Healing Doctor

Chapter 407 A Big Pot

"Director Sui." Section Chief Bai answered the phone.

Director Liu pricked up his ears and listened carefully to what Director Bai and the person on the other end were saying.

Director Sui first gave a brief report on the patient's medical history—the patient underwent a left total knee replacement under spinal anesthesia 8 hours ago.

Before skin incision, a pneumatic tourniquet was inflated for hemostasis. The tourniquet was used for 90 minutes. During the operation, routine osteotomy of the tibial plateau and distal femur was performed, and the posterior joint capsule was released. No abnormalities occurred during the operation, and the operation was successfully completed.

The patient did not feel a pulse in the dorsalis pedis artery after the operation, and Dr. Sui palpated the posterior tibial artery but did not feel a pulse either.

After waiting for about 15 minutes, I touched it again to confirm, but still no pulse was felt.

The skin temperature of the limbs distal to the left knee was significantly lower than that of the contralateral side, leading Director Sui to speculate that there might be damage or occlusion of the popliteal artery.

Therefore, Director Sui urgently requested the ultrasound department to perform a vascular ultrasound examination, which showed that no arterial blood flow spectrum was detected in the left anterior and posterior tibial arteries and the dorsalis pedis artery. The arterial blood flow spectrum was absent in the popliteal fossa and the proximal artery was normal.

The patient underwent knee replacement surgery, followed by popliteal artery occlusion. Director Bai listened quietly. Not only him, but even Director Liu could discern the problem.

No wonder Lao Bai was planning ahead; it's probably because Director Wang of the vascular surgery department didn't dare to make a move—his skill level wasn't high enough, and even if he did, he wouldn't understand it.

"Director Bai, Director Wang needs to insert a catheter for thrombolysis, and he needs to consult with him for thrombolysis?! If we wait any longer, the patient will have to have an amputation, an amputation!" Director Sui roared angrily.

"Understood," Director Bai said calmly.

"Director Bai, I'd like to request a hospital-wide consultation." Director Sui revealed his true intentions. "You'd better come. With you here, the vascular surgery department wouldn't dare say such outrageous things."

"Hospital-wide consultation, I'm coming right away. Are you at the hospital?"

"How dare I leave?" Director Sui complained. "Director Bai, the patient won't make it to dawn tomorrow."

"Understood." Director Bai hung up the phone.

"Hehe," Director Liu chuckled, "I guess Director Wang doesn't dare to do it. Catheterized thrombolysis is the simplest, but the results are terrible... That's an orthopedic issue. In the end, you'll have to take the blame for this whole mess."

Director Bai pursed his lips and dialed the phone.

"Xiao Ji, it's me," Director Bai said. "Orthopedics, consultation, come right away."

He spoke in a commanding tone.

"Director Bai, I'll be there in ten minutes," Ji Xiang replied without hesitation.

After a brief exchange, Director Bai hung up the phone, stood up, and said, "I'll go back and take a look."

"Old Bai, you're a section chief now, you should be in charge of this little thing," Director Liu said.

"Nobody's here." Director Bai was also quite helpless. "Let Xiao Ji take a look. If he can solve it, he can. If not, I'll discuss it with the First Affiliated Hospital."

Let's go take a look.

Director Bai glanced at Director Liu and said, "Dazhi, don't overthink Xiaoji's situation. I'm not kidding, after three years of residency training, it would be a good year and a half if he stayed at our hospital."

"Then you need to apply for an intermediate certificate for Ji Xiang."

"I was just thinking that it would be best if Ji Xiang could help develop the vascular or interventional departments within a year," Director Bai said with a smile. "It's a bit of a pipe dream, but I think it's possible. As for you, can you keep Ji Xiang? Don't even dream about it."

"Hey, that's not necessarily true." Director Liu knew what Section Chief Bai meant, but he still stubbornly said it.

When the two returned to the hospital, Ji Xiang had already changed his clothes and was looking at medical records in the doctor's office.

"Xiao Ji arrived quite quickly," said Director Bai.

"My home is closer." Ji Xiang looked up, smiled gently, and then looked down at the medical record again.

"Director Wang, Director Sui, let's have a meeting now. Please share your opinions," Director Bai said, getting straight to the point.

"Director Bai, please have a seat." Director Sui moved a chair and placed it in the innermost corner, directly facing the doctor's office door.

This is Director Bai's habit; ever since the death of an ENT doctor in Harbin, he has always insisted on sitting in the position facing the door.

This location offers a bird's-eye view of the entire area and is the safest place imaginable.

After Director Bai sat down, he glanced at Director Wang and Director Sui and said, "You two tell me about the situation first."

"Director Bai, I can remove the blood clot from the patient," Director Wang said first, making an assumption that Director Bai would dismiss such talk as nonsense.

"However, a stent needs to be placed in the local blood vessel, but the patient has just undergone knee replacement surgery, which is a contraindication for stent placement."

"So I suggested catheter-directed thrombolysis. But Director Sui said he was worried about potential complications and insisted on..."

"Is simple thrombolysis enough?" Director Sui immediately interrupted Director Wang of the vascular department, his voice filled with anxiety and extreme displeasure. "The thrombolysis is so slow, what if the patient's lower limbs become necrotic!"

Director Bai felt disgusted listening to their argument.

However, this is the norm in clinical practice, and neither Director Sui nor Director Wang wants to take the blame.

This job is a terrible one; whoever takes it will be in trouble.

If I were the head of the vascular surgery department, I probably wouldn't accept the job.

But this is a hospital, and there's no way things can be 100% problem-free; there are always a lot of unpleasant things happening.

"I've glanced at the medical records. Xiao Ji, what's your opinion?" Director Bai tapped the table and said to Ji Xiang.

"Thrombectomy, no need for stenting." Ji Xiang paused slightly, seemingly lost in thought before answering Director Bai's question, but immediately replied.

"Dr. Xiao Ji, don't talk nonsense," Director Wang of the Vascular Department scolded, his expression showing disdain but also increasing panic.

As for why, it seemed that everyone present, except for Ji Xiang, understood.

"Then prepare for surgery," Director Bai declared decisively.

"Director Bai, I can't do it; the patient has contraindications for surgery," said Director Wang of the Vascular Department directly.

He would rather apologize to Director Bai afterward than take the blame himself.

"Xiao Ji, are you confident?" Director Bai asked.

"Yes," Ji Xiang replied.

"I'm not going to be an assistant." Director Wang of the Vascular Department kept his distance.

Director Bai raised an eyebrow, glanced at Director Wang of the Vascular Department, and smiled as he took out a blue notebook from his pocket.

"This is……"

"We'll make an exception and apply for an intermediate-level certificate in interventional medicine for you."

"!!!"

"!!!"

"!!!"

Director Sui, Director Wang of the Vascular Department, and General Manager Xu Leyu were all stunned by the sight of stars.

He passed the medical practitioner's exam, but it seems the certificate hasn't been issued yet. So Director Bai went and applied for the intermediate-level certificate for Ji Xiang? And judging from Ji Xiang's expression, he doesn't seem to know about this.

"Xiao Ji, to be honest, this patient is a tricky one," Director Bai frankly admitted, not intending to hide anything from Ji Xiang. "If you don't want to take the blame, I'll get a team of experts from within the province to consult on the case. But time..."

"Director Bai, the surgery should be fine." Ji Xiang picked up his intermediate-level certificate, glanced at it, and then asked, "It seems that even the attending physician can't perform level 4 surgeries."

"Who said that?" Director Bai said expressionlessly. "If you can get it off, start the surgery right now."

(End of this chapter)