Chapter 2541: 2449 Hot Potato (Alliance Leader Wang Li Ping Extra Chapter 5)

Unfortunately this momentum only lasted three days, and Sun Yue Nan started to run a fever. At first she gritted her teeth, thinking she was young and healthy, and that she could tough it out and it would pass.

But soon she couldn't get out of bed from the fever, with no choice, she could only get an IV drip of antibiotics at a nearby clinic.

She thought it was because her tattoo covered too large an area, and the tattoo artist had said that such a large tattoo might cause fever after the procedure.

All sorts of bad luck seemed to happen to her, and Sun Yue Nan had no choice but to honestly just get the IV drip.

Her condition fluctuated, almost a day of improvement, feeling a bit better, but when she was about to go to work her temperature started rising again.

Lying in bed, Sun Yue Nan could hear her own heartbeat. Since her aortic valve replacement, with each heartbeat the mechanical valve's click-clack sounded like an alarm clock, making her annoyed again.

Half-asleep, half-awake, the click-clack sound echoed in her ears. In a daze, Sun Yue Nan felt cold and began to shiver. Her body seemed not her own, uncontrollable, she couldn't stop trembling.

These days of IV drip had no effect at all, and her condition showed no sign of improvement.

The clinic staff took her temperature, which was 40.5 degrees Celsius. Seeing this temperature frightened them.

With such a high temperature, wouldn't it burn someone up?

They wanted to ask for Sun Yue Nan's relatives' phone number, but she was already semi-conscious and unaware of what had happened. Only her trembling body and the click-clack sound of the aortic valve with each heartbeat lingered in her ears.

The 120 emergency ambulance took Sun Yue Nan to the 912 Emergency Department.

Zhou Litao was flipping through the New England Journal magazine, and this issue featured the case report he had written under Yun Ge'er's guidance.

Even a case of eating five catties of iron nails could appear in the New England Journal, so his own case, being stranger and rarer, deserved to be in it.

Having Yun Ge'er around was great, Zhou Litao thought happily. He also wondered how Zheng Lao Ban's Nobel Prize was coming along, smelling the ink drifting from the magazine as he thought.

The results might come out in the next few days, but Zhou Litao didn't dare ask. Yesterday when Zheng Lao Ban went to Cui Lao's office to check medical records and asked a question, he encountered Su Yun's disdainful look.

Being snapped at by Yun Ge'er a couple of times was nothing; he was sharp-tongued but soft-hearted. Yet Zhou Litao could clearly sense that Yun Ge'er cared a lot about the Nobel Prize. Then again, who wouldn't?

There was no need to be annoying; Yun Ge'er was just too nervous, and Zhou Litao inwardly made an excuse for Su Yun. Moreover, with Zheng Lao Ban around, maybe they couldn't miss the Nobel Prize? He had developed a blind trust in Zheng Lao Ban and the medical team.

"Manager Zhou, there's a patient with high fever; Manager Tang is busy, please take a look." The internal medicine doctor in the emergency department knocked on the door and said from outside.

"Oh, okay." Zhou Litao stood up, and the freckles on his face seemed to dance.

Since Su Yun pointed him toward a bright path, Zhou Litao felt life was full of promise. As for the girlfriend he had been pondering before, it was utterly meaningless.

When the time comes, everything will fall into place; there's no need to rush.

Arriving at the emergency resuscitation room, the internal medicine doctor began to report the condition. Even without anything else, a temperature of 40.5 degrees Celsius alone was enough to demand attention.

Zhou Litao began the physical exam, taking out his stethoscope to listen to the patient's lung sounds.

There were signs of pneumonia, but not severe. When he listened to the patient's left lung breath sounds, he heard a click-clack noise.

That's the standard heart sound after valve replacement; Zhou Litao paused, wondering if the patient had a history of valve replacement. How could someone so young have that? Perhaps it was congenital heart disease, and Zhou Litao instantly made a preliminary judgment.

He lifted Sun Chao Nan's outer clothing and saw a vivid, lush plum tree.

Young people these days really know how to have fun; Zhou Litao just glanced at it, didn't pay it much mind, but noticed the surgical scar hidden beneath the plum tree. He judged that the patient had undergone heart surgery, made an initial assessment, and then proceeded to examine the patient.

The precordial area showed no bulges or depressions, the cardiac borders were roughly normal, heart rate 54 beats per minute, rhythm regular, and at the mitral valve auscultation area a 3/6 grade diastolic blowing murmur could be heard.

A blowing murmur, post aortic valve replacement…… Zhou Litao's heart suddenly tightened—could it be another valve issue?

First do the tests, Zhou Litao ordered routine blood draws and a cardiac echocardiogram, lung CT, etc.

The tests proceeded smoothly, and Zhou Litao soon obtained the results.

Otherwise there's nothing much to say; the problem showed up on the echocardiogram.

After mechanical aortic valve replacement, there was perivalvular leak of the mechanical valve, formation of an aortic root dissecting aneurysm, formation of a fistula from the left ventricular outflow tract to the anterior mitral valve leaflet base, vegetations on the anterior mitral valve leaflet base, vegetations on the prosthetic aortic mechanical valve, and moderate mitral regurgitation.

Let's go to surgery; the valve vegetations are most likely caused by infection. These vegetations provoke infection and fever, and that's not even the worst—if they break off and lodge in an important blood vessel they could cause cerebral infarction and a series of complications.

Zhou Litao made a judgment on the patient's condition, called the thoracic department, and Zhao Yunlong came down for a consultation. After glancing at the patient and then at the echocardiogram and other data, Zhao Yunlong admitted the patient.

The 912 Emergency Department's rescue efforts were strict and precise.

But the problem was stuck with Zhao Yunlong.

If the whole hospital were a machine, Zhao Yunlong considered himself just a component—important yet insignificant.

He asked about the medical history and learned that the patient had undergone aortic valve replacement a few months ago elsewhere, and this time the aortic valve had again developed vegetations.

Damn it!

How difficult a repeat valve surgery is, Zhao Yunlong knows full well.

After assisting Zheng Lao Ban in a conjoined twin heart separation surgery, Zhao Yunlong's surgical progress has been astonishing.

Not only others, but even when he looks back at himself he finds it unbelievable.

But that doesn't matter; after admitting the patient, Zhao Yunlong reassessed the condition. He felt that if he rashly opened the chest, he might not actually be able to handle it.

This is different from the previous case where interventional cardiology dared not place a stent and the coronary artery bypass patient had extremely poor basic conditions; for a repeat valve surgery patient, the alteration in local anatomical structure is enormous, and to guarantee surgical success nobody has that confidence……

Is nobody capable? Zhao Yunlong suddenly thought of Zheng Lao Ban.

He should be able to, should…… maybe…… roughly.

However Zhao Yunlong didn't directly approach Zheng Lao Ban, but reported up the hierarchy. This patient isn't an emergency case, so he lacked the authority to perform surgery directly. Unlike the previous ICU patient, which was a pure emergency with no time to wait.

He was very clear about the difference.

Moreover, the next two days are when the Nobel Prize results will be announced; even if there's a chance, Zhao Yunlong didn't want to disturb Zheng Lao Ban.

The patient was admitted and relevant tests completed, but the problem immediately arose. Her coworkers were only a few young women around twenty; they pooled some money, but it was only a pitiful three or five thousand yuan.

They had no more, and this amount of money isn't even enough to stuff between teeth. One day in the ICU costs ten thousand; even if the surgery went smoothly, without money this girl might not survive.

But this isn't a problem; when encountering such a situation, just get the Medical Department to take the blame.

The patient is here; we want to treat her. Whether the Medical Department provides fake money is their affair. Although part of this money will eventually end up in the department, the bulk is ultimately borne by the hospital.

Small hospitals might care about annual expenses of hundreds of thousands, even millions, but a hospital the size of 912 doesn't really worry about it.

First treat it, and discuss the rest later. Actually, in clinical practice the most feared problem is when the Medical Department turns sour and directly shifts the blame back; the one who suffers most is the surgeon.

Reporting to the Medical Department and the on-duty team-leading professor, today's professor surnamed Chen is fairly competent. Although Zhao Yunlong thought his own level should be higher, according to the medical process he still called Professor Chen to see the patient.

Professor Chen took a look at the patient, then examined the echocardiogram imaging data, and was also worried.

"Xiao Zhao, what do you think?" Professor Chen asked.

"Surgery, I can't do it." Zhao Yunlong's finger, as thick as a little carrot, pointed to a spot on the echocardiogram image, "The excess tissue on the biological valve isn't serious, but here I think it's an abscess, deeply invasive. Performing surgery, the chance of not being able to get off the table is at least 70%."

"Even if he could get down, postoperative bleeding is also a trouble." Zhao Yunlong added another sentence.

This point is also what Professor Chen worries about. He knows Zhao Yunlong's level, so he didn't just treat him as the Inpatient Chief, but was unconsciously discussing it.

"The left atrium is affected, likely need to remove part of it." Professor Chen said, "Performing surgery under cardiopulmonary bypass, restoration of heartbeat is very likely to fail."

Both said the same thing, the possibility of surgical success is not high.

No money, no immediate family, condition severe to the heavens; for such patients, as long as there is a sliver of possibility, no one is willing to go onto the operating table to perform surgery.

If done well, the whole department would lose money. Speaking for myself, it's okay, but the nurses' income is low; not to mention the hardship of working night shifts, not earning money yet still having deductions, this is unbearable.

But if done poorly, although there are no relatives now, later various relatives will come flocking, arguing day after day; just thinking about it gives the doctor who takes over a feeling of being near death.

If the patient's fever weren't this high, one would definitely not think of returning to the hospital for admission. For such a difficult surgery, nobody's brain is wrapped; how could one perform a surgery with a fifty-fifty chance of success or failure.

But the patient is now delirious from fever, this cannot be pushed aside. The emergency and first-visit responsibility system have imposed countless rules that bind the medical community tightly.

But even someone like Zhao Yunlong, a tough guy, when facing such a difficult patient, also has a forehead full of lawsuits.

The two stared at each other while looking at the images; the department head wasn't home, so associate professor Chen had to make the decision.

"Professor Chen, anti-inflammatory symptomatic treatment, tomorrow arrange a hospital-wide consultation. If really not possible…… then let's go ahead, we must try." Zhao Yunlong said, gritting his back teeth.

"Xiao Zhao, why not try Zheng Lao Ban? He can supposedly do free surgery for patients. Moreover, Zheng Lao Ban's skill is also high; at least his chances are better than ours." Professor Chen finally had no other option, so he said softly.

"The surgery difficulty is too great, I worry about Zheng Lao Ban……" Zhao Yunlong didn't finish his sentence.

Professor Chen sighed; Zheng Lao Ban also does live-streamed surgery with his head tucked into his waistband. If I directly push such a difficult patient onto him, that would truly be unrighteous.

This problem is almost unsolvable; after the patient used an anti-inflammatory analgesic suppository, sweat poured all over. However, the temperature only dropped to 39°C, then rose again.

The abscess in the heart erodes the myocardium; even if doing surgery, at least the left atrium roof must be cut. This kind of inflammation, if one could easily bring down the temperature, that would be ghostly.

The next morning, after everyone went to work, Professor Chen briefly explained the patient's condition. After looking at the images and lab reports, everyone just shook their heads.

The patient's parents cannot be reached; reportedly they work away from home, and their phones have no signal every day.

No money, no relatives, and the condition is severe enough to make one grind their teeth.

The hospital-wide consultation, as expected, only had the surgical route. But this route is too steep, no one dares to take it.

Time trickled by; Zhao Yunlong and Professor Chen stared at each other, helpless. Finally Zhao Yunlong sighed and said, "I'll send the image data to Su Yun, let him see if it works."

Helpless, Zhao Yunlong sent the information to Su Yun, seeking help again.

Soon, Su Yun replied with an expression of surprise, then a string of exclamation marks. If Zhao Yunlong weren't familiar with the image, he would definitely think Su Yun's phone had a major problem.