Chapter 183

Xue Tao had by now completed the temporary compression hemostasis and handed over the disinfection site to Wang Zhongxing.

Wu Guo Nan looked toward Peng Yuanming with a surprised expression: "Amputate both lower limbs? Not save a single one?"

Peng Yuanming walked over, examined the situation, and said: "Director Wu, take another look at the perfusion of the lower limb distal ends right now?"

"After a certain length of time with proximal femoral artery injury, the distal arteries will form organized thrombi; this is a reactive blood coagulation process."

"Blood that does not flow clots; I fear the patient's deep veins currently also contain large amounts of thrombi. The body's self-protection mechanism will ensure blood supply to the head, heart, and other visceral organs."

"The surrounding vessels will naturally clot into thrombi."

"Even if I suture the femoral arteries, brachial arteries, and other major arteries right now, as far as the distal limbs are concerned, it would be of no avail!"

"Unless your Orthopedics can perform a limb-salvage procedure. Otherwise, rather than dealing with the arteries, better to amputate directly and manage it, to avoid subsequent accidents from limb necrosis." Peng Yuanming also advised decisively.

Hearing this, everyone's faces changed.

Amputation is easy; limb salvage is difficult, and not a simple surgical technique.

But Peng Yuanming was not shirking responsibility; the current situation simply was so.

"How long has it been since the patient was injured until now?" Wu Guo Nan asked Xue Tao; Xue Tao was the Orthopedics doctor who received the patient first.

After injury, thrombi do not form immediately; a certain reaction time is needed.

"From arrival at the hospital to now, only forty-odd minutes have passed, but the time of injury cannot be determined. From what people say, it seems someone discovered someone injured and then called the police." Xue Tao replied.

"Or transfer to Min Da Hospital." Seeing Wu Guo Nan's difficulty, Peng Yuanming offered another fair suggestion.

"If this patient could be transferred, they would have been transferred directly from the Emergency Department." Wu Guo Nan said.

"Then there's no way; I can't do limb salvage either." Peng Yuanming spread his hands.

The atmosphere fell into a deadlock.

Listening to this group's conversation, Nie Mingxian at the anesthesia machine rolled his eyes incessantly, inwardly vexed.

If no surgery is done, the drugs I used — how much money will I lose? Will I have to make it up in the end?

Watching a group of people engaging in pointless argument there!

Nie Mingxian truly wanted to give each of them a slap —

For just this thing, if you really can't manage, do limb salvage first; if it really can't be done, switch to amputation intraoperatively, can't you?

It's just that he is currently an Anesthesiology doctor, temporarily without Emergency Surgery surgical permission; otherwise he would have to put on the clothes and get on the table.

Anesthesiologists' registered scope is routine anesthesia operations, not surgical practice.

"The patient's vital signs are unstable right now; if we delay further, our Anesthesiology may not be able to maintain the current vital signs!" Nie Mingxian began urging.

Peng Yuanming looked at Nie Mingxian and said impliedly: "Director Nie, it's not that we don't want to do it; there's just no way now. My suggestion is direct amputation, save the life first."

"If the life is gone, the legs being there isn't very meaningful."

Coincidentally, Peng Yuanming was the only one in the hospital who knew Nie Mingxian's surgical attainments were not inferior to Min Da Hospital's Wu Xuanqi, only Nie Mingxian had by some twist of fate become an Anesthesiology doctor.

He couldn't throw the problem to Nie Mingxian, but limb salvage was something Orthopedics' Wu Guo Nan had to do, yet Wu Guo Nan definitely couldn't pull it off; then if he went to handle the vascular anastomosis at this time, it would be wasting precious time doing useless work.

"Good! Director Huang, you're the Vascular Surgery expert; I'll follow your suggestion!" Wu Guo Nan was very decisive.

Since Peng Yuanming suggested amputation, then amputate.

Wu Guo Nan understood Peng Yuanming's meaning, but in the current situation, even if they called Old Director Hong Du, it couldn't be handled.

Once thrombi form, whether DIC or long-segment thrombi, they are not something the Orthopedics of Enshi Central Hospital can handle.

Without a diamond drill, don't take on porcelain work.

"Director Peng, let's go talk to the patient's family together……"

Five minutes later.

Operating room doorway, Family Communication Room.

A middle-aged man in uniform before Peng Yuanming and Wu Guo Nan!

Slammed the table hard, face full of fury —

"Your meaning is, you're going to amputate both hands and both feet?"

"Not leave a single one?"

"If that's really the case, even if life can be saved in the end, how is he supposed to live afterward?" The middle-aged man glared with eyes nearly round, almost wanting to eat Peng Yuanming and Wu Guo Nan alive.

"If the life is gone, discussing whether hands and feet remain is an even more meaningless thing."

Peng Yuanming explained: "We cannot hesitate and delay any longer."

"The patient's condition is already complex; besides four-limb arterial injury, there are also internal cavity viscera and thoracoabdominal bleeding, multi-site bleeding, which will kill a person."

"In such a situation, the optimal solution is amputation for hemostasis to save the life."

"Because even if we call a Vascular Surgery expert for consultation surgery now, the patient's current condition may not hold until then."

"Want the life or want the four limbs?" Peng Yuanming was not threatened by Liu Chaodong's words at all; clear logic, exceptionally decisive.

"I want both!" Liu Chaodong continued pounding the table.

"Then you must bear the risk of the patient losing their life at any moment during surgery; can you represent the patient's family?"

"Let me put it clearly: in Enshi, under the current circumstances, the only doctor who can perform limb-salvage surgery and intravascular thrombectomy is Dr. Wu Xuanqi inside Min Da Hospital."

"Other doctors can't do it; don't bother asking. I understand the situation better than you."

"But Dr. Wu is already on the operating table doing a rescue surgery; Min Da Hospital has its own rescue patients; at the earliest, it will take two hours before he can depart."

"And he said on the phone, even if he comes, it's not certain……"

Peng Yuanming's words seemed to provoke the middle-aged man: "Two hours before he can depart? What kind of person the hell did you find? What a grand entrance?!"

"Why doesn't he just wait for the person to die and then come collect the corpse?"

"He doesn't know the situation here; you tell him to rush over?"

"People are about to die here."

"The person lying in the operating room — what identity, don't you have a number in your heart? Didn't I tell you?"

Liu Chaodong slapped the wall in rage, not holding back his violent temper in the slightest.

He took off his regulation cap, revealing a Mediterranean hairline. Then he smashed the brim of the cap directly until it broke.

Peng Yuanming, however, was very experienced. After taking a deep breath, he directly took out his mobile phone: "This family member, whose life isn't a life? Whose emergency surgery isn't saving a life?"

"Whose life is more important than whose, whose life is more noble, come on, say it right here!!!!"

Peng Yuanming pressed the recording button.

"Video recording works too!" Peng Yuanming chose the most forceful way to handle the emotions.

The middle-aged man fell silent.

Regardless of his identity, saying these words would get him dragged onto the moral high ground and roasted. He could feel his own subordinates were more important than others, but he couldn't say it.

"There's no way!"

"In an emergency situation, we must use severe measures."

"Do you think we're willing to amputate the patient? Are we willing to create a disabled person?"

"If we can't do it, it will only harm the patient!"

"Doctor Wu is currently on the operating table, we invited him for a consultation on the surgery, note it's an invitation, not a demand for him to come do surgery, can Doctor Wu ignore his own patient's surgery?"

"You decide quickly, we don't have much time to talk either." Peng Yuanming put the phone down again, not actually intending to record.

"Besides him, is there no one else in the entire Enshi City?"

"Must it be him?" Liu Chaodong rubbed his Mediterranean scalp fiercely with both hands. Very agitated.

Everyone understands the reasoning, but Zhang Yu lying on the operating table right now is his soldier, his nephew, the only orphan bloodline of his sworn brother, and he nearly lost him.

"There are people, but those who dare and can do it are almost none!"

"I myself do vascular surgery, I can't do it, in our Enshi there's only Minzu University Hospital, People's Hospital, and our Central Hospital that are somewhat up to par. Minzu University Hospital and People's Hospital also have dedicated vascular surgery departments, but I called around in a circle, not a single one dared to come do the surgery."

Peng Yuanming didn't give Liu Chaodong a chance to waste time:

"This isn't playing house, it's not manual labor where you just get a person to make up the numbers."

"If we don't amputate now, then after our other departments' surgeries are all done, the necrotic limbs of both lower limbs and both upper limbs will become even more fatal death warrants!"

The Mediterranean expression, however the special decision made his attention extremely sharp.

He pressed further: "What do you mean almost none? Speak clearly, besides Doctor Wu, is there anyone else who can do it?"

Peng Yuanming hesitated for a moment, then said: "There is, but he can't do it now, he's currently our hospital's anesthesiologist!"

"Then what are you standing here for? Go find him! What do you care if he's an anesthesiologist or not? As long as he's a doctor, save the life!" The Mediterranean man got so angry he was practically bubbling.

"May I ask if you have the authority to do a traffic cop's job and write tickets? Can you go?" Peng Yuanming also got angry and retorted right back, very experienced!

"Can this be the same?"

"Why can't this be the same? An anesthesiologist is an anesthesiologist, a surgeon is a surgeon, legally stipulated, the hospital's temporary authorization can't cross the law either, you're a cop yourself. You say it can't be the same?" After Peng Yuanming finished speaking, he turned on his phone.

"You have one more minute to consider and struggle, if the signing delays the surgery progress, we're also powerless to reverse it."

The Mediterranean man's eyes were bloodshot: "Do you know, he currently holds a very important clue! He can save..."

Peng Yuanming said: "This leader, I don't understand any of what you're saying!"

"I only know, he's currently in our hospital, a patient, a patient about to lose his life, if not treated in time, even if he's an immortal, it'll all come to nothing, however much wealth and information he possesses, will all turn to nothing."

"If you're not a family member, I hope you can contact the family members."

The Mediterranean man's chest heaved violently, looking at Peng Yuanming:

"Contact his family? His parents, my comrades, grandpa, uncles are all downstairs, grandma is over ninety years old. Legs and feet not very convenient, currently rushing over from the countryside, family is poor, no money to get married."

"Which family member do you want me to find? Do you dare go find them? I am the family member! ~"

"I want you to save him back, save him back perfectly intact, can you do it?"

When the Mediterranean man couldn't control his emotions, Peng Yuanming received a call, then couldn't care about anything else, answered it right there across the wall.

Tone extremely respectful: "Hello, this is Peng Yuanming!"

"Okay, I understand."

After Peng Yuanming hung up, he said to the Mediterranean man: "No way now, the patient on Doctor Wu's side, the situation is also life and death uncertain."

"Even two hours later he still wouldn't make it in time."

"Now we can only amputate."

"That other one, you said he can't do surgery, I'll call and ask him to do surgery, you don't dare ask, can I ask?" The Mediterranean man was determined.

Peng Yuanming knew Nie Mingxian: "You know I could have not told you about this person, but why did I tell you? To save time."

"I can give you the phone number, but I have to tell you a premise, he was originally a top student at Kyoto University Third Hospital, he signed a contract to work at our hospital in order to afford his father's cancer chemotherapy costs."

"And he entered the Anesthesiology Department which has a higher talent introduction fee, signed a contract."

"If you ruin his future, make it so he can't continue working, you're effectively killing his father, I advise you not to make this call!"

"But the choice is yours." Peng Yuanming actually also wanted Nie Mingxian to step in once, save this patient.

But, these words were his inner concerns at this moment.

Peng Yuanming ultimately still gave the phone to the Mediterranean man.

The Mediterranean man then personally composed himself and made the call, before connecting, he asked Peng Yuanming: "Is the surname Nie?"

Soon, the call connected, the Mediterranean man immediately became polite, gone was the toughness from before: "Hello, is this Doctor Nie? I'm asking you to come to Central Hospital for a surgery, Director Peng here said you."

The phone was directly hung up!

The Mediterranean man almost smashed his phone in anger right then.

Called again, it showed busy, wouldn't be surprising if it was blocked.

He even borrowed another phone, called again, just spoke and the other side hung up again.

"What dogshit thing is this?!" Blue veins bulged on the Mediterranean man's forehead, especially conspicuous because he had no hair.

Liu Chaodong looked at Peng Yuanming: "Several doctors, could you trouble yourselves to call Doctor Nie again?"

"His parents were my comrades-in-arms. Before they died, they entrusted him to me, but this kid is stubborn as hell — insists on walking his parents' old path."

"If all four of his limbs get amputated, I won't have the face to meet his parents. Please, I'm begging you."

Liu Chaodong was pouring out his true feelings — a tough man showing tenderness.

Peng Yuanming's mood was extremely complex.

He could understand Liu Chaodong's feelings, but could only secretly hate his own incompetence — if his own skills were that good, why would he need to beg others?

However, Liu Chaodong might not necessarily understand Liu Chaodong's current state of mind.

After Peng Yuanming made the call, he first announced his identity; fortunately, Nie Mingxian didn't hang up.

Peng Yuanming directly turned on the speakerphone.

Nie Mingxian's words came through loud and clear.

"Director Peng, what do you mean by calling? You'd better find someone more capable."

"You're someone who can save people, right?" Before Peng Yuanming could reply, Liu Chaodong took the phone, his voice hoarse and helpless as he responded.

"Doctor Nie, Doctor Nie, Professor, Expert — I'll call you Grandpa if you want. Can you come save my man? Can I kneel and beg you?" Liu Chaodong's words were crude, not at all like an educated person's.

The young man on the other end pondered for a while, then still took a deep breath and said, "I'm sorry, I still have a father to take care of!"

"You'd better find someone more capable."

"Hanging up now."

Having said that, Nie Mingxian prepared to hang up.

But Liu Chaodong heard Nie Mingxian implicitly admit he could perform such a surgery, and immediately interrupted: "Doctor Nie, wait a moment — I really want to ask for your help."

Liu Chaodong then backed down a step: "Doctor Nie, how about this — you tell me where you are? I'll send someone to pick you up, that's fine. Do you have any way to come take a look first? After you look, if there's still no way, we'll talk again."

Hearing this, Nie Mingxian paused a moment before replying: "I'm right in the operating room, but that doesn't help. I'm not a surgeon — I'm an anesthesiologist."

Liu Chaodong flared up: "What are you pretending at here? Are you even a doctor?"

"Refusing to save a dying man — where's your medical ethics?"

"Do you live up to the oath you swore? What 'powerless'? You just want to wash your hands of responsibility, want to watch him die!"

"A person with no medical ethics like you — might as well quit being a doctor, go home and nurse the grandkids."

"What kind of anesthesiologist are you anyway?" Liu Chaodong was provoking him.

Hard to get.

But this time, Nie Mingxian didn't hang up — instead he said with palpable relief:

"Thanks for the suggestion, but too bad — when I chose surgery back then, surgery paid too little."

"When my dad had no money, no one ever told me the kind of medical ethics you're talking about could be exchanged for cash."

Beep beep beep.

With that, Nie Mingxian hung up, his tone firm and cold, without the slightest hesitation.

Peng Yuanming still wanted to say something, but Chen Liwei came out and whispered a few words in Peng Yuanming's ear.

Peng Yuanming's face changed instantly; he asked in shock, "What?"

"Liver and intestinal rupture — need immediate hepatic repair surgery, possible hepatic pedicle injury not ruled out..."

"Thoracic Surgery says the thoracic situation is still okay..." Chen Liwei said, steeling himself.

This instantly doubled the pressure on Peng Yuanming — the meaning was clear: whether the patient lives or dies now rests entirely on him.

Whether the limbs can be saved is also his task — cold sweat kept seeping from his forehead —

"No more — we must amputate immediately. I'm not discussing this with you, I'm notifying you. You're not the patient's family — I'm done talking to you. I'm going to report to the hospital leadership now — immediate amputation!"

"If you have questions, take it up directly with our hospital leadership."

"If the life's gone, what the fuck use are legs? Shit." Peng Yuanming cursed as he turned and walked away, not wasting another word on Liu Chaodong, this outsider.

Hearing this, Liu Chaodong slammed his fist hard onto the table in the family communication room, making the table jump with a clang, his fist turning bright red.

Then he shouted toward the registration desk: "Save his life first! Save his life!"

Spittle flying, snot and tears sliding down both sides of his nasolabial folds to the corners of his mouth, mixing with saliva — he had no time to care.

Now that Liu Chaodong wasn't even negotiating with him, it proved the situation was already critically dangerous.

Right after Peng Yuanming and Wu Guo Nan obtained Liu Chaodong's verbal informed consent, the two headed straight for the operating room.

Xue Tao reached Wu Guo Nan and asked anxiously: "Director Wu, how did the family decide?"

He actually already had the answer in his heart.

Wu Guo Nan sighed: "The family decided on amputation. Has Ziye arrived? If he has, have him go get the signature right away — once we start the case we'll open both tables simultaneously."

Bilateral lower limb amputation, also called bilateral lower limb disarticulation — the surgery isn't difficult, no problem for Wu Guo Nan and Xue Tao to run both tables simultaneously, but each would definitely need an assistant.

Amputation isn't just hacking off a leg — one clean cut, quick and neat.

You also have to properly manage blood vessels, nerves, muscles and other tissues — without an assistant, it absolutely won't work.

"Ziye said he's already come down — estimates just a tiny bit more time."

"Joint Surgery's Director Li has also brought people down to help — handling the bilateral upper limbs situation, currently in the changing room." Xue Tao replied regarding the task and arrangements just now.

The patient doesn't just need bilateral lower limb amputation — if necessary, both upper limbs might have to come off too.

Son of a bitch — really ruthless.

Just as Fang Ziye finished putting on his sterile scrub suit and arrived at the operating room!

Xue Tao temporarily assigned Fang Ziye a task — have Fang Ziye take the surgical informed consent form and find the family to sign!

This is necessary.

Wu Guo Nan, Xue Tao and the others arranged the surgery and preoperative disinfection prep, while Fang Ziye went to print and handle the signed documents.

Fang Ziye had no hesitation whatsoever; at such an urgent moment, he could not drag his feet.

Fang Ziye quickly went down to the Anesthesiologist Workroom downstairs, printed the corresponding Amputation Surgery Informed Consent Form, then hurried back upstairs, looked at the patient's name, and called out: "Are Zhang Yu's family members here? Zhang Yu's family. Come over and sign."

Liu Chaodong was waiting outside; hearing this, he walked into the Family Communication Room with only one interconnecting window, but this time, another person was following beside him.

After Fang Ziye handed over the Informed Consent Form, Liu Chaodong scanned it meticulously on the side, while tears glistened at the corners of his eyes.

Beside him, a thin and tall youth, roughly thirty-five or thirty-six years old, said: "Bureau Chief Liu, Linjie is also inside; why don't you call a few doctors over to take a look?"

"Save Zhang Yu first." Liu Chaodong heard this, remained indifferent, picked up the pen, and began to sign.

"Then how will you explain to Sister-in-law later? They both entered the operating room the same way, yet you arranged such a large team for Zhang Yu's side — this is unfair to Liu Linjie."

"You cannot be unfair to your own child because of your own encounter; you can't do this, you have to make arrangements. He is yours." The thin youth beside him seemed unable to bear watching any longer.

Although Liu Chaodong wanted to repay the favor, if it meant using Liu Linjie's life as the exchange for that repayment, it was something he could not tolerate.

"Don't worry about so much, listen to the hospital's arrangement." After Liu Chaodong signed his name with a bold stroke, he pushed the file toward Fang Ziye.

Wearing a mask, he sniffed, his emotions steadying slightly: "Thank you for your hard work, Doctor; you must save Zhang Yu's life! ~ Please."

Fang Ziye had not participated in the earlier conversation with Liu Chaodong, but hearing these two's dialogue, he was inwardly startled.

He looked seriously at the two of them: "We will do our utmost."

"The other trauma emergency patient — is he also your colleague?" Fang Ziye asked one more question.

"Yes, Doctor." The youth beside him spoke.

And he cupped his fists slightly: "If possible, hope the Doctor can also take extra care of them; both were injured simultaneously, so please do not be negligent."

After obtaining the Surgical Informed Consent Form, Fang Ziye immediately turned and walked back without lingering.

However, just as Fang Ziye exited the Family Communication Room, he did something without much hesitation — he dialed a number, and the call connected immediately.

"Hello, Ziye, what's up? Want to go eat?" Huang Kai was extremely leisurely at the moment.

Not having to work a frontline shift, he naturally didn't know so many things had happened in the Department.

"Kai Ye, could you trouble yourself to come to the operating room? Today two severe patients arrived at once; Director Wu and Xue Tao, plus Brother Zhong Xing and I, all have to perform amputations in one OR, while the other severe patient was just entrusted to Doctor Guang of Director Zhang's Group..." Fang Ziye sought his opinion.

"The other patient, you know him? I'm coming right away." Huang Kai didn't refuse, but stood up immediately.

For a typical emergency surgery, assigning a senior attending is already giving enough face.

A surgery like Fang Ziye's — generally only extremely urgent cases get such treatment, with the Director and the Department's Deputy Directors personally taking the lead.

"Don't know him, but can think about getting to know him; both their identities are rather special, details later."

"Kai Ye, thanks! ~" Fang Ziye replied like this.

"Trivial matter, I'll go check the situation first; if it goes well, coincidentally we can have a drink together today?" Huang Kai said laughing.

"Okay, Kai Ye, tell Sister-in-law sorry for me." Fang Ziye knew Huang Kai coming was him cashing in a favor, and right now Kai Ye's wife was still pregnant.

"Your sister-in-law is still at work, not with me. I'll send her a message to explain." Huang Kai thought nothing of it; he wanted to accompany his wife, but on workdays her Unit Leader wouldn't agree.

(Chapter End)