"Doctor Jian, the Neurosurgery Intensive Care Unit has just admitted a stroke patient from the emergency room. His condition is very critical. Please come over immediately."
A nurse hurried into the office and said anxiously.
Jian Jianyun immediately stood up and walked to the door: "I'll go over right away. You can tell me about the patient's condition first."
"The patient was brought to the hospital by a friend who called 120. It is said that the two met for fishing in the suburbs. In the morning, he began to feel dizzy, but he did not pay attention to it. In the afternoon, the patient's headache worsened, his hands and feet were numb, and he suddenly lost consciousness and fell into a coma. Not awake."
"After emergency admission, the emergency department examination found that the patient's head CT showed massive brainstem bleeding, and the bleeding volume had exceeded 11 ml. The patient was in a severe coma, and his spontaneous breathing rhythm was extremely disordered. The emergency department was intubated and put on a ventilator for further rescue. Enter neurosurgery.”
The nurse kept talking and described the entire situation in detail.
"Heavy brainstem bleeding? This is not good." Jian Jianyun's face suddenly became solemn. She paused and said, "Go and invite Dr. Roman here."
"If there is an operation, it will be a major operation. The director is not here right now, so he may be needed to come on stage together."
"Okay, I understand." The nurse nodded, turned around and trotted away.
Jian Jianyun quickly arrived at the intensive care unit and saw the unconscious patient.
As soon as she arrived, Dr. Roman arrived with her hind legs.
Jian Jianyun smiled and said hello, then turned his attention to the CT and looked at it intently.
Dr. Roman came over to take a look and frowned.
"Hemorrhage in the brainstem is the most dangerous form of stroke, and this patient's condition is not optimistic."
"Yes," Jian Jianyun said calmly: "The mortality rate of brainstem hemorrhage is extremely high. The mortality rate is as high as 70% if the amount of bleeding is less than 5 ml. The mortality rate is greater than 90% if the amount of bleeding exceeds 5 ml. If the amount of bleeding exceeds 10 ml, death will occur. The rate is almost 100%.”
"And this patient's bleeding volume was as high as 11 milliliters. We are racing against death."
Dr. Roman nodded approvingly: "Time is life. He may stop breathing and heartbeat at any time. Conservative treatment is almost impossible and surgical treatment is necessary."
"But surgical treatment also carries huge risks. We must inform the family about this and wait and see what their decision is."
A look of surprise appeared on Dr. Roman's face: "Why should the family decide? The patient has suffered massive bleeding and is unconscious. Isn't it the decision of the doctor to make the decision on surgery? Isn't it in the hands of the doctor?"
"Well, national conditions are different. In China, we need family members to sign for surgery." The attending doctor on the side explained with a somewhat embarrassed expression.
"Why? Can family members be more professional than doctors? We are the best doctors in the world." Dr. Roman looked incredulous.
"It is dangerous to leave the decision-making power to the family. What if the family makes a wrong judgment and does not agree to the surgery due to their own limitations?
The attending physician scratched his head and said angrily, "This has happened before."
"Huh?" Dr. Roman was even more shocked and asked quickly: "Who will be responsible if the patient loses his life in this situation?"
The attending physician blurted out: "Of course the family is responsible."
"Oh my God," Dr. Roman's eyes widened: "In Eagle Country, if it is emergency treatment, the doctor can make a judgment after consultation. You only need to tell the family members about the condition and treatment."
The attending physician asked doubtfully: "What if the family does not agree to the surgery?"
Dr. Roman said categorically: "The decision-making power rests with the doctor. If the family disagrees, we will still perform the operation. If we listen to the family and make a wrong judgment and fail to perform the operation, resulting in the patient's death, the hospital will be jointly and severally liable." Besides, it goes against the doctor’s conscience to ignore the patient’s death.”
This time it was the attending doctor's turn to be shocked: "Is there such a thing? It seems that our medical systems are indeed very different."
Dr. Roman said with a serious face: "This is no joke. Professional people make professional decisions, which is the correct behavior."
Jian Jianyun interrupted the conversation between the two and said, "Let us focus on the patient's condition. I will communicate with the family members and I should be able to convince them to undergo surgery."
As soon as she arrived outside the ward, a middle-aged woman rushed over and cried out: "Doctor, save my husband. He is still young, only 42 years old. He is older and younger. Both of his children are studying. We can't live without him."
Jian Jianyun smiled and explained the condition very carefully, explaining every aspect as clearly as possible.
"The patient's condition is now very critical and requires surgical treatment. Surgery is also very risky, but it is not without a glimmer of hope."
When the family members heard this, they immediately became anxious: "Then what are you waiting for? Let's do the surgery right away. My old Zhou can't afford to delay."
She was holding the consent form and was about to sign it when suddenly a hand reached over and snatched the document away.
A fat middle-aged woman, holding documents in her hand, followed by two anxious-looking old men, scolded with an unkind look: "What's the matter? Do you really want my brother to die?"
"My brother's condition is so critical. What if the operation fails and he becomes a vegetative state? Will you take care of him for the rest of his life?"
The wife said timidly: "The doctor said the operation is expected to be successful."
The fat woman sneered, with a look of disdain on her face: "Kunshi is a small place. How great are the doctors here? Fortunately, I went home for the Chinese New Year and didn't let you kill my brother. Mom and Dad, what do you think? no?"
The two old men looked at me and I looked at you, but they didn't say anything for a while.
The fat woman became even more arrogant and said triumphantly: "I asked an old classmate who works in a tertiary hospital in Haicheng. He is also a doctor. After knowing the situation, he said that surgical treatment is of little significance. It is too difficult and can easily fail."
"Wouldn't it mean that both people and money will be depleted by then? You can run away, but what if I leave my two poor nephews behind?"
Jian Jianyun couldn't stand it anymore and interrupted: "Actually, I've done this surgery many times, and it's not completely hopeless."
The fat woman did not dare to be too presumptuous with the doctor, and said coldly: "Doctor, we have to decide this matter. I have discussed it with my parents and am going to ask my classmate to contact the experts in Haishi and try to invite experts to come and perform the surgery."
Jian Jianyun looked at his wife and asked, "You are the patient's spouse and the first signatory for the surgery. Do you want to do the surgery?"
The wife looked at her parents-in-law and sister-in-law beside her, shook her head with a pale face, and whispered: "Let's discuss it some more."
Jian Jianyun sighed in her heart. If she had followed her usual approach, she would have turned around and left at this time, waiting for the family to make a decision.
However, for some reason, the image of the patient unconscious suddenly appeared in her mind.
At the same time, Dr. Roman's words also flashed through his mind one by one.
"The decision to perform surgery should be in the hands of the doctor."
"It goes against the doctor's conscience to ignore the patient's death."
Jian Jian Yun made up his mind instantly and did not leave as usual. Instead, he walked up to the fat woman and asked with a smile: "I would like to ask, which hospital in Hai City is your classmate a doctor?"
The fat woman said with a proud look on her face: "How about Ruiqi Hospital? This is one of the best hospitals in the country. I will hire an expert from there to do the surgery later. They are not much better than you."
Jian Lian Yun smiled faintly: "Oh, I forgot to mention it. Before I came to Kunming, I worked at Ruiqi Hospital. My father was the director of the oncology department. I grew up in Ruiqi since I was a child. I know all the uncles in all departments. .”
"I'm familiar with neurosurgery from top to bottom. I haven't heard from my dad about any new and powerful people in the past few years. I wonder which expert you want to invite?"
"If you know the name, you might as well tell me and I can invite it for you without your classmates having to intervene."
The fat woman was immediately confused. Her old classmate said he wanted to hire an expert for her, but he didn't tell her who it was.
Her face was green and white, her lips were trembling, and she couldn't say anything.
At this time, Jian Jianyun said again: "If you don't believe me, you don't need to look far away to find a neurosurgery expert."
"In fact, Dr. Roman, the director of neurosurgery at the Cleveland Clinic, the best hospital in Eagle Country, has been studying and communicating with us in our hospital these days. If he were to perform the surgery on the patient, would you be willing?"
The fat woman was shocked for a moment, and after a while she said in a trembling voice: "Eagle, are you an expert from the Eagle Kingdom? That's okay, it saves me the time of going to Haishi to hire an expert."
The two old men on the side also showed expressions of surprise.
Seeing that there seemed to be something going on, Jian Lian Yun called Dr. Roman out.
Sure enough, when Dr. Roman, wearing a white coat and looking exotic, showed up, he only said a few words of hello and hello, which shocked the patient's family.
But he went back quickly, and the whole process from appearance to disappearance took less than a minute.
But the patient's family members were completely relieved, almost cheering, and signed the consent form at the speed of light.
Jian Lian Yun shook his head secretly, feeling a little uncomfortable in his heart.
But saving people was the most important thing now. She didn't have time to think too much and immediately started preoperative preparations.
In the previous endoscopic surgeries for brainstem hemorrhage, the bleeding volume was less than 10 ml.
Although everything went smoothly, there is still a gap in difficulty compared to an operation with a blood loss of 11 milliliters.
For neurosurgeons, ordinary craniotomy is already very complicated and dangerous, and operating on the brainstem is even more difficult.
Once important nuclei in the brainstem are damaged, the patient can die at any time during surgery.
Brainstem surgery is recognized as the most difficult area in the field of neurosurgery, and is regarded as an operation that is difficult to complete in most hospitals in the country.
Even the most experienced neurosurgery experts dare not say that they are completely sure.
Not to mention brainstem surgery in which the blood loss exceeds 10 milliliters and the mortality rate is as high as 100%.
This is also a severe challenge for her.
When Jian Jian Yun thought about the difficulties he was about to face, not only did he not have any intention of shrinking, but he was trembling all over and his scalp was numb with excitement.
She will lead the team to enter the restricted area of life, challenge the most difficult operation in the field of neurosurgery, and fight for the only hope of survival for the patient and the family behind him.
Isn't that what she means as a doctor?
The patient was quickly pushed into the operating room.
Dr. Roman has been instructing every aspect of the surgery without stopping, even when he was brushing his hands in the operating room.
"Young lady, I admire your courage very much. Since you are confident to be the chief surgeon, I can only remind you that precise positioning is the most difficult part, followed by the operation during the operation, but the most important thing is to maintain the feel. Stablize."
"Under extremely high magnification, the basic skills of the surgeon will be clearly demonstrated."
"I have seen many talented young doctors, but due to insufficient experience, they all have varying degrees of hand tremors under high-power microscopes, and they often have to interrupt operations and stop to adjust."
"In the field of neurosurgery, in order to be rock-solid in operating instruments, on the one hand, it requires battle experience and excellent psychological quality, and on the other hand, it requires continuous scientific training."
"This is also the reason why only those in their 40s can become neurosurgery experts. Surgery under a microscope is too delicate and demanding. Only after more than ten years of training can one achieve five or six hours without moving his hands."
Jian Jianyun smiled and said, "Dr. Roman, thank you for your concern. In fact, I am already thirty, and I am not as young as I look."
"You don't have to worry about this. Although I have only been a neurosurgeon for five years, I have many years of experience in skull base tumor surgery, which adds up to more than ten years."
"In addition, when I was 6 years old, I started dissecting frogs and rabbits at home. From then on, I dissected all the meat our family ate."
"Speaking of which, but for your reminder, I didn't realize that time flies by so fast and I have had surgeries for more than ten years."
She breathed a long sigh of relief, put aside these words, turned around and walked into the operating room.
"Craniotomy microscopic brainstem hematoma evacuation begins."
Standing in the chief surgeon's position, Jian Lian Yun gave the starting instructions succinctly.
When the patient's brain appeared in front of her eyes, the whole world seemed to disappear.
The neuroendoscope seemed to be alive in her hands, moving forward briskly and smoothly.
The brainstem was quickly found through the base of the skull. There is dense nerve tissue everywhere, and a slight carelessness will put the patient's life in danger.
Jian Jian Yun stared at the microscope without blinking, gently avoiding the nerve-dense areas.
She found a breakthrough point in the surgical approach where a superficial hematoma was about to break out.
Her movements became lighter and more gentle, moving between square inches.
The brainstem was lightly scratched and an incision was made.
Jian Jian Yun picked up the suction device and prepared to drain the hematoma inside.
However, the suction device sucked, but it didn't work at all.
Upon closer inspection, it turned out that the hematoma inside had clotted and could not be sucked out.
Countless thoughts flashed through Jian Jian Yun's mind instantly.
what to do?
How can I suck out the lump inside?
Damn it, why is my mind so messed up but I can't think of anything.
Jian Lian Yun was so anxious that beads of sweat appeared on his forehead.
At this critical moment, a serious voice suddenly came from the side.
"Use pliers to remove the blood clot bit by bit."
Hearing this voice, Jian Jianyun immediately calmed down.
"That's right, use forceps instead, just like you used to remove the tumor."
She replaced the suction device in her hand with pliers and took out the blood clot bit by bit.
When the last bit of blood clot was removed, the whole operating room let out a cheer.
Everyone had a happy smile on their face.
Jian Jianyun glanced at the clock. Five and a half hours had passed, and a stone fell from his heart.
After more than five hours of hard work, with the tacit cooperation of the entire surgical team, the patient was finally brought back from the brink of death.
She put down the endoscope in her hand and felt that her back was soaked and her legs were a little numb.
Dr. Roman's hearty laughter rang out: "Dr. Jane, the operation was successful. Congratulations."
Jian Lian Yun nodded slightly. She no longer had the strength to smile.
Soon, the attending doctor took over the follow-up work.
Jian Jian Yun Shen walked out of the operating room one step at a time, with Dr. Roman following closely behind her.
The fat woman who had been waiting outside the door let out a scream, crossed the concise cloud, and rushed straight to Dr. Roman. She shouted in surprise: "Doctor, is the operation over? How is my brother?"
Dr. Roman smiled and nodded, and the family members burst into cheers.
They surrounded Dr. Roman and asked questions.
Dr. Roman looked at the family members surrounding him, and the smile on his face gradually disappeared, replaced by faint anger.
"Give way." He said with a straight face. The family members looked at each other and quickly got out of the way.
Dr. Luo Man quickly came to Jian Lian Yun, pointed at her, and said loudly to the family members.
"The operation was successful, but I did not operate on the patient. She was the one who performed the entire operation."
"She is the one you should thank."
"It was her who brought your relatives back from the brink of death."
"She is the best and hardest-working doctor I have ever seen. She is much better than me."
"You should believe that Chinese doctors are no worse than us. In fact, I came to Kunming this time just to study."
The family members were stunned when they heard what the translator said.
Only then did they realize that it was the female doctor from Kunming who performed the surgery, not the foreign expert.
The fact that foreign experts actually came to Kunming for further study completely broke their inherent impression.
"It turns out that doctors in Kunming are better than foreign experts."
"It's really hard to see that at such a young age, foreigners are so convinced of her."
"That's great. You don't have to go to Shanghai for surgery in the future."
The family members once again marveled, but this time they surrounded Jian Jian in a cloud, expressing their gratitude one after another.
The fat woman came forward with a look of shame on her face, lowered her head and apologized: "I'm sorry, I said the wrong thing before."
"Doctor, thank you for saving my brother's life."
Jian Jianyun looked at the scene in front of him, his eyes bright and the corners of his mouth raised.
I felt all the fatigue disappear.
