Be Cautious in Speech and Action

Chapter 28 Be Cautious in Speech and Action

Listening to lectures consumes a small portion of mental energy.

It was just a kidney amputation. Ji Xiang had an exceptional memory, which could be considered a talent. Unlike surgical training, which completely depleted his basic endurance and led to him being chased away by the system NPC, Ji Xiang did not suffer the same fate.

After explaining the knowledge about renal autopsy, the system NPC looked at Ji Xiang with a kind expression, full of expectations.

"Dr. Ji, do you understand?"

"Understood." Ji Xiang nodded.

"Then tell me, what is your understanding of the medical incident you just experienced?" the system NPC asked.

He said he understood, but Ji Xiang's understanding was limited to renal autopsy and related complications.

Because of his ignorance revealed in his outburst of anger, Ji Xiang subconsciously put the matter out of his mind.

It's like when you made a mistake as a child and were terrified that your parents would find out.

Patients and their families may be angry, but I am a doctor, even if I am just a resident physician. My anger reveals my ignorance and low character.

Ji Xiang had a lot to say, but his thoughts were too jumbled up to know where to begin.

After hesitating for a while, Ji Xiang said sincerely, "Teacher, please tell me."

"I don't know if the urologist explained similar complications to the patient after the emergency surgery three years ago, but even if he did, he probably didn't explain it in detail or in detail to the patient and the patient's family. That's a mistake."

Ji Xiang nodded, agreeing that the system NPC's assessment was fairly accurate.

"But that's a secondary issue. The most important thing is the CT room doctor," the system NPC emphasized. "He can't even be called a doctor; he can only be called a CT operator."

Uh……

Ji Xiang could sense strong dissatisfaction in the calm tone of the system NPC.

Even if it's just a grumble, the system NPCs are still expressing their attitude.

"Looking at the video footage, analyzing the films, it's not that simple," the system NPC said calmly. "The right kidney is missing, that's a fact, but! Is the only possibility that it was removed?"

"Teacher, you're right." Ji Xiang bowed obsequiously, acting as a dutiful straight man.

The system NPC is cursing the CT room doctor, but in reality, he is also cursing Ji Xiang.

Ji Xiang admits that his skill level is simply not good enough.

"He lacks the necessary expertise and irresponsibly stated with absolute certainty that his right kidney had been removed."

"Maybe...maybe the hospital is too small?" Ji Xiang subconsciously tried to find a way to salvage the situation.

"No." The system NPC shook its head. "That's a large, top-tier hospital in Central China, the best hospital in the area. Otherwise, the patient and their family wouldn't have believed the CT room doctor so readily."

"!!!"

"The quality of doctors varies greatly. Some have low skill levels but an overwhelming sense of justice, leading to uncontrollable situations. With such a strong sense of justice, why not read more books and improve their basic diagnostic skills?"

The NPC's words were like a slap in the face to Ji Xiang.

When he experienced the situation firsthand, Ji Xiang understood the feelings of the CT room doctor quite well, and even felt that the doctor was being a bit too conservative at the time.

But in the eyes of the system NPCs, the doctor has become an operator, and doesn't even have the qualifications to make a diagnosis.

Ji Xiang felt ashamed and deeply embarrassed.

I have indeed made progress, but I am not yet a formally certified doctor.

"That's about it. Go back now and think carefully about today's cases," the system NPC said.

"Teacher, I'll be going now." Ji Xiang bowed respectfully once again, at a ninety-degree angle, expressing his respect for the old man through body language.

After leaving the system, before the morning meeting even started, Ji Xiang had already experienced a long period of time, with events taking one turn after another, until he finally grasped the secrets of a rare disease.

However, this matter was complicated and had serious consequences, leaving Ji Xiang looking somewhat haggard.

Will this cause me to age prematurely? Ji Xiang wondered to himself.

During the morning meeting and shift handover, Ji Xiang did not see Professor Mo and Colonel Wang.

Subsequently, the head of the urology department randomly assigned the three resident trainees to the department's teaching assistants, asking them to assign them mentors.

Finally, he didn't forget to add a final note: "His name is Ji Xiang. Professor Mo told me twice that he should take him under his wing."

The doctor who was following behind the director was the chief resident of the urology department.

The hospital's general manager gave Ji Xiang a deep look.

Ji Xiang was already quite eye-catching due to his tall stature and handsome appearance. Add to that Professor Mo's repeated requests for Ji Xiang from the director, and is there some gossip involved?

The surgical ward was busy early in the morning, and the anesthesiology nurses had already come to pick up the patients. The head doctor simply gave some basic instructions; he didn't care about the few resident trainees at all.

After assigning the short, fat, and sleazy-looking Lu Kai and the seemingly sleepy Liu Yunqing to the two professors' resident physicians, the chief resident said to Ji Xiang, "Professor Mo and Colonel Wang are outpatients this week and will be back soon. You can go to the outpatient clinic to find them."

"Okay, Mr. Wu." Ji Xiang knew the clinical titles. He saw the name on the ward manager's name tag and said with a smile.

"Xiao Wu, remember to go see that patient with the kidney contusion and give him a proper explanation." The voice of the head of the urology department came from the head's office.

Mr. Wu smiled wryly. He had a lot to do this morning. Although the resident general was in charge of emergency care and such, he always wanted to learn more, perform more surgeries, and even go on stage himself.

At this time, only Ji Xiang was free.

"Hey you, go check on the patient." The chief resident assigned the task and told Ji Xiang the patient's ward and name without any room for argument.

Ji Xiang just wanted to see the patient, so he certainly wouldn't refuse.

……

……

After finishing his shift, Dr. Liu, the head of the urology department, rushed to the operating room and took a quick shower.

The operating room is like a public bathhouse. Not only do surgeons take a shower after surgery, but some department heads also take a shower before surgery to refresh themselves.

Director Liu doesn't have this habit, but he was woken up in the middle of the night by a second-line professor on duty to participate in the emergency rescue of a group of car crashes, and he was extremely tired.

While showering, he heard the hospital's general manager chatting in the changing room.

"Damn it," Director Liu frowned, hurrying out.

"Xiao Wu, didn't I tell you to go and check on that patient in the liver and gallbladder department?" Director Liu scolded unhappily.

"Director, I'll go right after my surgery." General Manager Wu had no idea why Director Liu was ignoring a patient in the ICU who had undergone partial nephrectomy and instead focusing on a patient who had nothing to do with urology.

Director Liu's face darkened.

This matter is neither a big deal nor a small one.

The key issue is that the resident physician didn't understand what he meant, which shows that his understanding of kidney contusion is still inadequate.

Never mind, they're all young people.

Director Liu had already forgiven the clueless chief resident in his heart.

He is a humble person and generally doesn't get angry.

"The surgery will have to wait a moment. Let's get ready first, and then we'll go check on the patient," said Director Liu.

"Director..." The chief resident was stunned.

"Hehe." Director Liu put on his white coat, and without even changing his shoes, he put on plastic shoe covers and walked out.

The plastic shoe covers under my feet made a rustling sound, which was quite noisy.

The chief resident quickly caught up, seemingly realizing he had made a mistake, but upon closer examination, he couldn't figure out what he had done wrong, so he could only awkwardly follow behind Director Liu.

"Xiao Wu, patients with kidney contusions need to be especially careful, particularly when giving instructions," Director Liu patiently explained.

"Explain?"

"They're all standard templates; you can just print them out and have the patient's family sign them. But that's not enough," Director Liu said as he walked forward. "Let me ask you, of all the things you discussed with the patient's family this morning, what was the most important point?"

"Hemorrhage following a contusion can lead to the patient's death." Mr. Wu was confident that he was right.

"No, that's not right." Director Liu denied it directly. "That patient was in the hepatobiliary surgery department. The doctors there were always keeping an eye on things. If they didn't notice the patient's sudden death, it has nothing to do with us."

That may sound cold-blooded, but it's the truth.

The resident pondered for a moment.

What could be more serious than a ruptured hematoma and bleeding after a contusion?

"Xiao Wu, a few years ago, one of my classmates encountered a similar patient." Director Liu told the chief resident about the old story as he walked toward the hepatobiliary surgery department.

"It even made it onto the news channel later."

"!!!"

"The patient and his family are adamant that the surgeon removed the kidney and used it for a transplant."

"They don't understand, they're just talking nonsense," said General Manager Wu. "What kind of injury did he suffer, Director?"

"The car accident resulted in a ruptured left lung, diaphragm, and spleen. The left kidney and part of the intestines herniated into the chest cavity. A combined incision was made, and a urologist from the local hospital came on stage with us. They saw that the blood supply to the left kidney was good, and it was only contused, so it did not need to be removed. They repositioned it and removed it from the chest."

"Could it be spontaneous renal amputation?" Only then did Mr. Wu recall this diagnosis.

"Hmm." Director Liu nodded. "Statistically speaking, the likelihood of rupture and bleeding after a kidney contusion is far higher than that of traumatic nephrectomy. But the consequences..."

He hesitated for a moment, then shook his head helplessly. "Ordinary people can understand bleeding from a ruptured hematoma. When faced with the choice between removing the kidney and preserving it for observation, they almost always choose observation, since it is the kidney."

"However, patients cannot accept that their kidneys may become ischemic, necrotic, atrophy, or disappear a month or even longer after the surgery."

Mr. Wu remained silent. He vaguely understood what the director meant, but felt that the director was making a mountain out of a molehill.

The incidence of traumatic nephrectomy is very low. The kind of sudden disappearance of a kidney that the doctor mentioned, where the patient thinks it was removed during surgery and used as a transplant organ, is something that the patient will probably never experience in their lifetime.

Seeing that General Manager Wu was silent, Director Liu glanced back at him and already understood.

Mr. Wu doesn't think such a low-probability event will cause any problems.

This is related to a person's personality. Director Liu is the kind of person who is somewhat obsessive-compulsive and always wants to be perfect.

"In the future, we must repeatedly explain this to the patients' families for similar cases." Regardless of whether the ward director agrees with his statement, Director Liu emphasized, "We must say it at least three times, and we must also tell the patient after they regain consciousness, and we must make sure they sign the consent form."

"Director, isn't that unnecessary?" General Manager Wu chuckled.

As they spoke, the two arrived at the hepatobiliary surgery department and headed straight for the postoperative patients' wards.

Mr. Wu quickly walked a few steps and pushed open the door.

"There is a rare possibility, which I'd like to emphasize. In cases of renal contusion and laceration, the renal artery may..."

Director Liu paused, and General Manager Wu's expression changed slightly.

The voice was explaining to the patient's family the origins of autoresection of the kidney and the serious consequences it would cause.

As Director Liu listened, his expression gradually became serious.

(End of this chapter)