Back in 2002 as a doctor

"Go and see together." Zhou Congwen said.

Li Qinghua did not move, but glanced at Zhou Congwen's eyes.

Generally speaking, surgeons have strong hands-on ability, but if it really falls on diagnosing very rare diseases, they will be worse than physicians.

Diagnosis takes experience considerably.Some people may be dexterous about surgery, and they will accept it faster than others. This is a talent, and Li Qinghua understands it very well.

Speaking of complicated diagnoses...

He didn't believe that Zhou Congwen could be better than himself.

But Li Qinghua saw firm confidence in Zhou Congwen's eyes.

He didn't refuse, but nodded, "Thank you for your hard work, Congwen."

Chapter 0188

Along the way, Li Qinghua briefly told Zhou Congwen about the patient's condition.

Patient female, 60 years old this year.

Three years ago, the patient underwent bilateral total thyroidectomy for follicular thyroid cancer. Postoperative thyroid-stimulating hormone (TSH): 7.14mIU/mL, free thyroxine (FT4): 0.7ng/dL; he did not take Eumethalone.

A week ago, the patient came to Li Qinghua for one day because of fever, vomiting and abdominal pain.

Li Qinghua made an appointment to meet in the emergency room, and when she saw the elementary school teacher, she was already unconscious.

At that time, the body temperature was 36.7°C, the heart rate was 114 beats/min, the blood pressure was 117/58mmHg, the respiration was 18 beats/min, and the oxygen saturation was 96%. History of pulmonary embolism.

If a person has already appeared delirious, there is nothing to hesitate.Because of his critical condition, Li Qinghua directly contacted the critical patient and took the teacher in.

After the patient was admitted to the hospital, various examinations were completed. Zhou Congwen noticed that the thyroid function indicators of this admission were: TSH 0.89mIU/mL, FT4 1.25ng/dL.

Follow-up abdominal enhanced CT showed colitis; chest X-ray showed left lower lung pneumonia; therefore, he was given cefepime and metronidazole for 5 days and ertapenem for 7 days.After treatment, the clinical symptoms of the patient were relieved, and the vital signs were stable.

However, in the past one or two days, the condition that had been stable has recurred again.

What made Li Qinghua anxious was the recurrence of the disease, because although the patient was young, the cancer had spread and his body was extremely weak.

Doctors are very clear that every repetition does great harm to patients.If it is repeated several times, it may be difficult for a person to come out of the intensive care unit alive.

Zhou Congwen listened to Li Qinghua's narration silently, and did not express his opinion.After entering the People's Hospital, he took the elevator to the intensive care unit on the 7th floor. Li Qinghua hurriedly told the patient's family about the situation before changing clothes and going in.

"Qinghua, I won't go in. If it's convenient, I'll take a look at all the test sheets." Zhou Congwen said lightly.

Li Qinghua glanced at Zhou Congwen with some incomprehension.

The teacher's situation was rather troublesome. Li Qinghua highly suspected that it was multiple organ failure caused by advanced cancer.

In the words of ordinary people, this is called running out of oil, and there is no good way.

To be honest, Li Qinghua's mood is not very high today, because he is already planning to take a look and tell the teacher's lover and child to give up the rescue.

Thyroid cancer is generally mild, but only follicular carcinoma is the most serious.The teacher got follicular carcinoma, which is relatively rare, and this is fate.

I should have told Zhou Congwen that it was follicular thyroid cancer. Li Qinghua took a look at Zhou Congwen and felt helpless.It is estimated that Zhou Congwen belongs to the kind of surgeon who is extremely talented, can understand at a glance, and then can get started.

This kind of person is talented, but it should be limited to surgery.

Clinical diagnosis, treatment, and prospective judgment of successors require rich clinical experience and long practice accumulation. Zhou Congwen is still too young and lacks the time to grow up.

Although he thought so in his heart, Li Qinghua still did not refuse and nodded.

Just looking at the laboratory report and expressing concern, Li Qinghua thought about it.

Zhou Congwen sat down at random, and the lighter between the fingers of his left hand drew a graceful arc, "jumping" as if alive.

The patient's family members were about to give up. Zhou Congwen silently looked at the family members at the door with sad expressions. His son was comforting his father, but he was choked up and speechless after a few words.

The family is miserable and desolate.

The patient's son is about 30 years old, about the same age as Li Qinghua.He seemed to realize something, and after a few words of persuasion, he squatted by the wall, buried his head in his arms, and wept silently.

After more than 10 minutes, Li Qinghua came out.

He first handed Zhou Congwen a stack of laboratory test sheets, and then came to the old man.

"Mr. Xu, you know about Mr. Ma's situation."

"Qinghua, I understand everything. The last re-examination showed transfer on the ribs, and I'm mentally prepared." The old man sat on the chair, staring at Li Qinghua in a daze, weeping as he spoke.

Tears filled with sadness and inexplicable relief.

"Mr. Xu, don't be too sad." Li Qinghua comforted softly.

"I'm fine. Everyone has a day to leave. If you live and suffer, you can leave. No one can do anything about it. Qinghua, you are going to tell me that your teacher Ma is going to die." The old man's two lines of tears flowed, But his tone was flat, as if he had seen through the world of mortals.

The two emotions of sadness and indifference are mixed together, which is more moving than crying.

"Ms. Ma's condition is not good. I just talked with the critically ill doctor, and they all thought it was the failure of various organs caused by advanced cancer. Treatment... To be honest, there is nothing that can be cured." Li Qinghua said the truth with a hard heart.

"I'm going to lose my mother."

The man squatting by the wall whimpered.

"Brother Xu, just do your best, just do your best." Li Qinghua said with tears streaming down his face.

If there is no mother... This sentence makes him feel sad.

"Qinghua, if it doesn't work, just transfer out. I'd like to ask you to help me find a ward. It's best if you can be quiet. If..."

"Ms. Xu, I'll arrange the ward right away." Li Qinghua wiped away the tears from the corners of his eyes with his hands, squatted in front of the man and held his hand, and comforted him, "I think Teacher Ma is suffering a little bit, and I wanted to persuade you. It would be good if you think so too.”

"Manpower is sometimes exhausted, there is no way." Teacher Xu seemed to have aged ten years in an instant, holding Li Qinghua's hand tremblingly, "I will trouble you about the ward, and I will definitely not do anything else... ..."

"Qinghua, have you considered thyroid storm?" A clear voice interrupted the sad conversation.

Li Qinghua was startled, thyroid storm? !

It was Zhou Congwen who asked the question, and Li Qinghua's originally gentle temper also showed a trace of anxiety.

That shouldn't be asked at all.

Family members of patients and even ordinary doctors do not know what thyroid storm is.An experienced doctor would not consider this matter at all, because...the patient had undergone a total thyroidectomy.

You don't even have a thyroid gland, so where can you go to crisis? !

Li Qinghua patted Teacher Xu's hand, turned around and stood up, "Congwen, why don't you go back first? You have also seen the situation on my side, so we can't leave for the time being. Let's get together after I finish my work."

Hearing what Li Qinghua said, Zhou Congwen smiled slightly, "I think you guys forgot the possibility of thyroid storm when you diagnosed it. You didn't check for thyroid function, so now you have to check for it. Don't cry, I think it must be a thyroid problem."

"Who are you, talking nonsense here, don't you know that my mother's thyroid has been removed?" the patient's son said angrily.

If Li Qinghua hadn't been talking to Zhou Congwen, judging by his expression, he was already ready to punch Zhou Congwen.

Chapter 0189 Inexplicable Trust

"Brother Xu." Li Qinghua quickly stood in front of Zhou Congwen's body, lest the patient's family members get emotional and take action angrily, causing things to get out of control.

"Let him... go!" The patient's son still had a semblance of reason, instead of yelling, he gave Li Qinghua a face.

"Congwen, let's go." Li Qinghua patted Zhou Congwen's shoulder with a little force.

He told Zhou Congwen with body language that it's better not to talk nonsense.

Zhou Congwen didn't say anything, but smiled, "Qinghua, I don't have anything else, you need to check a Jiagong urgently, just tell me the result."

With that said, he turned and left with his hands behind his back.

Li Qinghua was stunned for a moment. Teacher Ma's thyroid gland was completely removed, and it is said that thyroid storm is absolutely impossible.

But why is Zhou Congwen so persistent?Is it necessary?

"Qinghua, is he your student?" The patient's son poured out his anger on Zhou Congwen.

When people are sad, no one knows how to vent their anger.

The patient's son was considered to be a more educated one. He didn't do anything, but cast a contemptuous look at Zhou Congwen's back as he walked away with his hands bent.

"A friend of mine is from the Third Hospital." Li Qinghua said helplessly.

The patient's son wanted to say a few words, but then he thought of his mother who was about to leave this world, and he was in no mood to dwell on strangers.He wiped away his tears, "Qinghua, I'm sorry to trouble you. Find a quiet place, and I'll accompany my mother. People can't see it in the intensive care unit, and I feel panicked."

"No trouble, everything should be done. If you and Mr. Xu agree, I'll go in and talk to the serious doctor."

Li Qinghua re-entered the intensive care unit. He walked in the corridor, heard his footsteps, and could vaguely hear his own heartbeat.

It seemed that something was wrong, but he couldn't tell what was wrong.

Li Qinghua hesitated again and again, feeling uneasy, so he simply stood down and pondered carefully.

Teacher Ma's life was about to come to an end, and Li Qinghua felt that his emotions were a little out of control.He knows very well that a doctor cannot have empathy, or else he will collapse within a year.

But Mr. Ma was really kind to him back then, and the already blurred memories from his youth flooded into his heart.Li Qinghua's nose was sour, and tears filled his eyes.

Although immersed in sadness, Li Qinghua quickly made himself sober.

There are still things to do. If people see that they are dying, then don’t try to rescue them.There is no practical significance in relying on machines to live an extra day or two. Although Mr. Ma cannot speak or move, he should be able to feel the pain.

Just like a patient after heart bypass surgery, once the ventilator is used, the patient will say that the ventilator-assisted breathing was particularly uncomfortable after extubation.Especially when there is sputum, but I can't cough it out, and I can't move my hands and feet, so I can only wait for the nurse to suck the sputum.

It felt like entering hell.

Li Qinghua didn't want Teacher Ma to leave just like that, so he concentrated his attention, and was about to go in and explain to the critically ill doctor that he had already contacted his family members, and gave up the rescue.

Find a private room for Teacher Ma, and let her walk more calmly and with dignity. As a student, I have done my best.

But just as he got his mood together, Li Qinghua's heart trembled suddenly, as if there was an idea in his subconscious reminding him of something he had forgotten.

Is that what Zhou Congwen said?Li Qinghua didn't understand why he thought so.

There will be hormones after the thyroid is removed, but I checked it when I was admitted to the hospital-the thyroid function index was TSH 0.89mIU/mL, and FT4 was 1.25ng/dL.

Li Qinghua remembered the values ​​clearly.

What Zhou Congwen said was wrong, it could not be thyroid storm, absolutely impossible.I have checked it very carefully, and there will not be too drastic changes in these few days.

Thinking in his heart, Li Qinghua stepped into the intensive care unit.

"Brother Li, do your family agree?" asked the critically ill doctor.

"I'm done explaining. I'll make a communication and I'll go to the family members to sign." Li Qinghua sighed, "I have to wait a moment. I'll contact Director Zhu and get a private room."

"Okay." The intensive care doctor didn't say much. Patients with advanced cancer have multiple metastases on their ribs, which is of no value for treatment.It is not necessary to live in a severe case for two or three thousand a day.

Seeing the intensive care doctor writing the communication, Li Qinghua subconsciously said, "Test the patient's thyroid function."

"Jiagong? It was tested in the hospital, and there is no major problem."

Li Qinghua was also taken aback, why should he trust Zhou Congwen?It's a weird feeling.

Although he said he didn't believe it, his body was very honest.Perhaps, this is the subconscious?Li Qinghua was surprised by what he just blurted out, and he thought about why for a few seconds.

Is it because he explained laparoscopic surgery to himself in the small private room just now?The professional is like my own teacher, like an expert professor in the imperial capital, so I...

But why is not important, since Zhou Congwen insisted, it would be better to do an inspection.Otherwise, what if... what if you regret it.

"Check one." Li Qinghua said firmly.

"Okay, Brother Li, what's the problem?" the intensivist asked.

"Thyroid storm ruled out."

The intensive care doctor's mouth opened, and he was astonished to the extreme.

She looked at Li Qinghua in disbelief for 3 seconds before she said, "Brother Li, no. The patient's thyroid function was fine when he was admitted to the hospital, and the thyroid gland has been removed, so there will be no thyroid storm." of."

Li Qinghua has the same brain circuit as hers, but since it has been said, let's do it.Otherwise, Li Qinghua couldn't face the anxiety in his heart.

Blood was drawn, tested, and when the blood samples were sent out, Li Qinghua was in the contact room.

The prince of thoracic surgery still has face, Director Zhu agreed without hesitation, and went to do the work of patients, and immediately vacated a single room.

It is too offensive to vacate a single room in the middle of the night, and the director must be involved.

"Brother Li, you are really amazing, you can get a single room if you want one." The critically ill doctor said enviously.

Li Qinghua shook his head and said nothing.

He silently sat beside Teacher Ma's bed, and gently held his hand with loose skin and loss of vitality.

Li Qinghua could feel the vitality disappearing in Mr. Ma's body. Maybe only 24 hours, maybe only 12 hours, before Mr. Ma would leave this world.

It would be great if there was a flashback, and I could say a few words, Li Qinghua thought wildly.