Chapter 2213: 2136 Zhao Wenhua, Not Worth It

2136 Zhao Wenhua, Not Worth It

"Zheng Lao Ban, the contrast agent doesn't look like that on CT images, does it?" Lin Yuan chased after him, asking.

"What do you mean?" Zheng Ren asked casually.

"It looks like a stone to me; I think what you said is wrong." Lin Yuan asked, "Zheng Lao Ban, don't be angry—I just don't understand."

Zheng Ren glanced sideways at Lin Yuan; this kid has talent, but he's still far behind Su Yun.

Lin Yuan froze for a moment, instinctively reaching up.

"Have you ever operated a CT?" Zheng Ren stared at Lin Yuan's left radial styloid process as he asked.

Lin Yuan felt as if an invisible hemostatic forcep had tapped his radial styloid process; Zheng Lao Ban's "pa" sent a chill through him.

"Answer my question." Zheng Ren stopped looking at him, found Director Luo's number, and called.

"I have, Zheng Lao Ban—what do you mean?"

"Director Luo, there's a patient here who needs an emergency gastroscopy."

"Yeah, it's an emergency, hemorrhagic shock. Probably a hepatitis B patient; I'll bring the chart and we'll talk later."

"Right, we suspect a ruptured liver tumor bleeding, but we can't confirm it here."

"No, no—I suspect the contrast is flowing retrograde up the bile duct into the pancreas and gallbladder; if so, there could be bleeding in the descending duodenum."

"Okay, let's talk in person."

Having said that, Zheng Ren hung up.

"What did you say?" Zheng Ren asked.

"I said duodenum… uh, I've done a CT; Zheng Lao Ban, what do you want to ask?" Lin Yuan asked.

"For the head CT, what window width and level did you use?" Zheng Ren asked casually.

"Usually for the head we set width 100, level 37."

"And the abdomen?"

"Width 400, level 40." Lin Yuan replied fluently.

Hmm, his basics are pretty solid, Zheng Ren thought. If you swapped in a domestic clinical doctor, few would know the CT window width/level concept.

But one can imagine he's a Harvard Medical School doctor; compared with ordinary Chinese undergrads there's little to compare. He's not a top scholar, nor could he get into an elite international medical school.

"Why are the window width and level different?"

"Because of visual contrast…" As he spoke, Lin Yuan paused, then tossed her head excitedly: "That's it, I get it!"

Zheng Ren ignored her and strode ahead.

"Zheng Lao Ban, wait a moment!" Lin Yuan chased after him; though tall and long‑legged, she was still a girl, so not catching up was normal.

"It's because the contrast pools together in the liver, making it look especially bright. When it flows backward against the blood into the gallbladder, it appears as a tiny speck of high‑density, sand‑like shadow." Lin Yuan said, bouncing excitedly.

"Is that right?"

Lin Yuan kept asking, but Zheng Ren merely nodded slightly, saying nothing.

"Wow, how did you think of that?" Lin Yuan exclaimed in surprise.

"I just followed the possible complications." Zheng Ren said.

Arriving at the endoscopy room, Director Luo was changing clothes.

"Director Luo, thanks for coming. Just a quick greeting would do—why did you come yourself?" Zheng Ren said with a smile.

"Let's see your skills, Zheng Lao Ban." Director Luo laughed, "The liver transplant you did a couple days ago was really beautiful."

"We still need Su Yun; the patient's condition was too poor, his heart stopped. If he hadn't done chest compressions, we couldn't have proceeded." Zheng Ren gave a simple smile.

Director Luo looked at Zheng Ren and smiled; Zheng Lao Ban was truly modest.

The emergency liver transplant on a poor‑condition patient actually went through, and it was remarkably calm—quite impressive.

"Is this your patient?" Director Luo asked. "Didn't you just fly to London for an intracardiac intervention? You've barely returned and aren't resting. The ward still has work—you're plenty busy."

"Oh, my patient's fine—it's Professor Zhao's patient."

Director Luo blinked, sensing something odd, but he didn't ask; he just smiled, changed clothes, and followed Zheng Ren to the endoscopy room.

Neither spoke of the patient's condition; at this point more talk would be meaningless, so they just chatted about the surgery from the past two days.

Lin Yuan also changed and followed them in; she wanted to ask Zheng Lao Ban several times, but with Director Luo present she didn't dare interrupt, so she held it in.

More than twenty minutes later, Zhao Wenhua finally brought the patient up.

If Su Yun were here, he'd surely give Zhao Wenhua a thorough dressing‑down. But Zheng Ren knew it was because there were still pre‑op instructions to carry out, not that Zhao Wenhua was being careless.

If he were truly careless, any problem would just lead to a consultation and then routine treatment.

In the end, as the patient's condition worsened, they'd call a hospital‑wide consultation or send him to the ICU.

Following the standard protocol, you don't need to think at all.

Being able to carefully consider the images makes him not bad. Although he's timid, avoids responsibility, makes excuses when things go wrong, and drags his own treatment team into trouble.

Zheng Ren keeps all this in mind; he doesn't need to make an effort to remember—he simply won't forget.

In Zheng Lao Ban's little black grudge book, everything about Zhao Wenhua is already written in full.

But,

The times are different now.

Their levels differ, their realms differ, so naturally what they think about differs.

After a few months, Zhao Wenhua had become a small‑time doctor in Hai Cheng, posing no threat to him. Moreover, Zhao Wenhua knows how to read the room, avoids him, and Zheng Ren can't be bothered to dig up old scores.

Furthermore, this is a case of misdiagnosis and mistreatment; you can't just pretend you didn't see it, stand aside cold‑heartedly laughing, and then finally use the record to slap Zhao Wenhua in the face.

One human life— the cost is too great; Zhao Wenhua is not worth it.

"Zheng Lao Ban, sorry I'm late." Zhao Wenhua brought the patient in, bowing repeatedly in apology.

"It's fine; go change, I'll start here." Zheng Ren pushed the patient forward, with Lin Yuan leading the way.

Zhao Wenhua watched Zheng Lao Ban's back, his heart filled with mixed feelings.

Zheng Ren brought the patient to the emergency endoscopy room, lifted him onto the bed, and the anesthesiologist administered inhaled anesthesia.

Director Luo said nothing and didn't care who performed the endoscopy.

Even if it were an ordinary doctor, or the head of some department, Director Luo would not allow him to personally operate in his own endoscopy room.

But Zheng Lao Ban was different.

A few minutes later, when Zhao Wenhua had changed his clothes and rushed in, the gastroscope had already passed through the pylorus and entered the descending part of the duodenum.

The descending part has vertical folds, its lower end a round bulge—that is the duodenal ampulla commonly spoken of, the common opening of the bile duct and pancreatic duct.

On the screen, the site of the duodenal ampulla kept spurting out streams of blood, clearly visible through the gastroscope.

Zhao Wenhua felt a wave of relief.

Fortunately I didn't refuse Zheng Lao Ban's help for the sake of face; with this bleeding, the patient will surely worsen into hemorrhagic shock tonight, be sent to the ICU, and if we continue treating this way, death is certain.

……

……

Note: The patient's case from a few days ago, after radiofrequency ablation. Xiao Di'er, having performed over a hundred radiofrequency ablations, had seen just such a patient with bleeding complications. In fact, it occurred seven days post‑procedure, when the patient was preparing to be discharged.

Various departments consulted; the diagnosis was clear—gallstones and acute pancreatitis. Later our director, going against the consensus, ordered a gastroscopy to confirm.

Objective examination, sometimes unreliable~~~