CHAPTER 532: CHAPTER 232: DIRECTOR SHANG’S HIGH PRAISE AND DR. YU’S INDIRECT PLEA FOR HELP

It’s like drilling through a wall; no one can guarantee a precise breakthrough to the designated point on the other side.

To veer off-course or off-target is nothing uncommon.

Moreover, the length of the obstructed anastomosis in the patient is not just a little.

When obstruction occurs, if one can receive surgical treatment immediately, the difficulty could be somewhat lessened. Now, months have passed, the obstructed segment has lengthened a lot, and the difficulty of opening it up has increased substantially.

Zhou Can painstakingly contemplated the surgical plan.

A bold surgical plan was gradually taking shape in his mind.

"With the aid of an ultrasonic endoscope, plus X-ray assistance, perhaps it can successfully penetrate the obstructed connection between the esophagus and jejunum. This requires a skilled nurse to assist, as well as the surgeon in control of the endoscope to have an exceptional foundation in endoscopic surgery and piercing techniques."

There is no need to mention Zhou Can’s proficiency in endoscopic operations; he is naturally gifted and skilled in technique.

The piercing technique is actually highly similar to the injection skill.

If the injection level is high, the piercing level is impressive as well.

Thus, there are no technical barriers for Zhou Can to personally perform the surgery on this patient.

Finding a skilled nurse to assist is also not difficult.

First, use the ultrasonic endoscope to penetrate the obstructed segment; it only requires a fine needle to puncture from the esophageal anastomosis end to the jejunum. Then place a covered metal stent to expand the obstructed segment from the esophagus to the jejunum.

That would successfully open it up.

As for resolving esophageal anastomotic fistula, under generally non-severe conditions, conservative treatment is often chosen.

For this patient, the condition is extremely severe, and surgical removal of the fistula is preferred.

Zhou Can reviewed the patient’s surgical plan several times in his mind, meticulously examining and checking for any oversights. He even hand-drew the surgical schematics.

After completing all this, what remains is to consult with Director Shang.

If approval is obtained, then communication with the family can proceed.

As long as the family trusts the hospital and agrees to the surgical plan, it can be implemented specifically.

With thoughtful consideration, he was now waiting for Director Shang to arrive.

Chief physicians usually come in later, many arrive around nine o’clock to the department office.

He didn’t have any other tasks at hand anyhow, so being idle was the same as being busy.

He began to review other cases in the group.

Thinking back to the patient in bed 73 who was groaning during the morning ward rounds, he decided to first understand the patient’s condition.

The patient was 51 years old, with a long history of alcohol consumption, a daily necessity. The reason for being admitted was unbearable abdominal distention and pain. Ultrasound and X-ray examinations both showed pancreatic duct stones.

The attending physician was Director Shang, who had arranged for an endoscopic surgery to remove the stones.

The surgery was conducted yesterday.

They performed a sphincterotomy and pancreatic duct dilation for stone removal.

The surgery went very smoothly.

Both the surgery record and the postoperative nursing records indicated that the surgery was successful.

This patient should be fine.

After reviewing the case, Zhou Can continued to examine other cases in the group.

What interested him the most were the cases of complex and miscellaneous diseases.

For each such case diagnosed, one could be rewarded with 100 Experience Points for pathological diagnostics.

Up till now, his level in pathological diagnosis remains at a sub-attending grade.

This medical skill is also one of the most difficult to level up among the many medical skills.

Pharmacological differentiation is also hard to advance, mainly because he previously lacked prescription authority.

Now that he’s got his Medical Practitioner Certificate and has entered the Internal Medicine department, which focuses on drug treatment, his experience in pharmacological differentiation is sure to skyrocket.

"Hey, Dr. Zhou, you’re early! An early bird catches the worm. No wonder your medical proficiency is so high with you being so diligent every day."

Resident Doctor Luo Shengsheng, after finishing rounds, came back to the office and saw Zhou Can, who was earnestly reviewing and studying the group’s cases, and immediately greeted him with a smile.

In fact, in the spacious office, there were two other interns and one resident doctor.

Luo Shengsheng ignored them and chose to greet Zhou Can first.

One could tell this person was a bit of an opportunist.

Seeing Zhou Can’s potential and that he was being personally mentored by Director Shang, with a bright future ahead, it was natural for him to hold Zhou Can in high regard.

In his eyes, Zhou Can’s status exceeded that of a common resident doctor.

"Don’t flatter me, Mr. Luo! Compared with the likes of you seniors, my diligence is nothing. Besides, isn’t there a saying: ’The early worm gets eaten by the bird’? I might just run into a difficult patient first thing in the morning and end up totally overwhelmed," responded Zhou Can with a smile.

"Haha! Dr. Zhou, your way of thinking is really unique. The early worm gets eaten by the bird, this kind of counterintuitive thinking is a first for me. Speaking of difficult patients, I did encounter one. The patient in bed 13 had several emergencies last night, and this morning from 6 a.m. onward, it almost drove me to the brink. By the way, has Dr. Chi arrived?"

Luo Shengsheng talked about that patient with a frustrated and downcast expression, amusingly enough.

Sometimes, whether they were resident doctors or interns, trainees, they all tried to avoid those problematic patients as much as possible.

Because nobody wants to deal with trouble.

Luo Shengsheng is the Chief Resident, on duty all year round; these kinds of situations were unavoidable for him.

However, being a Chief Resident is also a necessary step toward becoming an attending physician.

It can be seen as a form of tempering.

Indeed, it’s quite a training experience.

After a year of training, many resident doctors could be completely transformed.

The ability to handle medical cases solo, emergency response for critically ill patients, and dealing with various emergencies, rapid decline in patient vitals, family disputes, etc., would all significantly benefit them.