Rebirth of a Doctor Without Regrets

「病人死亡时间：2014年9月30日13时45分。上报医务处和陈院。」巡迴护士冷冷的一句话，让众人都停了下来。

"During the death case discussion, your anesthesiology department will bear the main responsibility," Lin Gaoming said, pointing at Zhao Xuemei.

"I...we were just following the guidelines." Zhao Xuemei was not in the wrong, but that didn't mean she wasn't remorseful.

"That's right, we neurosurgeons bear no responsibility," said Director Cheng from the neurosurgery department.

"The patient has renal insufficiency, so our refusal of anesthesia is in accordance with the guidelines. On the contrary, the patient developed heart failure during the operation. Isn't that a problem with your surgery?" the anesthesia technician behind Zhao Xuemei retorted.

"That's right, we neurosurgeons bear no responsibility," Director Cheng echoed.

"Our treatment was in accordance with the guidelines. It was your refusal to administer anesthesia that caused the patient to have emotional fluctuations, which in turn triggered the aortic rupture," Director Shen Hao retorted.

"It's you! It's you!"

"We, the neurosurgeons, bear no responsibility."

The operating room was noisy.

"We're probably responsible, Director Lin," Zhu Chunhua, who had been silent all along, suddenly spoke up. She walked to the film viewer in the corner and tapped the film hanging on it.

"You only had an ultrasound examination before the operation, and this scan is dated a week ago. We did not conduct a sufficient preoperative assessment. In particular, the scan already showed mild stenosis of the left anterior descending coronary artery, so it is difficult to say whether there will be any new developments in the past week."

The operating room was completely silent.

This is exactly what Wang Xiao needs to know.

Everyone's eyes turned to Lin Gaoming, who lowered his head in thought.

"The patient has renal insufficiency and cannot tolerate contrast agents, so I only performed an ultrasound. As for the coronary arteries..." Lin Gaoming reached into the patient's chest cavity and stroked the heart that had stopped beating.

Sure enough, there was a hard object in the coronary artery, but it was hard to say whether it was a blood clot that formed after the heart stopped beating.

"Brilliant! That was your mistake. If you couldn't do a CTA angiography, you should have just called the ultrasound department," Director Cheng said from the side.

Compared to contrast imaging, ultrasound examinations are highly subjective and rely more on the operator's experience.

CTA angiography, CT, MRI and other techniques will not produce significantly different images as long as the location and settings are correct.

However, the acquisition of ultrasound images is highly dependent on the operation technique, angle, pressure, and position of the probe. Doctors with different qualifications can perform these operations very differently, so some people include ultrasound in subjective examinations.

Generally speaking, conventional ultrasound can only visualize the heart structure and is insufficient to determine the condition of the coronary arteries.

However, experienced ultrasound doctors can deduce the area of ​​ischemic sites from abnormal ventricular wall motion, thereby determining the degree of coronary artery stenosis.

If you consulted the ultrasound department before the operation, it is very likely that you could have predicted the occurrence of heart failure.

A murderous glare met Director Cheng's, and Director Cheng unconsciously took a step back: "We in the neurosurgery department bear no responsibility whatsoever."

The operating room door was kicked open with a "whoosh," and Dean Chen and several men in black rushed in.

"Ah... Waaah..." Dean Chen seemed to have lost all his strength. He slid to his knees beside the operating table, supported himself with his hands on the ground, and cried so hard that he could hardly breathe.

Treating the wealthy and powerful is not always a good thing; high returns often come with high risks.

It's not just ordinary people who cause trouble at hospitals; even ordinary people can be stopped by security guards. But what about influential people?

Hua Tuo prescribed a groundbreaking treatment for Cao Cao, but what he received in return was a cold guillotine.

The scrub nurse standing nearby whispered, "I've never seen Dean Chen cry this sadly when his own father died."

Wang Xiao felt it was about time and silently said to himself: Activate the backtracking module.

[Ding! Patient brain dead, surgery failed. Activating time rewind module.]

[Current number of surgeries completed: 3]

Total backtracking attempts: 4

The world dissolved before Wang Xiao's eyes.

The operating room timer has returned to [00:00:00].

"Little one, you take charge."

Wang Xiao took a deep breath and organized his thoughts.

The reason this surgery failed last time was mainly due to heart failure caused by myocardial ischemia.

It is very difficult for a heart to restart after it stops beating in this state.

The culprit is stenosis of the left anterior descending coronary artery. The condition may worsen within a week, or the plaque may rupture, leading to a thrombus blocking the blood vessel.

The key is to detect coronary artery problems in a timely manner. In cases where CTA angiography cannot be performed, according to Director Cheng, the head of the ultrasound department needs to make a judgment in person.

"What's wrong? Is it because it's your first time in the operating room and you're scared?" Shen Hao asked. Seeing that Wang Xiao had turned into a wooden statue, he directly raised the electric knife.

"Wait, I think we need to change the surgical plan," Wang Xiao quickly stopped him.

Everyone looked at Wang Xiao.

"Old Lin, the new guy you hired is a complete idiot."

Lin Gaoming felt a throbbing sensation in his temple. He looked up at Wang Xiao and asked, "What did you say?"

"Doctor, I think the patient's heart condition is not good, and the stenosis of the left anterior descending coronary artery may be more serious than expected. We should conduct preoperative examinations first."

Lin Gaoming gave a wry smile, shook his head, pointed to the patient's chest, and signaled Shen Hao to begin the surgery.

"Professor, I think this student makes a good point. These images are from a week ago, and the patient's condition may have changed since then," said Deputy Director Zhu Chunhua.

Zhu Chunhua is said to be a talent that Dean Chen recruited from the United States, and she is accustomed to using school titles rather than hospital titles.

Lin Gaoming sighed impatiently. The reason why the chief surgeon is called the chief surgeon is not because he is responsible for holding the scalpel, but because he is in charge of the entire operation.

While the assistant has an obligation to remind the surgeon if the surgeon is not in good condition, this is within the scope of the surgical plan formulated by the surgeon.

The newcomer doesn't understand, but you, a deputy director, don't you know the rules either?

Well, maybe those who return from overseas studies are just a bit slow on the uptake.

"The patient has renal insufficiency and cannot tolerate contrast agents. I have already performed an ultrasound examination, and the surgical indications have not changed. We will proceed with the ascending aortic replacement and Sun's procedure as originally planned."

Shen Hao glanced back at the film hanging on the projector light and said hesitantly, "It really is from eight days ago. Lao Lin, is it too risky to drive in like this...?"

Lin Gaoming felt a throbbing pain in his temples.

It felt like the whole world was against him from the morning onwards.

My wife added vegetables to her congee with preserved egg and lean pork; my girlfriend said she was going on a team-building trip with her classmates and refused to go on a date; the anesthesiologist refused to administer anesthesia to the patient; the routine surgery turned into an emergency; the head nurse who was cooperating with me couldn't get on the operating table; and my cervical spondylosis flared up again, and I forgot to wear my neck brace...

Now even the authority of the surgeon is being challenged?

"Bang!" Lin Gaoming picked up an empty sterile tray and smashed it on the ground.

Everyone was startled and quickly lowered their heads, remaining silent.

"I'll take responsibility. If you don't want to do it, get out! The patient can't wait any longer! Electrosurgical!" Lin Gaoming reached out to the scrub nurse.

The scrub nurse trembled as she handed over the electrosurgical knife, only to have it taken by another hand.

Wang Xiao held down Lin Gaoming's hand as he tried to take the knife. "Director, why don't we ask the ultrasound department to take a look first? Who can come and check?"

If it weren't for the need to adhere to aseptic principles in the operating room, Lin Gaoming would definitely have slapped Wang Xiao across the face.

But then another hand reached out and pressed him down. "Brilliant! This young student is right. This is the best option for the patient."

Wang Xiao looked at Director Cheng of the Department of Neurosurgery with surprise. He exuded the domineering aura of a department head while maintaining his signature smile.

Adding to his earlier action of lunging at the patient, he's practically a smiling tiger.

The younger generation's reminders made Lin Gaoming, who was in a bad mood, feel like they were trying to stir up trouble, but the reminder from another authority figure was different.

Even though it's in a department head's nature to give orders, they usually keep quiet about matters concerning other departments.

Director Cheng poured a bucket of cold water on Lin Gaoming's head, though he did so with a smile.

Seeing Lin Gaoming's relaxed expression, Director Cheng quickly said, "Oh, I mean, since you've already had the pericardiocentesis, waiting a few more minutes won't be a big problem. Let the ultrasound department come and check it out, so you younger folks will be convinced."

Lin Gaoming gave the circulating nurse a look, and the nurse immediately picked up the landline on the wall.