The Enhanced Doctor-Chapter 561: It’s hard to handle

(Thanks to reader 20191123092721288 for the reward and encouragement, thanks to reader 20170820004210766 for the monthly ticket encouragement)

"Do you think it’s possible?" Liang Xiaolin asked after a moment of silence.

"Who should I consult about this? This matter... it’s difficult to handle, really tough to deal with," Liu Banxia said, a helpless smile on his face.

"I thought about it. If it’s a minor surgery that can be completed within an hour, that would be considered normal. Even if an incision is needed, as long as the patient is well-prepared pre-operatively and we distract him during the surgery, he could just about manage."

"But this is a coronary artery bypass! Think about it, if you were lying on the operating table and I was operating around your heart, what would you think?"

"We are both medical professionals. Imagine the amount of stress ordinary people would feel. I doubt it would go smoothly; the risk of this surgery is too high."

"If the patient gets too emotional during the surgery, the likely consequence is that the surgery could fail, and we could even lose the patient."

"Not to mention the severe psychological trauma the patient might suffer post-surgery. Without adequate psychological counseling over a period of time, it wouldn’t work."

"Don’t we have any other options? It’s a life-threatening surgery, not only risking the patient’s life but it may also cost us our careers. Secretary, we must be very careful."

Liang Xiaolin rolled her eyes. "We can’t be any more careful. Considering the patient’s condition, it could deteriorate at any moment. We might not even have the opportunity to save him at that point; otherwise, we wouldn’t be considering this option."

"Isn’t there no other way? I wouldn’t have approached you if I didn’t think you were persuasive. My brother will handle the director; how about you take care of the patient’s side?"

"Regardless of whether you are willing or not, being the head of the ward, all the patients from the cardiology department are your responsibility. This is about saving the patient’s life, so you must find a solution."

"Why can’t we use thrombolysis?" Liu Banxia asked hesitantly.

Liang Xiaolin didn’t say a word, just gave him a look.

"Ah... Of course, considering the severity of the situation, that wouldn’t work," Liu Banxia had to answer his own question.

"I’ll go see the patient. I’ve occasionally assisted with craniotomies where the patient was awake, but it’s stressful to even think about performing a coronary artery bypass on an awake patient."

He knew it was the only option left in a situation with no other alternatives.

As Liang Xiaolin said, it was about saving the patient’s life. If there were any other feasible options, such a bold decision would not have been made.

Liang Xiaolin seemed to feel relieved and jabbed her fist playfully at Liu Banxia.

Actually, this task should have been hers, but she lacked the confidence to do it well. That’s where Liu Banxia’s ’silver-tongued’ skills were needed and could now be freely used.

Following Liang Xiaolin to the patient’s room, the patient seemed quite unwell. He had just experienced an allergic reaction, and it was only thanks to timely resuscitation that his life wasn’t lost.

"Doctor, have you found a way to perform the surgery?" the patient’s wife asked.

"We’re still discussing it. I’m here to see how he is doing," Liu Banxia replied with a smile.

"Am I beyond help? I can’t even go through surgery, can I?"

The patient started to speak.

"Actually, there is a feasible plan; it just depends on how much confidence you have in yourself," Liu Banxia said.

"Doctor, what needs to be done?" the patient’s wife asked.

"We’ll perform an awake surgery using high epidural anesthesia," Liu Banxia said.

"Considering your current situation, this is the only feasible method. If we were to rely solely on medication, not only is its effectiveness uncertain, but even if it worked, we don’t know how long it would take to take effect."

"By using high epidural anesthesia, we can avoid issues caused by your allergy to general anesthetics, allowing your surgery to proceed smoothly. However, the downside is that you will remain conscious during the procedure."

"Additionally, this surgery will also take a long time, and the panic and anxiety you might experience could put the procedure at risk."

"The surgical procedure itself remains the same. This is something I need to inform you about specifically. You must consider this carefully, and you also need to tell us about anything that might help soothe your mood."

Liang Xiaolin gave Liu Banxia a surprised look. She hadn’t expected him to state things so directly to the patient without any preamble.

"Doctor, I didn’t quite understand. Could you explain it a little clearer?" the patient’s wife asked, furrowing her brows.

"Simply put, your husband will remain conscious throughout the surgery," Liu Banxia said.

"Such an extensive surgery will take a very long time, estimated to be over four hours. Emotional fluctuations can significantly impact vital signs."

"For example, if he is too tense or frightened, it will inevitably affect his heart rate, blood pressure, and adrenaline secretion, which could put his life in danger."

"Doctor, could he wear a blindfold or listen to music?" the patient’s wife asked.

Liu Banxia shook his head. "It’s not that if he doesn’t look or listen, he won’t think. On the contrary, during such a long period, he might think even more."

"So we should find a channel to communicate and divert his attention. Otherwise, the risk of this surgery would be too high."

"What about... me going in and being with him? Don’t they show on TV that partners can go into the delivery room? If we switch roles this time, would that be okay?" the patient’s wife asked again.

Liu Banxia frowned and shook his head again. "This surgery is very different from obstetric surgery, and you might find it even harder to handle than he will."

"Not everyone can withstand what happens on the operating table. Even many medical students experience fainting spells or vomit when they first encounter surgery, let alone ordinary people." 𝗳𝐫𝚎𝗲𝚠𝚎𝗯𝕟𝐨𝘃𝚎𝗹.𝗰𝗼𝗺

"Doesn’t he have any other hobbies? Any hobby will do, like a movie he wants to see? When the time comes, I can set up a player in the operating room so he can watch a movie."

"I love fishing. Whenever I’m stressed from work, I go fishing with friends," the patient spoke up.

Liu Banxia grimaced. "Let’s choose something else; I can’t exactly set up a fish pond for you in the operating room. Anything that can divert your attention is fine."

"If the surgery were shorter, I could even chat with you. But it’s a very long time, and I wouldn’t even know what to talk about for that long."

"There’s no rush at the moment; you two take your time to think about it. Once you come up with a method to divert his attention, we can proceed with the surgery. No matter how late, we can do it."

"Ah... thank you, doctor," the patient sighed.

Liu Banxia gave Liang Xiaolin a look, and the two left the patient’s room.

"What should we do now?" Liang Xiaolin asked with a troubled face.

"Let’s wait. We wait until the patient finds something he’s interested in; otherwise, we can’t proceed with the surgery," Liu Banxia shook his head.

"In such matters, we can’t coax the patient with sweet words. Although the surgery is necessary, if the patient isn’t fully mentally prepared, he might back out."

"The key to this surgery is that it takes a long time. This introduces many variables into the process, so we have to be fully prepared."

Liang Xiaolin nodded.

This was a factor she had forgotten to consider—the duration of the surgery.

All she had been thinking was that this patient would only survive if he underwent this surgery, as a fatal blockage could occur at any moment.

"How are the discussions with the patient going?" Chen Xuehai asked when they returned to the hall.

"The patient is considering it and also thinking about what might divert his attention," Liang Xiaolin said quickly.

"What does the director think about this surgery?" Liu Banxia asked.

"The director supports it but emphasized that we must handle the patient’s preparation and concerns meticulously. Awake surgery carries greater risks than general anesthesia and is more prone to complications," Chen Xuehai said.

"Unexpected things often happen during surgery, and when the patient is awake, the likelihood of these incidents increases. I’m starting to worry now; I haven’t performed a surgery of this level while the patient was awake."

"I haven’t seen one either; this surgery is not easy to do. Why don’t you go find a place to rest for a while? I’ll let you know when the patient makes a decision," Liu Banxia said.

Chen Xuehai nodded. "Try to persuade the patient if you can, but if you can’t, there’s nothing we can do."

"Teacher Liu, can’t we find another way?" Xu Yino asked.

Liu Banxia shook his head. "There are no other ways; this is the only solution. An allergy to anesthetic drugs has already closed off many options."

"The patient’s situation is so complex that even stenting can’t be done, only bypass grafting. Unless someone here can come up with a better solution, I’ll supply them with pig’s feet for a year."

The interns grimaced. There really were no other options; this was the only choice.

"Teacher Liu, what if the patient is still nervous during the operation?" Liu Yiqing asked.

"We do our best to guide his emotions and distract his attention. There’s no other way," Liu Banxia said.

"There are more cases of awake craniotomies; we could also ask for advice from neurosurgery to see how they help patients pass the time."

"But it’s still somewhat different from our situation, as this patient will be awake throughout. It’s troublesome. It all depends on what the patient thinks. If he can’t get over the mental hurdle, then unless he suffers another acute heart episode, we can’t even perform an emergency rescue operation."

"You guys should also think about how to distract the patient’s attention in your spare time. I guess the patient himself won’t be able to come up with anything."

This wasn’t him worrying unnecessarily; it was a genuine possibility.

The patient was extremely anxious right now, and his thoughts were certainly a little unreliable. Therefore, several plans should be prepared as a contingency.

It came down to the same principle: the ultimate decision lay with the patient. All the doctors could do was provide options and support.