The second-hand Jetta, which was probably new, whined and sent Ling Ran from the Xiagou Clinic to Yunhua Hospital at three o'clock in the morning.
Ling Ran manipulated the car with a concentrated expression, like a racing driver, making the dial speed infinitely close to 35 kilometers per hour on the road with a speed limit of 35 kilometers per hour.
I hurried to the hospital, it was just a quarter past three.
Ling Ran finally breathed a sigh of relief. Yesterday sent Meng Xue and others away, and he wrote a paper for a while, so that he didn't go to bed until almost 10 o'clock, and barely got up until almost 3 o'clock. Well we're going to be late.
After washing thoroughly in the operation area as usual, and changing into a new pair of underwear, Ling Ran finally felt that he had recovered.
Since he got the operation fee, the most purchased product is underwear. Moreover, as the operation time gets longer and the precision of the operation becomes higher and higher, the most important thing is that the income is getting higher and higher, and the underwear Ling Ran buys is getting more and more expensive. This is very in line with economic laws. Being a doctor Standing in the operating room for ten to twelve hours a day, and six hours of non-naked sleeping, buying clothes other than underwear is a complete waste.
The air in the operating area is clean, the temperature is constant, and it has a charming "nothing" smell.
Ling Ran was wearing a washing suit and new slippery, soft and tight-fitting underwear, walking with ease.
Entering the lounge again, Lu Wenbin happened to bring out a pot of steaming braised pork.
There is a slight yellow hidden in the brown of the stewed meat, and it trembles slightly with the bumps of the aluminum basin.
The six doctors on the night shift, plus one Ma Yanlin, cheered together. Everyone held the bowl with one hand, and operated WeChat to send money to Lu Wenbin with the other. The movements were neat and skillful, as if they had done it a thousand times .
"After a night's work, it's great to be able to have supper in the end." Zheng Pei, a senior resident, sighed repeatedly. He accurately pulled out a pig's tail and inserted it directly with chopsticks. After confirming the ownership , and put it into his own bowl with a smile.
Lu Wenbin put an extra serving of rice, pickles, and cold vegetables on Ling Ran's usual seat, and said with a smile, "We'll have rice for breakfast today. What kind of meat does Doctor Ling want?"
"Cut a piece of pork belly for me, and put it directly on the rice." Under normal circumstances, Ling Ran would have more than six hours of surgery in the morning before eating his second meal. His appetite for breakfast was excellent.
Lu Wenbin seemed to have guessed Ling Ran's choice, smiled evilly, and said, "I have better ones."
As he said that, he took out a steaming pot from the small kitchen, opened it, and saw a plate of pork belly cut into strips, steaming hot.
"Sauced meat with preserved vegetables?" Zheng Pei had a pig's tail dangling from his mouth, and couldn't speak clearly.
"Tiaozi Meat." Lu Wenbin smiled triumphantly, and said, "The main point of Shaanxi famous dishes is that the meat is tender, tasty, fat but not greasy. I have a secret for this."
"What's the secret?" Several doctors looked at the strips of meat Lu Wenbin held in his hands, and they cooperated one by one.
Lu Wenbin said mysteriously: "Put the sweet potatoes. Absorb the oil."
"oh… "
Everyone let out perfunctory sighs of emotion.
Lu Wenbin snorted twice, put the plate in front of Ling Ran first, took two of the largest and best strips of meat, covered him with hot bowls, and put them back on the table.
A group of extremely hungry doctors on duty, like vultures, pinched their bellies with one hand and wiped out the sliver of meat with the other.
"Cut the meat and go."
"Go together."
After eating and drinking enough, several residents returned to the treatment room with their waists supported, ready to play with debridement and suture for a while.
In the emergency department of a hospital of Yunyi’s scale, there is no shortage of patients with debridement and sutures at any time. Cutting meat and cutting meat is basically a compulsory course for young doctors.
Ling Ran took out the pad tethered in the lounge, and watched the MRI film of the first operation today while drinking tea.
He will not enter the operating room when he is just full. A full meal affects his thinking and judgment, but the judgment at the beginning of the operation will affect the entire operation process.
Lu Wenbin didn't need to remind, he called another Gui Peisheng to help clean up the pots and pans, and took Ma Yanlin himself, and rushed to the operating room to confirm various preoperative procedures.
After a while, Lu Wenbin returned to the waiting room, first briefly introduced the patient's situation, and then said in a slightly embarrassed way: "The patient has a history of smoking for 15 years."
"You started smoking at 16?"
"Yes. I asked the family members, and they said that they need at least two packs of cigarettes a day." Lu Wenbin paused, and said, "I think there may be more than that."
"Does the patient intend to quit smoking?" Ling Ran asked. If you can't quit smoking, there is no need to replant the amputated finger. As long as one cigarette is needed after the operation, the reattached finger will turn black and die.
The most important thing in the replantation of severed fingers is the blood supply, which is supported by tiny blood vessels, and the tiny blood vessels are most prone to thrombus. For this reason, when the severed finger is recovering in the early stage of replantation, the skin must be cut continuously to use heparin to resist blood clotting. Nicotine has the opposite effect. The dose in cigarettes is too large. The vasospasm caused by it will easily cause blood clots. At that time, no matter whether it is amputation or a little bit of necrotic part, it will cause secondary damage, which is meaningless and irrelevant. It is a waste of time and money, and the patient has to suffer more, it is better to amputate.
Lu Wenbin curled his lips and said, "Tell them that if they don't quit smoking, they will have to amputate their limbs. They must choose to quit smoking, but people forget the pain after their scars heal. With 15 years of smoking history, how can it be so easy to quit."
Ma Yanlin came from the hand surgery rotation, but said: "I have heard that there are patients who cleanly say that they will die of smoking."
Lu Wenbin was surprised: "The result?"
Ma Yanlin glanced at him and said: "The result must be that the patient's willingness is the greatest. If he wants to smoke, you forcefully replant the amputated limb, and then cut it off later. Isn't that equivalent to cheating on medical expenses? The director, the patient, and the patient's family members After repeated confirmation, the limb was amputated."
"That's easy." Lu Wenbin chuckled, "It might take three to four hours to replant a severed limb, and half a year to recover. A cigarette is ruined. It's better to make a decision in advance."
"Yes, if the patient can make a good decision, we can relax." Ma Yanlin nodded in agreement. Microsurgery is the hardest part of surgery. The operation time is extraordinarily long and the pressure is high. After a long operation, the doctor naturally hopes to get something from his labor, not just personal income, but also a sense of recognition and accomplishment.
Seeing patients unable to bear the temptation and lighting up cigarettes with a fluke mentality, for doctors, it can be said to be devastated.
"Doctor Ling, what should we do?" Lu Wenbin looked at Ling Ran.
Patients can decide whether to replant or amputate a severed finger, and doctors can also make a normative decision.
Many foreign doctors now refuse to replant severed fingers for smokers, and other bad living habits such as alcoholism will also be rejected. Now, there are similar arguments in China. Provincial Qi Zhenhai and Dean Liu of the Army General Academy had argued over this.
Ling Ran fell silent.
To be honest, he really had no such experience.
"Doctor Ling, do you want to meet the patient's family?" Lu Wenbin asked.
Many doctors like to chat with the patient or the patient's family members before deciding on this kind of decision. Huo Congjun is a typical example. He is a carefree old military doctor, but he is good at reading people.
Ling Ran only thought for a few seconds before shaking his head without hesitation: "We don't need to see each other again. Has the patient's family decided to replant the severed finger?"
"yes."
"Is the informed consent bookmarked?"
"Signed."
"You check the other documents again, and then ask the family members for their opinions. If they still decide to replant the severed finger, we will do it." Ling Ran's answer was somewhat unexpected to Lu Wenbin and Ma Yanlin.
Lu Wenbin had no choice but to remind Ling Ran: "The patient said he wanted to quit smoking, but smoking is very difficult to quit, especially if you have been a smoker for more than ten years. It is not as easy as quitting opium."
"We can only support his current decision." Ling Ran paused, looked at Lu Wenbin and Ma Yanlin, and said, "What do you think?"
The two thought about it carefully, but they couldn't say anything against it.
The patient may or may not quit smoking, and the final outcome is anyone's guess or influence.
In democratic European and American countries, doctors may decide to do or not to do it. As long as they write medical opinions that conform to the norms, there will be no problems. Domestic doctors don't necessarily care about their hours of labor.
Lu Wenbin originally thought that Ling Ran was a doctor who cared about time and efficiency, but he found that he hardly hesitated when making decisions.
Lu Wenbin muttered to himself, and checked with the patient's family again.
Ten minutes later, Ling Ran, Lu Wenbin, and Ma Yanlin went into battle together to deal with the pollutants and necrotic tissue on the surgical site, and trim the damaged part.