Chapter 409: with translation of title

401 Shameless excuse (Happy New Year, everybody!)

「Speak up. 」 Zheng Ren placed his left hand flat under his armpit, rested his right elbow on his left arm, propped his chin, narrowed his eyes at the film hanging on the viewbox, and focused intently.

「Here, this is the typical imaging presentation of traumatic wet lung. 」 Su Yun tapped the film with the knuckle of her right index finger, 「But, with such a severe fracture, there could be several hundred milliliters of bleeding, and a small amount of pneumothorax would also be possible. 」

「Do you think it's strange that the patient has no hemothorax? 」

「Mm. 」 Su Yun spoke without reservation; if she were being falsely polite, she would have to say it from the angle of hoping the patient's condition gets better and better.

But,

He didn't have.

Frankly,

Without reservation.

「Indeed there is a problem. 」 Zheng Ren pondered, following Su Yun's line of thought: 「The patient's blood pressure is not high; normally for his age, blood pressure should show fluctuation between 120 and 130. With multiple rib fractures and severe pain, maintaining blood pressure at 150–160 would be expected. Yet the patient's blood pressure is only 90–100, which warrants consideration. 」

A drop in blood pressure indicates bleeding.

But bleeding in the chest cavity, whether from lung rupture or intercostal artery rupture, will show imaging signs of pleural effusion.

However, this sign did not appear on the patient's lung CT.

Under normal circumstances, this patient could now be sent to the thoracic surgery ward for inpatient observation; we would take things step by step and handle any issues promptly.

But Zheng Ren and Su Yun worried that if a problem arose, it would be a major issue; to resolve it, now is the best time!

「Su Yun, for this kind of disease, are you also consulting me? 」 The two were debating when a voice came.

Looking back, it was Inpatient Chief Cao Guozhen of the Cardiothoracic Surgery Department.

He was tall and sturdy, like a black bear, and walked with vigor.

He was tall and sturdy, like a black bear, and walked with vigor.

It's also just the usual vigor.

His words carried a sting, likely because during the rescue of Yang Lili, Su Yun and Zheng Ren had embarrassed the Cardiothoracic Surgery team on the operating table, and he's still holding a grudge.

He glanced at the film, a hint of disdain curling at the corner of his mouth.

「This is the typical traumatic wet lung; do you two heads of the Emergency Department really need to study it together? 」

Zheng Ren recalled countless possibilities in his mind, while Su Yun ignored Cao Guozhen's provocation, furrowed her brows, and pondered.

「You just want to keep the patient in the Emergency Department, right? 」 Cao Guozhen sneered, 「Keep him there, no problem. Let me tell you: first give a hormone shock, then 10 mg of dexamethasone daily, plus anti‑inflammatory, nebulization, and phlegm‑reducing therapy. Don't follow the package insert for Mu Shu Tan; give 100 vials a day via intravenous pump—totally fine. 」 (Note 1)

"You guys want to keep the patient in the Jizhenbingfang, right?" Cao Guozhen sneered, "Keep him then, no problem. Brother tells you, first give a Hormone shock, then 10mg Dexamethasone daily, plus anti-inflammatory, nebulization, and expectorant therapy. Do not give Methylprednisolone according to the instructions; give 100 vials per day, pump it into the Vein, no problem at all." (Note 1)

「If you give Mu Shu Tan according to the instructions, severe aspiration pneumonia will definitely appear in three days—don't say I didn't warn you. 」 Cao Guozhen droned on.

What he said made sense; it was conscientious advice.

Su Yun knew that this imported Mu Shu Tan drug's advantage was its low price and almost zero side effects; in Di Du she had once used up to 300 vials a day, pumped continuously for 24 hours via intravenous pump.

Afterward, just pay attention to turning, back‑tapping, and coughing to prevent aspiration pneumonia; the patient could be discharged within a week.

But the problem is, Zheng Ren and Su Yun are not considering that the patient merely has a simple right‑side multiple rib fracture and traumatic wet lung.

Whether in the Emergency Department or the Cardiothoracic Surgery ward, once this opportunity is missed, the patient……

Whether in the Jizhenbingfang or the Cardiothoracic Surgery ward, once this opportunity is missed, the patient……

But, it's only a possibility.

Medicine is an empirical science, and also an evidence‑based science.

Without evidence, you dare tell me to do an open‑chest exploration—aren't you afraid the patient will sue you to death after surgery?!

After a few minutes of judgment, Zheng Ren suddenly realized why Su Yun had dragged him back here.

He wanted to perform an open‑chest exploration, but he lacked the authority.

Just like how I always get Director Pan to take the blame, this bastard is trying to make me take the blame!

「The patient can't be treated like this. 」 Zheng Ren lowered his hand, turned to look at Cao Guozhen, and said, 「At the very least we need to perform an emergency fracture internal fixation Shou Bing. 」

"The patient cannot be treated this way." Zheng Ren lowered his hand, turned to look at Cao Guozhen, and said, "At the very least, we need to perform an Emergency bone fracture internal fixation Shou Bing."

Zheng Ren's remark was downright shameless.

The patient's fracture alignment is good; there's no need to re‑fix it.

But…… this is a particularly good excuse and justification, isn't it?

「Mm, look here—the displacement is obvious; the bone fragment could puncture the pleura and lung when the patient turns and taps the back, causing a secondary hemopneumothorax. 」 Su Yun pointed to a tiny break on the film and said confidently.

Normally, a lung CT is a sectional scan, not used to view fractures.

To examine the fracture condition, one needs a chest X‑ray and a thoracic 64‑slice CT three‑dimensional reconstruction.

Although each slice of a lung CT can reveal a little bit of the situation, Su Yun latched onto one spot, spoke extravagantly, and claimed the fracture break was especially severe.

Although each slice of the lung CT could only show a glimpse, Su Yun seized on one of those spots, spoke extravagantly, saying the bone fracture was especially severe.

In the Emergency Department, to snag the surgery, they're being this shameless?!

Damn it, no wonder the General Surgery Department can't compete with them.

According to them, this surgery must definitely be done in the Emergency Department; if not, any future hiccup will give them something to say.

Cao Guozhen's mind worked just as quickly, and he then said, 「Then let's take it over—I'll do it. 」

「You? 」 Su Yun curled her lip with a mocking, punch‑worthy smile, 「You can do Shou Bing? Have you ever done a lobectomy? A sleeve resection? You know nothing, just know how to do a fracture, and you slap your face claiming you can do Shou Bing. 」

「You……」 Cao Guozhen really wanted to go up and beat Su Yun to death.

I've always spoken politely; although my tone carries a hint of mockery, I've never used foul language.

This Su Yun bastard actually sprayed me directly—is he some kind of wild dog?

「Rib spreaders, send over ten. 」 Su Yun blew the black hair from her forehead and said lightly.

"Send over ten rib clamps." Su Yun blew the black hair in front of the forehead, said lightly.

On what grounds!

"Looking for the Medical Department? Or looking for Director Pan? Thoracic Shou Bing, we don't have time to do it. If we find Director Pan, he'll surely leave the thoracic emergency as well." Su Yun laughed and said: "It's just inserting a chest bottle, even nurses can do it, you're embarrassed to say it's doing Shou Bing?"

These words…… really fucking choke someone.

Cao Guozhen realized Su Yun was telling the truth; if they just leave the thoracic emergency as is, the Director will find out and it would be no surprise if he scolded himself to death.

Holding his breath, Cao Guozhen turned and left.

Admit him to the hospital, I'll notify Yi Ren and them to prepare emergency Shou Bing." Zheng Ren said.

"Mm." Su Yun nodded, seeing Zheng Ren turn and leave, suddenly said: "Boss, thank you."

"It's fine." Zheng Ren waved his hand, "I believe you."

……

……

Note 1: The usage of Moxishutan like this was taught fifteen years ago by Teacher Chen Houkun of the Medical University. Teacher Chen was especially kind; using this method exceeding the dosage in the instructions, he cured several patients with extremely severe injuries + traumatic wet lung + stagnation pneumonia. One of those patients had been abandoned by the ICU, thrown onto my hospital bed. In 26 days, he was discharged and went home. Later, the patient came to see me once on crutches.

Note 2: This surgery was a patient I took in 09. Looking at the films, there were no indications for Shou Bing. I looked at the films for one hour, called the Director three times, and finally in the middle of the night brought the Director from home to do Shou Bing. Fortunately the Shou Bing was done early, and also thanks to the classmate Dai Li who was in the ICU at that time.

Note 3: Thanks to the Red Dust Alliance, please wait for the extra chapter, don't rush, don't rush.