Chapter 2365: with translation of chapter title

2370.2284 Ultimate technique—summon Zheng Lao Ban!

Su Yun wore light makeup, sharp and capable.

She received an important assignment—to interview Director Pan of the Haicheng First Hospital Emergency Department. First, she stayed at home and gathered all information about Doctor Zheng, then went to Di Du to stake out several months in advance outside the 912 Hospital, waiting for the October Nobel Prize news.

She had prepared over four months in advance, but Su Yun didn't think it was a big deal. For the Nobel Prize, no amount of emphasis is too much.

In Su Yun's view, this is a long-term main quest; if she does it well, she will definitely be a candidate for the next editor-in-chief of Haicheng Urban Daily.

To compete for this position, Su Yun put in a great deal of effort.

In the end, her previous interview with Doctor Zheng proved decisive; she had experience interacting with Doctor Zheng and had done a related special report.

With the support of the senior editor-in-chief, Su Yun secured this year's biggest project for Haicheng Urban Daily.

She must do it well! Su Yun cheered herself on.

Although she also knew that this matter would definitely not yield results this year. Before and after receiving the assignment, Su Yun gathered a large amount of data, and finally she drew a conclusion—Doctor Zheng would need at least ten years to win the Nobel Prize.

But who cares?

Getting it would be best; if not, just being a Nobel Prize nominee would already shock Haicheng. After all, this is the first time this city has ever been so close to the Nobel Prize.

She carefully planned, and after painstakingly pressing Director Pan for several days, she managed to squeeze out a lot of related information, like toothpaste.

But what surprised Su Yun even more was that, from the mouths of several inpatient chiefs who came to support from the 912 Hospital, she obtained even more information related to Zheng Ren and Doctor Zheng.

But on the weekend, Doctor Zheng actually came back once, and she missed him by a hair, which made Su Yun deeply regretful.

When interviewing Chief Wang and the other doctors who came to support, their tone let Su Yun realize that Chief Zheng's accomplishments in Di Du far exceeded her imagination.

So she moved up her plan, submitted the application, and without waiting for the process, she directly took her several capable aides and rushed to Di Du.

About to clash with the major media outlets and TV stations in Di Du, Su Yun had no confidence; she could rely only on the relationships she had built before.

But thinking of this, Su Yun cursed Wei Feng in her heart for the (N+1)th time.

But these were just trivial emotions; Su Yun rushed to Di Du at the fastest speed, preparing for a long-term stakeout.

……

……

At that moment, Zheng Ren stood in the cardiothoracic surgery doctors' office, looking at the images before him.

The large red stethoscope slung over Fang Lin's shoulder was so flashy, so eye-catching.

This consultation involved a difficult patient.

Male, 72 years old, poor nutritional status; chief complaint of recurrent cough, sputum, and wheezing for 30 years, pulmonary function tests indicating severe obstructive ventilatory dysfunction, having used inhaled therapy for many years.

The patient experienced sudden chest tightness, chest pain accompanied by dyspnea after activity one week ago.

A CT scan of the lungs at the local hospital showed: left-sided pneumothorax and scattered inflammation in the left lower lobe.

After left-sided closed chest tube drainage in the emergency department, symptoms improved, followed by continuous negative-pressure suction drainage.

Because the patient's own physical condition was relatively poor, the local hospital never even considered the possibility of surgery.

The patient gets short of breath after just a few steps and can't climb a single flight of stairs, which is a relative contraindication for thoracic surgery.

If mishandled, the patient might end up unable to wean off the ventilator after surgery. Then the patient would suffer, the family would incur huge expenses—not to mention the doctors would constantly have headaches.

During surgery, the patient might barely survive, but after the operation they would have to go to the ICU and rely on machines to stay alive. No doctor wants to encounter such a situation.

Having ruled out surgery, the local doctors decided to first perform closed chest tube drainage, then observe and treat.

Yet under drainage, the lung had fully expanded but still discharged a large amount of gas. This indicates a large breach in the lung surface, and given the patient's condition, it is unlikely to heal.

After a hospital-wide consultation, the local hospital again ruled out surgery and administered 50% glucose 50 mL intrapleural injection for pleural fixation.

But afterward, the patient continued to experience chest tightness and shortness of breath.

A repeat chest X-ray showed recurrent pneumothorax and revealed septations in the pleural cavity; the chest tube was adjusted and reset multiple times.

At most, the local doctors placed three drainage tubes simultaneously in the patient's left chest wall. Yet nothing worked; the closed chest drainage bottle kept bubbling, and the pneumothorax would not heal.

No choice—transfer to a higher-level hospital. The local hospital's greatest reliance is on the higher-level hospital; if we can't treat it, is it really wrong to admit defeat? Our skills are lacking; we can't treat it, so please go to a higher-level hospital.

So the patient ended up in Fang Lin's hands in the emergency department.

The inpatient chief handles emergencies; it's just a simple pneumothorax, and although Fang Lin found it tricky, she felt embarrassed to call a senior doctor.

If it had been a year ago, admitting such a difficult patient would certainly have required calling for help. But now Fang Lin has a trump card—the ultimate technique—summon Zheng Lao Ban.

Zheng Ren propped his chin on his hand, staring at the images before him in a fixed posture for a full thirty minutes.

It's so hard…… Zheng Ren sighed while looking at the images.

The patient's baseline condition is too poor; just getting past anesthesia on the operating table is difficult. In the System Operating Room, he performed ten surgical trainings. Although the surgeries could be completed, the completion rate was not high.

The highest was only 59%, the lowest only 43%.

With such a low completion rate, doing the surgery is worse than not doing it. Postoperatively, they can't wean off the tube—would they have to live on a ventilator forever? If so, it would be better to leave the chest tube in place.

Zheng Ren ruled out surgery and kept pondering what to do.

The patient's condition is truly difficult to manage; after admission, blood gas analysis showed: pH 7.47, PCO2 51 mmHg, PO2 74 mmHg, actual bicarbonate 37.1 mmol/L, standard bicarbonate 33.9 mmol/L, base excess 13.4.

Chest CT indicated: after left-sided pneumothorax drainage, left-sided hydropneumothorax, partially loculated, subcutaneous emphysema of the left chest wall, emphysema with bullae in both lungs, and inflammatory changes in both lower lobes.

These indices give almost every doctor a headache.

Not only Zheng Ren, but after Su Yun glanced at the images a few times, she gave Fang Lin a beating, saying he was unlucky to have taken on such a heavy patient.

For such a heavy patient, even Su Yun, the rising star of cardiothoracic surgery, found it quite difficult to handle.

Similar to end-stage dilated cardiomyopathy, the patient's COPD is very severe; from a certain perspective, it's as if the patient is old.

Lung transplantation is a good option, but the problem remains the same: enormous cost and lack of donor lungs.

Having ruled out transplantation as 'impractical,' Zheng Ren continued to think of other treatment methods.