Chapter 2645: 2546.2449 Hot Potato (Alliance Leader Wang Li Ping, extra chapter 5)

2546.2449 Hot Potato (Alliance Leader Wang Li Ping, extra chapter 5)

Unfortunately this momentum only lasted three days, then Sun Yue Nan started to run a fever. At first she gritted her teeth, thinking she was young and healthy, 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 a slow IV drip of antibiotics at a nearby clinic.

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

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

Her condition fluctuated, barely improving for a day, feeling a bit better, but when she was about to go to work her temperature rose again.

Lying in bed, Sun Yue Nan could hear her own heartbeat. Since her aortic valve replacement, the mechanical valve's click-clack with each heartbeat 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, trembling incessantly.

These days of slow IV drip had no effect at all; there was no sign of improvement in her condition.

The clinic staff took her temperature: 40.5 degrees Celsius. Seeing that, they were frightened.

With such a high fever, wouldn't it scramble someone's brains?

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

An 120 ambulance brought Sun Yue Nan to the 912 Emergency Department.

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

Even a case of eating five catties of iron nails could make it into the New England Journal; his own case was stranger and rarer, so belonging there was only natural.

Having Yun Ge'er around was great, Zhou Litao thought happily. He didn't know how Zheng Lao Ban's Nobel Prize would turn out, and as he smelled the ink drifting from the magazine, he pondered.

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 ran into Su Yun's disdainful gaze.

Being snapped at by Yun Ge'er was nothing; he was sharp-tongued but soft-hearted. Yet Zhou Litao clearly sensed that Yun Ge'er cared a lot about the Nobel Prize. Still, 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, could they possibly not get the Nobel Prize? He had already 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 emergency department internal medicine doctor knocked on the door and said from outside.

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

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

When the water reaches the channel, everything will come; 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 left lung's breath sounds, he heard a click-clack.

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; Zhou Litao instantly made a preliminary assessment.

Opening Sun Chao Nan's outer clothing, Zhou Litao saw a vivid, dripping plum tree.

Young people these days really know how to have fun; Zhou Litao just glanced at it, didn't think much, but noticed the surgical scar hidden beneath the plum tree. Likely from heart surgery, he formed an initial judgment 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 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 had the results.

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

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

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

Zhou Litao assessed the patient's condition, called Thoracic, 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 operations are strict and precise.

But the problem lies with Zhao Yunlong.

If the whole hospital were a machine, Zhao Yunlong would see himself as just a part—important yet insignificant.

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

Damn it!

How difficult a repeat valve surgery is, Zhao Yunlong knows 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 he himself looking back 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 be able to handle it.

This is different from the previous case where interventional cardiology dared not place a stent in a coronary‑bypass patient with terrible baseline conditions; for repeat valve surgery the patient's local anatomy is massively altered, and no one can be sure of guaranteeing surgical success……

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

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

However, Zhao Yunlong didn't go straight to Zheng Lao Ban but reported up the hierarchy. This patient isn't an emergency case, so he lacks the authority to operate directly. Unlike the ICU patient last time, which was a pure emergency with no time to wait.

He clearly understood the difference.

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

The patient was admitted, relevant tests completed, but then a problem arose immediately. The coworkers were only a few young women around twenty; they had scraped together a mere three or five thousand yuan.

They had no more; this amount couldn't even cover a tooth gap. One day in the ICU costs ten thousand yuan; even if the surgery went smoothly, without money the girl might not survive.

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

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

A small hospital might care about annual costs of hundreds of thousands, even millions, but a hospital the size of 912 doesn't really worry about it.

First treat it; we'll talk about the rest later. In fact, what clinicians fear most is running into this problem—if the Medical Department turns hostile and dumps the blame back, the one who suffers most is the surgeon.

Reporting to the Medical Department and the on‑call Team‑leading Professor, today's professor surnamed Chen is fairly competent. Although Zhao Yunlong thinks his own level should be higher, per protocol he still called Professor Chen to see the patient.

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

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

"Shou Bing, I can't do it." Zhao Yunlong pointed his finger, as thick as a carrot, at a point on the echocardiogram image, "The issue with the biological valve is not serious, but here I consider it an abscess, deeply invasive. Performing Shou Bing, the possibility of not being able to get off the operating table is at least 70%."

"Even if he can get off the operating table, postoperative bleeding is also a trouble." Zhao Yunlong added another sentence.

This was also a concern of Professor Chen's. He knew Zhao Yunlong's level, so he didn't just treat him as the Inpatient Chief, but unconsciously discussed it.

"The left atrium is affected; we estimate we need to remove part of it." Professor Chen said, "Performing Shou Bing under cardiopulmonary bypass, restarting the heart is very likely to fail."

Both meant the same thing; the possibility of a successful Shou Bing is not high.

No money, no immediate family, the condition is severe—such a patient, as long as there is a sliver of possibility, no one is willing to get on the Operating table to perform Shou Bing.

If it succeeds, the whole department will lose money. As for me, it's fine to say, but the nurses' income isn't high; not to mention the hardship of working night shifts, not making money and still having deductions—this is unbearable.

But if it goes wrong, although there are no relatives now, later all kinds of relatives will come flocking in, arguing every day; just thinking about it makes the doctor who takes over feel near death.

If the patient's fever weren't this high, one would definitely not think of readmitting to the hospital. For a Shou Bing of this difficulty, nobody would dare to attempt it—how could one perform a Shou Bing 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 rescue, first-visit responsibility system, with its countless regulations, has the medical community in a stranglehold.

But even someone as stalwart as Zhao Yunlong, when faced with such a troublesome patient, ends up with a headache.

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

"Professor Chen, anti-inflammatory symptomatic treatment; tomorrow we'll arrange a hospital-wide consultation. If it really doesn't work…… then let's go ahead, we must try at least." Zhao Yunlong said, gritting his back teeth.

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

"The Shou Bing is too difficult, I Worry about Zheng Lao Ban……" Zhao Yunlong didn't finish his sentence.

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

This problem is nearly unsolvable; after the patient used an anti-inflammatory analgesic suppository, he sweated profusely. However, his temperature only dropped to 39°C, then rose again.

The abscess in the heart erodes the myocardium; even if performing surgery, at least the left atrium's roof must be removed. If this inflammation could easily bring down the temperature, that would be uncanny.

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

The patient's parents couldn't be reached; reportedly they were working away from home, with no phone signal every day.

No money, no family, and the condition being so severe makes people grit their teeth.

The hospital-wide consultation, as expected, only had one option: Shou Bing. But this path is too steep; nobody dares to take it.

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

Left with no choice, 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.