Since 1981 Health School Chapter 554

  Chapter 554 Accidental Esophageal Perforation

   Chen Qi's endoscopic surgery takes about 50 minutes on average.

   After one morning, 5 surgeries were done with ease. Chen Qi showed this group of colleagues from the United States what "Hua Guo Speed" is.

  When the foreigners were eating lunch, their mentality was actually broken. Many people sat in twos and threes and talked softly:

   "John, are you surprised that this is how endoscopic surgery can be done?"

   "Not surprised, just frightened. I think I learned a lot of **** after studying endoscopy for so many years."

   "It seems that the sky will change in the future. We are no longer the most developed country in endoscopic surgery in the United States. This is so frustrating."

   "It seems that this magical Chen's mentor is too powerful. It would be great if I could also be his student."

   "Who says no, this level is better than Professor Bradrick."

   "Keep your voice down, idiot!"

  Compared to the surprise, unwillingness, and shock of other doctors, Professor Grace, who is the president of the World Society of Gastroenterology Organizations, has a much more complicated mood.

  On the one hand, as the leader of an international medical organization, he should be happy to see the new technologies and procedures for gastrointestinal system diseases invented around the world, and actively promote them.

   On the other hand, as a white man and a top doctor in the United States, Professor Grace originally had a very strong sense of superiority in his heart, but now this sense of superiority has disappeared.

  What was the medical field in Huaguo before? Those were all low-end existences that he looked up and would not catch his eyes at all.

  Every time the WGO held a meeting, those Hua Guo doctors would nod and bow their heads when they saw him, showing as much humility as they needed.

  But Professor Grace took it for granted, and even met doctors from third world countries, and it was a gift to mention a few words to them.

  As a result, today a young doctor from Huaguo slapped him hard.

  Medicine is the same as competitive sports. The first place is the first place, and the second place is the second place. There is no blur in the middle.

  Chen Qi can perform operations that others cannot, he is NO1.

  Even if Grisgui is the president of the WGO organization, a member of the American Academy of Sciences, the dean of Duke University Medical Center, the director of the gastroenterology department, a senior professor and a series of positions or titles.

   But he can't do such complicated endoscopic surgery, then he can never say that he is the best doctor in the field of gastroenterology.

  Professor Grace never dreamed that he would be defeated by a young doctor.

  Of course he is not a small-hearted person. As the president of WGO, he has a bigger structure. After all, he is not the president of the National Society of Gastroenterology.

  So Professor Grace didn't intend to hit Chen Qi, and he would affirm Chen Qi's achievements with tears in his eyes. No matter who said that his bounden duty is to promote the development of gastrointestinal medicine, he still has professional ethics.

  Compared to Professor Grace's inner sadness, Professor Bradrick from Sid-Sinai Medical Center is thinking about his little one.

  He had repeatedly studied Chen Qi's surgery videotape in the United States before, and this morning he also saw the whole process of Chen Qi's surgery with his own eyes.

  For Professor Bradrick, a senior doctor who has been engaged in gastrointestinal specialties for more than 20 years, POEM surgery does not seem to be that difficult.

if…

  If Bradrick himself has learned the POEM technique and the tunneling technique, then can the huge bounty offered by the Hollywood tycoon be saved?

  The possible bounty of several million dollars, even if Bradrick himself is a top doctor, is also full of temptations.

   Who doesn't like money?

  Thinking of this, Professor Bradrick coughed a few times, pretending to be decent and suggested:

"Chen, the POEM technique you invented is really amazing. You also know that I have traveled all the way to China to learn this new technology. Can you let me try a POEM surgery this afternoon? "

  As soon as Professor Braderick finished speaking, Professor Grace next to him gave him a meaningful look.

   But it is clear that Chen Qi still lacks experience in the world, and he has never seen the insidiousness of Americans. He thinks that he can help this foreign colleague purely from the perspective of medical technology promotion.

   Another important reason why Chen Qi was not vigilant was that the POEM technique was plagiarized for him, so he didn't cherish it that much.

   "Professor, you mean, you want to do an endoscopic surgery for achalasia yourself?"

   "Yes, Chen, I want to get your permission, and I can do it under your guidance."

   Seeing that the professor of the University of the United States of America spoke so modestly, Chen Qi shrugged and said indifferently:

   "OK, this is not a problem, I will leave the chief surgeon in the afternoon to you."

  Professor Bradrick saw that Chen Qi took the hook so easily. He was excited and nervous for a while, and he was eager to try. At the same time, he was a little secretly happy.

  In the afternoon, in the operating room, the patient was already under general anesthesia.

  Professor Bradrick held the handle of the endoscope and slowly put the gastroscope catheter into the patient's mouth until it reached the esophagus.

   Then, following Chen Qi's technique, he injected normal saline into the submucosal tube 10cm above the cardia, and then cut the mucosal layer longitudinally. Until this step, Professor Braderick has done it very steadily.

  He can become one of the most famous gastroenterologists in the United States, which also has two brushes.

  Then it is time to "open the tunnel". In this step, the doctor needs to separate the submucosa and muscular layer of the esophagus.

  The separation is entirely dependent on the surgeon manipulating the gastroscope operating rod, cutting off or melting away the submucosa tissue with a Hook knife, so that there is no connection between the mucosal layer and the intrinsic muscle, and a tunnel is formed.

  It is equivalent to making a long hole in the wall of the esophagus.

  This process seems simple, but for doctors who have not practiced, the brain understands it, but the hands may not understand it.

  Surgical operations require millions of times of training, which is an important reason why medicine is called "empirical medicine".

   After successfully completing the first few steps, Professor Bradrick felt that the operation was nothing more than that. After explaining the principle, it was actually quite simple, so he was a little confused for a while.

   He was even in the mood to joke with the doctor next to him. At this time, if nothing else happened, an accident happened.

When Professor Braderick was manipulating the Hook knife to dig the tunnel, he didn't grasp the strength well. When he stabbed down with a little force, the muscular layer and adventitia of the esophageal wall were all opened up at once. .

   It was too late for Chen Qi to stop.

  Esophageal perforation.

   "Hiss~~~"

   "God~~~"

  The onlookers were all gastroenterology doctors. Everyone gasped. This esophageal perforation is not a joke. If it is not good, it will kill people.

  Professor Bradrick froze there on the spot, even forgot to take back the gastroscope, and kept perforating.

  Professor Grace's face darkened all of a sudden, and he cursed: "Idiot, you have caused great harm to an innocent patient."

  The white old man was really angry, because he knew Bradrick's little thoughts, and now his operation failed, which made Professor Grace furious.

  Medical ethics has an important principle, that is the principle of "do no harm".

  If the US media knows that this well-known doctor at Sid-Sinai Medical Center is using patients as experiments, not treating patients as human beings, and even piercing his esophagus, he will be sprayed until he can't take care of himself.

  Professor Bradrick came here on behalf of the WGO organization this time, and was known by outsiders and the media, causing the WGO organization to be criticized.

  The older the doctor, the less courageous he is.

  Chen Qi didn't have time to blame the American doctor for his three-legged cat kung fu.

  Now this patient is nominally operated by him, Chen Qi. People trust Chen Qi, so they waited for so many days, and waited for all the foreign doctors to come to perform this teaching operation.

   As a result, his achalasia was not cured, but instead he had a perforation of the esophagus. How can this be justified?

   After being pushed away by Chen Qi, Professor Braderick knew that he had caused trouble. As a gastroenterologist, he also knew the danger of esophageal perforation.

  Especially POEM is to make a hole in the esophagus. Now, once the hole is pierced, the outside is connected to the inside, which becomes a "fistula", that is, an esophageal fistula in Chinese.

   That is even more dangerous.

   "Chen, I'm sorry I'm sorry, I didn't know there would be a piercing."

  Professor Bradrick even apologized, completely panicking. If this kind of medical accident happened in the United States, he would not be able to get it without millions of dollars in a lawsuit.

   There could also be massive reputational damage to his career.

  Chen Qi didn't mean to blame the American doctor. An accident occurred in the operation, which is also a normal clinical thing. What's more, this American professor is doing POEM surgery for the first time.

  However, how to solve this esophageal perforation has become the top priority.

   Fortunately, in order to meet the leaders of the departments and offices and foreign friends, all the staff of the People's Hospital have to go to work these days and are on standby.

  So Chen Qi roared:

   "Head nurse, quickly call Guo Shuji and surgical director Zhu, and ask them to come to the operating room as soon as possible. There is a patient with esophageal perforation who needs immediate thoracotomy."

   "Good Dean Chen!"

  The head nurse in the operating room is more experienced. Seeing that the dean rarely yelled at others, she knew that these foreign doctors probably screwed up the endoscopic surgery, which might cause serious harm to the patient, so they ran to the office in two steps.

  In less than 5 minutes, Lao Guo's loud voice came in from the outside:

"What's the matter, what's the matter? What's the matter? Chen Qi, you bastard, I've ordered you to take this reception task seriously, what are you doing, why did you perforate other people's food for no reason? ?”

  Before he finished speaking, Lao Guo entered the operating room, and Director Zhu also came running, panting.

   "Chen Qi, what happened, the esophagus was perforated no matter what."

  Chen Qi didn't have time to explain:

"During the endoscopic surgery just now, the endoscopic electric knife accidentally opened up the wall of the esophagus. Fortunately, the patient is now under general anesthesia. I have asked the anesthetist to adjust the dose, and urgent esophageal perforation is needed immediately. Repair surgery, I can't do it alone."

  Old Guo was taken aback when he heard this, and asked in Chinese:

   "This endoscopic surgery is still dangerous. Will it affect the visit of these foreigners and cause bad influence?"

  It is called a failure when a doctor fails an operation, but if the operation fails in front of colleagues, it is called a failure. But if your operation fails in front of a group of foreign experts, it is definitely a super failure.

  As the leader, Lao Guo immediately thought about how to deal with the aftermath and whether it would have a negative impact on Chen Qi himself.

  Chen Qi replied softly: "It wasn't me, it was the foreigner next to me who performed the operation. The perforation was caused by him, and it has nothing to do with us."

  Both Lao Guo and Director Zhu heaved a sigh of relief when they heard that, as long as Chen Qi is fine.

   "Okay, push this patient to the next operating room. We will do this prosthesis. You can explain it to the family members. We can't be sorry for the patient."

  Chen Qi nodded heavily: "Sure, please trouble Guo Shuji and Mr. Zhu."

  Professor Bradrick couldn't understand Chinese, so he asked anxiously: "Chen, what should we do now? Can your hospital perform esophageal repair?"

  The white doctor was in a hurry and accidentally asked this kind of discriminatory question.

  Chen Qi was also a little upset when he heard it. What do you mean by "will your hospital do it?"

"Professor Bradrick, don't worry, the two surgeons just now are the best surgeons in our hospital. They have 30 years of clinical experience in surgery. One esophageal repair is not a problem. The point is that now I have to ask the patient's family for forgiveness." , after all, this is considered a medical malpractice."

  Professor Bradrick shuddered when he heard the word "malpractice".

  Americans pay attention to rights protection in everything, and American lawyers are all-pervasive, so medical lawsuits in the United States are hard to guard against, and there are countless cases.

  It's just that the insurance in the United States is relatively sound, even if the hospital loses the lawsuit, there will be insurance compensation.

  Although the doctor himself does not have to bear the loss of money, if the doctor has too many medical accidents, the insurance company will downgrade the doctor's credit and even refuse to insure the doctor.

  The doctor who was abandoned by the insurance company also ended up a tragedy.

  So sometimes, as long as the amount of compensation is not too huge, those top doctors who are not short of money would rather choose to go private and pay a sum of money to buy a peace, so as not to cause adverse effects.

   "Chen, I'm really sorry, please tell the patient's family for me, I am willing to compensate them 50,000 US dollars, oh no, 100,000 US dollars, as long as they give up pursuing my responsibility."

  Professor Braderick does not have the qualifications to practice medicine in China. He is an "illegal practice of medicine". According to the laws of the United States, if he fails to do so, he will be jailed.

  The combination of many factors scared the white doctor into a panic.

   But he seems to have forgotten that this is Huaguo, and the relevant laws of Huaguo in the 1980s did not seem to be so sound.

  Chen Qi was surprised to hear that this American doctor was willing to pay so much money.

  Even if the official exchange rate is 1:4, this patient can still get a compensation of 400,000 RMB, which was 400,000 in 1989.

  It doesn't take so much to stretch your waist.

  If you know that you can get 400,000 compensation, let alone a hole in the esophagus, it is estimated that many people would rather have stomach perforation, intestinal perforation and heart perforation, and wait in line for foreigners to have the perforation.

  (end of this chapter)

Chapter end