"What else does a blood test show that creatine kinase is too high?" Grigory calmed his emotions and then gave everyone this message. "Creatine kinase increases are common after strenuous exercise, after childbirth and after painkiller injections," another student replied. "Considering the kidney failure, we have deduced that his symptoms may be due to the injection of Demerol, so I think this judgment can also verify this, just let him rest in bed for a few days-"

"Are you sure?" Grigory raised an eyebrow.

"yes," the student seemed sure of his judgment. "Creatine kinase is too high is typical of Du-"

"Do you know what's worse than trash?" Grigory interrupted him in a very violent manner. "That's a useless stupid waste like you who doesn't have self-knowledge!"

Under the rage, the audience was silent.

"Tell me, what else is possible?" Gregory kept a straight face, and shouted at the somewhat frightened students in front of him. "Tell me!"

His cane struck the ground, the force was so fierce, and the tone was so strong that the faces of individual girls were already a little pale.

"Sir," said the male student, who was also under great psychological pressure, but still mustered up the courage. "You're ...... It scared my classmates and it affected their performance. ”

"Oh, yes, you think I scared them?" Grigory is clearly still angry. "Do you think you're going to be less stressed than you are now when you actually diagnose patients in the tail stage, huh? Now, tell me, what are you guys overlooking? Tell me! ”

At this moment, a cold female voice came from behind the group of students, from the corner of the classroom.

"Muscle damage, huh?" Although the girl was also a little nervous, her voice was clear. "Muscle damage can lead to excess creatine kinase, and the myoglobin released from the damage can also damage the renal tubules, causing kidney strikes."

"......" Grigory suddenly calmed down after hearing this answer, and after a moment of silence, he nodded. Smart, at least much smarter than the doctors of the time. If you were there, it wouldn't be that long. ”

When he said this, Grigory looked at the girl sitting in the farthest distance, and his eyes were complicated.

"Finally, how long was their diagnosis delayed?" The male student asked.

"Three whole days." Grigory then withdrew his gaze from the girl's body, and said in a somewhat helpless tone. "For three days, they put him on bed rest and gave antibiotics as you just gave the diagnosis. The doctors, like you, boil it all down to the simplest things, and they don't have someone like the little girl who can remind you of the mistakes you've made. Ignorant and incompetent doctors are like this, if they make a mistake they will kill people, and if they can't accept that they will commit crimes, they should either change their careers as soon as possible, or they will go to teach after medical school and leave the task of harming people to others. ”

"It took three days for those seniors to realize that the problem might be muscle necrosis?" The schoolgirl was in disbelief. "I thought they should be able to ...... faster"

"It's not that it took them three days to realize that the muscles were necrotic, but ......," Grigory sighed and sat back in his chair with some grunge. It was the patient himself who thought three days later that it might be muscle necrosis and requested an MRI. ”

The girl sitting in the back row looked at the boy with a surprised look, and the boy just nodded.

"His MRI results showed that the leg pain was not caused by a private injection of Demerol, nor was it caused by an infection, but a muscle infarction caused by an aneurysm that embolized a blood vessel." Gregory's eyes flickered, as if what had happened was right in front of him.

"The doctor told the patient that he might need to have his leg amputated, and the patient did not agree, but asked for bypass surgery, a new access and simply to restore blood flow - this is normal, the doctor asked for amputation because after all, it was not his leg that was cut off, and of course it was not a backache to stand and talk."

"But if it took three days to diagnose, it means that the blockage may have lasted four days or more – muscle necrosis releases cytokines and potassium, which would flood back into his circulatory system in large quantities in a short period of time if recovered from bypass surgery, cytokines can lead to organ failure, and potassium can cause cardiac arrest, which is too dangerous!" The male student questioned it.

"It's dangerous," Grigory nodded. "But the question is, who is it too dangerous for the patient not to amputate in such a situation, the patient, or the doctor who made the decision?"

"Of course we are thinking about his life!" The male student was puzzled. "At least you can live without a leg, but if you die because of this leg......"

"Do you think that if it were you, you would tell the doctor that amputation is okay, because you can just quietly polish the delicate steel frame on your leg in the middle of the night when no one is around, instead of looking at the place where there used to be a leg?" Grigory asked rhetorically. "Ask yourself, do you really care about making your patients live with dignity?"

"Of course, our purpose as doctors is to save lives, of course—" The boy replied immediately, but was interrupted by Gregory in the middle of his sentence.

"Of course you care about the patient's rights, but what you can't deny is that the doctor actually cares more about himself." Gregory spreads his hands. "Of course, this is not incomprehensible, because if doctors try to keep more tissue from patients, the greater the possibility of error, and the greater the risk, so many doctors will choose a more secure approach, even if it is just to keep their jobs, their families, and their children in their families to thrive."

"And finally, did he amputate his leg?" The schoolgirl asked.

"They did a bypass operation, but after the operation, the patient was in severe pain and volunteered to undergo a chemically induced coma to survive the most painful period." Gregory's tone was low and slow. During that time, his wife, in her capacity as a health agent, informed the hospital's ethics committee of the matter and, knowing the patient's opposition, agreed in her capacity as regent to a compromise between conservative treatment and amputation: the patient's necrotic muscle was removed to ensure his life. The patient was safe, but because of the excessive muscle removed, his leg function was almost completely destroyed and he could no longer walk normally. More seriously, because the diagnosis was delayed for too long, the time for treatment was delayed, and he was tormented by severe pain for the rest of his life. ”

"She abused her power, she shouldn't have done anything like that." Schoolgirl sighed.

"But she saved him," the male student retorted. "The ethics committee has already passed it, and I think this matter can basically be closed."

At that moment, Gregory let out a sigh.

"Yes, the ethics committee supported Stacy and made a choice that the patient was not willing to make." Grigory began to roll up his right leg of his trousers. "Because they think it's better to die than to live, but the price of surviving is this—"

By the time he said that, he had rolled up his right pant leg to a very high point - even exposing the mid-thigh. "Don't you think there's something here that should be?"

On his thigh, a huge depression that covered almost the entire surface of the leg made everyone present lose their voices.

"I also told Stacy before the chemical induction that when I recover, we're going to go on a bike trip and go golf together, so can you imagine how I felt when I woke up and found out that she had made me a wreck?" Grigory looked at them and said. "You can say I'm living a decent life now, but you'll never be able to imagine how much pain I suffer – that's why I've worked with a lot of companies that develop painkillers and muscle growth drugs, and I just want to take back the dignity that they took from me as a normal person...... Forget it, I told you that you don't understand, how long will it take to get out of class? ”

Grigory looked up, only to see that the pointer seemed to be just in time for the end of the lesson.

"So, after class - and, the two children in the back wait for me, I have something to do with you."