Back in 2002 as a doctor

He didn't feel anything special, but the pain was severe.

Seeing that the patient's condition was very simple, only multiple rib fractures on the right side, Li Ran was relieved.

He took a pen and paper to record everything the patient narrated, and then went to the office to write the medical record.Fortunately, I went to bed early yesterday and was able to finish my work early in the morning.

But before the medical record was finished, the nurse called Li Ran and told him that the patient reported severe pain and asked him to take a look.

With so many broken ribs, it will definitely hurt. What's so strange about this, Li Ran didn't take it seriously at first.

But when he went to see the patients in the ward, he found something was wrong.

Although Li Ran said he was transferred later, he has seen dozens of patients with rib fractures after working in the Thoracic Surgery Department of the Third Hospital for half a year, and he has never seen anyone in such severe pain.

It's not that the patient is being hypocritical, but that it really hurts, and beads of sweat are dripping down.

What's going on here?Li Ran was at a loss.

Doctors who have just been working for two years know some common medical knowledge, but they are definitely not experienced.

Not even the old nurse in Corey sometimes.

What is written in the book and the patients actually met are two completely different concepts.

Li Ran auscultated the patient with a stethoscope, the breathing sounds of both lungs were clear, and there was no obvious sign of pneumothorax.

Afraid that he heard it wrong, Li Ran decided to ask the patient to have a CT scan.

Although chest tightness, shortness of breath and pain of pneumothorax are two different concepts, Li Ran was a little at a loss, not knowing what he should do now.

Subconsciously, Li Ran felt that something was wrong with the patient, but he couldn't tell what was wrong.

Communicating with the patient, his family members had not yet arrived, and Li Ran was worried about an accident, so he took the first-aid medicine box and pushed the patient to the CT room for examination.

The man who was on duty today was the buddy who lived in the same dormitory as Li Ran. He did sit-ups all night. When Li Ran called him out, he had a bad temper, and he kept a straight face and didn't say a word.

After the CT scan, he clicked on the screen, "Li Ran, are you sleepy? The patient has no pneumothorax, but the rib fracture is quite obvious, and the dislocation can be seen on CT."

If there is no pneumothorax, that's fine, that's fine, Li Ran also let out a sigh of relief.

But the CT doctor suddenly froze, his eyes fixed on the image on the computer screen.

Li Ran felt something was wrong, looked carefully at the images twice, and asked suspiciously, "Is the thoracic aorta an artifact?"

"..." The CT doctor was silent for a few seconds, then whispered, "Why do I feel like I have a thoracic aortic dissection?"

"!!!" There was an exclamation mark on Li Ran's serious face.

Chapter 0508 This is life

CT imaging is not the most typical imaging standard for determining aortic dissection, because it is a tomographic scan, which can only be estimated initially and judged by the experience of the reviewer.

Both Li Ran and the CT doctor belonged to the kind of fledgling rookies who vaguely felt that something was wrong when watching the film, but if they really wanted to confirm the diagnosis, neither of them could do it.

"Produce a film for me, no need to issue a report, I'll call the director." Li Ran said cautiously.

The CT doctor nodded, and printed out the film to Li Ran as quickly as possible.

"Be careful, don't really have an aortic dissection, if you break it all at once, you will be gone." The CT doctor warned Li Ran carefully.

It was nonsense, but it was said anyway.

Li Ran's serious expression became more serious, and he nodded.

He did not explain anything to the patient, but told the patient that the examination was finished in as gentle a tone as possible, and with the help of the CT doctor, he tried his best to move the patient onto the flat car.

The simple movements made Li Ran feel like he was on the verge of an enemy, because every second was like a dead end, and patients with aortic dissection had the possibility of sudden sudden death.

But fortunately, the patient moved to the flat car, and there was no accident. His forehead was covered with cold sweat from the pain.

"Fuck! The fracture is really painful!" The patient cursed in a low voice.

Li Ran didn't have time to talk to him in detail, so he hurriedly pushed the flat car back to the ward, and ordered the nurse to monitor the patient's ECG and use antihypertensive drugs to control blood pressure.

For general fractures, blood pressure rises transiently, as long as analgesic treatment is enough, but analgesic treatment needs to ensure that there are no other internal organ trauma, after all, the pain mechanism is a self-protection instinct of the human body.

Clinically, trauma patients are generally not given analgesics, because doctors are not sure whether the patient has other trauma.Rashly giving analgesic drugs may cover up the condition and lead to greater accidents.

However, aortic dissection is another concept, and it is necessary to reduce blood pressure and analgesia.

The diagnosis is different, and the treatment methods are also different. After thinking about it, Li Ran still didn't dare to give analgesics immediately, but called Director Li Qinghua.

Explaining the patient's situation, Li Ran did not hide it, even if he "felt" wrong.

Li Qinghua on the other side of the phone seemed to be brushing his teeth. He began to answer vaguely, but when he heard that Li Ran thought it was aortic dissection, he immediately rinsed his mouth and told Li Ran that he would arrive as soon as possible.

Within ten minutes, Li Qinghua hurried over.

He watched the film for 2 minutes, and sighed deeply, "Give 75mg of pethidine to control blood pressure. Has the patient's family arrived?"

"Not yet, let me remind you." Li Ran knew that his "feeling" was right by seeing Li Qinghua's expression.

"Ask the patient's family to come quickly, and I will explain the patient's condition to her." Li Qinghua said in a deep voice.

Early in the morning, both Li Qinghua and Li Ran became nervous. Li Ran's already serious expression ×2 looked a little scary.

Taking medicine and contacting the patient's family members, Li Ran kept complaining in his heart, and the patient's family members really had nothing serious to do, so why didn't they come!How long has it been! !

It took a full hour for the patient's family to come over.

Li Ran was taken aback when he saw the patient's family.

It was a 22 or 3-year-old young woman who was pregnant and looked about 6 months old. Her hair was messy, her face was pale, and her eyes were full of endless confusion.

Because she was a pregnant woman, Li Ran didn't dare to urge her, and suppressed all her complaints.

"The director has seen your lover's film, and wants to tell you about his illness in person." Li Ran's expression was serious, but his tone was as gentle as possible.

"Doctor, is my husband okay?" the woman asked blankly.

Seeing that she was already in a state of bewilderment, she had no idea where she was or what she was going to do.She didn't even seem sure what was going on, it was like a dream.

"There's something wrong... let the director talk to you." Li Ran didn't dare to say more, and he took the patient's family to Li Qinghua's office.

Asking the woman to sit down, Li Ran stood aside and listened to Li Qinghua's communication with the patient's family.

Li Qinghua first asked about the patient's family situation. When he learned that the patient's parents were paralyzed in bed, and the woman was pregnant with a second child and had a 2-year-old son, Li Ran suddenly felt that Director Li Qinghua's emotions were a little broken.

And this kind of collapsed emotion reached its peak when the woman timidly said that if possible, she would trouble the doctor to spend as little money as possible, because the perpetrator was very poor, did not pay any money, and accepted the sentence.

Li Qinghua didn't dare to hide it, but explained the situation with the patient's family.

Aortic dissection aneurysm, need to go to the provincial capital for interventional surgery, after surgery can return to normal without sequelae.

But one operation costs 10,000+, hundreds of thousands...

After hearing this number, the woman seemed to be in a dream, and she was extremely confused.

After Li Qinghua said it three times, she finally understood what the doctor and herself had explained.

Facing such patients and their families, Li Qinghua and Li Ran were helpless.

Not to mention the risk of patients being transferred to the provincial capital hospital, just at their own expense, 10,000+, and the young woman's plain clothes and vicissitudes of life, they all know that the operation may not be possible.

"Doctor..." The woman said two words, and burst into tears with a "wow".

"Li Ran, call the head nurse." While comforting the patient's family, Li Qinghua told Li Ran to call someone.

After some comfort, it took more than ten minutes for the mood of the patient's family members to stabilize.

"Doctor, why don't you talk to my husband." The woman said sadly, "I don't have so much money after selling my house."

In order to break a few taels of silver, he ran around in a hurry and barely made ends meet, but unfortunately, disaster happened.

Li Qinghua sighed, this is fate.

After working in the clinic for a long time, there will naturally be a kind of "illusion" that everything is fate and cannot be controlled at all.

After thinking twice, Li Qinghua still explained his condition to the patient.

At first, the patient was a little confused and scared, but when he heard key words such as the provincial capital, 10,000+ to hundreds of thousands, he immediately said without hesitation, "Doctor, I'm fine, it's just a pain. I'll be fine in two days. Do not go to the provincial capital."

What he said was firm and there was no wiggle room.

"En." Li Qinghua nodded. He had seen many similar situations clinically, and there was nothing he could do.

This is life.

"Sign it." Li Qinghua said, "You pay attention to your emotional stability and ensure that your blood pressure is not high. We save all the money that our department can save you. There is no charge for monitors and so on. You can just pay the bed fee, eight yuan a day. money."

"As for the cheapest antihypertensive medicine, all others are stopped, and the medicine that promotes fracture healing is no longer needed. You are still young and can recover very well."

Li Qinghua rambled on for a few minutes, and Li Ran could sense that the director felt very guilty and could only do what he could do.

The patient expressed his thanks repeatedly, and Li Qinghua and Li Ran silently sighed and left the ward.

Chapter 0509

After a busy morning, Li Ran was ready to leave work after lunch.

When he came to the duty room, Li Ran sighed deeply when he thought of that "bad" patient.

He felt powerless all over his body.

Generally speaking, doctors will not bring themselves into the patient's situation with empathy, except for people like Shen Lang who gossip.

But this time the patient's situation broke Li Ran's defenses.

"Li Ran, what's the matter with you?" Shen Lang was smoking, and he had already seen that Li Ran was in a bad mood, so he asked curiously.

"Give me a cigarette." Li Ran didn't change clothes directly, but sat on the bed in the duty room, and asked Shen Lang for a cigarette with a sad face.

Shen Lang was startled, Li Ran didn't usually smoke, he must have encountered some embarrassing things.

After lighting the cigarette, Li Ran took a deep breath, coughing until he was choked.

"Hey, that's not the way you commit suicide, is it?" Shen Lang said, "What's the matter?"

Li Ran was silent for a while, and then told the situation of the patients admitted earlier in the morning.

The patient's parents are paralyzed in bed and unable to work; there is a 2-year-old son who can just walk; a young wife who is 6 months pregnant, illiterate, and presses her fingerprints when signing...

The operation costs tens or hundreds of thousands, which is unbearable for patients.

It is normal to estimate that the patient must give up treatment and go home to resign himself to fate.

Can this disease be resigned to fate?

Both Li Ran and Shen Lang couldn't speak well.

They don't encounter many aortic dissection aneurysms, but judging only by medical common sense, it must not work.

Shen Lang sighed, it's useless to hear similar "bad" things.

Doctors only care about treating diseases, as for how much they spend... How can an ordinary doctor in Jianghai City allow multinational medical device manufacturers such as Johnson & Johnson, Olympus, and Olida to cut prices?

Nonsense.

And at least 10,000+ is almost equivalent to the life savings of Shen Lang and Li Ran's parents, so helping each other will not be of much help.

Shen Lang, who was always gossip, was silent, and took a nap after hastily smoking.

If you can't solve the problem, just pretend it doesn't exist, otherwise what else can you do.

Li Ran smoked half a cigarette and threw the butt into the ashtray, with more complicated and entangled emotions on his serious face.

He changed his clothes, wrote down the patient's home address, and instead of going home, he took a taxi directly to the village where the patient's home was located.

The patient's family lives in a remote urban village.

It is said that it is an urban village, which is different from the urban villages in the first-tier cities. Jianghai City has a large area and few people, and the urban villages are remote like suburbs.

Li Ran asked the way and came to the patient's house.

It was an ordinary small bungalow, although it was dilapidated, it was kept very clean.A dirt dog guards the house, and a little boy sits at the door, chatting with the dirt dog.

Before Li Ran could enter, the earth dog bared its teeth and yelled at Li Ran.

Li Ran hesitated for a moment, instead of entering the door, he looked around.This action attracted the attention of the neighbors nearby, and an aunt came out with a kitchen knife, "What are you doing!"

Uh... He probably regarded himself as someone who stole the child, Li Ran smiled wryly.

"I'm a doctor from the Third Hospital. Zhao Xingzhu is in hospital, and I'm in charge."

After listening to Li Ran's detailed explanation, the neighbor aunt felt a little more at ease.