go find him! Who cares if he's an anesthesiologist or not? As long as he's a doctor, he can save lives!" The Mediterranean man was so angry he was practically bubbling with rage.

"Do you have the authority to do the work of a traffic policeman and issue tickets? Can you do it?" Peng Yuanming retorted angrily, showing considerable experience!
"Can this be the same?"

“Why can’t they be the same? An anesthesiologist is an anesthesiologist, and a surgeon is a surgeon. It’s all governed by law. Even temporary authorizations from hospitals cannot override the law. You yourself are a police officer. You’re saying they can’t be the same?” Peng Yuanming said, then turned on his phone.

"You have a minute to consider and hesitate because you're so talkative. If the surgery is delayed because of your signature, there's nothing we can do to fix it."

Mediterranean's eyes were bloodshot: "Do you know that he now possesses a very important clue! He can be saved..."

Peng Yuanming said, "This leader, I don't understand anything you're saying!"

"All I know is that he is now in our hospital, a patient who is about to lose his life. If he is not treated in time, even if he is a god, he will be reduced to nothing. No matter how much wealth and information he has, it will all vanish."

"If you are not a family member, I hope you can get in touch with the family."

Mediterranean's chest heaved violently as he looked at Peng Yuanming:

“Contact his family? His parents, my comrades, grandfather, and uncle are all down here. His grandmother is over ninety years old this year. She has difficulty walking and is on her way from the countryside. Her family is poor and has no money for a wedding.”

"Which family member are you looking for? Do you dare to go looking for them? I am the family member!"

"I want you to save him, to save him unharmed. Can you do that?"

When Mediterranean couldn't control his emotions, Peng Yuanming received a phone call, and without caring about anything else, he answered it right there in front of him, even through the wall.

His tone was extremely respectful: "Hello, this is Peng Yuanming!"

"Okay, I know."

After hanging up the phone, Peng Yuanming said to Mediterranean, "There's nothing we can do now. The condition of Dr. Wu's patient is also uncertain."

"Even if he arrives in two hours, he won't be able to get there in time."

"The only option now is amputation."

"The other one, the one you said couldn't have the surgery, I called him and asked him to do the surgery. You didn't dare to ask him, can I ask him instead?" Mediterranean said confidently.

Peng Yuanming knew Nie Mingxian: "You know I could have kept him a secret, but why did I tell you? It was to save time."

“I can give you his phone number, but I have to tell you a premise: he was originally a top student at Kyoto University Third Hospital. He signed a contract with our hospital so that he could afford the cost of his father’s cancer chemotherapy.” “Moreover, he joined the anesthesiology department, which has a higher talent recruitment fee, and signed a contract.”

“If you ruin his future and prevent him from continuing to work, you're essentially killing his father. I don't recommend you make this call!”

"But the choice is yours." Peng Yuanming actually hoped that Nie Mingxian could help save the patient.

But these words are precisely the concerns he has in his heart right now.

Peng Yuanming eventually handed the phone to Mediterranean.

So Mediterranean composed himself and made the call. Before answering, he asked Peng Yuanming, "Is your surname Nie?"

The call was quickly connected, and the man with the Mediterranean hair immediately became polite, losing his previous arrogance: "Hello, is this Dr. Nie? I'd like to ask you to come to the Central Hospital for a surgery. Director Peng here is looking for you."

The call was immediately disconnected!
Mediterranean was so angry that he almost smashed his phone.

When I called back, it showed that the line was busy; it would be strange if it hadn't been blocked.

He even borrowed a phone, but after making the call, the other party hung up immediately after he had spoken.

"What rubbish is this?!" The veins on his bald forehead stood out prominently because he was bald.

Liu Chaodong looked at Peng Yuanming: "Doctors, could you please make another call to Dr. Nie?"

“His parents were my comrades-in-arms. Before they died, they entrusted him to me, but this boy is very stubborn and wants to follow in his parents’ footsteps.”

"If all four of his limbs are amputated, I don't know how I'll face his parents. Please."

Liu Chaodong's true feelings were revealed, showing the tender side of a tough man.

Peng Yuanming's feelings were very complicated.

He could understand Liu Chaodong's feelings, but he could only secretly hate himself for his incompetence. If he were that good, why would he need to ask others for help?

However, Liu Chaodong may not understand Liu Chaodong's current feelings.

After Peng Yuanming made the call, he first identified himself, and thankfully Nie Mingxian did not hang up.

Peng Yuanming immediately turned on the speakerphone.

Nie Mingxian's words could be heard clearly.

"Director Peng, what's the meaning of your call? Please find someone else."

"You can save people, right?" Before Peng Yuanming could reply, Liu Chaodong took the phone and answered in a hoarse and helpless voice.

"Dr. Nie, Dr. Nie, Professor, Expert, I'll call you Grandpa, please come and save my person? I'll kneel down and beg you, please?" Liu Chaodong's words were rough, completely unlike those of a cultured person.

The young man opposite him hesitated for a moment, then took a deep breath and said, "I'm sorry, I still have my father to take care of!"

"You should seek help from someone else."

"It's hung up."

After saying that, Nie Mingxian prepared to hang up.

But when Liu Chaodong heard Nie Mingxian's implicit admission that he was capable of performing such surgery, he interrupted, "Dr. Nie, wait a minute, I really want to ask you for a favor."

Liu Chaodong then took a step back and said, "Dr. Nie, how about this? Tell me where you are. I'll send someone to pick you up. Do you have any way to come and take a look first? If you can't do anything after that, then we can talk about something else."

After listening to Liu Chaodong's words, Nie Mingxian replied after a while: "I am in the operating room, but that won't help. I am not a surgeon, I am an anesthesiologist."

Liu Chaodong got angry: "What are you pretending for? Are you even a doctor?"

"You refused to help someone in distress; where is your medical ethics?"

"Do you live up to the oath you made? What do you mean by 'powerless'? You're just trying to shirk responsibility and stand by and watch someone die!"

"Someone as unethical as you should just quit being a doctor and go home to breastfeed your baby."

"What kind of anesthesiologist are you?" Liu Chaodong was trying to provoke the other party.

Play hard to get.

This time, however, Nie Mingxian didn't hang up the phone. Instead, he said with a sigh of relief:

"Thank you for your advice, but I can only blame myself for not paying enough when I chose to go into surgery."

“When my father was poor, no one ever told you that this kind of medical ethics could be exchanged for money.”

beep.

After saying that, Nie Mingxian hung up the phone, his tone firm and indifferent, without any hesitation.

Before Peng Yuanming could say anything more, Chen Liwei came out and whispered a few words in Peng Yuanming's ear.

Peng Yuanming's expression immediately changed, and he asked in astonishment, "What?"

"The liver and intestines have ruptured, requiring immediate liver repair surgery. Damage to the liver pedicle cannot be ruled out..."

"The thoracic surgery department said the situation there is alright..." Chen Liwei said, forcing himself to speak.

These words instantly increased the pressure on Peng Yuanming, meaning that the patient's survival now depended entirely on him.

Whether his limbs could be saved was also his responsibility; fine sweat kept seeping from his forehead.

"No, it's time for an immediate amputation. I'm not discussing this with you anymore, I'm informing you. You're not the patient's family member. I'm not talking to you anymore. I'm going back to report to the hospital leadership. The amputation needs to be done immediately!"

"If you have any questions, you can communicate directly with our hospital's leadership."

"What the hell do you need legs for if you're dead? Damn it." Peng Yuanming cursed and turned to leave, not saying another word to Liu Chaodong, this layman.

Upon hearing this, Liu Chaodong slammed his fist hard on the table in the family communication room of the operating room again, making the table bounce loudly, and his fist turned red.

Then he shouted into the window, "Save your life! Save your life!"

He spit out saliva, and snot and tears slid from the sides of his nasal grooves to the corners of his mouth, mixing with his saliva, but he didn't have time to care.

The fact that Liu Chaodong is no longer talking to him proves that the situation is extremely critical.

……

After Peng Yuanming and Wu Guonan received Liu Chaodong's verbal consent, they rushed directly towards the operating room.

Xue Tao approached Wu Guonan and asked anxiously, "Director Wu, what decision did the family make?"

I already knew the answer in my heart.

Wu Guonan sighed: "The family has decided to amputate. Has Ziye arrived yet? If he has, have him go over immediately to get the signature, and then we'll start the show together once he's on stage."

Bilateral lower limb amputation, also known as bilateral lower limb severance, is not a difficult surgery. It is not a problem for Wu Guonan and Xue Tao to operate the procedure simultaneously, but each of them will definitely need an assistant.

Amputation is not the same as cutting off a leg; it's a quick and clean cut.

They also need to properly organize and store blood vessels, nerves, muscles, and other tissues; this is absolutely impossible without an assistant.

"Ziye said it's already been approved, but it will probably take a little longer."

"Director Li from the joint surgery department has also come down with his team to help treat the condition of both upper limbs. They are in the changing room now," Xue Tao replied, reiterating the tasks and arrangements he had just made.

The patient may need to have both upper limbs amputated, not just both lower limbs.

That bastard, he really went all out.

……

When Fang Ziye arrived at the operating room after putting on his sterile scrubs!
Xue Tao temporarily assigned Fang Ziye a task: to take the informed consent form for surgery to the family members for signature!

it's necessary.

Wu Guonan and Xue Tao arranged the surgery and preoperative disinfection preparations, while Fang Ziye went to print and sign documents.

Fang Ziye did not hesitate at all; in such an emergency, there was no time to waste.

Fang Ziye quickly went downstairs to the anesthesiologist's office, printed out the necessary informed consent form for the amputation surgery, and then rushed back upstairs. Looking at the patient's name, he called out, "Is Zhang Yu's family here? Zhang Yu's family. Come and sign the form."

Liu Chaodong waited outside. Upon hearing this, he went into the family communication room, which had only one window for communication. This time, however, there was another person with him.

After Fang Ziye handed over the informed consent form, Liu Chaodong carefully scanned it while tears welled up in his eyes.

A thin young man, around thirty-five or thirty-six years old, said, "Director Liu, Lin Jie is inside too. Why don't you call a few doctors to go and see him?"

"Save Zhang Yu first." Upon hearing this, Liu Chaodong remained indifferent, picked up a pen, and began to sign.

"Then how are you going to explain this to your sister-in-law? They both went into the operating room at the same time, but you arranged so many things for Zhang Yu. This is not fair to Liu Linjie."

“You can’t be unfair to your own child because of your own experiences. You can’t do this. You have to make some arrangements. He’s yours.” The thin young man next to him seemed to find it unbearable.

Although Liu Chaodong wanted to repay the debt of gratitude, he could not tolerate using Liu Linjie's life as an exchange for it.

"Don't worry about all that, just follow the hospital's arrangements." Liu Chaodong signed his name in bold strokes before handing the document to Fang Ziye.

Wearing a mask, he sniffed, his emotions calming down slightly: "Thank you, doctors, please save Zhang Yu's life! I beg you."

Fang Ziye had not participated in the previous conversation with Liu Chaodong, but upon hearing their exchange, he was secretly taken aback.

He looked at the two of them carefully and said, "We will do our best."

"Is the other trauma emergency patient also your colleague?" Fang Ziye asked.

“Yes, doctor,” the young man beside him said.

He then clasped his hands slightly and said, "If possible, I hope the doctor can take good care of them. They were both injured at the same time, so please don't be careless."

After receiving the informed consent form for the surgery, Fang Ziye immediately turned around and walked back without stopping.

However, as soon as Fang Ziye left the family communication room, he did something without much hesitation: he dialed the number, and the call was answered immediately.

"Hey, Ziye, what's up? Want to go out for dinner?" Huang Kai was very relaxed at the moment.

Since he wasn't on duty at the front line, he naturally had no idea that so many things had happened in the department.

"Brother Kai, could you please come to the operating room? We have two critically ill patients here today. Director Wu, Xue Tao, Brother Zhongxing, and I all need to have amputations done in one of the operating rooms. The other critically ill patient has been entrusted to Director Zhang and Dr. Guang..." Fang Ziye asked for his opinion.

“You know the other patient? I’ll be right there.” Huang Kai didn’t refuse, but immediately got up.

For general emergency surgery, having a senior attending physician present is already quite a favor.

Surgery like Fang Ziye's is usually reserved for extremely urgent cases, requiring the head of the department and the deputy chief physician to personally perform the procedure.

"I don't know them, but I'd like to try to get to know them. Both of them have rather special backgrounds. We'll discuss the details later."

"Thank you, Mr. Kai!" Fang Ziye replied.

"No problem, I'll go check it out first. If things are good, how about we grab a drink together today?" Huang Kai said with a smile.

"Okay, Mr. Kai, please apologize to your wife for me." Fang Ziye knew that Huang Kai was able to come because of his connections, and that Mr. Kai's wife was currently pregnant.

“Your sister-in-law is still at work, she’s not with me. I’ll send her a message to explain.” Huang Kai didn’t care. He wanted to spend time with his wife, but her boss wouldn’t allow it on weekdays.

(End of this chapter)