Medical trouble seems to be a relatively modern term.
Because of the massive information brought by high-speed Internet, many things have become more and more transparent. Coupled with the rapid increase in human lifespan, people's expectations for medical care are also rising. With a large amount of medical information + high expectations + some media hype + a relatively complete medical compensation system, the contradiction between doctors and patients has become increasingly irreconcilable. 【1】
Medical treatment in the 19th century was not that troublesome. There were not many diseases that could be diagnosed, and there were very few drugs available. They were basically things that could be found on the periodic table of elements.
"First Evolution"
Generally, the more poisonous a "drug" is, the more likely it is to become a miracle drug in the eyes of patients, because the body reacts violently, and a response is effective. If the person dies. If the toxicity is too great and a patient accidentally dies, it is because of his serious illness and has nothing to do with doctors or drugs.
Surgery does not seem to use much medicine, and the results of operations are often either death or disability, but the people who go to the operating table are dying people. If you die, you will not lose, if you are disabled, you will gain, so there is nothing to complain about.
At the Municipal General Hospital, Kawei saw patients being covered with white cloths every day, but crying was not common, and no one was making trouble. Losing a loved one can bring about a lot of legacy in addition to some sadness, but there is no legal support for compensation for medical failure, so there is nothing to fuss about.
Looking at the knife in this guy's hand, Kawei's first thought was not medical trouble. Because even death can be endured, what else cannot be endured?
"That quack doctor took away my love!" The man who was pressed under Hills roared, "He took away my love! Linette is going to marry someone else!"
Kavi:? ? ?
Hills opened his palm and kicked away the knife: "If you have anything to say, wait until the patrol officers come and talk to them."
"There's nothing to say." The man suddenly laughed, "As long as Olgi dies, hahaha, as long as he dies!!!"
"madman......"
The doorman was quickly in place, replacing Hills, and patrol officers were on their way. But the matter is not over yet. Now there is a doctor lying in the surgeon's office who is in urgent need of rescue.
Kawei came very suddenly. Under normal circumstances, Hills would not have kicked him away, but he would never have shown much enthusiasm. He is not a saint, he cannot distinguish between public and private affairs, and he cannot even control his emotions perfectly on the operating table.
But the situation was different now. Hills felt a little "happy" in her heart, so she pulled Kawei and ran to the office.
He didn't know that this was actually a kind of dependence hidden deep in his heart, because the murderer said that Orji was very seriously injured.
There were many people around the office. In addition to doctors and nurses, there were also many patients who came to "join in the fun." The patients who were originally on the operating table for people to watch have become spectators, and the doctors who operate on the patients have become commodities to be watched.
"Stop looking, there's nothing to see. Go back and lie down." Hills separated the crowd and asked as soon as he entered the office, "How is Teacher Orji?"
"The situation is not good, there is too much bleeding." The person doing first aid in the office is Dr. Lockard, who previously attended the regular meeting of the College of Surgery. "The injuries to the shoulder and arm are not bad, but the most troublesome thing is that it was stabbed in the stomach. This incision cannot stop the bleeding alone, so the teacher needs to operate immediately."
Carvey walked behind Hills, at a slower pace.
In addition to coming here to see Orji's injury, he also wanted to see if there were any suitable mothers in the ward. After all, Orji is a doctor at Graze Hospital, and it is Graze Hospital itself that has to save people. Kawei is not easy to overstep, and the purpose of coming here is to solve the problem of the efficacy of oxytocin.
The office was full of bloody footprints, and there was a lot of bleeding.
The vest on his body was unbuttoned, and his white shirt turned bright red. Kawei couldn't see clearly from a distance, and could only vaguely see that he was still holding a coat in his hand. Apparently, he was attacked when he was changing clothes and getting ready to leave work.
"Teacher, teacher~"
Orgi closed his eyes and could hear the sounds in his ears, and there was a reaction on his face, but he was completely speechless: "..."
Hills was very worried. He stepped forward to take a look at the injury, then turned around and called Kawei's name: "Doctor Kawei!"
"I am here......"
Kawei stood at the outermost edge of the rescue crowd, standing closer than the patients who were watching. He didn't talk nonsense, because once he did, he would list Dr. Orji as his patient.
Since he is his own patient, his nature is different, and all subsequent rescue measures must be under his own command.
"There are already enough people rescuing, and I can't help much even if I come in." Kawei said, "Actually, no matter how injured you are, you have to do surgery first to stop the bleeding."
"Kavi?"
"Yes, it's me."
Lockard also attended the regular surgery meeting and reported on the iliac blood vessel blocking technique during amputation, so I naturally got to know him. Like Hills, he was not in the mood for small talk now: "There's too much bleeding, go get some more gauze!!!"
"By the way, push a stretcher cart and let the theater prepare for the operation. Hurry!!!" Hills also joined the first aid team. "The position of this knife is too bad. I'm afraid it has cut off the intestines and even cut the spleen. , otherwise there wouldn’t be so much bleeding.”
"This guy is too cruel, he just wants the teacher's life!"
Hills took Lockard's gauze, pressed the wound on his stomach, and asked, "How is the shoulder injury?"
"I've checked, and it's fine. No major blood vessels have been injured. I've just done a temporary bandage, and the bleeding is very small."
"What about the arm?"
"It's just a skin injury."
"The most troublesome thing is my stomach."
"I think we need to open the abdomen immediately and perform intestinal anastomosis..." Lockard doesn't know much about the spleen, "But if the spleen is really ruptured, what should we do? Directly perform splenectomy?" [ 2】
"I don't know either." Hills has almost no experience in trauma management and has only learned one or two splenectomy cases in textbooks. "If the bleeding is severe, the only option is to remove it..."
Seeing that something was wrong in the atmosphere, Kawei asked abruptly: "Haven't you ever had a splenectomy?"
"..."
"Watch it? You haven't even seen it, have you?"
"..."
These two sentences made the atmosphere in the entire office extremely depressing. Orgi's face was pale, and the two young surgeons were even paler. They had no confidence in the upcoming operation.
If one of the two people fell in a pool of blood, Orji, as the chief of surgery, might have had an accurate surgical plan. Right or wrong, it is better to do something before death than to do nothing.
As for confidence, that is something a mature surgeon must have, and it has nothing to do with the difficulty of the surgery he faces.
After the two nurses left, Kawei's vision finally improved, and he could see clearly the abdominal wound they were dealing with: "There's so much bleeding?"
"Yeah, can't stop."
Kawei felt strange: "Wait a minute, don't you think there is a strange smell in the office?"
"odor?"
"What smell?"
"gunpowder."
Kawei shrugged his nose and walked back following the faint smell of gunpowder. He found the door of the office and quickly picked up a pistol from the door: "A gun was fired just now. Didn't you hear the gunshot?"
"I did hear a noise before, but I didn't expect it to be a gun."
"That guy actually has a gun!" Hills looked at Orji, his heart full of anger, "The teacher is the best surgeon at Graz Hospital, and he is the one who ensured that I was the chief surgeon. If anything happens to the teacher, ..."
"Don't think too much." Lockard consoled him, "Actually, what the teacher did was inappropriate."
"What's wrong?" Hills was a little excited. "He just did what a kind and normal person should do."
"But he violated professional ethics after all."
"Should you be cut off if you violate professional ethics?"
Kawei didn't know what the two were talking about, and he was not interested in the complicated reasons for the medical trouble. The appearance of the pistol allowed him to see that there was something fishy about Orgi's injury. After all, a ruptured spleen was an internal bleeding. Even if there was blood gushing out from the body surface, it would not flow everywhere under the pressure of so many gauze.
He walked up to Hills and finally saw the problem: "You pressed in the wrong position."
"What's the meaning?"
"You only saw stab wounds, not gunshot wounds." Kawei moved Hills' hand to the right, "You have to press it here."
Hills' fingers felt the warmth of blood again, and the gunshot wound was located in the middle of Orji's abdomen. The gushing blood and several stab wounds made them ignore the small holes in their shirts: "In this position, there won't even be a liver...that hateful guy, we must hang him!!!"
"do not talk......"
Lockard is different from Hills. He is a student that Orgi brought up from medical school, and his relationship will only be deeper than Hills. But he still found it difficult to agree with the teacher's approach: "This cannot be blamed on Mr. Nodil."
While the two were discussing the motive for the murder, Kawei looked around and found Orji's surgical instrument box: "You have time to talk about this, why not do the surgery as soon as possible."
"We're waiting for the stretcher."
"Why wait?" Kawei moved the equipment box over. "Whether we go there or not, will the surgery be done differently? Or do you also have to follow my example of pre-operative disinfection?"
There are a few things in the equipment box, not as miscellaneous as Ignatz put it, but it is enough for simple hemostasis during abdominal surgery. Although the amount of Orgi's bleeding seemed exaggerated, it was not to the point of being directly sentenced to death. At least Kawei could barely feel his pulse.
He took out the scalpel from the box and didn't have time to argue with them. He asked directly: "Should you do it or should I do it?"
Hills and Lockard looked at each other: "You do it."
"Come on a nurse to drive away the people outside and keep them quiet." Kawei immediately took over the power and directed the team that had been temporarily set up in the room. "Come on and bring in two more to pull the desks over and act as temporary The operating table. Hills went to prepare the ether, and Lockard went to find the equipment box for laparotomy. The set in my hand should be for amputation. "
"good."
...
In just two minutes, the originally chaotic ward gradually became orderly.
The onlookers were sent back to their beds, and the office where the crime occurred became a temporary operating room. Kawei's scalpel had already cut open Orji's stomach: "This knife feels pretty good."
"After all, the hospital spends a lot of money and is never stingy in terms of equipment." Hills used crow's beak forceps and tweezers to take over the skin cut by Kawei. "What kind of surgery are we going to do this time?"
Kawei shook his head: "I don't know."
"have no idea???"
"How will I know what to do if I don't cut it open to see what's going on in my stomach."
In the 19th century, one of the criteria for evaluating the quality of doctors was the speed of diagnosis.
The fewer questions you ask, the better. It is the most correct way to make a judgment with a very positive tone after just two glances, because this way the patient will believe you. But Kawei has long developed the habit of not jumping to conclusions easily. This is the attitude a doctor should have towards his patients.
Hills took out the needle and thread from the equipment box: "Here, suture."
Kawei's amputation left a deep impression on Hills, but Kawei's choice was different this time: "With such a serious knife and gunshot wound, we don't need to worry about the bleeding around the incision. We will enter the abdomen as soon as possible."
The scalpel's cutting was faster and rougher than before in the surgical theater. After incising the muscles in two or three strokes, Kawei quickly opened the peritoneum: "No blood clotting."
"A lot of blood clots."
"Where is the attractor?" Kawei looked around, "I want the attractor!"
"Come on, come on, the suction device is here!" Lockard was carrying two equipment boxes and a long suction device tube, and opened the door. "Everything is here."
"Hurry up to the stage." Carvey dug out several crow's beak pliers from the box, "Hiles will draw blood, and the nurse will report the heart rate."
"Heart rate..."
The nurse in the ward was not yet skilled and could not keep up with Kawei’s rhythm. Just when she was looking down for the stethoscope, Kawei had already pinched Orji’s right hand: “110, 120 at most, it’s a bit troublesome. "
Hills kept shaking the handle of the suction device in his hand, and the semi-coagulated blood was quickly extracted from Orji's abdominal cavity, and a glass bottle was quickly filled.
"There is a tear in the spleen." Kawei's eyes were sharp. He pushed the intestines slightly to open up some vision and saw a hematoma under the spleen capsule. "There was only a small tear in the spleen capsule. The bleeding was not much. The blood in the abdominal cavity was It didn’t cause the clot.”
"Where is that? Is it really the liver?"
"Don't be anxious, you have to take your time to find the blood spots." Kawei didn't say much, and used a retractor to pull open the skin on the other side: "There is indeed a tear on the lower edge of the left lobe of the liver, and there are also scorch marks."
"If the spleen is ruptured, it can be cut off. Does it mean that if the liver is ruptured, it should be cut off as well?"
"Who said the spleen needs to be cut off if it's ruptured?" Kawei moved the suction nozzle in Hills' hand toward the liver, "The spleen has very little bleeding, it's just a hematoma, and a simple suture will be done later. The trouble is still the liver..."
Being born in a safe country was a blessing, but it also made Kawi less experienced. He really didn't deal with many gunshot wounds. Most of them were injuries to bones, muscles and blood vessels. It was really the first time that he had punctured the liver.
This time is also a challenge for him.
