top student at medical school

Chapter 584 The Last Attempt
"Senior brother, Wu Xuanqi has also come to the sanatorium. Could he be here to deal with you?" At 11 p.m., Luo Tingzhu tightened her trench coat as she walked out of the laboratory, her eyes filled with worry.

"I can't rule out that possibility, but we'll deal with whatever comes our way. Even if Senior Brother Wu wants to target me, there's nothing we can do," Fang Ziye replied with a smile.

"I heard Wu Xuanqi's methods are a bit underhanded." Luo Tingzhu's boots creaked on the ground. She turned her head so much that she almost stepped into a haystack by the roadside.

Fang Ziye pulled him up, and before he could finish speaking, he interrupted, "Walk carefully, don't fall."

Luo Tingzhu glanced at the roadside, then leaned closer to Fang Ziye: "Senior brother, I think you'd better be careful."

"Well, it's possible, but seeing is believing."

“We can’t define a person based on rumors, otherwise your senior brother’s reputation would have been ruined long ago,” Fang Ziye said with a smile.

Others may not know that Luo Tingzhu traveled with him in November and heard some of Fang Ziye's "rumors" in Yishi, where her senior brother lived!
What a sycophant of the powerful and wealthy, arrogant and aloof...

“How can that be the same? Those are all rumors…” Luo Tingzhu was quite protective of her own.

Fang Ziye then said, "So you personally witnessed Wu Xuanqi's ruthless methods?"

Fang Ziye shielded Luo Tingzhu on the right, saying, "Be careful with the car..."

As a result, the car stopped right in front of Fang Ziye with its hazard lights on. A person got out of the passenger seat, facing away from the streetlight, but the light was too dim to see clearly.

However, after the other party spoke, Fang Ziye confirmed his identity as Qu Tangwei. After getting out of the car, he said with a grin, "Professor Fang, I was just about to come to see you."

Fang Ziye did not let go of Luo Tingzhu's hand, but asked frankly, "Professor Qu, you're still up so late?"

Qu Tangwei glanced at Luo Tingzhu next to Fang Ziye, but didn't pay much attention: "Professor Fang, it's like this, there is an emergency surgery at Minzu University Hospital."

"I just called you, Professor Fang, but you were probably busy and didn't answer..."

"Emergency surgery? What kind of surgery?" Fang Ziye asked.

This time isn't considered very early.

"The injuries were severe, and the patients' families had a very strong desire to save them."

"If Professor Fang, you are willing to go there, the consultation and surgery fees are negotiable."

"Moreover, the damage to this machine is a bit unusual. Professor Fang, if it's convenient for you, could you go and take a look?" Qu Tangwei explained.

A middle-aged man also got out of the driver's seat. He approached Fang Ziye, shook hands with him, and explained, "Professor Fang, I'm so sorry to bother you so late. Our hospital just received an emergency patient. A former superior of mine called and asked me to do everything I can to help..."

"Professor Wu drank alcohol again today. The patient is still in the operating room and cannot travel to Wuhan."

"I wonder if Professor Fang has the time?" Ding Meng was around fifty years old, and his voice was quite steady.

Fang Ziye glanced at Ding Meng, then at Professor Qu Tangwei. Before he could reply, Luo Tingzhu said, "Senior brother, you go ahead. I'll head back now."

After saying that, Luo Tingzhu turned and walked forward on his own initiative, showing that he was very sensible.

"Okay, Tingzhu, you can go first." Fang Ziye nodded.

Professor Qu Tangwei immediately led Fang Ziye to the car: "Professor Fang, thank you, you've really gone to a lot of trouble."

Fang Ziye didn't move for the moment: "Professor Qu, what is this patient's identity? He was injured in Enshi? You seem to know him quite well."

Qu Tangwei blinked rapidly with his left eye a few times, then scratched his head: "Professor Fang, can we talk in detail after we get in the car?"

"If Professor Fang feels it's not a good time to make a move, I'll bring you back. Time is of the essence."

Qu Tangwei was in a hurry, but he also gave Fang Ziye face.

Fang Ziye then sat in the back seat with Qu Tangwei.

After getting on the bus, Qu Tangwei gave a brief introduction to the patient's condition, and Fang Ziye immediately became unwell.

"Professor Qu, are you joking with me?"

"The damage extends from the lower abdomen to the pelvis? Is there any chance of recovery?"

"Director Ding, please let me out of the car. I don't need to go!" Fang Ziye knocked on the car door and said.

Fang Ziye can treat injuries, but it depends on the segment of the injury. Injuries to the head, chest, or abdomen are not within Fang Ziye's area of ​​expertise.

Ding Meng, however, showed no intention of putting on the brakes: "Professor Fang, please do me the honor of going over to take a look. It won't take long anyway."

"If you find it difficult after reviewing it, we will send it back to you."

Please try to understand!

Fang Ziye looked in Qu Tangwei's direction, and Qu Tangwei seemed to have the same idea.

Upon hearing this, Fang Ziye's gaze darkened.

He didn't explain much, but just to be on the safe side, he made a phone call to Dean Chen Song to report on his current situation.

He further explained, "I currently only have the authority to practice at the sanatorium and Enshi Central Hospital. My practice authority at Minzu University Hospital has not been registered, so..."

"I need to report this to Dean Chen."

Fang Ziye forced a smile: "Professor Qu, could you elaborate on what makes this patient so special..."

Something unusual is bound to happen. Fang Ziye had done Qu Tangwei a favor before, and Qu Tangwei's behavior today was truly abnormal.

Upon hearing this, Qu Tangwei cautiously replied:

"The person who was injured happened to be a member of the traffic police system, and the driver was caught red-handed..."

"Drunk driving?" Fang Ziye asked.

If it's just normal driving and an accident occurs, even if someone is killed, it shouldn't cause people to spend a lot of time and effort to recover.

Traffic accidents are very common, but if the injured party is a traffic police officer, then the driver might have some issues.

"The driver's condition is still being determined."

Qu Tangwei didn't dare to define it for the time being: "But what we doctors need to think about is to try our best to save the injured."

Ding Meng said, "Professor Fang, I had already asked the medical department to handle the matter of the professional license before I came. We should be able to get it done by the time we arrive!"

“There have been previous cases of patients with severe pelvic injuries who were successfully treated. Professor Fang, it was only two years ago that you, in collaboration with Professor Duan, managed to save the patient's life and restore their function,” Ding Meng explained with a smile.

Clearly, he has a very vivid memory of this incident.

Fang Ziye also remembered that case of trauma, which was the most unique trauma he had ever encountered. It was on that occasion that Fang Ziye's manual reduction technique was used to its fullest extent, allowing him to truly see the real value of the manual reduction technique.

……

The group didn't waste any more words.

Fang Ziye put on his surgical scrubs and followed Ding Meng into the operating room, where the emergency rescue was still in progress.

The current situation is that the active bleeding from the abdominal aorta and vein has been resolved, and arteriovenous fistula surgery is underway to establish extracorporeal circulation.

The patient received a significant amount of blood transfusion. Currently, his vital signs are stable with low blood pressure, but his heart rate is very fast, as if he is about to go into shock and die.

However, the most troublesome thing was not his bleeding, but the mess below his navel, where all his reproductive signs had completely disappeared...

The damaged sections are not smooth, as if they have been trampled over.

This is definitely not just a simple case of drunk driving...

Either the driver was scared and wanted to run him over, or he wanted to kill him, so he drove back and ran him over again.

On the operating table, Fang Ziye also saw an acquaintance, Director Wu Guonan from the Municipal Central Hospital. He was methodically performing small-scale debridement inside the pelvis, and dared not move the large bone defects, only slowly removing some of the fleshy residue.

There were also other unfamiliar green-clad creatures diligently and carefully cleaning the intestinal tract, bladder remnants, and other areas, while also working hard to repair the blood vessels.

After looking at the house for about forty seconds, Ding Meng asked in a low voice, "Professor Fang, what do you think?"

"How can this be?" Although Ding Meng had invited Fang Ziye over, he still felt that he was putting Fang Ziye in a difficult position.

However, this was an order from above, and he had to obey it!

Moreover, city leaders, through various connections, contacted Professor Qu Tangwei, hoping that Fang Ziye could come and save the patient.

Fang Ziye then moved to the medical record reading area, suppressing his inner bias, and said, "This patient has a ruptured spinal canal in his lumbar spine with exposed nerves. Even if he is rescued, he will become a disabled person."

"With a burst fracture of the pelvis, and damage to the bladder, rectum, and part of the digestive tract, is such a rescue truly meaningful?"

"Besides, even if I can rebuild the pelvis, what about the rest of the body?" Fang Ziye did not answer the question of whether he could be saved!
Even if such patients are rescued, they will need to undergo enterostomy to replace bowel function, and will need a urinary catheter to survive!

Even if such a rescue is successful, the patient will only have a few years of painful survival.

Forget about walking in the lower limbs, forget about any quality of life. At most, they can still retain consciousness and speak clearly.

This is completely different from the damage Fang Ziye has done before.

Ding Meng did not reply.

Fang Ziye continued, "Director Ding, even if I can rebuild the pelvis, the damage to other organs in the abdomen may not be properly treated."

"I'm not a general surgeon, let alone a vascular surgeon. Connecting the abdominal aorta to the arteries of the lower limbs is an extremely complicated matter."

"It would be pointless for me to take the stage."

Enshi's medical resources are still insufficient; they cannot treat injuries other than orthopedic ones.

Moreover, the patient's postoperative survival status has exceeded Fang Ziye's bottom line, so Fang Ziye has no intention of calling in any more people.

“What about a high-level transection of the body?” Ding Meng suggested.

High-level transection of the body is one of the surgical options in medicine, which involves transection surgery performed through the abdomen!
Fang Ziye replied, "Then this is a general surgery procedure! I've never been exposed to it before."

Specializing in specific fields, Fang Ziye had never studied or considered high-level transection surgery, and had absolutely no surgical background...

During his standardized residency training, Fang Ziye never witnessed anything like it while rotating through the general surgery department.

Even Fang Ziye himself dared not easily perform the legendary techniques.

After all, the high-level transection surgeries reported in the news are all successful cases, but no one has ever carefully counted how many "failure cases" there were.

Fang Ziye was still hesitant to take on this kind of cross-disciplinary adventure.

Fang Ziye looked at it for a few more minutes before turning his head and saying, "Director Ding, I really can't be of much help here."

"Given the patient's current condition, if we cannot perform a partial amputation of the body in time, it would not be too late for our orthopedic surgery to begin tomorrow at noon."

"How about I go back first?"

Ding Meng himself was a trauma surgeon, and even though he thought Fang Ziye's skills were superb, he couldn't say anything more about this complicated and tricky situation.

"Professor Fang, then I'll trouble you to make the trip..."

"I'll take you back." Ding Meng turned around and followed Fang Ziye.

"No need to trouble Director Ding, I can take a taxi back myself. The patient's vital signs can fluctuate greatly at any time, so it would be better for you to stay here."

"I'm a local from Enshi, I wouldn't get lost!" Fang Ziye smiled and politely declined, then strode away.

There's not much point in Fang Ziye staying here.

Unless Minzu University Hospital can simultaneously think of and resolve the issues concerning Nie Mingxian, Wu Xuanqi, and Fang Ziye's practice licenses, and also bring them to the operating room, there might still be a glimmer of hope!
However, the overall level of emergency medical care in Enshi ultimately depends on the average improvement of the comprehensive quality of all hospitals in Enshi, rather than relying entirely on consultations and emergency treatment from other hospitals.

A distant solution can't quench a nearby fire!
Based on Fang Ziye's own understanding of life, most rescue efforts should be implemented as soon as possible, but for some rescue efforts, it is better to do nothing than to do something!

Fang Ziye quickly returned to the villa, where Luo Tingzhu had already finished washing up and was fast asleep.

Luo Tingzhu only reacted when Fang Ziye climbed into bed, but she simply found a comfortable spot to lie down and fell back asleep.

The next day, early in the morning.

Exhausted, Luo Tingzhu hadn't gotten up by 7:20. Fang Ziye went for a run first, and then saw that his knowledge points balance had once again increased to 50,000.

Fang Ziye decisively upgraded his basic theory of infectious disease surgery from level 5 to level 6...

In the hand surgery department, the patient with osteomyelitis, multiple sinus tracts, and multi-organ infection is currently receiving palliative treatment in a sanatorium.

Fang Ziye had originally planned to increase his efforts in January to see if a miracle could happen.

However, at the time, Yuan Weihong's situation happened quite suddenly. Fang Ziye felt that for this patient to recover, it would be impossible without a miracle, rather than any theoretical change.

As expected, even though Fang Ziye had leveled up his basic infectious disease theory to a terrifying level of 6, he was still helpless...

The only thing that can be confirmed at this point is that the bacterial infection has not yet crossed the blood-brain barrier and has not yet developed into meningitis.

The rest of the area has basically been 'visited' by bacteria.

Such a patient?
The surgery missed the optimal time, and trying to reverse it through theoretical and internal medicine treatments is a bit of a challenge for humanity with the current level of medical expertise.

It must be said that, unfortunately, Fang Ziye still doesn't have a good solution, but he has a few more risky ideas to choose from.

At 7:55, while Fang Ziye was showering and drying his hair, Luo Tingzhu walked out of the room in her pajamas and slippers. Enshi in March was still chilly, and the heating had been turned off, so her pajamas were actually thicker than in winter.

"Senior brother, what time is it?" Luo Tingzhu tilted her head to fix her hair, her face flushed, probably because she was very embarrassed.

"Eight o'clock, you must be exhausted from yesterday."

“I told you to go to Han City and back today, but you wouldn’t listen!” Fang Ziye said with a laugh, his voice mingling with the popping sound of a hairdryer.

Fang Ziye's hair was completely dry in just over a minute. He unplugged the plug and said, "Your experiments in the lab haven't started yet, and some equipment hasn't arrived. There's no rush."

"Take a good shower, have breakfast, and then leisurely go over to prepare for the experiment."

Luo Tingzhu said, "It's the weekend... Senior brother, let's go out and buy some things..."

“Okay!” Fang Ziye nodded.

After Fang Ziye arrived at the cafeteria, Professor Qu Tangwei waved to him: "That patient from yesterday still passed away. The situation must have been extremely difficult, right?"

Fang Ziye nodded: "Professor Qu, it's not just tricky, it's a complete mess!"

"I stood in the operating room for more than ten minutes, and I felt that I wouldn't survive the first round of resuscitation; specialist treatment was useless!"

In emergency care, saving lives comes first, then treating the illness.

If you're already dead, no matter how well you reconstruct your pelvis, it won't help. You might as well find a good mortician.

"Then we've done our best."

Qu Tangwei glanced around before saying, "Professor Fang, Director Ding was there yesterday, so I can't explain too much to you."

"This patient is, firstly, a traffic policeman, and secondly, the grandson of a bigwig in the province. He came to Enshi to gain connections."

"So he has a rather strong temper. He must have offended someone, and his maternal grandfather?" Qu Tangwei looked around again.

"He's my dad's former boss. It was my dad who called. Otherwise, I wouldn't have personally invited Professor Fang."

"Still making a fuss there so late..."

"However, not many people know about this connection. The perpetrator's family is still figuring out how to settle things with money..."

"Now that everyone's gone, things are going to get lively."

Upon hearing this, Fang Ziye blinked and asked in a low voice, "Did you offend someone by arbitrarily fining them or something?"

"More or less..." Qu Tangwei replied.

Alright, a bunch of people have bumped into each other, this is definitely going to be a good show.

However, Fang Ziye wasn't thinking about watching the show at the moment; he had a new idea.

This is all thanks to what I saw last night, and combined with the basic surgical theory of level 6 infectious diseases that I just learned this morning!

Although this idea is not yet fully developed, it is worth exploring!
After saying goodbye to Qu Tangwei, Fang Ziye immediately called Nie Mingxian over!
Immediately afterward, Fang Ziye explained something to Professors Wu Xuanqi and Fang Zhikuan, and then went on the inspection with Professor Du Donglin.

After the inspection, Nie Mingxian rushed to the surgical clinic area.

Before Fang Ziye could stand up, Liu Guo from the liver and gallbladder team got up and walked over, lowering her voice: "What are you doing here? You can talk to me on WeChat."

Clearly, Liu Guo and Nie Mingxian had been warned.

In principle, couples or relatives should not work in the same area, in order to avoid one or both of them getting angry due to special feelings.

It's not good for a couple to have a fight and it's affecting their normal work.

"Professor Fang sent me, it's an official matter!" Nie Mingxian explained, bypassing Liu Guo.

Fang Ziye then said, "Professor Du, Professor Ye, Professor Yao, Director Nie, whom I invited, has arrived. Let's move to the demonstration room first."

"Let's discuss this patient with chronic osteomyelitis and multiple sinus tracts together."

"If we still can't reach a solution this time, then we don't need to discuss this patient anymore."

"Anyway, the patient and his family have already accepted the consequences!"

Waiting for death!

This morning, Fang Ziye suddenly came to the hand surgery group to participate in the inspection, and Du Donglin suspected that Fang Ziye wanted to do something to "that" patient.

Just thinking about it gives me a headache.

Now that Fang Ziye had spoken, Du Donglin, though still feeling a headache, finally felt relieved.

"Han Zhiliang, Han Hongquan, go over the preoperative examination for that diabetic foot ulcer again carefully, in preparation for Tuesday's surgery," Du Donglin instructed before following Fang Ziye.

Professors Ye Fusheng and Yao Zhanzhong also stood up quite naturally.

The group wasn't very familiar with Nie Mingxian, so Fang Ziye only gave a brief introduction. Afterward, Fang Ziye took the initiative to recount the patient's medical history and current condition.

He said, "This patient originally had chronic osteomyelitis, but it has now developed into bacteremia and toxemia. Currently, there are signs of infection in both upper limbs and multiple organs."

"It belongs to a particularly severe terminal infection."

“Before he came here, he had traveled to many, many places and tried all sorts of methods. He has been here for almost three months.”

"But the current treatment has not shown any clear progress!"

“I have been following this patient closely, and I have a bold but immature idea that I would like to discuss with you professors.”

Nie Mingxian listened attentively, and only after Fang Ziye finished speaking did he say, "Professor Fang, this patient is not something within my area of ​​expertise."

He's a vascular surgeon, not an infectious disease specialist or an infectious disease surgeon!

This patient's blood vessels are in very good condition; otherwise, the bacteria wouldn't have been able to spread so quickly.

"Director Nie, please don't rush. Let me explain my thoughts first."

"That's right. Yesterday I visited an emergency consultation and saw the arteriovenous fistula procedure performed by the vascular surgery department."

Fang Ziye, considering that Professor Du Donglin and others were not very familiar with this procedure, continued to explain: "Arteriovenous fistula surgery uses vascular surgery techniques to artificially create a short circuit between an artery and a vein, providing a long-term and effective vascular access for extracorporeal circulation in hemodialysis."

"It can also be used for arteriovenous circulation reconstruction after emergency hemostasis and clamping following major arterial rupture injury."

This is Nie Mingxian's specialty: "Yes, arteriovenous fistula surgery is to temporarily create a short arteriovenous circulation! It prepares for hemodialysis and can filter all the blood in the body."

"But Professor Fang, this patient couldn't possibly have never tried such a simple approach before, could he?"

If dialysis were effective in treating the infection, this patient would have been cured and discharged from any military hospital long ago.

Fang Ziye smiled and said, "Director Nie, I wonder if you still remember the working mechanism of the micro-circulation instrument?"

Nie Mingxian was taken aback upon hearing this, not understanding what Fang Ziye meant.

Brother, this thing was developed by our team. You're asking me if I know its significance?

Why didn't you mention these things when you were giving me money?

The patent for the micro-circulatory device, while technically belonging to Fang Ziye, actually belongs to Fang Ziye's team. However, since Fang Ziye is the primary patent representative, it is often attributed to the team.

According to the "Several Provisions on the Management of Intellectual Property Rights of Research Results of National Scientific Research Programs", except for research results involving national security, national interests and major social public interests, the project undertaking unit can independently enjoy the intellectual property rights of the research results and decide on matters such as implementation, licensing, transfer and valuation of the intellectual property rights of the research results as equity investment in accordance with the law, and obtain corresponding benefits.

This profit needs to be redistributed, but Nie Mingxian didn't receive as much as Fang Ziye.

The miniature circulator is a powerful tool for emergency rescue of severed limbs in hand surgery, and Du Donglin knows a great deal about it.

Fang Ziye said, "So I have a bold idea."

"Professor Du, the primary site of this patient's chronic osteomyelitis is in both lower limbs. Let's assume for now that the bacteria are currently originating in the lower limbs, or perhaps inside some other organ!"

"Is this interpretation a bold guess?"

"So, is it because all the blood vessels in our body are connected as one?"

Du Donglin nodded and cautiously replied, "This is the basic anatomical type of the human body."

Fang Ziye continued, "What if we separate them?"

"Do we have a chance to get rid of the germs or infections in other parts of the body?"

"Amputation?" Du Donglin asked.

"This won't work either?"

"Given the patient's current condition, even amputation would be too late."

Amputation is a mature surgical and treatment approach in orthopedics for treating severe osteomyelitis.

"No, no, no, it's not amputation. What I mean is, based on arteriovenous fistula surgery, to rebuild five or even six multi-center small circulatory systems in the human body."

“The difference between traditional arteriovenous fistula surgery and microcirculation device is that it does not have independent blood movement power and still relies on the heart’s pumping power.”

“The miniature circulator is an exogenous blood pumping system.”

"In this way, can we separate the hands, lower limbs, and the circulatory system in the human body?"

"Without venous return from both upper limbs, intracranial arteriovenous return is naturally unobstructed."

"The artery suturing between the aorta and the inferior vena cava is one of the most mature vascular surgical procedures."

"We will break down the problem into smaller, more manageable parts."

"If we can clear the infection from both upper limbs and abdominal organs, then even if both lower limbs are amputated, it would be a much better outcome than what we have now."

"I believe this is the last attempt."

"After the infection sinuses in both lower limbs are removed, the body's ability for pathogens to mutate may not be as strong! We can quickly locate sensitive bacteria and find sensitive antibiotics, which can have a relatively good effect in a short period of time!"

This is a good idea.

However, the limb-sparing time of a miniature circulatory device is relatively limited, isn't it?

However, before Du Donglin and the others could even raise the issue, Nie Mingxian spoke up first: "This is a very good method, breaking it down into smaller parts!"

"Professor Du, there's no need to worry about the working time of the microcirculation device. Since we can create an arteriovenous fistula, we can also create an arteriovenous shunt between the aorta and the lower limb arteries in the dialysis model."

"This will allow the blood in each of the several circulation systems to function independently."

"The place where the blood sample returns to calm first indicates that the infection is mildest there."

"This patient already had multiple organ infections, but could still survive for several months on dialysis, which proves that bacteria have not yet established themselves permanently in the organs or caused cavitary erosion!"

"Break it down into smaller parts, that's a bold idea! But I think it's feasible, we might as well try anything."

“If the patient and their family agree, we’ll do it; if they don’t, forget it. We’ve only wasted less than an hour of their time!” Nie Mingxian wasn’t exactly a humble person.

If you can do it, then do it; if you can take the lead, then take the lead!
He supports this good idea!

“Then I’ll report to Team Leader Zheng and Dean Chen of the surgical team. If they both agree, we’ll go talk to the patient. This is a completely new approach!” Du Donglin began to put away his notebook.

He wanted to get started on it immediately.

……

In the courtyard outside the clinical and treatment areas, Nie Mingxian looked at Fang Ziye strangely: "How did you come up with such a bizarre idea?"

"It mainly relies on broadening my horizons," Fang Ziye said without hiding anything.

He recounted everything that had happened yesterday in a straightforward manner, and then said, "Since survival after high-level amputation is feasible, then the worst outcome of breaking it down into smaller parts is nothing more than high-level amputation!"

"This patient is completely different from the emergency patient yesterday. He has good motor function, including his lower limbs."

"The organs in the abdomen, and the functions of the heart and lungs, have not yet reached a period of extreme weakness, and it is possible for them to recover."

"So, he can also use this approach!"

Nie Mingxian opened his mouth: "You ran over to see an emergency patient, but couldn't save him. Instead, you used the feasible treatment ideas from that patient on another dying patient."

"Isn't this kind of logic a bit too strong?"

"These two people?"

"Could it be some kind of mysterious cycle of fate?" Nie Mingxian shook his head and walked outside.

He didn't wait for an answer, because waiting for an answer was pointless.

The number of surgeries performed will only guarantee the lower limit of your surgical quality; what always elevates the upper limit of surgical quality is understanding.

Studying other specialized subjects, other disciplines, or even other majors can potentially create a huge synergy with medicine…

(End of this chapter)