top student at medical school

Chapter 701 Taboos and Misdiagnosis!
"Professor Xiong, Professor Gong, Professor Yuan, let me first give a brief introduction to the patient's basic situation on behalf of our group." Qin Geluo stood in front of the demonstration room, stepped aside to make way, and then the projector screen scrolled down to refresh.

"Elderly male, 63 years old."

"The current primary diagnosis is the sequelae of bilateral lower limb trauma. Post-cystectomy, post-urethroplasty; and post-rectal injury with persistent colostomy."

"Hemipelvic defect, bilateral femoral segment defects, multiple soft tissue infections and skin infections in both lower extremities, and fungal infections."

"Type 2 diabetes, hypertension, hyperlipidemia; post-coronary artery stenting, post-abdominal aortic replacement."

"Lacunar infarction".

"Today, we mainly want to ask the professors whether this patient is suitable for surgery. If surgery is necessary, what kind of surgical treatment should be performed?" Qin Geluo finished his concise report in just over two minutes.

In the demonstration classroom, Yuan Weihong sat upright, his eyelids drooping and his eyes dull.

Fang Ziye's lips twitched uncontrollably, his right hand clenched into a fist, the knuckles of his thumb occasionally making a cracking sound.

There were quite a few people in the demonstration room, including Gong Jiahe, Xiong Zhizhang, Yuan Weihong, Chen Fang, Peng Long, Qin Geluo, Li Nuo, and Fang Ziye.

The nine people lived in a room that was so quiet you could hear a pin drop.

Qin Geluo paused for about half a minute, and when no one spoke, he braced himself and continued, "There are some more minor examination results, I..."

Professor Xiong Zhizhang tapped the table, cleared his throat, and turned to Yuan Weihong: "Young Yuan, just tell me about this patient's background."

The word "messy" is not enough to describe his current state; "utterly chaotic" is barely enough.

Yuan Weihong scratched his chin with his right fingernail, leaving white-gray marks: "Teacher Xiong, this patient has no special background. He was just strongly recommended by Director Wang of the urology department after he performed surgery on him."

Xiong Zhizhang withdrew the words he was about to say: "The situation has already become so chaotic, what are his and his family's current demands?"

Yuan Weihong said, "The old man's children are all very filial. He has a son and a daughter, and his family is in good financial condition. His current request is for our hospital to find a way to treat him."

"There's no need to worry about medical expenses. The elderly person has commercial insurance, and once the insurance coverage exceeds the limit, their children can also afford the recuperation costs."

“I have spoken with the patient’s family several times, but they just are unwilling to give up treatment.”

Xiong Zhizhang continued, "Have you been to other hospitals?"

Xiong Zhizhang's idea was that this family couldn't possibly drag Zhongnan Hospital down with their hair, could they?
Yuan Weihong knows this like the back of his hand: "The old man's son took his medical records to almost every well-known hospital in the country. If the old man hadn't been unable to move around easily, he probably would have done it all by now."

“Teacher Xiong, you must know that given the old man’s current condition, no one wants to get into trouble.”

"He was injured last November, and the surgery was performed in the emergency operating room of our Zhongnan Hospital. I personally performed his lower limb salvage surgery."

"It took a lot of effort just to save his life."

"Later, I was transferred to the urology department, and after the surgery, I kept asking to continue treatment."

“Since January of this year, Professor Wang Xinghuan from the Department of Urology has been requesting to transfer to our Department of Trauma Surgery.”

“I refused to see the patient for almost eight months, citing poor control of other specialties in the patient.”

"In the middle and late part of this month, the patient's systemic infection was brought under control, and the patient requested treatment for multiple infections and bone defects in both lower limbs; so he was transferred to our trauma surgery department."

"After being transferred to our department, we originally planned to treat the patient's bilateral lower limb infection with microcirculation transection using a microcirculation device, but the patient has segmental vascular sclerosis and is not currently suitable for microcirculation transection."

Hearing Yuan Weihong's long string of complaints, Xiong Zhizhang couldn't help but mutter under his breath, "Damn, Wang Xinghuan will stop at nothing to climb the ladder!"

Yuan Weihong had tried his best to refuse, but with Wang Xinghuan constantly endorsing him, the trauma surgery department had no choice but to accept the patient now.

Now that the patient has arrived, Yuan Weihong dares not make any rash moves: "After being transferred to my department, I have discussed the matter with the patient's family several times."

"The patient's family's minimum goal is to resolve the infection and bone defects in both lower limbs and restore normal limb function!"

"Otherwise, I demand that we continue to live here."

"Just treat it as routine rehabilitation and maintenance."

Comprehensive hospitals cannot arbitrarily refuse to treat patients, let alone expel them.

Unless it can be confirmed that the patient's condition has been cured.

However, this patient cannot be proven to be cured.

"The family has some money, so they thought of using the hospital as a kind of sanatorium."

After grumbling for a moment, Xiong Zhizhang said, "If the patient's family is really adamant, Yuan Weihong, you should go directly to the medical affairs department and the security office and suggest amputation."

"If the patient and their family insist on refusing, then we will say that the patient's family has refused the treatment and ask the hospital to find a way to make room for them."

"Given his current condition, amputation is the recommended treatment, and no one would dare to say no."

Professor Xiong Zhizhang was very helpful, immediately finding a suitable fallback plan for trauma surgery that was above the minimum acceptable level.

In hospitals, specialists can provide highly professional treatment advice, which is reflected in the medical records.

If the patient and their family refuse the treatment recommendation, they will bear the consequences themselves.

Yuan Weihong said, "Professor Xiong, if the family had been willing to have the limb amputated, they could have done it long ago. They would have chosen that option when the injury occurred."

Gong Jiahe had remained silent, maintaining a relatively objective perspective, before interrupting, "Director Yuan, when the patient was transferred to our department, did Professor Wang Xinghuan give any other specific instructions?"

Yuan Weihong shook his head: "No, they just said to think of more ways, and that the patient should be the priority."

Upon hearing this, Gong Jiahe immediately looked in the direction where Fang Ziye was.

Fang Ziye gently released his hands and slowly said, "Master, is Professor Wang testing us?"

Yuan Weihong and Xiong Zhizhang slowly turned their heads: "Testing us?"

Fang Ziye nodded: "My personal feeling is that Professor Wang's idea is to send this patient to our department first to see if we can perform extended functional reconstruction surgery."

"For example, urinary function, defecation function, sexual function, etc."

"Of course, this is just my guess."

Fang Ziye's reasoning was largely thanks to Professor Lin Peng from the China-Japan Friendship Hospital, whom he had met at the Enshi Sanatorium.

This Professor Lin only talks about dreams, never about how to make them a reality.

In his discussion of his dreams, he mentioned that he wanted to focus on the functional reconstruction of the limbs and expand it into a brand, including the reconstruction of bowel and bladder functions.

Although Professor Lin Peng did not discuss its implementation, it does not mean that his idea is bad.

The dream of a world in harmony, where everyone is prosperous and productivity is highly developed is certainly good, but for now it can only remain a dream.

Fang Ziye continued, "Master, Professor Xiong, Professor Gong, there's no point in talking about anything else now."

"Since patients and their families have their own demands, we will first break down their demands and clarify which ones are feasible and which ones are currently beyond the capabilities of our department."

"After the discussion, we will report back to the family so that they can discuss it and make a decision."

"Master, you just said that the patient's family hopes to resolve the infection and bone defects in both lower limbs and restore normal limb function!"

"Restoring normal limbs is impossible. The directional goal is to control the infection and repair the bone defects."

"Based on the patient's current condition, the multiple soft tissue infections in both lower limbs are mainly caused by impaired local blood supply and damage to the vascular wall structure of both lower limbs."

"When local blood supply is impaired, even the best antibiotics cannot be delivered to the affected area through blood circulation, and thus cannot exert their intended effect."

"Furthermore, the patient's vascular wall structure is poor, making it impossible to perform antibiotic pulse therapy that interrupts microcirculation by using a combined microcirculation device."

"Under such circumstances, controlling the infection is a major challenge."

"As for the treatment of bone defects, given the blood supply factors analyzed above, it is more difficult to achieve healing through surgery."

"Without microvascular supply, even if bone defect reconstruction surgery is performed, the bone will eventually fail to heal or the fracture will not unite."

"Therefore, the two simplest requests from family members are very complicated and difficult to handle."

Fang Ziye has treated severe infections and complex bone defects.

However, these patients' conditions can be resolved only if their objective circumstances are relatively good.

Without even the most basic conditions, trying to solve the problem is like trying to create a new treatment path out of nothing.

Upon hearing this, Yuan Weihong said, "Ziye, let me share my thoughts first."

"The patient's current bone defects are hemipelvic defects and bilateral femoral defects, which are very, very complicated to treat."

"Could we put this aside for now and just focus on figuring out a solution for his infection?"

"This way, we can give the patient's family an explanation, and we can also get a response from Dean Wang Xinghuan before we figure out how to get rid of them."

"To avoid making things too tense and offending the patient's family, who might then refuse to leave!"

"Infection is the most superficial symptom, and it is extremely painful for both the patient and their family to experience it."

Surgeons find infections challenging, and so do patients' families.

The infected wound not only looks dirty but also smells foul, and this has been going on for more than just a day or two.

If the infection cannot be controlled, this will continue.

Yuan Weihong's point is that if one option can be handled well, then you can talk to the patient's family about discharge, transfer to another hospital, or other options.

Otherwise, given the current situation, if a patient is discharged from the hospital, the patient's family really wouldn't know where to put the patient.

“Doesn’t our hospital have an infectious disease surgery department?” Gong Jiahe suggested.

Gong Jiahe had previously worked with Fang Ziye at the Enshi Sanatorium to treat severe osteomyelitis, as well as patients with severe osteomyelitis complicated by systemic infection.

During the discussions, the possibility of transferring to the Department of Infectious Diseases was considered.

“This patient has bone defects and multiple infections in both lower limbs, so the infectious disease surgery department definitely won’t admit him.”

“He has a specific type of patient that is absolutely essential for our trauma surgery department, and we can’t turn him away,” Yuan Weihong explained first.

If this patient did not have a bone defect, the infectious disease surgery department would have to take over, and the patient would not have come to the trauma surgery department.

The Department of Trauma Surgery at Zhongnan Hospital is not omnipotent. When faced with a disease that causes headaches and sleepless nights, no one's first thought is not to show off, but to figure out how to get rid of it.

Fang Ziye had also thought about this, but after comprehensive analysis, there was simply no way to get rid of it, so this line of thinking had to be temporarily shelved.

Fang Ziye said, "The treatment principles for infection are early diagnosis, appropriate anti-infection treatment, surgical intervention, nutritional support, and prevention of complications!"

"The infection has now progressed to the point where early diagnosis is no longer meaningful, and the patient's infection spectrum has already been recorded in the test data."

"Based on our assessment of the patient's current blood supply, surgical intervention requires considerable caution."

"Given the patient's current blood supply, if local debridement is performed lightly, it could easily lead to non-healing of the local wound."

"If debridement is absolutely necessary, then revascularization and vascular replacement must be performed simultaneously. The scope of these procedures is sufficient for us to treat bone defects at the same time."

"Therefore, caution is still necessary at present."

“Nutritional support and prevention of complications must be integrated throughout the entire process; it is meaningless to separate them now.”

"So at the moment, we only have one option: appropriate anti-infection treatment."

"During the anti-infection process, there is no need to discuss the selection of sensitive antibiotics based on drug sensitivity results. It is meaningless to assess the course of treatment now, as we will definitely ensure that the dosage and duration are sufficient."

"The only point we can discuss is the method of administration."

"There are two traditional methods of administration: oral and intravenous administration. In fact, the anti-infection principle of both is the same: antibiotics are absorbed through the stomach, enter the bloodstream through the veins, and then circulate throughout the body to reach the local area and achieve the anti-infection effect."

"However, the patient's local blood supply is very poor. Even if the dosage of antibiotics is increased, the drug concentration that can reach the local area is very low, or may not even reach the local area at all."

"Therefore, it seems that the only anti-infective drug administration method we can use is the forceful local administration."

"However, a very thorny problem has arisen: how to administer the medication locally."

"If you only apply medication to the surface, the infection inside will still exist. It's just self-deception. But if you want to administer medication locally with the same precision as during debridement, the scope of debridement is no less than that of bone defect reconstruction surgery."

"It cannot be cleaned, cannot be drained, cannot be administered locally, and systemic administration is ineffective! This problem is almost unsolvable."

Fang Ziye analyzed the patient's current condition in detail using very thorough theoretical knowledge.

Based on treatment principles and guidelines, the current situation was determined.

Yuan Weihong's tone immediately turned cold: "Since there's no other way, let's do as they want and drag it out as long as it's done."

"I will talk to the patient's family then."

Yuan Weihong's words were swift and decisive, catching Xiong Zhizhang and Gong Jiahe off guard. After a moment of stunned silence, they stared blankly in Fang Ziye's direction.

The reason for being completely devoted has already emerged.

Gong Jiahe clasped his hands together in front of his abdomen and cautiously said, "Director Yuan, we can discuss these matters later. Let's finish analyzing the cases first."

"While it may not be able to truly solve the patient's problem, it can still help build up knowledge by summarizing and applying it to other cases."

Gong Jiahe left Fang Ziye a sliver of an opening to create a miracle.

Fang Ziye then added, "Based on the patient's current condition and diagnosis, the primary issue to address is not the infection."

"The question is whether we can achieve the kind of deal that the patient's family wants: to 'trade money for life'."

"Type 2 diabetes, hypertension, hyperlipidemia; post-coronary artery stenting, post-abdominal aortic replacement."

"It will inevitably be accompanied by cardiopulmonary insufficiency."

"The patient was previously admitted to the ICU due to bacteremia. Although the infection has now localized, the infection could still enter the bloodstream from the lower limbs at any time, causing a recurrence of bacteremia."

"Given the patient's physical condition before being transferred to our department, even after the infection was controlled, all he would have been able to recover were his two lower limbs, which were completely unfunctional."

"His overall health condition is extremely poor!"

"We should discuss the issue of 'life' versus 'treatment' with the family as early as possible and in great detail."

"At 63 years old, he is no longer young and strong, and his body's inherent functions can no longer allow him to continue."

"One of the purposes of our trauma surgery is to save patients' limbs, but the prerequisite is to save patients' lives. We should not disregard the possibility of life in order to save limbs."

"In the current situation, discussing the treatment of the infection is meaningless!" Fang Ziye's voice was very calm, and his attitude was resolute.

Upon hearing this, Yuan Weihong frowned slightly and said, "If the patient's family had agreed to the amputation, it wouldn't have dragged on until now!"

"If we bring it up now, we probably won't get the desired result."

"What we need to think about is how to stabilize the infection in the patient's lower limbs through anti-infection treatment."

Although Yuan Weihong supports Fang Ziye, he also hopes that some of the problems can be solved in a practical way before communicating and explaining to the patient's family.

He had more contact with patients' families and was therefore more aware of their attitudes.

Fang Ziye turned to Yuan Weihong and asked in return, "Do these old man's children truly believe in filial piety?"

"They were willing to risk their lives to save their leg?"

"Do you really think our hospital's ICU is the strongest fortress? If something goes wrong, just send him to the ICU, and at the very least, he'll survive?"

Professor Xiong Zhizhang began, "Ziye, with the rapid development of the times, people's ways of thinking have changed slightly."

"Some people are willing to take a gamble in pursuit of a higher quality of life."

"I think that, for the elderly themselves, it might be better to die a quick and painless death than to live with hemiplegia."

"Although he is not very old, only in his sixties, his children are all successful and have established their own businesses. They have enjoyed what they deserve..."

"Sometimes, the only thing the elderly rely on is not wanting to be a burden."

Xiong Zhizhang used his own age as a starting point to analyze the psychology of the elderly.

Fang Ziye fell silent.

Although people say that it's better to live a miserable life than to die a good death, this idea is outdated.

Rather than tormenting the survivors, it's better to die a quick and painless death.

If this is the elderly person's own wish, then strongly demanding amputation from the patient and family is unlikely to lead to an agreement.

In such a situation, if the family is of average means, they might give up due to medical expenses. However, since the elderly person has commercial medical insurance and their family is well-off, they certainly will not give up due to economic factors.

Nearly a year has passed since the elderly man was injured, and his attitude remains firm.

This effectively shut down any way to persuade the family members.

The dilemma facing the team right now is that they either have to watch the elderly die, or they have to find a way to control the most direct and deadly infection.

Thinking of this, Fang Ziye pinched his brow heavily with his right thumb and forefinger: "Isn't that just being a scoundrel?"

"If they don't even care about life and death, then there's no point in us discussing this here." "Using lives as a wager to force us is another form of moral blackmail."

“It’s pointless!” Fang Ziye’s attitude was firm.

The old man's condition is currently very difficult and complicated; it's as if there's nowhere to start.

“Isn’t it pointless for us to just do our job, follow the treatment principles, and administer intravenous antibiotics to fight infection?” Yuan Weihong offered Fang Ziye a fallback option after hearing his firm stance.

Fang Ziye nodded: "The premise for the effectiveness of intravenous antibiotics is that blood supply reserves are still above a certain threshold."

"For example, 20% to 30% of the drug dosage can be precisely delivered to the localized area."

"But his basic conditions don't meet that requirement."

"If we were to perform a biopsy on his body surface tissue right now, we would definitely find that there is already a large amount of necrotic tissue inside!"

"These tissues, under the influence of bacteria, have a large amount of inflammatory proliferation and putrefactive substances..."

"Right now, these two legs only look like the beginnings of lower limbs; in reality, they've already died, and gangrene is only a matter of time!"

"This is already the final stage!"

"The remaining blood supply is only enough for a portion of the cells in the lower limbs to barely survive; it can no longer support anything else," Fang Ziye shook his head.

"Amputation is the only option; there is no hope for any miracles."

"The effect of intravenous medication is not even scratching the surface."

“If the medication was truly effective, then his infection should have been controlled long ago during his hospitalization in the ICU.”

"Under such circumstances? Unless..." Fang Ziye paused, seemingly wanting to say something but then stopping himself.

Upon hearing this, Yuan Weihong and Gong Jiahe's eyes immediately lit up.

Gong Jiahe hesitated to speak directly, so Yuan Weihong asked, "Unless something else, Ziye, just say what you have to say. Why are you beating around the bush at a time like this?"

Fang Ziye lowered his hand from his brow and said, "Master, even if I told him, he can't wait any longer!"

"Speak!" Yuan Weihong was probably also thoroughly tormented by this case, and his tone became stern.

"After voluntary amputation, limb transplantation is then performed."

"For this kind of surgery to pass clinical approval, it must first go through the approval of the National Health Commission, and then undergo animal and clinical trials layer by layer."

"It will take at least six months to complete the animal trials."

“Even if he were selected for clinical trials immediately, he couldn’t wait that long.”

“Refer to the whole bone inactivation and replantation procedure for tumors of the entire lower extremity.” Fang Ziye looked at Yuan Weihong calmly.

Yuan Weihong's feigned anger did not affect Fang Ziye's mood.

Fang Ziye's proposal was quite bold.

Currently, limb transplantation in hand surgery is merely a stopgap measure!
These were some county hospitals and prefecture-level city hospitals. Due to limited expertise, they temporarily amputated the limbs to save the patients' lives, and then used a microcirculation device to preserve the severed limbs.

The patient was transferred to a higher-level willing hand surgery department for limb replantation.

This type of surgery can only be performed if the patient's limbs were normal before the injury.

Fang Ziye's current idea is even bolder: he wants to remove a single lower limb from the body for a period of time and then replant it.

This deviates from the principle of "acting expediently in urgent situations" in limb transplantation.

The approval process by the ethics association can take six months or even a year.

This is an extreme solution that has been devised, but one that has not been thought of at all.

After Fang Ziye finished speaking, the demonstration room fell completely silent.

As an orthopedic surgeon, I've heard of inactivation and reimplantation surgery in bone tumor specialists, but to associate it with the current case seems rather far-fetched.

This requires very meticulous logical thinking and adaptability, as well as the courage to think big.

The sound of Miyako gasping for breath was impossible to conceal and became extremely shrill in the demonstration room.

Ultimately, neither Professor Gong Jiahe nor Professor Xiong Zhizhang spoke again.

This kind of surgery has deviated from the most basic ethical and moral standards and could not possibly be approved.

At least for now!

After calming down, Yuan Weihong realized that his emotions had driven Fang Ziye to a state of 'madness', so he quickly said, "Then forget it, I'll go talk to the patient's family about the amputation."

"This surgical idea did not come up in our discussion."

Whether a patient can have their limb saved is incomparable to the overall development of the hospital.

Even if Fang Ziye could find a way to obtain the authorization, Yuan Weihong wouldn't dare gamble with Fang Ziye's future.

Everyone else remained silent, not uttering a single word.

Fang Ziye is a genius, but everyone knows that there's only a fine line between genius and madness. If they keep pushing him, he'll no longer be on the normal path of a doctor...

After the conversation ended, Yuan Weihong led Qin Geluo away from the demonstration room.

Li Nuo quickly followed.

Professor Xiong Zhizhang remained still for the time being. After watching Yuan Weihong and the others leave the demonstration room and close the door behind them, he turned his head and said, "Ziye, you must not discuss this kind of surgery you just mentioned in other places."

Fang Ziye immediately nodded obediently: "Teacher Xiong, I wouldn't have said it if my teacher hadn't insisted that I say it."

"The main problem is that this patient's condition is too complicated; they've now reached the terminal stage!"

"In the final stage, if we don't take extreme measures, then we will be out of options."

After Fang Ziye finished speaking, he stood up, took a few steps closer to Professor Xiong Zhizhang, and sat down next to him.

"But we can't go to such an extreme!"

"This is the ultimate standard for us doctors," Xiong Zhizhang said.

This precedent cannot be set, otherwise the medical system will definitely be thrown into chaos, as it involves too many, too complicated, and too messy consequences.

It can be considered taboo.

The simplest point—

Lower limb allogeneic transplantation!
However, it must be said that Fang Ziye's existence is inherently taboo. When faced with a situation where there is no other way out, Fang Ziye can always give you a 'miracle'.

Xiong Zhizhang then stood up and said, "Since Dean Wang Xinghuan wants to treat this patient, let him figure out a way himself."

"It's been a long time since I've visited this dean. I'll go and listen carefully to his insightful opinions."

After speaking, Xiong Zhizhang glanced at Professor Gong Jiahe.

Gong Jiahe immediately understood and said, "Professor Xiong, I am the most forgetful person, and I never mention things that are just rumors."

“Team Leader Fang knows my character very well.” Gong Jiahe immediately used Fang Ziye as a shield, as he didn’t want to be targeted by such an old man.

Although I'm not afraid, it will definitely be extremely troublesome.

After saying that, Gong Jiahe and Fang Ziye got up and walked behind Xiong Zhizhang. The three of them took off their white coats and said goodbye downstairs in the orthopedic building.

Professor Xiong Zhizhang had other matters to attend to, so he wandered off to the urology department. He didn't know where Wang Xinghuan was, so he went to ask her in person.

In this situation, neither Fang Ziye nor Gong Jiahe is suitable to join in.

After saying goodbye to Xiong Zhizhang, Gong Jiahe looked at Fang Ziye with a complicated expression and gave him a thumbs up: "Professor Fang!"

"Professor Gong, let's not play this game of mutual flattery."

"To be honest, I will never touch anything that involves my bottom line."

"Otherwise, I will try my best if there are any other ways."

“But right now, the best option for this patient is amputation!” Fang Ziye didn’t bring up the previous line of thought again, but instead returned the topic to the patient’s condition that they had just discussed.

Gong Jiahe nodded frankly: "Although Zhongnan Hospital is the birthplace of limb-saving surgery, it does not need to be labeled and portrayed as someone who absolutely refuses amputation."

"Living like this is too tiring. Once you unload this burden, everyone will feel much lighter and more open-minded when starting anew."

"It's good." What Gong Jiahe saw was a state of mind.

"Professor Gong, thank you for taking care of our patients today. Why don't you go back and rest earlier?"

"I still need to go back and organize and process the data later. It's almost the end of the month, and I have to go through each of these data in detail." Fang Ziye took the initiative to end the conversation, not because he was putting on airs.

"Okay!"

"The sooner you finish here, the sooner we can go to Enshi."

“We should start the next phase of our clinical research as soon as possible. Professor Zhang Yue has been urging me a lot lately!” Gong Jiahe gestured for Fang Ziye to do as he pleased.

……

In the elevator of the apartment building, after pressing the button for his floor, Fang Ziye was still pondering the "rationality" of his proposed surgery!
After about a minute, Fang Ziye shook his head and said, "No! No, it won't work."

Fang Ziye's thinking is now at a very high level, so he occasionally comes up with some 'ineffable' research topics and surgical ideas.

However, while these topics and surgical approaches are ingenious, they are also too difficult to control. There is a high-voltage line laid underneath them, the kind that must never be touched.

After Fang Ziye exited the elevator and unlocked the door with his fingerprint, he settled on this idea, suppressing this brilliant surgical thought deep within his heart and putting it aside.

However, before Fang Ziye could even sit down, his phone rang.

Holding a water glass in one hand and answering the phone in the other, Fang Ziye walked towards the sofa, then stopped halfway, his neck hunched forward like a shrimp: "Huh?"

"Director Xiong, are you kidding me?"

On the other end of the phone was Xiong Hanzhong, director of the Medical Affairs Department of Zhongnan Hospital.

"Professor Fang, how could I dare to joke about such a serious matter?"

"Our 'Complaints Reception Office' under the Medical Affairs Department has indeed received a complaint about you."

"As soon as our medical affairs department received the complaint, we checked our hospital's registration system."

"It shows that the patient did indeed come to Professor Fang's clinic on September 21st of last month, and there is a record of your consultation with him."

"Then on October 15th of this month, the patient was diagnosed with osteosarcoma and was admitted to the Department of Bone Tumors at Peking Union Medical College Hospital for inpatient treatment. On October 17th, a biopsy was performed, and the diagnosis of osteosarcoma was confirmed."

"However, we did not find any relevant description of you, Professor Fang, in our hospital's outpatient medical record system!"

"Now the patient's family has come to complain that Professor Fang misdiagnosed him." Xiong Hanzhong's tone was very calm, and he did not blame Fang Ziye for this, but was simply stating a fact.

"Based on this, Professor Fang, would you like to come over in person so we can have a face-to-face confrontation in the complaints office?"

"We also want to understand the details of what happened more specifically, and we can't just believe one side of the story."

Fang Ziye nodded immediately upon hearing this: "Okay, Director Xiong, I'll be right there. I might be able to remember which patient made the appointment only after I see them."

After hanging up the phone, Fang Ziye didn't dare to delay. He drank the water in his hand in one gulp and then hurriedly ran out again.

When Fang Ziye arrived at the Medical Affairs Department's Complaint Management Office, it was already 3:49 PM.

There were quite a few people gathered in the office at that moment.

Fang Ziye knew several people, the leader of whom was Xiong Hanzhong, the director of the medical department, whose prominent cheekbones were very noticeable in the crowd.

Next is Director Hu Liangpei from the Safety Office. With his broad frame, he is currently patiently calming down the patient's family.

"Don't be anxious, we're sitting here to solve the problem. Criticizing won't help, right?"

"Professor Fang from our hospital will be here soon..."

Beside Hu Liangpei were three people: an old man who looked to be around sixty years old and was very thin; a young couple who looked to be around thirty years old; and an emotional couple who were accusing Fang Ziye of his crimes.

"With such obvious osteosarcoma, your hospital's professors just told my mother to go home?"

"If this drags on for too long, and it recurs or metastasizes, how will you take responsibility?"

"The professors at Peking Union Medical College Hospital said that there is already focal lymph node metastasis. If we go any later, it may become late-stage cancer."

Fang Ziye looked at the three people, his eyes slightly narrowed, because he was not familiar with any of them.

Upon seeing Fang Ziye arrive, Xiong Hanzhong quickly said, "Brother, please stop arguing. Professor Fang from our department has arrived as well."

“Let’s review what happened in more detail, including some of the minor details.”

“We have prepared some materials, including the electronic medical records that Professor Fang recorded after his consultation.”

After Fang Ziye arrived, the old man stood up somewhat agitatedly and pointed at Fang Ziye, saying, "Professor Fang, you are so young and handsome, why would you want to harm us?"

"Sir, please calm down. My memory might not be very good!"

"Are you sure you know me?" Fang Ziye asked.

"Of course, my wife's name is Liang Tengxiang. She went to see a doctor here. I accompanied her. How could I not recognize you?"

“It’s you!” the old man said decisively.

“We came with the X-rays from the local hospital, and we waited in line for a long time. You spent almost twenty minutes looking at them.”

"Finally, they said my wife didn't have any major problems!"

"Fortunately, we were cautious enough and thought the young doctor was unreliable, so we went to Peking Union Medical College Hospital to wait for an appointment."

"Otherwise?" The old man said, tears streaming down his face.

While the old man was speaking, Xiong Hanzhong had already printed out the person's electronic medical record.

The patient's name, gender, place of origin, and other basic information all match, and the medical record was indeed written by Fang Ziye.

Everyone has their own "formula" for writing medical records, which Fang Ziye could tell at a glance.

The diagnosis written on the electronic medical record clearly states that the local hospital's MRI of the right knee joint (viewing the film, no report) (2023-11-2) showed: right knee joint cartilage damage.

Standing X-ray examination of both lower limbs (viewing the film, no report) (2023-11-2) showed: edema signal in the right knee joint and cartilage abrasion shadow.

At the same time, the other party also provided a diagnosis report from Peking Union Medical College Hospital and a rapid biopsy result report.

All of these clearly point to the patient having osteosarcoma.

At the same time, the other party also produced a bunch of relatively old imaging data, including MRI and X-ray data.

Upon seeing this, Fang Ziye frowned.

"Director Xiong, all these examination data and results are laid out here in perfect order. This is a case of misdiagnosis by your hospital's professor!"

"Such an obvious misdiagnosis almost caused my mother's tumor to metastasize!"

"Look at what his opinion is!" The young man was very agitated and took out the medical record from Zhongnan Hospital.

"1. Get plenty of rest...and have a follow-up MRI if necessary..."

"2. Administer nonsteroidal anti-inflammatory drugs for pain relief and Daflon for swelling reduction."

"3. If symptoms do not improve within half a month, please have a follow-up examination at any time."

“4. Follow up if you feel unwell.” He patted the medical record book, which was filled with Fang Ziye’s handwriting.

However, Fang Ziye suddenly raised a point of contention: "The time shown in your MRI report is 20240812!"

"This is from this year?"

Why isn't this reflected in my medical records?

Upon hearing this, the young man flew into a rage and retorted, "You haven't shown it, so why are you asking me? Are you the doctor or am I the doctor?"

"You ask me why you don't show it?"

"If you can't even diagnose a tumor, who knows how careless you are?"

"How terrible is technology?"

"Director Xiong, and all the hospital leaders, did you hear that? He asked me why I didn't show any results?"

"Is this professional?" The young man's voice was a mix of anger and amusement.

(End of this chapter)