Chapter 1857: with translation of chapter title

1792, you idiot! (Monthly ticket 13500 extra update times 27)

Su Yun sensed the hostility, walked over to Zheng Ren's side, and faced Professor Zhang directly.

His gaze was like a knife.

"That's right, Professor Zhang." Zheng Ren inserted all the films into the viewer and began to speak. His voice was gentle, as if he hadn't noticed the mockery in Professor Zhang's words.

"The patient's main problems are a few." Zheng Ren held a ballpoint pen and lightly tapped on the viewer, making a thumping sound.

"First, the patient's occult onset in the medical history, I consider it due to incomplete myocardial blood supply leading to transient cerebral ischemia."

"..." Professor Zhang stared for a moment.

"This is a typical case of moyamoya disease with infarction." Zheng Ren tapped again at the tangled vessels on the MRI film.

"Second, because of the occult history, I consider the patient's moyamoya disease to be severe. Here there are tiny vascular malformations; here as well, similar tiny vascular malformations, at least five or six. Because the image isn't clear enough,..."

Professor Zhang took off his glasses, rubbed his eyes, and examined the MRI film carefully.

A tangled mess of vessels, and Boss Zheng says there are tiny vascular malformations? Is that a sign of high skill or just talking nonsense?

Anyway, Professor Zhang stared at it for a while and still couldn't be sure whether the vascular malformations existed.

That's not surprising, since Professor Zhang is a cardiothoracic surgery professor; it's normal for him not to understand neurosurgical images.

"I looked at the operation record; it was a coronary artery bypass graft performed while the heart was stopped and on cardiopulmonary bypass." Zheng Ren said, "Systemic heparinization was used, which very likely caused the tiny vascular malformations to rupture and bleed."

Professor Zhang's heart sank; was this implying his surgery was poorly done? The blame pointed directly at the bypass surgery performed with the heart stopped.

"Fortunately, nothing has happened; looking at the patient's condition now, there should be no intracranial bleeding. However, during the heparin reversal, bleeding could occur at any time—I can't guarantee when."

"What exactly are you trying to say?" Professor Zhang asked displeasedly.

"You've seen the patient's condition; even with IABP support, the cardiac load remains high. I recommend putting the patient on ECMO!" Zheng Ren said, "But putting the patient on ECMO would keep heparin levels elevated, posing a significant risk of cerebral hemorrhage."

"..." Professor Zhang was stunned, thinking Zheng Ren wouldn't... wouldn't actually want to perform neurosurgery, would he?

It's not just any surgery; it's for moyamoya disease, a rare condition.

Young people, so full of confidence—Professor Zhang was frightened by his own speculation.

The diagnosis does have its own coherent logic, but neurosurgery... probably no one dares to operate.

Given the patient's current condition, is it even worth performing neurosurgery now?

"Su Yun, call Xiao Feng, Xiao Hu, and Lao He, and also have Yiren come over." Zheng Ren suddenly said, "Also have the legal department of Xinglin Garden come immediately."

Although Su Yun didn't understand what his boss wanted to do, since the boss said so, he would just follow orders.

In emergency resuscitation, one voice is enough; saying more is useless.

"Boss Zheng, the patient's condition is poor; I think neurosurgery won't perform the operation." Professor Zhang pondered and advised.

"Look at the current vital signs; in this situation, even a slight disturbance could cause ventricular fibrillation and death." Professor Zhang earnestly advised: "I know you want to save the patient, but in this situation, life or death is entirely up to fate."

"Professor Zhang, the patient could actually attempt resuscitation." Zheng Ren also urged him earnestly: "Neurosurgery could resolve the moyamoya disease and the risk of cerebral hemorrhage, while ECMO could let the patient get through this most dangerous period."

"You..." Professor Zhang wore an expression of ignoring elders' advice, as if he were about to suffer a loss. He looked at Zheng Ren, remained silent for a few seconds, and finally sighed.

"Boss Zheng, your surgery is indeed good; that cannot be denied." Professor Zhang's tone grew much colder, "But for a large-scale emergency rescue involving cooperation among departments, I think we should let the medical affairs office give its opinion."

"Well, Director Lin should..." Zheng Ren said, asking Su Yun, "Have you called Director Lin yet?"

"I have." Su Yun stared at the monitor and the IABP control panel, occasionally adjusting some parameters.

The machine isn't something you can just leave there and turn on; countless parameter combinations exist, leading to countless treatment approaches.

Deciding how to adjust the parameters on the fly according to the patient's condition requires deep clinical experience and theoretical foundation.

Su Yun has been training in medicine since childhood—over a decade of medical fundamentals—plus innate talent; standing there, Zheng Ren feels reassured.

We should try to convince everyone; we certainly can't go ahead with surgery unilaterally.

"What waxes must wane; what reaches extremes must break." Zheng Ren understands these principles. Under Su Yun's care, the patient's condition should be maintainable for a while.

"It's time to explain things to the patient's family," Zheng Ren thought, while Professor Zhang added: "The patient's family has already agreed to sign and give up further treatment. Boss Zheng, as medical workers, while we treat and save lives, we must still respect the family's wishes."

"I'll handle talking to the family," Zheng Ren said firmly.

Professor Zhang's eyebrows furrowed.

Is there really someone in this world who worries that their troubles aren't enough?

Idiot!

Just now, Professor Zhang explained the condition to the patient's family, reading their expressions, and discovered that the husband had absolutely no intention of pursuing resuscitation.

Although the patient's daughter had that idea, she lacked financial means—or rather, she didn't have enough resources to support a major resuscitation effort.

Trying now to change the family's mindset would likely result in a medical accident.

Many patients' families are like that: they appear eager for resuscitation on the surface, but deep down they wish the patient would die sooner.

A sick person is essentially a burden, whether financially or needing constant care. Over time... there's an old saying: "Long illness sees no filial children at the bedside."

That's basically what it means.

Even biological sons behave this way, let alone a step‑elderly spouse.

This is also human nature; nobody finds life easy.

Knowing full well that it's a bottomless pit, pouring in all one's wealth, the person may still not be saved in the end.

How to choose is therefore easy to imagine.

Professor Zhang felt that Boss Zheng lacked sufficient clinical experience and hadn't realized this.

He grabbed Zheng Ren and, with a sincere expression, urged: "Boss Zheng, the patient's family has already decided to give up. If you tell them now there's still a slim chance and they could be saved, they won't appreciate your kindness. If any problems arise after surgery, all their anger will..."

Professor Zhang, thank you. Zheng Ren said earnestly: "I will try my best; whether it works or not depends on the patient's family's opinion. As for how to treat it specifically... we can't just watch a patient who could be treated die, can we?"