Chapter 407: A Big Pot

"Director Sui." Chief Bai answered the phone.

Director Liu pricked up his ears, listening carefully to the conversation between Chief Bai and the person on the other end.

Director Sui first briefly reported the medical history—the patient underwent a left total knee arthroplasty under spinal anesthesia 8 hours ago.

A pneumatic tourniquet was inflated for hemostasis before the skin incision, with a usage time of 90 minutes; during the surgery, routine tibial plateau and distal femoral osteotomy were performed, the posterior joint capsule was released, no abnormal conditions occurred during the operation, and the surgery concluded smoothly.

Postoperatively, the patient's dorsalis pedis artery pulse could not be felt; Director Sui palpated the tibial posterior artery, but neither vessel pulse could be felt.

After waiting for about 15 minutes, he palpated again to confirm, but still could not feel a pulse.

The skin temperature of the limb distal to the left knee joint was significantly lower than that of the contralateral side; Director Sui suspected the possibility of popliteal artery injury and occlusion.

Therefore, Director Sui urgently requested the Ultrasound Department to perform a vascular ultrasound, which showed: no arterial blood flow spectrum could be detected in the left tibial anterior/posterior arteries and dorsalis pedis artery; the arterial blood flow spectrum distal to the popliteal fossa had disappeared, while proximal exploration was normal.

Knee arthroplasty, postoperative popliteal artery occlusion—Chief Bai listened quietly. Not only him, but even Director Liu could hear where the problem lay.

No wonder Lao Bai wanted to take precautions; it was likely that Director Wang of the Vascular Surgery Department didn't dare to act, as his skill level wasn't enough, and he wouldn't understand it even if he stepped in.

"Chief Bai, Director Wang wants to perform catheter-directed thrombolysis, and he still needs a consultation for thrombolysis?! If we wait any longer, the patient will have to undergo amputation, amputation!" Director Sui roared in anger.

"I understand." Chief Bai said calmly.

"Chief Bai, I want to apply for a hospital-wide consultation." Director Sui finally revealed his true intent, "You must come; with you presiding, the Vascular Surgery Department won't dare to say such bullshit."

"A hospital-wide consultation, I'll go immediately. Are you at the hospital?"

"How would I dare to leave." Director Sui complained, "Chief Bai, the patient won't last until dawn tomorrow."

"I understand." Chief Bai hung up the phone.

"Heh heh." Director Liu laughed, "It's probably that Director Wang doesn't dare to handle it; catheter-directed thrombolysis is the simplest, but the results are poor... that's the Orthopedics Department's business. This big pot, in the end, still has to be picked up by you, Lao Bai."

Chief Bai curled his lip and dialed a number.

"Xiao Ji, it's me." Chief Bai said, "Orthopedics, consultation, come immediately."

He spoke in a commanding tone.

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

After a brief exchange, he hung up the phone, and Chief Bai stood up, "I'm going back to take a look."

"Lao Bai, you're a Chief now, after all; you still have to be responsible for this kind of thing." Director Liu said.

"There's no one else." Chief Bai was also very helpless, "I'm asking Xiao Ji to go take a look; if it can be solved, we'll solve it; if it can't, I'll discuss it with the First Affiliated Hospital."

"Let's go take a look together."

Chief Bai glanced at Director Liu, "Dazhi, don't think too much about Xiao Ji's situation. I'm really not joking; in three years of standardized residency training, it would be a lot if he could stay in our hospital for a year and a half."

"Then you still want to apply for an Intermediate Certificate for Ji Xiang."

"I'm considering that if Ji Xiang can use a year to help bring up the Vascular Surgery or Interventional Department, that would be best." Chief Bai laughed, "It's wishful thinking, but I think it's possible. As for you, you want to keep Ji Xiang? Don't dream."

"Heh, that's not necessarily true." Director Liu knew what Chief Bai meant, but he still stubbornly insisted.

When the two returned to the hospital, Ji Xiang had already changed his clothes and was reading the medical record in the Doctor's Office.

"Xiao Ji came quite fast." Chief Bai said.

"My home is closer." Ji Xiang looked up, smiled gently, and then lowered his head to read the medical record again.

"Director Wang, Director Sui, let's hold a meeting now; state your opinions." Chief Bai didn't mince words and got straight to the point.

"Chief Bai, please sit." Director Sui moved a chair and placed it in the innermost corner, facing the door of the Doctor's Office.

This was Chief Bai's habit; ever since the death of an otolaryngologist in Harbin, he had always insisted on sitting in a position facing the door.

From here, one could overlook the entire room, which was the safest.

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

"Chief Bai, I can remove the patient's thrombus." Director Wang said first; he made an assumption, and Chief Bai treated this kind of rhetoric as farting.

"But a stent needs to be placed in the local blood vessel, yet the patient just finished knee arthroplasty, which is a contraindication for stent placement."

"So I suggest catheter-directed thrombolysis. But Director Sui says he's worried about future complications and insists on..."

"Is simple thrombolysis problem-free?" Director Sui immediately interrupted the Vascular Surgery Director Wang, saying with extreme unhappiness amidst his anxiety, "The speed of thrombolysis is so slow, what if the patient's lower limb becomes necrotic!"

Chief Bai felt a wave of annoyance listening to their argument.

But this was the norm in clinical practice; neither Director Sui nor Director Wang wanted to take the blame.

This job was a rotten job; whoever took it would be in trouble.

If he were the director of the Vascular Surgery Department, he probably wouldn't take it either.

But this was a hospital; it was impossible for there to be a situation with zero problems, and there were always plenty of rotten messes.

"I've roughly scanned the medical record; Xiao Ji, tell us your opinion." Chief Bai tapped the table and said to Ji Xiang.

"Thrombectomy, no need to place a stent." Ji Xiang was slightly "startled," as if he had been distracted before answering Chief Bai's question, but he answered immediately.

"Doctor Xiao Ji, don't talk nonsense." Director Wang of the Vascular Surgery Department scolded; he felt some disdain, but was even more flustered.

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

"Then prepare for surgery." Chief Bai made the final decision.

"Chief Bai, I won't do it; the patient has surgical contraindications." Director Wang of the Vascular Surgery Department said directly.

For such a big pot, he would rather apologize to Chief Bai afterward than take the blame himself.

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

"I am." Ji Xiang replied.

"I won't be the assistant." Director Wang of the Vascular Surgery Department dodged completely.

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

"This is..."

"An exception; I've applied for an Intermediate Certificate in Interventional Medicine for you."

"!!!"

"!!!"

"!!!"

Sui Zhuren, Department of Vascular Surgery Director Wang, and General Manager Xu Leyu saw stars before their eyes.

The Physician Certificate exam had been passed, but it seemed the certificate hadn't been issued yet, and Bai Chuzhang had already gone to apply for an Intermediate Certificate for Ji Xiang? Furthermore, looking at Ji Xiang's expression, he didn't seem to know about this matter.

"Xiao Ji, to be honest with you, this Patient is a tricky Patient," Bai Chuzhang said frankly, not intending to hide it from Ji Xiang, "If you don't want to take the blame, I will go find the provincial Expert Group to come for a consultation and see. But time..."

"Bai Chuzhang, the surgery should be no problem," Ji Xiang picked up the Intermediate Certificate, looked at it for a moment, and then asked, "It seems an Attending Physician cannot perform Level 4 surgeries either."

"Who said that?" Bai Chuzhang said expressionlessly, "If you can handle it, get on the operating table now."

(End of this chapter)