Chapter 918: with translation of chapter title

On stage, in the surgery, going to the demonstration classroom for consultation, Zheng Renye also experienced it for the first time.

But the patient's condition is far from optimistic—it's extremely complex and hopeless. If the hospital-wide consultation yields no constructive opinion, we can only step down and wait for the patient to die.

After weighing the pros and cons of both options, we can only make this choice.

Even in 912, such a situation is rare. All the department heads looked grave, seated in their chairs, watching Vice President Yuan on the stage, each with their own thoughts.

The main dilemma lies in whether or not to perform the kidney transplant surgery.

If we go ahead with it, the patient on the table cannot be saved, and it would cause irreversible damage to the severely burned patient—how would we explain that to the patient's family?

The patient's records had already been printed in dozens of copies, one for each person. Since it was only the emergency rescue process, everyone quickly glanced through them.

Both brothers are in critical condition; one cannot keep both kidneys. The other has extensive full-body burns, with a tracheostomy, airway burns, inhalation pneumonia—whether he can survive is also unlikely.

It is estimated that after enduring a period of painful suffering, this patient will die miserably. Everyone present is well aware of the situation regarding severe burns.

But what does that matter? Once injuries reach a certain extent, even the best medicines have limited effect—no matter how skilled the doctor or how powerful the general hospital, they are powerless.

Even if we performed the kidney transplant, both brothers would still die, and if a corrupt media outlet twisted the story and added fuel to the fire, even 912 would struggle to handle this situation.

"Cough, cough." Seeing everyone present, Vice President Yuan coughed twice and said, "Close the door, everyone share your opinions freely, but quickly."

Zheng Ren lowered his head to look at the medical chart—it belonged to the other boy.

My burn department skills are really low; Zheng Ren didn't check the system space, so I estimate I'm only at the level of an attending physician.

But that level is sufficient.

Vice President Yuan didn't mention the background of the rescue; he personally came to the operating room immediately after receiving the news to direct the rescue. Zheng Ren also didn't gossip, focusing all his thoughts on the patient's condition.

The condition is very serious, especially serious.

This pair of brothers are both in especially critical condition; the combined probability of survival is less than 1%.

This is truly thorny; Zheng Ren furrowed his brows and let out a slight sigh.

Seeing Zheng Ren's demeanor, Su Yun felt somewhat hopeless. He knew exactly how monstrous his boss was. When they were in Hai Cheng, Su Yun even had the illusion that as long as a person could be brought to the hospital alive, his boss could save them.

But now, even he is at a loss?

That doesn't sound right either; just now the boss said a kidney transplant could be done.

But in this extreme situation, how would the patient's family choose to proceed with a kidney transplant, and how would the public onlookers view it?

But these have nothing to do with Su Yun; he knows clearly in his heart that whether or not to perform this surgery, his and Zheng Ren's opinions don't count. Even Director Miao of the urology department has no say—it depends on the hospital's decision.

Time is pressing; meanwhile, they're still applying pressure to stop bleeding, the kidneys are missing, metabolism is problematic—this intra-operative discussion certainly won't be overly complicated.

All the pressure rests on Vice President Yuan's shoulders.

Seeing no one speak, he directly called on Director Miao to explain the patient's condition on the operating table.

Actually, there's not much to say; in short, it's three words: "It's over."

The head of the burn department had just visited the patient in the emergency EICU, and he also wore a worried expression.

He thought that patient's condition was also not optimistic.

Because the burn area is huge, the patient is suffering severe fluid loss. Moreover, the only venous access available is a single vein near the left ankle that can establish a venous line.

The accumulated fluid cannot enter, and the patient has already entered a near-death state.

Furthermore, with extensive full-body burns, there is simply no site for autologous skin grafting. This makes the later recovery process extremely complex and unpredictable… actually, it's not that it's unpredictable; he believes this burn patient cannot undergo skin grafting, and will inevitably develop countless complications leading to multi-organ failure and death.

Adding to the extensive burns over the whole body, there was simply no place where skin could be harvested for autologous grafting. This made the later recovery process extremely complex and unpredictable… actually not unpredictable; he believed that this burn patient could not undergo skin grafting and would inevitably develop countless complications leading to multi-organ failure and death.

But as a doctor, who wouldn't want to save the patient?

The consequences are unpredictable; that's just a kind of official speak, representing only a hopeful wish.

The burn department head raised all these opinions, offered no conclusion, and then fell silent.

They are all veteran doctors who have seen many battles, nationally renowned professors. In this situation, there's no need to state the conclusion—everyone already knows what the final conclusion will be.

Vice President Yuan's eyes were like those of a hawk; he scanned the demonstration room, and after a few department heads gave brief remarks, his gaze finally settled on Zheng Ren.

"Who just said that a kidney transplant could be done? Stand up and explain."

Zheng Ren stared at the medical chart in his hand, lost in thought, until Su Yun nudged him with his elbow a few times, bringing him back.

Seeing Vice President Yuan looking at him, he mentally ran through the situation and stood up.

"Let me share my opinion." Zheng Ren, without stating his affiliation, said directly: "For the burned patient, the venous access issue can be resolved by the intervention department or the vascular department. Performing a procedure on the calf vein to establish a conduit should not be difficult. Once the tube is placed into the inferior vena cava, the fluid infusion problem can be solved. As for the airway burns and pulmonary edema, I believe the burn department and ICU have similar treatment experience. Currently, we face a patient whose both kidneys need to be removed, and another patient who lacks skin flaps for grafting."

The two patients are twins, possibly identical. In this special situation, I suggest obtaining the family's consent first, then performing the kidney transplant. The burned patient has third-degree or higher burns and cannot heal on its own. After the kidney transplant patient recovers, they can provide skin grafts for multiple procedures to solve the problem.

Zheng Ren's suggestion was simple; on the way here, he combined the system diagnosis with the task description and already had a preliminary idea.

Because the Big Pig Trotter gave a rare hint this time—identical twins. If that's the case, everything is still possible.

For Director Miao, or rather 912, a kidney transplant is nothing at all. Even for Zheng Ren, if he's willing to open that master-level skill book and spend some gold on training, it's no big deal.

As for burn skin grafting, the key lies in the fact that 95% of the patient's skin is burned, plus postoperative care; the surgery itself is basically not difficult.

Zheng Ren believes his proposal is the most suitable for the current situation.

The two brothers could mutually provide skin flaps and kidneys; as long as there's no rejection, what was originally an S-rank surgery with perioperative treatment would be downgraded directly to an A-rank.

But even doing so would be a dead end; both sides are abyssal chasms, and a single misstep would leave no place to bury the dead.

Often, what doctors face is not the condition, but people's hearts.

"How do you know they're twins?" Vice President Yuan asked.

"The emergency department doctor who brought up the films said something, and I remember." Zheng Ren said.

"Director Ren, is that right?"

The head of the emergency department nodded and said, "The patient's father said these two patients are twins."

Zheng Ren sat down; no one else had any better suggestions. The matter has come to this point—whether to proceed with surgery depends on the hospital's responsibility and whether the patient's family approves.

Vice President Yuan said nothing, merely thinking silently.

What remains is up to this hospital director.

The road, there are only two, this goes without saying. But Zheng Ren's consideration, is it really appropriate?

Identical twins, dubbed the lucky ones with backup organs. But not all twins are identical; for fraternal twins, transplant rejection remains significant.

Seeing Vice President Yuan lost in thought, the chief directors also remained silent. Zheng Ren's imaginative ideas were not agreed upon by many.

Risk is something everyone considers.

But let the director take the blame for this.

Who made the institute take it seriously?

"Let's adjourn, Director Miao. You handle the hemostasis on your side; give me ten to fifteen Minute." After saying that, he waved his hand, signaling to disperse the meeting.

Such Discussion in the technique originally wouldn't take long either. The solution is only one: that which Zheng Ren said.

Vice President Yuan gazed at Zheng Ren's back, sighing inwardly, 'Youth is truly good—unafraid of risk, that spirit is truly vigorous!'

……

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Note 1: Before and after my tenure as attending physician in Jin, I was young and ignorant, and once had this idea. Hmm, too ignorant.