Chapter 166: Dawdling Emergency!
“Doctor Zhang, is there really nothing you can do about my old man’s condition?”
In the Emergency Surgery Clinic, an elderly couple sat facing Zhang Tiesheng, their eyes vacant.
Zhang Tiesheng and Lu Cheng were leaning together, carefully reviewing the medical images. After Zhang Tiesheng pointed at the computer screen for a while, Lu Cheng also shook his head.
Zhang Tiesheng then said, “Elderly sir, the tumor on your uncle’s liver is too large for us to handle here.”
“Perhaps you could wait until after the holiday to see a doctor in General Surgery during outpatient hours.”
“But I still suggest you call your son or daughter soon and have them quickly take you to the Prefecture Hospital or Xiangya for a check-up.”
Both elders were silent for a moment. The old man, with his slightly small head and curly white hair, suddenly said, “Never mind, let’s go back.”
But as he spoke, it seemed to cause a change in intra-abdominal pressure, making the old man’s brows furrow deeply, deepening his wrinkles.
The old woman said with some concern, “Doctor, even if you can’t treat it, can you at least prescribe some pain medication? He hasn’t slept for nearly two days, he’s been in pain all along…”
“And my feet hurt too.”
The old woman was plump, but the old man was exceptionally thin, and his left leg was noticeably shorter than his right, with his hip joint in a deformed valgus position.
Zhang Tiesheng said, “It’s no use. The pain medication I can prescribe for you won’t relieve this kind of pain.”
“Effective painkillers cannot be prescribed by us in the Emergency Department. You need to go to the Oncology Department. We don’t have an Oncology Department in our county, so these medications cannot be prescribed here.”
“That’s the regulation, and there’s nothing we can do to help you.”
“You should have come to see us sooner, it’s dragged on this long…”
Zhang Tiesheng quickly finished writing the medical record, handed the medical record book back to the two, and said, “We can’t treat it here. Please call your children quickly.”
“Go to a prefecture-level or provincial hospital as soon as possible to find a solution.”
Lu Cheng happened to be in the clinic when the elderly couple came in for their appointment, so he didn’t leave.
Of course, Lu Cheng didn’t dare to speak.
There was a large tumor, about ten centimeters in size, on the lateral lobe of the old man’s liver, adhered to the surrounding mucosa. It was clearly malignant.
In this situation, even Professor Chen Song probably couldn’t handle it. This wasn’t an emergency condition, but a massive mass belonging to the Oncology Department or General Surgery.
The old man explained, “There’s no way to treat it, you’ve heard it yourself. I’m already old, why would I go so far?”
“If the county can handle it, then handle it. If not, we’ll just accept our fate.” The old man, leaning on his crutches, tried to stand up.
The old woman, unable to bear it, gently pressed the old man down, then looked at Zhang Tiesheng, “Doctor, please help us, think of a way.”
“Even just to relieve the pain.”
Zhang Tiesheng waved his hand, “I can’t help it. I don’t have the authority to prescribe pain relief for your condition. I can’t issue it.”
“These pain medications are controlled substances, only the Oncology and Anesthesiology Departments can prescribe them. Our hospital does not have that authority.”
“I’ve already told you, you need to call your children and have them take you out for treatment. That’s the best way.”
The strongest pain relief the Emergency Department can prescribe is tramadol hydrochloride by intramuscular injection. Tramadol is not very effective for cancer pain.
Moreover, even if it were effective, it would only be temporary and wouldn’t meet the patient’s needs.
“They are all busy, working outside. If they rush back, we won’t be able to make ends meet at home,” the old woman explained.
“My eldest son’s three children barely have enough for living expenses.”
“Where would we get the money to seek treatment elsewhere?”
The couple’s attire was very simple. Although there were no tattered patches, their clothes were clearly washed many times and were of common brands.
Judging by the style and fit, they were likely wearing hand-me-downs from younger people.
“Then I really can’t help,” Zhang Tiesheng spread his hands.
Although not having money is not an absolute contraindication in China, the medical cost system in China operates on both medical insurance and out-of-pocket payments.
This was not something Zhang Tiesheng could decide.
The old woman helped the old man out, hobbling along with his crutches, their backs bent and helpless.
Zhang Tiesheng yawned, “Xiao Lu, it’s getting late. You should go take a break too.”
“You’re on a twenty-four-hour surgery shift today. If a patient comes in later, you might not be able to rest.”
Lu Cheng quickly cleared his mind of the inner turmoil the elderly couple had caused. “Okay, Zhang Ge, I’ll go check on some other patients. Call me if anything comes up.”
Zhang Tiesheng looked at Lu Cheng with surprise. “You’re still going to check on them?”
“These patients are unlucky to have run into you managing their beds. They probably won’t even have a chance to move out overnight.”
“Moving out overnight” meant not paying the bills and fleeing in the middle of the night.
Lu Cheng recognized the teasing in Zhang Tiesheng’s voice but didn’t mind. “I’ll take another look. That young man with the severed limb wasn’t following instructions. He managed to get one yesterday.”
“It would be a shame if it got infected and died.”
Zhang Tiesheng could understand the young man’s situation, but he still grumbled, “If he’s asking for it, then we can only respect his fate.”
A limb replantation patient smoking on the third day post-operation? Even the gods can’t save him!~
Lu Cheng walked out of the Emergency Surgery Clinic—
Just then, Doctor Han Rong was picking up her father. Han Rong’s big brother was also there.
“Doctor Lu, good noon. Have you had lunch yet?” Han Rong saw Lu Cheng and greeted him first.
As Lu Cheng paused, Han Rong’s brother, Han Pingxiao, stepped forward and shook Lu Cheng’s hand. “Brother Lu, thank you for your hard work!~”
“As expected, your reputation precedes you. My father’s recovery is excellent.”
Lu Cheng looked at Han Pingxiao’s distinctive diamond-shaped face and receding, protruding forehead. After a slight start, he quickly replied, “Hello, Teacher Han. Doctor Han mentioned that you are also a teacher in our Orthopedics Department.”
“It has made me feel quite humbled for a long time.”
Han Rong and the others’ luggage had likely been taken ahead of time, so they were traveling light. The patient, Han Yongshan, had no issues with his legs and was just wearing a jacket.
He politely thanked Doctor Lu and then smiled as he watched Lu Cheng and Han Pingxiao converse.
“Brother Lu, you’re too kind. I’m younger than you. If you don’t mind, you can call me Xiao Han.”
“I’m in Joint Surgery, what kind of teacher am I?”
Han Pingxiao glanced at his father again and said in a low voice, “Outsiders watch the spectacle, insiders see the skill. Your technique, Brother Lu, is well-known in our hospital.”
“That’s why I immediately asked my parents to come back and find you.”
“Professional matters should be handled by professional people,” Han Pingxiao replied candidly.
He was a professional, and in orthopedics, he didn’t have the obsession with a hospital’s name. As long as the doctor’s skill was good, he would travel from Jishi City to Long County.
Only by finding the right person can one be cured, not just by finding a good hospital.
Han Rong was much younger than Lu Cheng. Han Pingxiao looked several years older than Lu Cheng, perhaps due to looking older.
“Brother Han, I can only say I did my best.”
“Fortunately, Professor Tong from Orthopedics came for a rural visit. If I felt I couldn’t handle it, Professor Tong would be there as a backup, so I went ahead boldly.”
“Of course, Uncle’s recovery is also good now. The most important thing to focus on is quitting smoking!!” Lu Cheng emphasized.
Han Pingxiao nodded, “I understand this point. I will definitely watch over my father…”
“If he doesn’t listen to advice, it would be a disrespect to Professor Tong…”
“Doctor Lu, you keep busy here. In a couple of days, when you’re free, we must have a meal together… I’ll reserve a table in advance and call you…” Han Pingxiao decisively stated.
“Brother, is Doctor Lu’s technique really that good?” Lu Cheng could faintly hear Han Rong’s voice from afar.
“Hearing is false, seeing is believing. Dad’s injury was to the tendons in District Two. It’s a location that’s easily prone to suture failure. You can see how well he’s recovered now, right?”
“If it weren’t for a coincidence, where the attending doctor in our hospital’s Hand Surgery department compared the tendon sutures Lu Cheng had performed previously, creating a stark contrast, and the people in the operating room were gossiping, I wouldn’t have known our county hospital had such a skilled doctor!”
“Doctor Lu’s technique and reputation are both good, and he is very patient, although his patience is a bit ‘nagging’…” Han Rong’s mother concluded.
Han Pingxiao had clearly heard about Lu Cheng’s “nagging.” “Everyone has different working styles. As long as good technique can solve the problem, that’s what matters.”
……
After Lu Cheng entered the observation ward and looked around, he confirmed that the batch of patients who had returned from Hanshi City had all recovered and been discharged. A new group of patients had varying recovery situations.
However, the patient with the severed limb who had been there before Lu Cheng went to Hanshi City was still here for rehabilitation, to salvage as much function as possible for him.
Lu Cheng immediately went to the young man with the severed limb, took off his mask, and sniffed. “Good, no smell of smoke.”
“You absolutely must not smoke. Not even secondhand smoke,” Lu Cheng said sternly after putting his mask back on.
The young man’s father also said sternly at this moment, “If he dares to disobey, I’ll break his leg myself.”
“Doctor Lu, how is my son’s recovery progressing?”
Lu Cheng looked at the patient’s fingers again, their skin rosy. “The blood supply to the fingertips is good; at least they can survive. However, his dressing hasn’t been changed yet, so I can’t see the local condition of the wound.”
“As for functional recovery, that remains to be seen. Please don’t expect too much.”
“A severed hand, whether in terms of strength or dexterity, will certainly not be as good as the other side.”
“Oh, and don’t feed him anything too rich. Eat more lean meat, eggs, and other high-protein foods. Have less soup and watery things, and fewer greasy items.”
“I heard you prepared chicken soup for him, and there was half a bowl of oil floating on top? You can’t eat it like that,” Lu Cheng said.
“The child wanted to eat it. He said he hadn’t eaten meat in a long time,” the child’s mother replied.
Lu Cheng instructed, “You still can’t eat it like that. You can’t just eat what you want. Excess fat intake will increase the metabolic burden.”
After speaking, Lu Cheng looked at the young man himself and said, “Don’t worry too much. What’s happened has happened, let’s deal with it actively. For now, at least our hands are still here, right?”
“Let’s strive to become left-handed in the future and learn a trade. Many people online who have lost both hands can still cook and make meals with their feet. Don’t worry about the future…”
The young man nodded, the panic in his eyes receding somewhat. “Okay, Doctor. I’ve seen videos of these people recently.”
The young man’s father fiercely ran his hands through his hair. “We had just planned for him to learn carpentry, to have a trade to make a living.”
“If I had known it would turn out this way, he might as well have come with me to the construction site.”
Lu Cheng comforted him, “This was an accident, not intentional.”
“I think this brother is quite sensible. Many people his age never listen to their elders; those are the difficult ones to manage…”
“Sigh,” the man sighed.
The child wasn’t good at studying, which was a matter of aptitude. His willingness to learn carpentry was a matter of attitude.
He didn’t blame his son for not being academically successful. It was just that his obedient son’s hand was suddenly sawed off, and he felt deeply guilty.
……
Lu Cheng walked towards bed 3 next door. Bed 3 was an appendicitis patient who had just been admitted yesterday. Zeng Huanqi had performed the appendectomy.
The patient was a young man of twenty, and his companion was his girlfriend.
However, at this moment, his girlfriend was lying in bed, while he, having undergone surgery, was sitting by the bedside.
“Young man, it’s good that you’re caring for your girlfriend’s pain. She’s resting even after surgery,” Lu Cheng said, washing his hands with disinfectant, making a joke.
“Doctor Lu!~” The young man smiled sheepishly and tried to stand up, but his movements were not very smooth. “She said her stomach felt a bit uncomfortable. Maybe it’s from the food we ate yesterday that caused diarrhea.”
“She’s just resting for a while.”
During morning rounds, Lu Cheng had heard the young man say that his girlfriend was the same age as him, and even a few months older. They had been dating since school, and after graduating from junior high school, they had been together until today, having been in a relationship for six or seven years.
Lu Cheng nodded upon hearing this and casually asked, “Have you eaten?”
“Doctor Lu, I was supposed to eat, but my girlfriend is asleep, so I ordered takeout, and it hasn’t arrived yet.”
“I’ve already finished my bowel movement,” the young man replied with a smile.
He knew Lu Cheng liked to trick patients, for example, by telling them not to eat without having a bowel movement, and then directly asking what they ate today.
For example, if Lu Cheng instructed them not to over-train secretly, he would suddenly ask how many times they had clenched their fists. Many patients had been tricked and reprimanded by Lu Cheng.
Lu Cheng’s smile froze for a moment. “Feel your girlfriend’s temperature?”
The young man was very good to his girlfriend, and Lu Cheng could tell the girl was also good. They just weren’t good students, not that they were inconsiderate of each other.
Even if the girl didn’t go back to cook, she wouldn’t not order takeout for the boy.
It didn’t make logical sense.
It didn’t add up.
The young man was taken aback. “What is it, Doctor Lu?”
“No fever.” The young man touched his girlfriend’s forehead, then patted her. “Zhuzhu, wake up.”
The girl wearily opened her eyes, her delicate brows furrowed. She instinctively clutched her lower abdomen with her right hand, and her legs were curled up under the quilt.
Seeing this, Lu Cheng decisively drew both curtains and shouted back, “Tian Duoduo, come to the ward!”
After shouting, Lu Cheng asked the girl, “Is it pain in your lower right abdomen?”
The girl nodded, a slight sweat beading on her forehead. “It hurts even more now.”
“Doctor Lu.” The young man was a little flustered, as his own mobility was quite restricted.
Lu Cheng quickly put on examination gloves and said, “I need to perform a physical examination on your girlfriend. Her condition seems a bit strange. You just watch here, don’t say I’m taking advantage or anything.”
Since it was pain in the lower right abdomen, Lu Cheng immediately pressed on McBurney’s point.
Tenderness was evident, and the girl’s expression immediately tightened.
However, Lu Cheng could see that there was also tenderness at non-McBurney’s points, and the degree of tenderness was no less than at McBurney’s point.
“Doctor Lu, what’s wrong?” Tian Duoduo hurried over.
“Call for a bedside emergency color ultrasound, and draw blood for an emergency test!~”
After Lu Cheng gave the instructions, he paused for a moment and asked the girl, “When was your last menstrual period?”
“My last one was August 15th. I didn’t get it last month.”
The girl was a little flustered. “Doctor, do you mean…?”
The young man was stunned for a moment, then quietly took out his phone, feeling hesitant and uncertain.
Lu Cheng turned to Tian Duoduo. “Tian Duoduo, come help her with the registration process!~ I’ll go write some medical orders and request a consultation.”
Then, Lu Cheng looked at the young man. “I’ll help you to the doctor’s office first. You’re a family member. I need to ask you some basic information…”
Although the young man was a patient, he couldn’t afford to worry about that now, as he had only just had appendicitis surgery.
Ten minutes later, after Lu Cheng had asked about the general condition and quickly written the blood test orders, he turned and said, “You two have likely been hit by something.”
“I strongly suspect it’s an ectopic pregnancy. This is a very dangerous situation.”
The young man didn’t seem embarrassed or hesitant this time. “It happened on the first try?”
They had a history of sexual intercourse, so this was normal. They were both adults and no longer studying, and at most, the young man hadn’t reached the legal age for marriage.
They usually used protection, but young people liked to try new things…
After the young man finished speaking, he calmly asked, “Doctor Lu, is she pregnant?”
Lu Cheng saw that the young man was thinking too simplistically and quickly said, “She is pregnant, but this is a pregnancy that absolutely cannot be carried to term.”
“The gestational sac did not implant in the uterus; it has implanted in the fallopian tube. This must be dealt with, otherwise, if it ruptures, it will endanger her life.”
“Of course, this is just my speculation at the moment, but your girlfriend’s period is nearly half a month late.”
“Haven’t you ever come to the hospital to check before?” Lu Cheng found it unbelievable.
Even if young people are careless, wouldn’t they go for a check-up if their period is missed?
The young man replied, “We were planning to check, but it was the holiday a few days ago, so we decided to wait until after National Day.”
“Who would have thought we’d get food poisoning yesterday.”
“Doctor Lu, I will be responsible for her. We have already met each other’s parents,” the young man said chivalrously.
Lu Cheng: “…”
Are we on the same wavelength?
