Life is like a journey
Chapter 35 Meaning
"I will do it myself"
Subtle self-esteem caused the stubborn fire instructor to reject her kindness. The person who had been lying down for more than a month couldn't wait to stand up, so he got up a little anxiously with the help of the wheelchair. As soon as his feet stepped on the ground, his muscles felt sore and weak. She leaned forward slightly, and Lu Qingshi reached out to support her firmly.
"Don't worry, there will be a process for the recovery of physical strength"
Gu Yanzhi looked at the children who were walking and jumping on the grass in the distance, his eyes dimmed a little, he pursed his lips and nodded.
"Come on, I'll hold you"
This time she didn't refuse the doctor's kindness again. After walking about ten steps away from her, sweat began to break out on her forehead, and she panted slightly while propping up her knees.
The nurse quickly pushed the wheelchair over, Lu Qingshi's lips moved.
"Come on firefighter sister!!!" The immature voice of a child came from a distance. He Miaomiao was sitting in a wheelchair and was being pushed by his mother, looking at her shiny and full of expectation. The chest of the white hospital gown Wearing the armband she gave last time.
Gu Yanzhi laughed, pursed the corners of his lips slightly, and his eyes became firm. Lu Qingshi felt his wrist tighten, and she stood up while holding her hand, and walked forward step by step.
He Miaomiao cheered for the doctor in a white coat who never left her. Seeing her go farther and farther felt more exciting than being able to stand up.
"Sister firefighter is awesome!!!"
This little guy calls himself aunt but Gu Yanzhi's older sister. He is obviously not a few years younger. Lu Qingshi turned around and said, "Miaomiao, why do you call her older sister but call me auntie? We are about the same age."
Gu Yanzhi burst out laughing, he couldn't see that Dr. Lu, who had always been indifferent, would care about this kind of problem, he was unexpectedly childish.
"Because you are indeed six years older than me."
The doctor raised his eyebrows: "How do you know my age?"
As expected of Dr. Lu, he was very precise in focusing on the key points, Gu Yanzhi felt a little ashamed.
"Uh...the experts in your department wrote on the wall..."
Is there writing on the expert wall?Lu Qingshi frowned and thought for a while, but found that he couldn't remember clearly, so he gave up.
"Miaomiao?" After waiting for a long time without hearing the child's answer, Lu Qingshi turned around, and Miaomiao's mother squatted beside her and called her name.
He Miaomiao didn't answer, Lu Qingshi felt that something was wrong, let go of her hand, took two steps forward, and suddenly started to run.
Gu Yanzhi was also anxious to go over to have a look. After taking two steps, his feet gave way and he almost fell to the ground. The nurse held her down and stopped her, so he saw Lu Qingshi put the stethoscope on her chest and listened carefully. After a while, he picked her up and ran to the emergency center.
"Notify the Department of Cardiology, Cardiac Surgery, Thoracic Surgery, Anesthesiology, and Critical Care Medicine to come down for consultation, hurry up!"
She kicked open the door of the emergency room and put the person on the bed. The nurse swiftly pushed over the bedside ultrasound and electrocardiogram.
Yu Gui also rushed in to help. Mother He watched her daughter lying on the hospital bed pale and lifeless, covering her lips to keep herself from crying.
"Go and wait outside first, we will notify you as soon as there is a result"
Yu Gui invited people out, and Mother He held onto her sleeves and did not let go: "Doctor, we must save Miaomiao..."
She couldn't say anything but nodded.
"Sister Lu, the blood oxygen can't come up!"
Seeing the blood oxygen drop below the normal level, the monitor beeped sharply.
"Oxygen inhalation, 0.25mg digoxin intravenously"
For children, this dosage is a bit surprising, but Lu Qingshi knew that if the medication was not increased at this moment, Miaomiao might not be able to survive this test.
"Blood oxygen recovery!" Yu Gui glanced at the monitor, and just as he finished speaking, he fell back again.
"Prepare the 6.5mm tube." Hao Renjie handed the laryngoscope and catheter together to her hand, and Lu Qingshi held her head up and pushed the catheter in steadily.
"Okay, let's give it another shot"
After Hao Renjie finished the injection, he immediately moved out of the way for her, while Lu Qing kept doing cardiopulmonary resuscitation, and changed after 3 minutes.
Yu Gui rolled up his sleeves and rushed forward, staring at the screen desperately, wishing to poke a hole, but 10 minutes later, after three waves of people, her vital signs still hadn't returned to normal. Means there are no indications for surgery.
"Epinephrine 5mg intravenously!" Hao Renjie gritted his teeth and injected the medicine into the vein through the catheter.
Lu Qingshi pressed her chest again and again, fine beads of sweat oozed from his forehead, and Father He and Mother He waited anxiously in the corridor.
"Bring the defibrillator!"
"Charging 200J is complete, get out of the way!" Yu Gui picked up the defibrillator and pressed it on her chest. The electrocardiogram was still a straight line.
Lu Qing continued to do CPR, his forehead was wet with sweat, and after another 3-minute round of CPR, Yu Guina connected the defibrillator.
Four empty adrenaline injections had already been thrown into the medical waste bin at Hao Renjie's feet. When he looked up at Lu Qing: "Sister Lu..."
Yu Gui gritted his teeth and looked back at him: "Don't give up!"
After half an hour of all-out rescue, more than 20 medical staff in the department took turns to perform effective heart compressions, but Miaomiao still did not recover her own heartbeat.
The director of medical affairs explained to Father He and Mother He outside: "That is to say, the child's heartbeat is now all pressed by our medical staff, and the ECG shows a straight line as soon as you let go of your hand. Do you understand?"
Mother He has already burst into tears, almost crying into tears, and Father He's seven-foot boy is also in tears, holding his sleeve tightly: "If there is any possibility, please save Miaomiao."
Liu Changsheng held his hand: "Don't worry, our mood is as urgent as yours, but we will never give up if there is even a chance."
An hour passed, and all the medical staff involved in the rescue were panting heavily. Yu Gui's eyes were slightly red, and he looked at everyone who was no longer moving, including Lu Qingshi.
The green line representing life is dead silent, just like the silent emergency department at this moment.
The child lying on the hospital bed is so young, he has never been in contact with the world since he was born, and his biggest wish is to go to kindergarten with other children. For this reason, he gritted his teeth and insisted on taking medicine, and survived countless surgeries, large and small. Is life going to stop here?
Hao Renjie was not reconciled, Qin Xuan who came after him was not reconciled, and all the medical staff present were also not reconciled. Some young nurses had already begun to wipe their tears.
The director of the heart who came to the consultation also said: "It can't be done... just give up... the brain has been hypoxic for so long and can be rescued..."
Yu Gui rushed forward: "No...don't...don't give up...let's try again...try..."
She turned around and jumped on Miaomiao's body to continue doing CPR, but was pulled away by someone, Yu Gui struggled, and when she saw who was pulling her, tears welled up in her eyes.
"Teacher Lu!"
"Go aside, don't get in the way, Hao Renjie, give me the scalpel." Lu Qingshi glanced at the mannitol that had been hung up since the beginning of the rescue, slightly bent over and knelt down beside the bed.
"Lu Qingshi, what are you doing?! Opening the chest without surgical indications will only lead to faster death!"
The doctor in the intensive care department called out.
Lu Qingshi had already disinfected the poison and opened a hole on Miaomiao's skin: "Is she still alive now? I want to open the chest and directly massage the heart. Why don't you come and help if you have time to criticize me?"
When the head nurse came to report on Lu Qingshi's next rescue work, Liu Changsheng directly sprayed a sip of tea on the medical record, and wiped the cold sweat on his forehead with a veil.
She really dared to put this conjecture that only appeared in the paper into practice. Everyone is happy if the rescue is successful. If the rescue is not successful, it is not only a medical negligence but also a medical ethics issue.
"Quickly, quickly, invite He Miaomiao's family members in." He circled back and forth, and suddenly stopped: "No, let's inform Dean Meng first."
"Director Lu, the blood gas analysis and chest X-ray are here." The nurse ran in and handed her the test results. Lu Qingshi knelt beside the bed with blood on his hands and chest.
The result of the "right ventricular failure caused by pulmonary hypertension" made everyone look ashen. The congenital left heart dysplasia had seriously affected her hemodynamics, and now the right ventricle...
The director of heart surgery took off his glasses and let out a long sigh: "I can't wait for the transplant."
But after waiting for a full five years, there is no suitable match. Where can I find it now?
"Old Liu, you are embarrassing us. You also know that the system is automatically assigned now. Your hospital is nervous and other hospitals are not nervous? With all due respect, after waiting for ten or eight years, there are not many transplants. yes!"
Director Liu called the Jinzhou Human Organ Donation Committee. He clenched the receiver and said in a low voice, "I know, I know. You also know the situation of the patient He Miaomiao. The child is still so young, and he waited for five years to be ranked. Also ahead, if you don’t have you in China, please help me pay attention to overseas ones, saving a life is better than building a seven-level pagoda!”
While talking, the other party pulled out He Miaomiao's data medical records and compared them with the registered organ donation volunteers in the database.
"It's not that I don't want to help you. The request for a heart donation is too difficult! The child is still so young, even if you take a 50-year-old heart, it won't fit into your chest!"
This is the consensus that all medical practitioners understand. Liu Changsheng hung up the phone in despair, and sighed: "Lu Qingshi, it's not that I won't help you, it's really that there is nothing I can do."
He was going to go out and talk to the patient's family again.
Lu Qingshi had knelt on the ground and massaged her heart continuously for 3 minutes. Her immature heart was trembling slightly in her palm. She knew it was the result of her hard work. Once she let go...
Seeing her slightly red eyes, Yu Gui was also a little moved: "Mr. Lu, let me come."
The people in the emergency room gradually dispersed. Lu Qing was a little dazed, and withdrew her hand. The moment she let go, her heart beat slightly. She thought she was dazzled, until there was another fluctuation on the monitor. People wept with joy.
Lu Qingshi heaved a sigh of relief, and sat slumped on the ground with a smile in his eyes.
Yu Gui erupted into cheers, hugging Hao Renjie and screaming and jumping, Lu Qingshi got up from the ground: "It's not over yet, Cedilan 0.3mg plus glucose intravenous infusion, increase oxygen flow, save life The symptoms are maintained"
As long as there is a heartbeat and breathing, then transplantation is meaningful.
"Hello, this is the Emergency Center of the First Affiliated Hospital of Renji Medical University." As soon as the phone rang, the operator grabbed him.
"This is Anzhen Hospital. There is a 15-year-old patient with traumatic brain injury in a car accident. Our hospital's treatment capacity is limited. Please transfer to another hospital!"
"Okay, bring it here!"
The greater the ability, the greater the responsibility, so the green passage opened wide, and the ambulance rushed in. Lu Qingshi's mobile phone vibrated violently in her pocket. She was stitching for He Miaomiao, fine beads of sweat oozing from her forehead. Come.
"Yu Gui, help me pick it up"
Yu Gui frantically took out the phone from her pocket, pressed the call button and put it next to her ear: "Car accident, open abdominal trauma with traumatic brain injury, send to No. age?"
"15 years old, female"
Lu Qingshi glanced at He Miaomiao's pale face beside him: "Urgently do an HLA matching and blood gas analysis, I'll finish it right away."
She took her hands out of He Miaomiao's chest, took off the gloves and threw them into the trash can: "You do the rest"
"Ah? Me?" The person who had looked happy just now turned pale.
"Want to save her?"
Yu Gui nodded dumbly.
Lu Qingshi stuffed the needle holder into her hand: "If the suture is not complete, you will die."
This is a hot potato, everyone looked at her with sympathy, Yu Gui wanted to cry but had no tears.
Qin Xuan got the news a long time ago, and stopped her as soon as she came out: "You entrusted such an important patient to an intern?"
Lu Qingshi walked around her, turned around and left: "I have other patients."
Qin Xuan chased after her: "What about Miaomiao?! She is not out of danger yet! Didn't you watch her grow up?! You were the one who performed her last operation..."
Lu Qingshi pushed her away, his tone became cold: "Get out of the way"
"Director Lu, the HLA matching results are out." The nurse ran out of the emergency room and handed her the test sheet.
Qin Xuan glanced at her, immediately grabbed her by the collar, and shouted with red eyes, "Lu Qingshi, you are not allowed to go!"
That child's heart type is exactly the same as that of He Miaomiao, if she is brain dead...
Lu Qingshi's brows and eyes were completely cold. She looked down at this friend who had known her for three years, who was not a friend, and felt so strange.
She opened Qin Xuan's hand bit by bit: "Qin Xuan, remember your own identity, you are a doctor, not an executioner"
Subtle self-esteem caused the stubborn fire instructor to reject her kindness. The person who had been lying down for more than a month couldn't wait to stand up, so he got up a little anxiously with the help of the wheelchair. As soon as his feet stepped on the ground, his muscles felt sore and weak. She leaned forward slightly, and Lu Qingshi reached out to support her firmly.
"Don't worry, there will be a process for the recovery of physical strength"
Gu Yanzhi looked at the children who were walking and jumping on the grass in the distance, his eyes dimmed a little, he pursed his lips and nodded.
"Come on, I'll hold you"
This time she didn't refuse the doctor's kindness again. After walking about ten steps away from her, sweat began to break out on her forehead, and she panted slightly while propping up her knees.
The nurse quickly pushed the wheelchair over, Lu Qingshi's lips moved.
"Come on firefighter sister!!!" The immature voice of a child came from a distance. He Miaomiao was sitting in a wheelchair and was being pushed by his mother, looking at her shiny and full of expectation. The chest of the white hospital gown Wearing the armband she gave last time.
Gu Yanzhi laughed, pursed the corners of his lips slightly, and his eyes became firm. Lu Qingshi felt his wrist tighten, and she stood up while holding her hand, and walked forward step by step.
He Miaomiao cheered for the doctor in a white coat who never left her. Seeing her go farther and farther felt more exciting than being able to stand up.
"Sister firefighter is awesome!!!"
This little guy calls himself aunt but Gu Yanzhi's older sister. He is obviously not a few years younger. Lu Qingshi turned around and said, "Miaomiao, why do you call her older sister but call me auntie? We are about the same age."
Gu Yanzhi burst out laughing, he couldn't see that Dr. Lu, who had always been indifferent, would care about this kind of problem, he was unexpectedly childish.
"Because you are indeed six years older than me."
The doctor raised his eyebrows: "How do you know my age?"
As expected of Dr. Lu, he was very precise in focusing on the key points, Gu Yanzhi felt a little ashamed.
"Uh...the experts in your department wrote on the wall..."
Is there writing on the expert wall?Lu Qingshi frowned and thought for a while, but found that he couldn't remember clearly, so he gave up.
"Miaomiao?" After waiting for a long time without hearing the child's answer, Lu Qingshi turned around, and Miaomiao's mother squatted beside her and called her name.
He Miaomiao didn't answer, Lu Qingshi felt that something was wrong, let go of her hand, took two steps forward, and suddenly started to run.
Gu Yanzhi was also anxious to go over to have a look. After taking two steps, his feet gave way and he almost fell to the ground. The nurse held her down and stopped her, so he saw Lu Qingshi put the stethoscope on her chest and listened carefully. After a while, he picked her up and ran to the emergency center.
"Notify the Department of Cardiology, Cardiac Surgery, Thoracic Surgery, Anesthesiology, and Critical Care Medicine to come down for consultation, hurry up!"
She kicked open the door of the emergency room and put the person on the bed. The nurse swiftly pushed over the bedside ultrasound and electrocardiogram.
Yu Gui also rushed in to help. Mother He watched her daughter lying on the hospital bed pale and lifeless, covering her lips to keep herself from crying.
"Go and wait outside first, we will notify you as soon as there is a result"
Yu Gui invited people out, and Mother He held onto her sleeves and did not let go: "Doctor, we must save Miaomiao..."
She couldn't say anything but nodded.
"Sister Lu, the blood oxygen can't come up!"
Seeing the blood oxygen drop below the normal level, the monitor beeped sharply.
"Oxygen inhalation, 0.25mg digoxin intravenously"
For children, this dosage is a bit surprising, but Lu Qingshi knew that if the medication was not increased at this moment, Miaomiao might not be able to survive this test.
"Blood oxygen recovery!" Yu Gui glanced at the monitor, and just as he finished speaking, he fell back again.
"Prepare the 6.5mm tube." Hao Renjie handed the laryngoscope and catheter together to her hand, and Lu Qingshi held her head up and pushed the catheter in steadily.
"Okay, let's give it another shot"
After Hao Renjie finished the injection, he immediately moved out of the way for her, while Lu Qing kept doing cardiopulmonary resuscitation, and changed after 3 minutes.
Yu Gui rolled up his sleeves and rushed forward, staring at the screen desperately, wishing to poke a hole, but 10 minutes later, after three waves of people, her vital signs still hadn't returned to normal. Means there are no indications for surgery.
"Epinephrine 5mg intravenously!" Hao Renjie gritted his teeth and injected the medicine into the vein through the catheter.
Lu Qingshi pressed her chest again and again, fine beads of sweat oozed from his forehead, and Father He and Mother He waited anxiously in the corridor.
"Bring the defibrillator!"
"Charging 200J is complete, get out of the way!" Yu Gui picked up the defibrillator and pressed it on her chest. The electrocardiogram was still a straight line.
Lu Qing continued to do CPR, his forehead was wet with sweat, and after another 3-minute round of CPR, Yu Guina connected the defibrillator.
Four empty adrenaline injections had already been thrown into the medical waste bin at Hao Renjie's feet. When he looked up at Lu Qing: "Sister Lu..."
Yu Gui gritted his teeth and looked back at him: "Don't give up!"
After half an hour of all-out rescue, more than 20 medical staff in the department took turns to perform effective heart compressions, but Miaomiao still did not recover her own heartbeat.
The director of medical affairs explained to Father He and Mother He outside: "That is to say, the child's heartbeat is now all pressed by our medical staff, and the ECG shows a straight line as soon as you let go of your hand. Do you understand?"
Mother He has already burst into tears, almost crying into tears, and Father He's seven-foot boy is also in tears, holding his sleeve tightly: "If there is any possibility, please save Miaomiao."
Liu Changsheng held his hand: "Don't worry, our mood is as urgent as yours, but we will never give up if there is even a chance."
An hour passed, and all the medical staff involved in the rescue were panting heavily. Yu Gui's eyes were slightly red, and he looked at everyone who was no longer moving, including Lu Qingshi.
The green line representing life is dead silent, just like the silent emergency department at this moment.
The child lying on the hospital bed is so young, he has never been in contact with the world since he was born, and his biggest wish is to go to kindergarten with other children. For this reason, he gritted his teeth and insisted on taking medicine, and survived countless surgeries, large and small. Is life going to stop here?
Hao Renjie was not reconciled, Qin Xuan who came after him was not reconciled, and all the medical staff present were also not reconciled. Some young nurses had already begun to wipe their tears.
The director of the heart who came to the consultation also said: "It can't be done... just give up... the brain has been hypoxic for so long and can be rescued..."
Yu Gui rushed forward: "No...don't...don't give up...let's try again...try..."
She turned around and jumped on Miaomiao's body to continue doing CPR, but was pulled away by someone, Yu Gui struggled, and when she saw who was pulling her, tears welled up in her eyes.
"Teacher Lu!"
"Go aside, don't get in the way, Hao Renjie, give me the scalpel." Lu Qingshi glanced at the mannitol that had been hung up since the beginning of the rescue, slightly bent over and knelt down beside the bed.
"Lu Qingshi, what are you doing?! Opening the chest without surgical indications will only lead to faster death!"
The doctor in the intensive care department called out.
Lu Qingshi had already disinfected the poison and opened a hole on Miaomiao's skin: "Is she still alive now? I want to open the chest and directly massage the heart. Why don't you come and help if you have time to criticize me?"
When the head nurse came to report on Lu Qingshi's next rescue work, Liu Changsheng directly sprayed a sip of tea on the medical record, and wiped the cold sweat on his forehead with a veil.
She really dared to put this conjecture that only appeared in the paper into practice. Everyone is happy if the rescue is successful. If the rescue is not successful, it is not only a medical negligence but also a medical ethics issue.
"Quickly, quickly, invite He Miaomiao's family members in." He circled back and forth, and suddenly stopped: "No, let's inform Dean Meng first."
"Director Lu, the blood gas analysis and chest X-ray are here." The nurse ran in and handed her the test results. Lu Qingshi knelt beside the bed with blood on his hands and chest.
The result of the "right ventricular failure caused by pulmonary hypertension" made everyone look ashen. The congenital left heart dysplasia had seriously affected her hemodynamics, and now the right ventricle...
The director of heart surgery took off his glasses and let out a long sigh: "I can't wait for the transplant."
But after waiting for a full five years, there is no suitable match. Where can I find it now?
"Old Liu, you are embarrassing us. You also know that the system is automatically assigned now. Your hospital is nervous and other hospitals are not nervous? With all due respect, after waiting for ten or eight years, there are not many transplants. yes!"
Director Liu called the Jinzhou Human Organ Donation Committee. He clenched the receiver and said in a low voice, "I know, I know. You also know the situation of the patient He Miaomiao. The child is still so young, and he waited for five years to be ranked. Also ahead, if you don’t have you in China, please help me pay attention to overseas ones, saving a life is better than building a seven-level pagoda!”
While talking, the other party pulled out He Miaomiao's data medical records and compared them with the registered organ donation volunteers in the database.
"It's not that I don't want to help you. The request for a heart donation is too difficult! The child is still so young, even if you take a 50-year-old heart, it won't fit into your chest!"
This is the consensus that all medical practitioners understand. Liu Changsheng hung up the phone in despair, and sighed: "Lu Qingshi, it's not that I won't help you, it's really that there is nothing I can do."
He was going to go out and talk to the patient's family again.
Lu Qingshi had knelt on the ground and massaged her heart continuously for 3 minutes. Her immature heart was trembling slightly in her palm. She knew it was the result of her hard work. Once she let go...
Seeing her slightly red eyes, Yu Gui was also a little moved: "Mr. Lu, let me come."
The people in the emergency room gradually dispersed. Lu Qing was a little dazed, and withdrew her hand. The moment she let go, her heart beat slightly. She thought she was dazzled, until there was another fluctuation on the monitor. People wept with joy.
Lu Qingshi heaved a sigh of relief, and sat slumped on the ground with a smile in his eyes.
Yu Gui erupted into cheers, hugging Hao Renjie and screaming and jumping, Lu Qingshi got up from the ground: "It's not over yet, Cedilan 0.3mg plus glucose intravenous infusion, increase oxygen flow, save life The symptoms are maintained"
As long as there is a heartbeat and breathing, then transplantation is meaningful.
"Hello, this is the Emergency Center of the First Affiliated Hospital of Renji Medical University." As soon as the phone rang, the operator grabbed him.
"This is Anzhen Hospital. There is a 15-year-old patient with traumatic brain injury in a car accident. Our hospital's treatment capacity is limited. Please transfer to another hospital!"
"Okay, bring it here!"
The greater the ability, the greater the responsibility, so the green passage opened wide, and the ambulance rushed in. Lu Qingshi's mobile phone vibrated violently in her pocket. She was stitching for He Miaomiao, fine beads of sweat oozing from her forehead. Come.
"Yu Gui, help me pick it up"
Yu Gui frantically took out the phone from her pocket, pressed the call button and put it next to her ear: "Car accident, open abdominal trauma with traumatic brain injury, send to No. age?"
"15 years old, female"
Lu Qingshi glanced at He Miaomiao's pale face beside him: "Urgently do an HLA matching and blood gas analysis, I'll finish it right away."
She took her hands out of He Miaomiao's chest, took off the gloves and threw them into the trash can: "You do the rest"
"Ah? Me?" The person who had looked happy just now turned pale.
"Want to save her?"
Yu Gui nodded dumbly.
Lu Qingshi stuffed the needle holder into her hand: "If the suture is not complete, you will die."
This is a hot potato, everyone looked at her with sympathy, Yu Gui wanted to cry but had no tears.
Qin Xuan got the news a long time ago, and stopped her as soon as she came out: "You entrusted such an important patient to an intern?"
Lu Qingshi walked around her, turned around and left: "I have other patients."
Qin Xuan chased after her: "What about Miaomiao?! She is not out of danger yet! Didn't you watch her grow up?! You were the one who performed her last operation..."
Lu Qingshi pushed her away, his tone became cold: "Get out of the way"
"Director Lu, the HLA matching results are out." The nurse ran out of the emergency room and handed her the test sheet.
Qin Xuan glanced at her, immediately grabbed her by the collar, and shouted with red eyes, "Lu Qingshi, you are not allowed to go!"
That child's heart type is exactly the same as that of He Miaomiao, if she is brain dead...
Lu Qingshi's brows and eyes were completely cold. She looked down at this friend who had known her for three years, who was not a friend, and felt so strange.
She opened Qin Xuan's hand bit by bit: "Qin Xuan, remember your own identity, you are a doctor, not an executioner"
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