Chapter 168

Fang Ziye had already finished his own matters, stood up at once, but did not rush to leave; instead, he asked, "Brother Lei, in our hospital's emergency consultations, is it always the duty doctors who run them?"

If Fang Ziye had not misheard, it should be such a model.

Guo Yunlei had obtained his physician qualification certificate last year, and after registering, he formally participated in duty shifts; if following such a model, Guo Yunlei must have run emergency consultations before.

"Yes, Brother Ye." Guo Yunlei nodded slightly, shifted the keyboard a bit, and angled toward Fang Ziye's direction to show respect.

"Are there any precautions for running an emergency consultation? If not, I'll head straight there." Fang Ziye asked casually, not wanting to waste time.

Guo Yunlei's gaze flickered slightly, thought for a moment, then said, "If the patient has been seen before, Brother Ye, you might need to pay a bit more attention."

"Because whether it is Enshi People's Hospital or Minzu University Hospital, transferred patients might be difficult patients, but if it is a first visit, it is relatively simpler."

"Generally, routine emergency patients are called directly to the ward by the Emergency Department; such emergency consultations are mostly multidisciplinary combined injuries, and since our department has treatment indications, we suggest other specialties consult to evaluate vital signs before hospitalization."

Actually, Fang Ziye's question surprised Guo Yunlei quite a bit, but considering Fang Ziye had previously been at Zhongnan Hospital, where junior doctors basically found it hard to obtain permission.

Not to mention master's and doctoral students like Fang Ziye, even mature doctors who went for further training could not be allowed to do duty shifts, and even the chance to go on stage could only be waited for and strived for.

"Okay, thank you, Brother Lei. If there are problems, I might still call you, Brother Lei, don't brush me off. The mutual learning I speak of is not commercial mutual flattery; I really will ask you." Fang Ziye gave these instructions, then walked out.

From Jie Han and Luo Tingzhu, Fang Ziye had learned a little: if you don't understand, ask; don't worry about losing face; if you can learn something, what does face matter?

Fang Ziye glanced at his chest; his name badge had not been made yet, but it did not matter. He was going as a licensed physician, and a name badge was not absolutely necessary. Even if he wore one, it could only be the title of Resident Physician.

Fang Ziye was very familiar with Enshi Central Hospital. He had been to the Emergency Department once before. Although there was some distance to the inpatient building, it was still fine.

The elevator speed could not be increased. After getting off the elevator, Fang Ziye hurried into a jog.

During an emergency consultation, the consulting physician must arrive within fifteen minutes. There might not be such an absolute restriction, but if possible, Fang Ziye still tried to get there as fast as possible to save time.

What if it were a large hematoma or trauma?

Then they would have to call the operating room immediately and have a superior find time to send the patient to the operating room.

However, before seeing the patient, Fang Ziye could only speculate based on the general procedure.

Fang Ziye soon arrived at the Emergency Department, which was still somewhat chaotic.

Family members supporting patients, patients, stretchers, wheelchairs, patients covering their hands, patients covering small wounds, nurses pushing carts, and white coats hurrying in and out—too many to take in at a glance...

Fang Ziye quickly ran to the door of the Surgical Emergency Clinic and called inside, "Teacher, which patient is the Orthopedics emergency consultation patient?"

The Surgical Emergency Clinic covered an area of about twenty-plus square meters, slightly larger than a ward room. Directly opposite the door was the workbench, and on the left and right sides were stretcher beds.

Two patients lay on the left, three on the right. Each had white coats beside them processing or reading films, and some were writing emergency medical record books.

Fang Ziye asked the white coat sitting at the doctor's workbench while approaching.

"Orthopedics? Emergency consultation?" He was stunned for a moment, clearly unable to match which of the five beds outside needed an orthopedics consultation.

"Oh! ~"

"Orthopedics, come with me."

"Brother Yu, help me take a look..." After standing up, he called out toward the distance.

Although there was no verbal response, Doctor Yu, who was performing debridement on a patient, had already nodded.

"Teacher Du, did he go to the operating room?" Hearing this, Fang Ziye's heart tightened slightly.

Fang Ziye saw that the doctor in front of him, with a very square head, was named Du Gaozhong, so he politely called out Teacher Du.

Du Gaozhong wore a mask and cap. Hearing this, he shook his head: "No. This patient and his family are a bit difficult. They were transferred from Minzu University Hospital. The medical record book already has treatment opinions."

"For this patient transferred from an outside hospital, we will definitely prioritize the outside hospital's opinion. We hope he gets an MRI first, then asks your Orthopedics Department to come look. But the patient disagrees, insisting on asking whether Minzu University Hospital called to say hello, claiming we are in collusion."

"Earlier, they were making a scene in the emergency clinic, and our director took them aside."

"You need to be careful and cautious." Seeing Fang Ziye was young, Du Gaozhong kindly reminded him.

He was probably in his thirties, steady in character, neither flustered nor hurried.

Those who had stayed in the Emergency Department had seen no small number of casualties; if flustered, they definitely could not stay.

"Thank you, Teacher Du. Now I understand." After listening, Fang Ziye followed Du Gaozhong to what looked like a relatively private Deputy Chief Physician's Office.

They had just reached the doorway when Du Gaozhong was about to knock, but a voice came from inside: "Director Ning, don't keep speaking up for those doctors from Minzu University Hospital."

"Just tell me what's wrong with them. I just twisted it a bit, and they did X-rays, did MRIs, and even insisted that without an MRI there would be no treatment, even suggesting hospitalization."

"What kind of doctors are these."

Du Gaozhong's hand paused slightly, but after a stalemate of three seconds, he knocked with his left hand and pushed the door open with his right: "Director Ning, the Orthopedics consulting physician has arrived. I'll bring him in directly."

Fang Ziye stood beside Du Gaozhong and did not linger. After Du Gaozhong opened the door, he walked straight in.

Orthopedics and the Emergency Department were parallel units; there was no such thing as upstream or downstream departments. Moreover, when Fang Ziye had previously been in the Trauma Surgery Department at Zhongnan Hospital, the first lesson he received was: when encountering a patient, go look first, worry about whether you can treat later; do not hesitate, do not waver.

This was an art of getting along.

"Hello. Which patient is it, and where are you uncomfortable?" After entering the office, Fang Ziye first smiled at Director Ning, then asked the two people sitting directly opposite Director Ning's desk.

One man and one woman, probably in their forties, likely a couple.

"Sigh, you look yourself. One person comes and asks once, another person comes and asks once. I say, what's wrong with your hospital nowadays?"

The injured man directly used the arm of his right healthy hand to nudge the medical record book on the table.

His palm was still carefully protecting his shoulder joint.

Director Ning immediately said: "Doctor Fang, the injured one is this gentleman. The family member beside him is his wife. It should be a shoulder joint dislocation."

"He was seen at Minzu University Hospital before. They suggested an MRI and possibly surgical treatment. You are a professional orthopedics doctor; please take a look too."

Director Ning did not even acknowledge Du Gaozhong, who had brought Fang Ziye over. Instead, with a seemingly ordinary sentence, he projected a huge amount of information to Fang Ziye.

The patient and family member were both difficult to deal with. They had been seen at Minzu University Hospital before and wanted examinations and surgery.

Fang Ziye's voice and tone were very gentle. While flipping through and carefully examining all the data and medical records, he said: "You were seen at Minzu University Hospital before. Why didn't you choose to be treated there?"

"The Trauma Surgery Department at Minzu University Hospital is excellent."

Fang Ziye did not say his own hospital's Trauma Center was bad, nor did he dare say such a thing.

"That's all just talk. They treat patients differently based on status. Those with connections get a manual reduction and are sent away. People like us, ordinary common folk with no connections, they keep us here and cut us open."

"It's the same problem, but the solution is completely different."

At the same time, Fang Ziye saw the signature on the medical record book, and his heart tightened once again.

Wu Xuanqi.

Then he quickly scanned the medical records written by Wu Xuanqi; they could be described as concise and sharp.

It had been two hours since the injury, because Doctor Wu had very professionally recorded the time the medical record was written, writing nine fifty in the morning, and the recording time was thirty minutes ago.

The diagnosis given was moderate posterior shoulder joint dislocation, rotator cuff injury?

For shoulder joint dislocations, the most common is anterior dislocation, then inferior dislocation, and posterior dislocation and superior dislocation are the rarest.

And the reason they are rare is that the violence of the injury is great; generally, such violence causes fractures rather than dislocations. Only in extremely rare cases can it manifest as a posterior dislocation, but the possibility of accompanying rotator cuff injury is as high as over ninety-five percent.

The probability of ninety-five percent might still be relatively conservative.

There was no need for a physical examination; there were definitely signs of dislocation. Fang Ziye just took one look and roughly understood what was going on.

He then asked: "Uncle, just now you said Minzu University Hospital also reduced a dislocation. Can you be sure that the patient Minzu University Hospital previously reduced manually was also a moderate posterior dislocation injury like yours?"

"It seems I am ignorant and uninformed; I've never heard of a moderate posterior dislocation being able to be reduced manually!"

First, what Fang Ziye could be sure of was that the complications of posterior dislocation were definitely one hundred percent; the reason he left a few percent probability of no accompanying symptoms was just not wanting to speak too absolutely.

Second, Wu Xuanqi was a professional doctor; his professional operation of manual reduction and diagnostic ability were definitely possibly better than his own. Since he didn't perform reduction and analgesia immediately but suggested an MRI, the problem was definitely not small.

"What do you mean? You think I'm lying to you?" The middle-aged man turned his head, his tone and expression both somewhat fierce.

Because he knew that if he wasn't fierce, then what he faced would be the doctor's indifference.

"That's not it; it's just my personal understanding that yours is a posterior shoulder joint dislocation. Originally, this form of dislocation is rare, and basically it can rarely be completely solved by manual reduction; at most it's just temporary analgesia."

"To solve the problem, surgical treatment is definitely still needed." Fang Ziye explained slowly.

Just as he was about to ask if there were any more films.

The man roared again: "You already know, you don't even look at me, and you can tell what reduction I had? Are you here to see a doctor or to read a book? You believe whatever he writes?"

Fang Ziye was not angry, knowing that at this time he must not add fuel to the fire: "Uncle, this is wronging me. I wanted to ask you directly at the first opportunity, but you said you were too lazy to talk and told me to just look myself?"

"Right, this auntie can also make the decision for me on this point."

"You only let me look at the medical record; I certainly can't just perform a physical examination on you directly, can I?"

The middle-aged woman glanced at Fang Ziye; Fang Ziye's eyes carried a smile, and he was somewhat endearing.

But she also said somewhat angrily: "Doctor, don't be so long-winded. Just say one thing: when exactly will the treatment be?"

"My husband has been injured for almost two hours. Until now, no one has come to handle it. How is this problem to be solved? If your hospital is all like this, perfunctory and evasive, then I can only report you."

Hearing this, Fang Ziye's eyes flashed, suppressing the fire in his heart, and he spoke calmly: "This, handling is within the scope of treatment and must be after a precise diagnosis. From receiving the emergency consultation call until now, it hasn't even exceeded fifteen minutes."

"And getting here took eleven or twelve minutes. Right?"

"I don't even know what the diagnosis is, so how can I handle it? I can't even make a suggestion."

"If you don't give me a chance to diagnose, then you complaining about our hospital is also unreasonable and illogical. We are not unreasonable people and won't do such things, right?" Fang Ziye had only been in the door for about a minute.

"That certainly can't be unreasonable." Fang Ziye's one sentence of flattery was slightly effective.

"I'm here to treat an illness, not to specially complain. It still hurts a lot here; I certainly don't have time to complain about anything. You look at me and see how to handle it." The man's affected left shoulder trembled slightly; obviously he was in great pain.

"Alright."

Fang Ziye approached while gently touching a few times, and after casually asking a few questions about medical history and the injury process, he asked: "Do you have printed copies of the films you took before? Or can you check the results on your mobile phone?"

"Based on preliminary consideration of the physical examination, posterior dislocation of the shoulder joint definitely exists; otherwise you wouldn't hurt this much. But as for the degree of dislocation..."

"Can it be reduced?" The man didn't listen to Fang Ziye's many explanations.

"That also depends on the situation. I don't know the degree, so I don't know if it can be reduced. If you make me believe the medical record, then I tell you, it can be surgically reduced, but not manually reduced." Fang Ziye answered without leaving a loophole.

"Hey, who are you? Don't you have a senior physician in your department? Where is your director?"

"Doesn't the director come for consultations?" The middle-aged woman didn't notice any loophole in Fang Ziye's words and was slightly annoyed.

Director Ning was now active: "Sister, this really is the case."

"For an emergency like yours, the director does not directly participate in emergency consultations unless it's a problem the junior doctor can't solve, in which case the junior doctor will request a senior physician to come inspect."

"Then request him! He can't handle it; one look and you can tell he can't handle it." The woman gently slapped the table.

Director Ning's tone stalled for a moment.

Fang Ziye took over the conversation: "How about this? For your situation, first return to the Orthopedics Department ward, then I'll call our director. After the director finishes surgery, he'll come take a look. This process might take one or two hours."

"Because the director..."

"One or two hours? Are you joking? You make an emergency like us wait one or two hours? What's the point of an emergency then?" Hearing this, the man seemed to think Fang Ziye was a weirdo.

"Uncle, the emergency is not the emergency you understand."

"Our hospital doesn't just have emergency; there's also the outpatient clinic and surgery. The director is currently in surgery, and the patient on the operating table needs our director to solve the problem with surgery. So, according to triage, your case will be scheduled even later."

"The director definitely wouldn't leave the operating table directly to come see an emergency shoulder joint dislocation." Fang Ziye also became a bit more temperamental.

"I don't care anyway. If you can't solve it, call your director over. Otherwise I'll complain about you. What kind of damn rules are these? Surgery here, surgery there—is your hospital's business just the best?" The man began to act like a rogue, turning his head aside, as if he had Fang Ziye trapped.

"Then I'm powerless. If you want to complain, I can't do anything about it."

"Then I'll write it: you refuse to cooperate with my suggestion and strongly demand a senior title physician to see me. Is that what you mean? Right?" Fang Ziye was also decisive, directly picking up a pen to start writing.

"When did I refuse?"

"You young man, don't talk nonsense, okay?" The woman wouldn't let Fang Ziye write and snatched the medical record book away in one grab.

"If you can't solve the problem, just ask your superior to come over. It's such a simple thing; do I need to teach you?"

Fang Ziye said: "Thank you, not necessary, but I also won't make a phone call. None of my teachers ever taught me that a dislocation patient should directly call a superior."

"The choices you can make now are only these few: first, let me diagnose you and give you a relatively reliable suggestion based on my seniority."

"Second, you can go to other hospitals for treatment. Third, you just wait for the senior physician to come and examine you."

"To solve the problem, there are only these methods. No matter how you choose, your power is the greatest."

"You don't listen to my suggestion or my opinion; you just want me to call my superior. That's absolutely impossible. Our superiors won't come either; they'll just make you wait in the ward. I've already analyzed the approximate waiting time for you."

"Do you have any other questions?" Fang Ziye asked patiently again.

"You really think I don't dare to whistleblow? You believe me or not, I'll go right now?" The middle-aged man's face hardened as he said to Fang Ziye.

"Whether you go or not is your freedom. If you want to go, I also cannot restrict your personal freedom. I have already fulfilled the duty I should do. It's just that you refused my diagnosis and suggestion. What else can you whistleblow about?"

"Whistleblow that I didn't agree to your unreasonable demand?"

"Also, your emergency medical record book, I still need to use it. I have to write my suggestion clearly and understandably." Fang Ziye explained like this, and also did not flare up, relatively calm and composed.

Hearing Fang Ziye say this, the middle-aged man only then squeezed out a sentence: "You give me one sentence, does Minzu University Hospital have a misdiagnosis or not?"

Exposed his true intention.

(Chapter End)