From small clinic to medical empire

Chapter 74 The Game of Risk

As a scholar from West China Medical College on exchange visits to the United States, UCLA has helped Zhang Zifan apply for a temporary license to practice as a foreign doctor.

After coordination, Kuta Hospital quickly prepared a high-standard operating room.

However, because it is a major operation under general anesthesia, the patient needs to fast from food and water, so the operation cannot start until 7 o'clock in the evening.

During the period, Professor Trudeau invited Zhang Zifan to have dinner together at a good Chinese restaurant near the hospital.

It can be said that Trudeau is quite considerate.

It's a pity that neither Zhang Zifan nor Yuan Qiang is sensitive to the taste of this Chinese restaurant.

General Tso's Chicken, Siu Mai Xiao Long Bao, Fortune Cookies...

These "Chinese food" with an obvious American taste did not make the two feel the taste of their hometown.

After eating something casually and resting for a while, Dr. Russell informed that the operation could be carried out.

Zhang Zifan and Yuan Qiang immediately made preoperative preparations under the leadership of relevant personnel.

Shi Xiaoya had already entered the operating room early in the morning to prepare instruments.

Every doctor's surgical habits are very different, and the instruments they like to use are also different.

Therefore, the most important task of Shi Xiaoya's trip is to ensure that Zhang Zifan can get the convenient equipment as soon as possible.

Including the surgical microscope extracted by the system, it was also placed in the operating room after air consignment and clear sterilization.

Shi Xiaoya's English is very poor, but she still knows when she nods yes and shakes her head no, coupled with her courage, with the help of local nurses, she still sorts out the relevant equipment and equipment.

When Zhang Zifan and Yuan Qiang changed into hand washing clothes in the changing room and entered the operating room, everything was ready.

Russell and three other surgeons from Kuta Hospital also put on hand sanitizers and prepared to observe the operation.

Zhang Zifan is not very unfamiliar with this kind of onlookers.

The First Attached to S University is a teaching hospital. When he was an assistant, he was surrounded by students.

But Yuan Qiang seemed a little nervous.

Zhang Zifan encouraged in Chinese: "Just treat these foreigners as green winter melons. Believe in yourself!"

"Oh, dear Dr. Zhang, what are you talking about!"

Professor Trudeau came over with a female assistant, also wearing hand washing clothes.

The only difference is that he and the female assistant are each holding a handheld video camera.

Zhang Zifan smiled and said, "Dear Dr. Trudeau, I am telling my assistant that you Americans are really hospitable!"

Trudeau smiled and said: "Haha, you're welcome, Chinese food is my favorite, but to be honest, I still prefer our Chinese restaurants in the United States. You know, they don't use so much oil..."

Trudeau is a middle-aged man with a fat body. He has a bucket figure common to white men and pays great attention to a low-calorie diet.

Yuan Qiang nodded and looked at Professor Trudeau's figure and his green washcloth. Well, it was indeed a green winter melon. Sure enough, he was no longer nervous!
At this time, Trudeau pointed at the camera and said, "Dr. Zhang, as I said before, I need to videotape this operation. Only iron-like evidence can shut up those stupid guys!"

Zhang Zifan nodded and expressed understanding: "Don't worry, I will make them speechless."

"Haha, Dr. Zhang, you have the most humorous sense of humor among the Chinese people I have ever met. You are much more interesting than my good friend Gu."

Gu, Trudeau is referring to Gu Guoxiong.

That is, Professor Zhao Shihua's eldest disciple, it was he who took the lead to facilitate Zhang Zifan's surgery abroad.

Zhang Zifan spread his hands helplessly, but he wasn't joking.

As for whether a foreigner would steal a teacher after watching his surgery video, Zhang Zifan found it difficult.

Because of course you can learn something by watching Lu Benwei eat chicken, but it is impossible to learn the true essence of eating chicken.

……

The anesthetist has completed the patient's anesthesia, and the operation officially begins.

The patient's cancer focus was in the central area of ​​the lower lip, with an area of ​​3X4 cm, and it had accumulated to the vermilion and skin of the lips.

The first step in this major surgery is to remove the cancer.

Removal of cancerous foci can be said to be simple or difficult.

Traditionally, malignant tumors can be divided into carcinoma and sarcoma.

Cancer cells arise from mutations in epithelial cells, and sarcoma cells arise from mutations in cells such as muscle and connective tissue.

In this case of lip cancer, the epithelial cells of the lips were irradiated by strong short-wave ultraviolet rays for a long time, resulting in mutations.

In human terms, the lip cancer cell itself is homologous to the surrounding normal skin and lip red blood cells, and the junction is extremely chaotic.

Therefore, extended resection must be done.

It is better to kill three thousand by mistake than to let one go.

But there is also a problem here, wrong killing cannot go on indefinitely, can eight thousand wrong killings work?
Is it okay to kill ten thousand by mistake?

Is it okay to kill [-] by mistake?
I'll chop off the whole head to make sure the tumor is completely removed, okay?
The answer is of course no.

How to balance between reducing damage and preventing cancer cells from missing is the key to testing a doctor's level.

Professor Trudeau's hand holding the camera was slightly sweaty.

Whether Zhang Zifan can prove his worth this time is also crucial to him.

There are not one or two people who have coveted Trudeau's director position in the past two years. He urgently needs a consolidation of his position.

However, when Zhang Zifan dropped the knife, Trudeau almost cried out in surprise.

I saw that Zhang Zifan's first cut was almost close to the edge of the cancer!
The difference is no more than 4 mm!

What's happening here?
Does this Chinese doctor want to make big news for the sake of gaining attention?
Although he is a doctor of nephrology, Trudeau also knows that cutting a cancerous lesion in this way is extremely risky.

First of all, what appears to be normal lip tissue and skin tissue to the naked eye may have infiltrated cancer cells.

If you cut close to the edge like this, there is no doubt that there is a high probability of missing those infiltrating and spreading cancer cells.

This is not the most terrible.

When you cut through such a dangerous zone with a knife, the blade may also be contaminated with cancer cells.

Then when you make a cut, even if it is cut in normal tissue, the cancer cells on the blade will be transferred to the normal tissue, take root and sprout again, and form a new cancer focus.

In medicine, it is an obvious medical error to call such a situation tumor cell implantation, or implantation metastasis!
The young man in front of him who had hoped for him made such a mistake in his first move!
At this time, Russell, an Indian doctor who was also watching, also yelled in horror: "Zhang, you can't do this, you are irresponsible for the patient's life, I will report to the patient's family in detail !"

Zhang Zifan frowned.

Yuan Qiang, who has long trusted Zhang Zifan's medical skills, immediately said in unfamiliar but powerful English: "Be quiet! Don't disturb our director of surgery! Frozen sections will prove everything!"

Hearing this, Russell nodded, but still said in a deep voice: "If any cancer cells are found in the frozen section, I will immediately explain the situation to the family, and ask for the right to perform the operation, and try to make up for your mistakes! "

Zhang Zifan smiled, he didn't expect this third brother to be quite cute, and he has the responsibility of being a doctor.

"Thank you, Dr. Russell, although your precautions are worthless."

As he said that, Zhang Zifan made a second cut. This time, the cut was 1.2 centimeters away from the lesion.

(End of this chapter)