The Enhanced Doctor-Chapter 506. Liu’s Great Demon King’s Godlike Prediction (Additional Release 4/8 for Emptiness, Loneliness, and Coldness671112)
(Thank you, TaoTao1974999, Silence529, qwerasdfghjk, book friend 20181026075010625, 819570573 for your tickets of encouragement)
On the eve of the Lunar New Year, it was quite a special day.
After getting up, Liu Banxia moved her left hand a bit. Although it was still a little uncomfortable, she thought it wouldn’t affect her work today.
"Teacher Liu, are you going to perform the surgery today?" Xu Yino asked as she approached Liu Banxia.
"The director will handle it; I won’t. Liver lacerations are quite tricky, huh?" Liu Banxia asked casually.
Xu Yino nodded. "I just went to the ICU. The patient’s vital signs have improved, but the blood pressure is still unstable. Is it dangerous if the bleeding point in the abdominal cavity hasn’t been sealed off properly?"
"That’s common. Packing the abdominal cavity to stop bleeding is just an emergency measure. If the bleeding point is too large, it often only serves to reduce the blood flow," Liu Banxia said thoughtfully.
"For this patient, we should notify Dr. Chen again. The liver’s blood vessels are complex. If the gauze is removed and bleeding cannot be quickly stopped, we’ll need to resort to a large vascular clamp."
"Anyway, the patient survived the night, and today is the last day of the Year of the Dog. Let’s do our best not to lose the patient."
"Teacher Liu, is there anything else we should pay attention to?" Xu Yino asked curiously.
"What else to watch out for? Mainly the blood vessels. If you want to perform well, you need to thoroughly understand all the blood vessels in the liver," Liu Banxia said with a smile.
"It’s not just the arteries that supply blood; the veins are equally important. For example, the main veins. If these vessels rupture, the rate of blood loss is no slower than that of arterial vessels."
"The inferior vena cava in the posterior segment of the liver is the largest vein trunk in the human body. If this vessel is damaged, suturing it quickly is quite challenging. In that case, we need to perform a shunt to buy time for the patient."
"Basics, the basics are the most important. In any surgery, as long as you master the fundamental aspects, you’ll handle things with ease. If you haven’t even mastered the basics, even the simplest operation will be a clumsy struggle."
"Anatomy, hemostasis, ligation, and suturing—simply put, these are the four components. But none of them are easy to master; they all require hard work. Only when you possess a technical foundation that is steady, accurate, gentle, fast, and skillful will you have truly succeeded."
"Don’t put so much pressure on yourselves. Even I am still in the stage of laying the groundwork. Take it slow. Later, I’ll buy some chickens for you all to practice dissection and suturing."
Xu Yino had been listening intently. Indeed, Liu Banxia had just mentioned many things she hadn’t considered before.
It’s more about the relationship between active thinking and passive acceptance. Anyway, I’m just shadowing the director during surgery, right? I just need to see how the director operates, and that’s it.
She had never anticipated what she would do if a certain situation arose and she were in that position. She might have thought about it while observing, but she wouldn’t consider it before actually going into surgery.
But just as I was admiring her in my heart, the Devil King threw out this torturous method. That’s not going to be an easy task!
"Cheer up! Let’s aim for everyone to eat on time today. Zhou Qiang has already confirmed the menu again; everything everyone ordered will be there and it’ll be good," Liu Banxia called out, raising her voice.
Everyone brightened up. Truth be told, they were now genuinely looking forward to lunch and dinner.
"Hopefully, everyone can have a peaceful New Year today. Based on past experience, there are usually more trauma patients in the afternoon and evening; the morning is generally more relaxed," Xu Hui chimed in as he approached.
"Let’s hope so. It would be best not to have major cases like last night; we can’t handle that. If everyone has a safe and peaceful New Year, that would be perfect," Liu Banxia said with a laugh.
"Banxia, Huang Bo’s patient is muttering about wanting to be discharged. What should we do?" Zhou Li walked over at that moment.
"If he wants to leave, let him. Actually, the treatment is the same whether he’s in the hospital or at home. As long as he can control what he eats, he can control the condition. If he can’t, nothing will help," Liu Banxia nodded.
"Later, I will issue another discharge order and explain everything thoroughly to him and his family. He already has brain fog syndrome, and his days ahead won’t be easy."
Zhou Li nodded and went to make the arrangements.
Liu Banxia also began writing the discharge orders. They were similar to the last time the patient was discharged, but this time she emphasized things more, as the patient’s brain fog symptoms had become quite prominent.
This symptom was also very distressing, affecting the patient’s factual recall, episodic memory, visual memory, attention, decision-making, inhibitory control, and more.
"Doctor, if my father is discharged, should he continue with the current medication dosage?" the patient’s daughter came over and asked.
Liu Banxia nodded. "Continue with the current dosage for about ten days, then come back for a follow-up. We’ll need to reassess his condition and adjust the dosage accordingly."
"At home, someone needs to monitor him constantly, and all snacks must be strictly avoided. I’ve written down the main categories of food to be careful with. This illness is much more troublesome than diabetes."
"Doctor, is there really no other way? We’d even consider surgery," the patient’s daughter asked.
"I also hope it can be completely cured, but at the moment, it can only be managed. It also requires very careful attention to diet, which will be very hard. This hardship isn’t just for the patient, but also for you, those who care for him," Liu Banxia said.
"What I mainly wanted to discuss with you is this brain fog symptom. It’s worse this time than last. For now, it seems to have eased somewhat with medication."
"But if it recurs next time, not only will the brain fog symptoms be severe, but his responsiveness to the medication might also be affected. You understand what I mean by responsiveness to medication, right?"
The patient’s daughter nodded. "I understand. Last time, the first medication had no effect, so we switched to another drug."
"So, you all need to persevere. Help manage your father’s emotions and guide him correctly. Treat it like coaxing a child; it will be a bit difficult at first."
"Thank you, Doctor. I’ll go handle the discharge paperwork now. He gets a bit restless staying in the hospital," the patient’s daughter said with a wry smile.
Liu Banxia wasn’t sure what else to say. Anyway, she had explained everything that could be explained. With this disease, one has to be prepared for a long-term struggle.
With nothing pressing for her to do, she joined the group for some casual chat. Xu Yino and the other interns were diligently lining up at the scrub sinks, waiting to wash their hands.
Seeing Chen Xuehai, Xu Yino thought to herself, Teacher Liu really is incredible; she thought of everything.
Once inside the operating room, the patient was also wheeled in. After routine checks, the surgery began.
"There’s still a large amount of active bleeding. I’ll try to clamp the inferior vena cava. No, still bleeding. We need to do a venous bypass," Zhou Shuwen said as he operated, while removing the gauze pads that had been packed into the patient’s abdominal cavity.
"What about the inferior vena cava of the posterior segment of the liver?"
Xu Yino didn’t even know why, but upon seeing the situation, she blurted it out.
"Indeed, it’s here. Prepare the biological pump and cannula. We need to perform an end-to-end anastomosis around the liver," Chen Xuehai, the first assistant, said.
"Xu Yino, right? Very good. Your thinking is thorough and comprehensive. How about you come over and assist? Once we deal with this, the remaining bleeding points will be easier to manage," Zhou Shuwen said.
"Ah, no, no, it wasn’t me," Xu Yino responded, a bit flustered. Then, realizing something was amiss, she added, "I mean, I did speak just now, but those weren’t my thoughts."
"Just look at you, all flustered. Did Teacher Liu give you some special coaching? I saw you approach her this morning," Liu Yiqing said with a grin.
Xu Yino glared at her. "I just mentioned it briefly to Teacher Liu, and Teacher Liu said we should anticipate potentially more severe bleeding in the patient and suggested bringing Teacher Chen along, just in case."
"Then she mentioned that the patient’s current condition might be due to a site of major bleeding where the blood couldn’t clot, hence the unstable blood pressure. It was either the aorta or a large vein."
"Hmm... she also mentioned the inferior vena cava of the posterior hepatic segment. She said if that ruptured, it would generally be difficult to suture. Then, when I got nervous just now, I just blurted it out."
"Xuehai, did you tell this kid about our discussion?" Zhou Shuwen asked.
Chen Xuehai shook his head with a wry smile. "We discussed it on the phone last night, and then I went to sleep. I didn’t have time to tell her."
"I’m tempted to open up her skull to see what she thinks about all day. She can come up with so much just from reading the surgery report?"
"Tell me about it. I’m also curious what she thinks about all day," Zhou Shuwen said.
"It looks like for today’s lunch... oh, wait, lunch and dinner are already arranged. Tomorrow is the first day of the new month; let’s have her treat us to a meal. If we don’t get a meal out of her, I won’t feel right," Chen Xuehai said.
"Haha, me, as a mentor, extorting my student? That doesn’t seem quite right," Zhou Shuwen added with a laugh.
Their casual conversation startled the interns.
The implications were too obvious. Director Zhou and Teacher Chen had discussed the surgical plan. And their conclusions seemed to align remarkably well with what Liu Banxia, the "Devil King," had casually mentioned.
But the bleeding in the abdominal cavity yesterday had been so complex; no one had seen exactly where it was coming from. Then the patient’s vital signs became unstable, so they could only resort to packing to stop the bleeding.
So the implication now was simple: Liu Banxia’s (the Devil King’s) prediction was astonishingly accurate. You could say she guessed, but as long as she correctly anticipated that such a situation might occur, it was a success.
Director Zhou and Teacher Chen had also made this prediction, which was why they were so methodical and calm during the procedure just now. That was the difference between being prepared and unprepared.
Director Zhou actually laughed in the operating room. Undoubtedly, he was thrilled by the Devil King’s brilliant prediction.
