With the flow of people in and out, the thick cotton curtain at the emergency door is constantly lifted and lowered, and the cold wind drills in and out, causing patients and family members to shiver from time to time sitting in the corridor waiting for treatment, and some people can't help but shiver, although it is early spring, but the county town under the night is still cold and cold, and the temperature has been maintained at minus five or six degrees.

When Mi Zixuan and Miao Lao Mo entered the doctor's office in the emergency department, Lu Pengyu had already arrived, he was not wearing a white coat, obviously he went straight to the emergency department after coming from home, Che Zhiping was sitting not far from him, and both of them were frowning.

Not only them in the office, but also Ji Wenbo from the anesthesiology department, the old Ji is old, and he is a senior anesthesiologist in the anesthesiology department of the county hospital.

Che Zhiping saw Mi Zixuan and Miao Laomo, and the first sentence was: "The patient is in the emergency room, you go to see it first." Without waiting for Mi Zixuan and Miao Laomo to go out, Che Zhiping said in the second sentence: "When will Ji Meichen arrive?" ”

The call was made by Mi Zixuan, and he said, "I'm rushing to the hospital." Then he followed Miao Laomo to the rescue room.

After seeing the patient, the two of them were staring at each other, and they were all dumbfounded.

Before coming, Mi Zixuan guessed that the patient's condition was urgent and complicated, but after he came, he found that the patient's condition was urgent but complicated.

The patient's name is Yang Li, female, 48 years old, suffering from severe rheumatic heart disease with severe mitral stenosis, metastatic right lower quadrant pain three days ago, judged to be appendicitis by the local hospital, after conservative treatment, the abdominal pain aggravated today, the white blood cells were as high as 23,000, and was sent to the emergency department by ambulance an hour ago.

The condition is not complicated, a rheumatic heart disease, and mitral valve stenosis caused by wind heart disease, and acute appendicitis, the former can be known without consultation and physical examination, because the patient has this disease not for a day or two, but for several years, has been to the big hospital in Beijing for diagnosis and treatment, and has various auxiliary checklists and medical records at that time.

The latter can be seen even if he is a rookie doctor who has just entered the hospital for a short time, acute appendicitis, metastatic right lower quadrant pain, this symptom is really too typical to be typical, and the white blood cells are reported as high as 20,000 when there is a blood routine, what can this not be appendicitis?

The condition is not complicated, the two diseases can be diagnosed, but it is very tricky, these two diseases are not enough to be fatal no matter which one appears alone, with the existing conditions and technology of the county hospital, the rheumatic heart disease can be controlled after medication, and after the patient's condition is stable, it can be transferred to a large hospital in Beijing to do mitral valve closure dilation, or artificial valve replacement, with the existing medical conditions and technology, the patient's postoperative condition will be greatly relieved, and the problem is not big when taking medicine on time.

The latter is as simple as a single appendicitis resection that can completely cure the patient's disease.

But the tricky is tricky because the patient has both rheumatic heart disease and severe mitral regurgitation, and appendicitis, judging from the patient's symptoms, the appendix can not be kept, conservative treatment has no effect on her, and now appendectomy must be performed.

If the appendix is not removed, there is a possibility of perforation of the appendix at any time, and once perforated, acute peritonitis will appear, and severe inflammation, coupled with the patient's poor heart condition, can kill her within a few minutes.

However, in the case of surgery, the patient's poor heart cannot tolerate the operation, and in her current state, it is likely that her heart will fail during the operation and eventually die on the operating table.

If you don't do it now, you will die, and if you do, you may still die.

With such a tricky condition, Mi Zixuan also frowned, and there was no good way in his heart, so he glanced at Miao Laomo, and saw the look of difficulty in the other party's eyes, and the two of them sighed silently and walked out.

Yang Li's husband Gan Fei had red eyes and an anxious look, and when he saw Mi Zixuan and them going out, he hurriedly caught up and said urgently: "Doctor, hurry up and think of a way to save her, hurry." ”

Now there's a way to do that? This is simply a multiple-choice question with almost no answers, Mi Zixuan can't give Gan Fei a correct choice, and so does Miao Laomo.

Mi Zixuan thought for a moment and said, "Don't worry, her illness is very serious, we need to have a meeting to study it, and we will give a treatment plan as soon as possible." ”

Gan Fei could also see that his wife couldn't drag on for long, so he stomped his feet and said hurriedly: "Doctor, you must be fast, I beg you." "When you say that, you have to kneel.

Mi Zixuan and Miao Laomo hurriedly grabbed him, comforted him for a while, and only after a while did Gan Fei's mood stabilize a little, the two of them looked at each other and returned to the office.

Che Zhiping walked around the office with his hands behind his back, and he was about to become ants on a hot pot, and when he saw them coming in, he hurriedly said, "How is it?" What is your opinion on internal medicine? ”

As soon as these words came out, Che Zhiping regretted it, he knew very well how difficult Yang Li's condition was, how to choose now? Transferred to internal medicine for her rheumatic heart disease? However, the appendix can no longer be kept, and there is a possibility of perforation at any time, and once the patient is perforated, he will definitely die.

Immediate surgical removal of the appendix? In terms of the state of Yang Li's heart, I'm afraid I can't even get off the stage, what can Mi Zixuan and Miao Yu have about such a tricky condition? Now it's not right to choose treatment, but it's not okay not to choose, there is no one treatment plan that can get the best of both worlds.

Without waiting for Mi Zixuan to talk to Miao Laomo, Che Zhiping said to Lu Pengyu: "Director Lu, what is your opinion?" ”

Lu Pengyu took out a cigarette and slowly lit it: "After Director Ji comes and sees the patient, listen to her opinion." ”

Lu Pengyu obviously has no idea, and he doesn't want to take responsibility, he has to wait for Ji Meichen to delay the patient's time, according to Mi Zixuan's temperament, if he can call the shots, I'm afraid he will immediately operate on the patient without even thinking about it, for Yang Li, there is no best of both worlds treatment plan now, there is only one way - take a risk.

Although her heart condition is very bad, as long as the operation is fast enough and the anesthesiologist administers the drug as much as possible to control the amount of medicine, she may still survive, but even with Mi Zixuan's technology, he is only 30% sure that he can save Yang Li, and Yang Li has a 70% chance that he will not be able to get off the operating table.

But if she didn't dare to take the risk of operating on Yang Li, she would definitely die.

But Lu Pengyu didn't dare to take this risk, the patient died like this, and he didn't have much responsibility, her condition was already tricky, not to mention in the county hospital, even if it was sent to the big hospital in the capital, those big experts and professors didn't have a good way, not that the doctors in the big hospital in the capital were not skilled, but the patient's condition was caused by the patient's condition, her heart condition was too bad, and the risk of causing a small appendicitis was also quite large.

The condition is so tricky that the doctors in the big hospital in Beijing don't have a good way, he Lu Pengyu is a doctor in a small county hospital, he can't be normal, and he has nothing to do with the death of the patient.

But if he did this operation, the meaning would be different, it would be good to say that the patient was saved, but if he couldn't be saved, the patient's family would make a fuss, Lu Pengyu was yellow mud and dropped his crotch not was, even if you and the family members explained the patient's condition clearly before the operation, there was a high chance that the patient would not be able to get off the operating table in black and white on the surgical consent form, and the family members didn't care about these at all, just one sentence, the doctor in your county hospital can kill people if he has appendicitis, what kind of doctor is he? What kind of hospital are you?

People always sympathize with the weak, and when the family members shout like this, who will the public believe? It must be sympathetic to the weak, trust the family, and say that the patient did die on the operating table because of appendicitis, which is a fact.

How many of the public are medically savvy? How many people are willing to listen to the doctor explain that Yang Li died on the operating table because of an appendix, but not because of an error during the operation, but because she suffered from severe rheumatic heart disease, her heart condition was too bad, and she had heart failure during the operation, which eventually led to death?

No one is willing to listen to the doctor's explanation, but most people will listen to the wind and rain to condemn the doctor and the hospital.

In order to calm the "public anger", the hospital must deal with Lu Pengyu, of course, the hospital knows very well that Lu Pengyu wants to save people, not to harm people, but now the family members are making trouble, biting and saying that you are making an appendix to kill people, and constantly posting such news in the circle of friends on Weibo and WeChat, more and more people who do not know the truth began to condemn the hospital and condemn you, and the hospital had to punish you under the pressure of public opinion, you Lu Pengyu will admit it, Sacrifice once for the hospital.

The final result was to deduct Lu Pengyu's salary and bonus for several months, make him apologize to his family, and remove him from the post of director to see the after-effects.

But no matter what the result is, Lu Pengyu can't accept it, why should I suffer so much grievance for someone I don't know?

In his heart, he thinks about his salary, bonuses, and the position of director, that is, there is no life or death for patients.

So he definitely wouldn't take the risk to save patients.

He thought about it carefully, Che Zhiping could see it, Mi Zixuan and Miao Laomo could also see it, but he couldn't say anything, doctors are also people, ordinary people, and people have selfish intentions, why should an ordinary person be wronged so much in order to save a person he doesn't know? Why?

Ji Meichen came, went to the rescue room, and when she came back, she was at a loss like Mi Zixuan and Miao Laomo.

Che Zhiping knew that the patient could not be delayed, and immediately said: "Director Lu, Director Ji, you have an idea, how to treat it." ”

Ji Meichen sighed and said: "The risk of surgery is too great, but it can't be done if you don't do it, my opinion is to transfer to the first department, our internal medicine department will fully cooperate with the first department of surgery, do our best to treat the patient's rheumatic heart disease, improve the patient's heart function, once the heart function can tolerate the operation, let's operate immediately." ”