Chapter 18 Hospital-wide consultation (Part 1)
"Xiao Luo." Seeing Luo Hao's presence, Director Wen complained to Luo Hao, "Look at the Department of Gastroenterology, what it looks like! The patient's gallbladder has been removed The diagnosis is clear that it is liver abscess. Your medical office has clearly stated that patients with liver abscess should be sent to the gastroenterology department for treatment.” I just recommend it as a patient. You happen to be here. Please tell me what the medical office's opinion is."
"Director Wen, I will report this to Director Lin immediately," Luo Hao said in a low voice, "You go first. Bring the patient in, don't leave him in the corridor."
"This!" Director Wen glared.
"What I mean is to organize a hospital-wide consultation. We will explain things clearly in person and turn the patient over. As for whether it can be cured, it has nothing to do with our general surgery department. It is the Department of Gastroenterology that is doing something wrong now, and it is always wrong to blame the patient. Yes, but you cannot leave the patient in the corridor no matter what."
Director Wen thought for a few seconds and said, "Chen Yong, please bring the patient in."
"Little Luo, are you going to report to Director Lin or should I come in person?" Wen Youren was very dissatisfied with Luo Hao's handling and asked angrily with his lips curled up.
In person?
Luo Hao almost stopped laughing when he heard what Director Wen said.
Director Wen really takes himself seriously. The word "personally" sounds a bit funny.
"Director Wen, let me report first. There are many trivial matters. Director Lin knows about them. Then you can express your attitude and apply some pressure." Luo Hao gave suggestions very considerately.
Seeing that Director Wen was still dissatisfied, Luo Hao smiled and said, "I would suggest that the scale of the hospital-wide consultation be larger, as long as all relevant departments or departments related to geriatric diseases come. We will present it in front of all departments in the hospital Please explain the matter clearly to the director. If there are more people in the Department of Gastroenterology, they will have concerns next time."
"Yes! Come and see what gastroenterology is," Director Wen agreed in a low voice.
Every word Luo Hao said spoke to his heart.
In Wen Youren's opinion, this matter was the Department of Gastroenterology deliberately passing the buck to the patient.
I can't treat difficult patients myself, and then I let the patient come to the general surgery department under the pretense that he had had a cholecystectomy 20 years ago.
It is simply ridiculous. What is the relationship between the cholecystectomy performed by the patient 20 years ago and the current liver abscess!
Bullshit! !
Director Wen looked at Luo Hao with great satisfaction. He felt that this young man was simply outstanding. He could see the essence of the problem at a glance and was willing to help the general surgery department rather than fight with others.
"Thanks for your hard work, Ronaldinho." Director Wen said a rare "Thank you for your hard work."
"Director Wen, don't worry, this is what I should do. You are busy first, I will report the situation."
Luo Hao did not go back to the medical office directly; Help Chen Yong take in the patients and learn as much information as possible.
Based on Luo Hao's own judgment and the confirmed diagnosis calculated by the diagnostic assistant AI, Luo Hao believed that the diagnosis of cesspool syndrome was correct.
However, Luo Hao knew that the matter was very important. He asked about the medical history and found out that the surgery 20 years ago was also performed at the mine. He went to the medical record room.
Until he found the "old" medical record, Luo Hao showed a confident smile on his face.
Back at the medical office, Luo Haoxian and Lin Yuming reported the patient's condition.
“The surgery was performed by the old director of the Department of Surgery Guohua 20 years ago. I also went to the medical record room and borrowed the medical records from that year.”
“20 years ago... It would be nice to be able to write medical records at that time. Most of them were copied by interns. "Is it valuable?"
"Yes!" Luo Hao took out a yellowed medical record. , put it on the table, "The medical records and disease course records have no reference value, but the handwriting of the surgical records is different from that of the person who wrote the medical records. I think it should have been written by Director Guohua himself."
"Oh?!" Lin Yuming's eyes lit up.
Now that electronic medical records are available, directors and surgeons rarely write surgical records.
In those days, medical records were written by hand. There must be a reason why Director Guohua was able to write surgical records by hand!
“The patient’s situation is a bit special. Although he was diagnosed with cholecystitis and gallbladder stones, Director Guohua did not perform a simple cholecystectomy when it came to surgery, but also performed a difficult side-to-side bile duct and duodenal anastomosis. . ”
“Director Guohua wrote very clearly that the patient had sludge-like stones in the common bile duct, so a side-to-side bile duct duodenal anastomosis was performed. ”
Lin Yuming found the page of surgical records and flipped it gently.
Times have passed by, and this medical record has not been touched since it was put into storage.
The faint musty smell wafts from the medical records, silently telling future generations what happened that year.
"How to diagnose patients now?" Lin Yuming asked directly.
“Cesspool Syndrome.”
"???" Lin Yuming had a question mark on his head.
“This disease is also called blind end syndrome, blind bag syndrome, and blind pit syndrome. It is a rare complication after side-to-side choledochoduodenal anastomosis.
Refers to a series of clinical symptoms caused by the accumulation of food residues, stones, etc. in the blind bag formed from the choledochoduodenal anastomosis to the ampulla of Vater after side-to-side choledochoduodenal anastomosis.”
< br>Lin Yuming could roughly understand what Luo Hao described.
“Does surgery need surgery?”
"In the past, surgical intervention was required. But in the past ten years, endoscopic papillary sphincterotomy, commonly known as ercp surgery, plus biliary clearance has been mainly used for treatment."
"Endoscopy." Lin Yuming's hand tapped lightly on the medical record.
A ray of sunlight shines in, and in the light, the dust in the old medical records flies up and floats gently.
Lin Yuming was deep in thought.
Hit the snake seven inches.
There must be conclusive evidence to beat Wen Youren to death with a stick. Even if he does not die, he must be unable to hold his head high in the mine.
Beating Wen Youren was only one of his purposes. Lin Yuming also wanted to take the opportunity to develop new technologies.
It was great to hear what Luo Hao said, but the key point was that Lin Yuming had no idea what was going on with this disease.
After the cholecystectomy twenty years ago, the postoperative complications took so long to break out. Lin Yuming subconsciously thought that the possibility was unlikely.
But his trust in Luo Hao is growing day by day.
Lin Yuming caught a glimpse of Luo Hao from the corner of his eye. Lin Yuming was in a daze. Unknowingly, Luo Hao was already a young man.
In the light and shadow, I vaguely saw my old friend.
Luo Hao and his father look really alike.
"Uncle, do you still have any questions? I think you can consult Teacher Liu. If Teacher Liu is not sure..." Seeing Lin Yuming not speaking, Luo Hao thought he had concerns, so he asked Give your own suggestions.
“What other tests are needed?” Lin Yuming asked.
"Magnetic resonance cholangiopancreatography."
"Okay, tell me again what you and Wen Youren said."
Luo Hao once again recounted his conversation with Director Wen Youren. , not a single word left.
"When you take the patient for examination, the diagnosis must be clear and cannot be vague. If you are not sure, just tell me and I will consult experts in the province. Of course, you can also consult your teacher." Lin Yu Ming whispered.
“Okay.”
Luo Hao left, and the A4 paper in front of Lin Yuming was filled with words that only he could understand.
Picking up the phone, Lin Yuming called Deputy Director Liu.
"Lao Liu, you said that if there were any complications from the cholecystectomy 20 years ago, they should have appeared long ago." After a brief description, Lin Yuming asked.
"Boss Lin, generally speaking, the peak period of complications occurs within 5 years after side-to-side choledochoduodenal anastomosis. 20 years, it is not unprecedented." Liu Haisen replied.
But when the conversation changed, Liu Haisen said easily, "Boss Lin, the diagnosis was not given by you, nor was it given by the directors of your mine. It was Luo Hao. I guessed it right. ”
"..." Lin Yuming was startled.
"This disease is not common. I'm afraid your mine boss won't be able to perform side-to-side choledochoduodenal anastomosis." Liu Haisen said, "If you can't even perform the operation, let alone what it will be like 20 years later. There are complications."
"Luo Hao told me, I'm not sure, so I'm asking you now."
"It's right to do MRI next, how many days after diagnosis. A solution. It used to be a surgical solution, which was difficult and risky. Recently, Director Shi has done several similar cases from the hospitals below, and the results have been good! Yuming's eyes lit up.
"Do you have ercp equipment?" Liu Haisen asked.
“Yes.” Lin Yuming said jokingly, “A few years ago, there was money in the mining area, and almost all new equipment was bought upon request. It was still the most advanced. It was really good back then, not like it is now. What a waste.”
“It’s been ten years, can it still be used?”
“It should work. Although it is getting dusty, I follow the manufacturer every year for maintenance. Lin Yuming said, "ERCP can solve it, right?"
"Well, you have to have all the information. In this case, Boss Lin, I will communicate with Luo Hao." >
You don’t understand either, this is a bit offensive.
But Lin Yuming didn't take it seriously. When he was in college, he said a lot more ugly words than these. They were all daily, everyday.
Besides, this is the truth.
After hanging up the phone, Lin Yuming took a pen and scratched it out on the A4 paper, writing what he wanted to do next like ghostly symbols.
Wen Youren?
Hey!
I will give you a good look.
……
……
Luo Hao and Wen Youren "reported" and persuaded him to perform magnetic resonance cholangiopancreatography on the patient.
Wen Youren's skills are only limited to simple cholecystectomy, gastrectomy, intestinal resection and anastomosis. He knows nothing about the difficult diagnosis and differential diagnosis of pancreatic duct and bile duct.
He readily agreed.
A few hours later.
The patient's pain was relieved after anti-inflammatory and symptomatic treatment.
Luo Hao and Chen Yong took the patient for magnetic resonance cholangiopancreatography.
After the image came out, Chen Yong frowned and looked at the image on the screen, "Luo Hao, there are ill-defined low-signal filling defects in the intrahepatic and external bile ducts. There should be foreign bodies."
"Well, consider it. It's the intestinal contents that caused the obstruction in the common bile duct duodenostomy."
"Sure enough!" Chen Yong clenched his fists and stared at the screen, "My master said the patient. It is very likely that he had a side-to-side choledochoduodenal anastomosis! The images prove that the master is right!"
Luo Hao nodded, Jiang Wenming is really good, it is a pity to leave the clinic.
But there is no way, everyone has his own ambitions.
"I just said that Director Wen must be wrong. Luo Hao, did your medical office have nothing to say?" Chen Yong asked.
"Expression? What expression do you want?" Luo Hao asked.
“In clinical treatment, right is right, wrong is wrong, black and white are clear!”
When talking about black and white, Chen Yong’s eyes were extremely firm.
He was not wearing a three-layer mask, and his handsome face seemed to have the words black and white written on it.
"Director Wen is the director after all, and his face must be taken into consideration." Luo Hao said vaguely.
"You...are such dogs!!" Chen Yong was angry.
It’s really easy to get angry, Luo Hao smiled slightly.
"As long as the patient is treated properly, the disease can be cured, isn't it?" Luo Hao asked.
"What happens after that? Director Wen's level is so low, and he suppresses other doctors wantonly. My master did a good job in surgery, but he forcefully forced him to go to the outpatient clinic."
"The outpatient clinic is pretty good. At least you don't have to work night shifts. Besides, don't you think you have the idea of using public equipment for private use? It doesn't seem that noble."
Luo Hao said a few words, then turned around and started to prepare. Image data.
Liu Haisen started a group and gathered himself, Luo Hao, Lin Yuming, and Director Shi in the group for the convenience of talking.
After checking all kinds of information and finding nothing missing, Luo Hao sent the patient's cloud information to the group.
[Teacher Shi, please take a look and see if our diagnosis is correct. 】
[Wait a minute, let me take a look. 】A few minutes later, Director Shi replied with a message.
Director Shi didn’t leave a positive reply until the patient was sent back.
Luo Hao’s diagnosis was correct and he recommended that the patient undergo endoscopic papillary sphincterotomy + biliary tract clearance.
What happens next is not what Luo Hao cares about.
The uncle is going to deal with Director Wen, otherwise Director Wen would really not be able to handle such a stupid thing like inciting the patient's family to sue the hospital.
"You guys are going too far." Chen Yong kept talking, but his voice became much softer after being scolded by Luo Hao.
"It's okay, it's okay. At least the patient has a diagnosis." Luo Hao comforted, "Director Lin is contacting experts from higher-level hospitals to perform minimally invasive surgery. Don't worry, the disease will definitely be cured. "Cure."
Chen Yong looked a little better, but he was still full of disdain for Luo Hao.
Luo Hao also had a good impression of this young doctor who believed that black was black and white was white. Even though Chen Yong has always been disdainful and slightly hostile to him.
"Let's go have a cigarette. Don't be angry." Luo Hao settled the patient and took Chen Yong to the fire escape.
“Smoke-free hospital!” Chen Yong’s words were very strong.
"Harm, I can see your master smoking." Luo Hao didn't care, smiled, "Let's go, don't be angry."
Chen Yong glanced at Luo Hao, as if thinking of something, Standing up "reluctantly".
The two of them went out and came face to face with a 1.7 meter beautiful woman, about 25 or 6 years old, wearing a long khaki coat, stockings and high heels.
With this outfit and the current weather, Luo Hao shuddered when he saw it.
The anti-freeze index of beautiful women is truly incredible.
"Why are you here?" Chen Yong stopped and asked with a straight face.
"You said you, I can't come yet? Did it delay your date with the nurse?" The woman smiled sweetly and only made a joke. For fear that Chen Yong would be angry, she said softly, "Here you go. The meal is here.”
“……”
Looking at the insulated lunch box handed over by the woman, Chen Yong did not reach out to take it.
Chen Yong is pretty good, there are people delivering food, Luo Hao stands aside and watches the fun.
"Bao, let me tell you something." The woman said affectionately.
"Say."
"If we quarrel again, can you come over and give me a hug without getting angry? Just give me a hug." The woman said delicately, "We are lovers, no Enemy, don’t always keep a straight face.”
"Do you know that at that time you were harder to press than a pig during the Chinese New Year?" Chen Yong asked.
“You!”
Luo Hao reached out and pushed Chen Yong from behind.
"We need to prepare the information for the whole hospital's consultation later, so hurry up." Luo Hao reminded Chen Yong in a low voice.
Chen Yong realized that now was not the time for romance. He took the lunch box and whispered a few words to the woman.
The woman smiled like a flower and turned to leave.
The khaki yellow coat seemed to smile like a flower, a flower in full bloom.
When they came to the fire escape, Luo Hao joked, "Yes, there are people delivering meals. I have been in the hospital for almost two years, and I have a lot of clinical contact. I have never seen anyone from my family delivering meals."
"It's boring." Chen Yong took out a cigarette and didn't give it to Luo Hao. He lit it himself and sat carelessly on the steps.
“You don’t admit it even after you put on your long johns. It’s a typical scumbag mentality.”
"That's nonsense." Chen Yong said, "I do things honestly. I promised at the beginning that we would only fall in love and not get married."
"Uh..."
"It's not because I'm greedy for my body."
“Fuck!”
Luo Hao really didn’t know that Chen Yong was so narcissistic, and he didn’t know who gave him the courage.
"That girl looks good."
"A wise man will not fall in love unless he meets a rich woman."
"Who did you learn all these things from?" Luo Hao asked road.
“My master.” When Chen Yong talked about Jiang Wenming, his tone softened a little.
“……”
"My master said that there are several new ways to do good deeds and accumulate virtue - don't advise people to get married, don't advise people to have a second child, and don't prevent people from getting divorced."
"Is he single?"
"Well, we have been divorced for five or six years."
Luo Hao thought of his uncle. According to Jiang Wenming's standards, his uncle was not considered a good deed.
"Write your medical record carefully. When you finish it, I will review it."
"!!!" Chen Yong looked at Luo Hao like he was an idiot.
"You know how to bully people, right?" Chen Yong said disdainfully, "Director Wen, if you don't dare to move, you only know how to bully little doctors, you are the same as the others."
"It's all for you. Okay." Luo Hao smiled.
"Everything should be done under the banner of being good for you. This is also the mantra of the bosses in the agency. What is the other one? By the way, if you are willing to do it, do it. If you don't dare, get out. You are not bad. One. If you have the ability, go to the pediatric department and see if the pediatric department in our hospital can hold on."
"So many complaints."
"Complaining? I'm just stating a fact." Chen Yong already regarded Luo Hao as one of the senior men in the agency, and didn't bother to say a word.
He put out the cigarette and staggered out of the fire escape.
Luo Hao ignored Chen Yong. If he wrote the medical records well, he would become a little transparent when the whole hospital consulted.
Otherwise, Chen Yong might be dragged out by Director Wen to block the gun.
Luo Hao only had some affection for Chen Yong's master, Jiang Wenming, and had no interest in this guy who was always messing around with women and was full of misfits.
Lighting a cigarette, Luo Hao sat on the steps of the fire escape and began to think carefully about the ERCP surgery.
My boss has never done any similar surgery, so it is very important to do it before the surgery.
Luo Hao used the system surgery training time carefully.
The first operation, 70% completion.
Luo Hao regained his composure in an instant. There was an operation that was very difficult when the Nets were removing stones, and they needed to keep improving.
But this is secondary.
After one operation, Luo Hao realized that some consumables may not always be available.
After thinking about it for a while, Luo Hao took out his mobile phone and made a call.
"Manager Yin, I remember that the company invested in a medical device company three years ago."
"Mr. Luo, yes." A low, magnetic voice came from the other side of the phone.
"Are there any ERCP surgical supplies? I need them urgently." Luo Hao made the request.
After selling his Bitcoin that year, Luo Hao put part of his money in a trust company with a long history in Xiangjiang.
But the rich die in trust.
A trust company in China caused heavy losses to many high-net-worth families. After that, Luo Hao took out 75% of the funds, half of which was deposited in the bank for fixed term, and the other part established two companies - Luo Lin Real estate company, Luo Lin Investment Company.
There are professional managers in charge of taking care of it, so Luo Hao doesn’t need to worry.
He vaguely remembered that he had invested in a domestic medical consumables company, and he happened to be in need now.
Luo Hao glanced at the system panel in the upper right corner of his field of vision, and the luck value of 33 was shining brightly.
"Mr. Luo, I will provide the relevant content within 30 minutes..."
"No need to be so detailed. If there are consumables for ercp, please help Manager Yin find one for me. For surgery. If not, buy one temporarily, or bring me the supplies through the channels of a medical consumables company. "
The other side of the phone fell into silence.
"Okay, that's it. I'm busy here. I'm waiting for your news, Manager Yin."
"Okay, Mr. Luo, as you wish."
After hanging up the phone , Luo Hao once again entered the system operating room and began surgical training.
A few minutes later, Luo Hao left the fire escape with satisfaction.
The surgery completion rate was 100%. Although the cost was that all the system surgery training time was consumed, Luo Hao was still very satisfied.
Back at the doctor's office, Chen Yong was busy writing medical records without saying a word, as if he didn't know Luo Hao.
Luo Hao didn't care either, standing behind Chen Yong and watching him write medical records.
"Hey, can you stop standing behind me!" Chen Yong immediately protested.
"Sooner or later, you have to show me. I am stationed in the general surgery department on behalf of the medical office." Luo Hao said lightly.
“!!!”
Chen Yong finally understood why Master chose to go to the outpatient clinic.
Although outpatient clinics also have to deal with these gentlemen, their dealings with them are relatively few.
Md!
Chen Yong cursed in his heart and stopped talking to Luo Hao.
"Ronaldo, come here."
Just when Chen Yong was feeling awkward in every possible way, Director Wen appeared at the door of the doctor's office to greet Luo Hao.
For the first time, Chen Yong felt that Director Wen looked a bit pleasing to the eye.
"Ronaldiner, how many people in the hospital are participating in the consultation?" Wen Youren asked.
“There should be enough.”
“Should? That’s not possible.” Wen Youren was not happy, “The Department of Gastroenterology, relying on itself as an upstream department, always miscellaneates some difficult problems that should belong to them. This is an evil trend that must be stopped.”
"Director Wen, you are right." Luo Hao smiled.
"I suggest, just a suggestion, I hope Ronaldinho and Director Lin will mention it."
"Director Wen, please tell me."
"This time the whole hospital will consult me It is recommended that it be done in the form of a grand round, with directors of all departments participating. "
Luo Hao smiled happily. He saw Wen Youren dug a hole for himself and jumped into it.
After contacting Lin Yuming, there was no resistance at all. In the end, the hospital-wide consultation was held in a lecture theater.
Within 4 hours, Luo Hao made a ppt.
Although time was tight, Luo Hao still completed all this in an orderly manner.
At Wen Youren's urging, Luo Hao and he came to the lecture theater.
Most of the directors of many departments in the hospital have already arrived. Their expressions were serious, and they realized that something was wrong. Something big was going to happen today.
(End of this chapter)