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When the Doctor Uses A Hack-Chapter 676: Walking on Thin Ice (Whatever the Alliance Hierarch Wants, Added - !)
After Chen Cang left, although Zhao Xing muttered to himself, thinking of Chen Cang's obviously urgent and tense emotions just now, he still started to carefully examine the images.
Could it be that he really missed some abnormal signals?
However... Chen Cang, you're an emergency department doctor, just because you perform surgeries well doesn't mean you're equally skilled at reading images, right?
After all, each profession has its own expertise!
Zhao Xing couldn't resist criticizing.
Nevertheless, he still began to carefully compare the images!
Indeed, after he changed several films one after another, he suddenly froze!
This... What's going on with the slight enlargement at the right upper margin?
It doesn't look normal, does it?
Zhao Xing had never seen such a thing before, and with that thought, he quickly stood up and started to flip through reference books.
After looking for a long time, he still didn't understand what was wrong!
Suddenly, Zhao Xing felt even more nervous and uneasy.
Could it be that Chen Cang really understood radiology?
And realized that something was amiss?
Thinking of this, Zhao Xing felt somewhat apprehensive.
Should he... apologize to Chen Cang?
No, that's not right!
Apologize to Chen Cang for what? If someone needs to be apologized to, it's the patient...
Realizing this, Zhao Xing actually started to feel a bit guilty, acknowledging that he should have handled it with more care.
With that thought, he quickly printed out an image and wrote up a report:
"Heart shadow normal in size, unusual protrusion on the right upper margin to be investigated?
Consideration:...
Suggest a cardiac CT to refine the diagnosis…"
After writing, Zhao Xing hurriedly got up and ran towards the emergency department.
Although Chen Cang now suspected that the little girl had a congenital transposition of the great arteries with associated cardiac malformation, he still couldn't be entirely sure.
It was still necessary to expedite the completion of relevant diagnostics.
Zhao Xing failed to notice, and Chen Cang didn't blame him, understanding that there were differences in levels of skill, so he hoped to discuss it with Director Shi Tao.
Chen Cang even graciously offered a way out for the other party, saying that it might be because of the child's poor positioning, and he volunteered to adjust it.
However, Zhao Xing completely failed to understand Chen Cang's intentions and instead felt that Chen Cang was questioning his skills, deliberately making things difficult for Chen Cang, which was somewhat unreasonable.
Logically, as medical staff, we should all be pulling together and exerting our efforts as one. Yet, even after Chen Cang's repeated reminders, you still act imprudently, which is somewhat unacceptable.
As a doctor, the most important thing is to take responsibility for your patients and not betray their trust!
Possibly today, if it hadn't been for Chen Cang, but another doctor instead, who took Zhao Xing's report and left, maybe there wouldn't have been an issue.
Just like Luo Zhou who couldn't have spotted the condition, after all, you're not a specialist in radiology, and compared to your own abilities, you would definitely trust the professional doctor's judgment and conclusions more!
Well, perhaps years later, when the patient suddenly has a recurrence of the illness, they might not blame Zhao Xing, as diagnostic results do have limitations.
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If it were an urgent patient case, they would likely not just do a chest X-ray but would also complete other tests.
Speaking of which, some doctors don't take small tests like chest radiographs seriously—empiricism prevails, or they simply don't read the images attentively.
But as a doctor in the radiology department, you should still earnestly fulfill your duty and obligation, provide a clear diagnosis for patients, and at the very least, issue a reminder.
That's the least you can do to show respect for the pen in your hand with which you sign.
...
Zhao Xing had just stepped out when a sudden thought made him turn back.
After all, by delivering this report, he had shifted the responsibility from himself, but... he couldn't make a definitive diagnosis, and Chen Cang wasn't a specialist either. It might be better to consult some experts to see if they could make a diagnosis. Enjoy exclusive chapters from novelbuddy
Although he had delayed, at the very least, it would provide an explanation to the patient!
It would also help Chen Cang understand the patient's condition.
With that in mind, he picked up the telephone and dialed an expert's number.
Muttering under his breath, "Chen Cang, oh Chen Cang, I'm not afraid of you; I'm considering the patient's well-being!"
This was a director from the imaging department he had met during his advanced studies at the Shenyang Military Region General Hospital, someone who had a deep research interest in chest radiographs.
He had a good relationship with Director Xu at the time, and with this thought, he directly dialed Director Xu's WeChat.
"Director Xu, hello, hello, this is Zhao Xing! Uh, sorry to bother you, but I have a question to consult with you. It's about a young girl's chest radiograph. I've looked at it and felt there was nothing wrong, but... I just felt something was off. Could you take a look for me?"
After hanging up, Zhao Xing took a photo of the radiograph with his cellphone and sent it over.
A few minutes later, the other side initiated a call back.
"Zhao Xing, this radiograph... eh? No, that's not right! Such a strange cardiac silhouette, it looks normal, but... I always feel it resembles transposition of the great arteries. You see this protrusion at the upper right edge, doesn't it look like a great artery?
This arch-shaped protrusion isn't something that most people have... It's very likely! It could very well be that chest radiograph of what's called transposition of the great arteries!"
"This is a rare case; you better follow up on it, and let me know the results."
Hearing Director Xu Nan say this, Zhao Xing was immediately stunned!
There was indeed a problem!
And it was a big problem!
Transposition of the great arteries?
That... could be a life-threatening disease!
With this realization, Zhao Xing's face turned red with both shame and panic!
How could he have said there was nothing wrong with such an x-ray?
At this thought, Zhao Xing almost wanted to slap himself!
If it was his fault that the patient missed the optimal time for surgery, then he was to blame.
Moreover, thinking about what Chen Cang had just said, Zhao Xing was overwhelmed with panic and couldn't help but be filled with self-reproach.
Dammit, Zhao Xing, oh Zhao Xing, why are you acting so ignorant?
How skilled are you, really?
If you were really to delay this young girl, the fault would be tremendous.
He had never expected that what seemed like a common radiograph would hide such a massive challenge!
At that thought, Zhao Xing was immensely ashamed, yet also filled with deep self-blame!
He hurriedly reprinted a copy of the report.
Following Xu Nan's speculation, he added to the report, got up in a rush, and headed towards the emergency department.
In his heart, he prayed nonstop, "Please don't leave, young girl, if you do, I will blame myself for the rest of my life."
The more anxious he became, the more worried Zhao Xing grew, even beginning to sweat coldly from his back.
Internally, he swore that from this moment on, he would be earnest, more earnest, then earnest again!
Today, he truly realized what it meant:
Practicing medicine is like facing an abyss, every step must be taken as if on thin ice!
It really is so!
...
...
Chen Cang had returned to the emergency department and said to Lu Jie, "The child's condition still presents some issues. Her chronic chest tightness, I believe, is related to hemorrhage and obstruction in the great vessels!"
This situation was not so bad when she was younger, but as she got older, and as her heart function continued to improve, various problems would arise."
"So I still recommend that we perform an echocardiogram to clarify the diagnosis. What do you think?"
Lu Jie didn't speak up, but Yang Kaihua did, "Okay, okay, no problem, Doctor. You're the professional. We'll do whatever you say!"
Lu Jie also nodded her head but didn't say a word.
What Chen Cang had just told her reaffirmed her worst fears; recalling life at home, there really had been numerous unusual occurrences, sometimes even waking up suddenly in the middle of the night, clutching at her chest, gasping for breath for a long time!
At first, Lu Jie thought her child was having nightmares, especially since they had indeed occurred after her father passed away, but now...
Hearing what Chen Cang said had suddenly enlightened her.
Lu Jie looked at her little girl with distress, only to see her pouting her lips, glancing at Chen Cang, and thinking to herself, you broke our promise!
Seeing the little girl's expression, Chen Cang also gave an awkward smile.
Shi Tao arrived shortly after, he lived in the hospital's family building.
Upon seeing Chen Cang with a group of patients, Shi Tao asked, "Director Chen, what's going on?"
When Lu Jie, Yang Kaihua, and the others heard Shi Tao referring to Chen Cang as the director, although their expressions remained unchanged, their trust in him deepened even more internally.
After all, to patients, the word "director" carried significant weight.
Chen Cang said, "Director Shi, take a look at these films. The patient is this little girl, with a long history of chest tightness..."
Shi Tao glanced at the little girl and immediately took the films to examine them carefully. A moment later, Shi Tao's brow furrowed.
"A very strange protrusion, have any other tests been done?"
Chen Cang shook his head: "We're waiting for the ultrasound room to do a color Doppler ultrasound."
After saying this, Shi Tao pulled Chen Cang into the office: "Xiao Chen, do you have an ECG?"
Chen Cang nodded and handed over the ECG. As soon as Shi Tao saw it, he slapped the table: "It could very likely be that..."
Chen Cang asked, "Transposition of the great arteries combined with an intracardiac abnormality?"
Shi Tao was stunned for a moment: "How did you know?"
After all, Chen Cang was an emergency department doctor, known for his surgical skills. To be able to diagnose such a rare disease just based on films was impressive!
Thinking this, Shi Tao was naturally astonished.
Because transposition of the great arteries combined with an intracardiac abnormality was exceedingly rare.
Even he had only seen it once or twice, and he had nearly dismissed it due to his empiricism. Luckily, it was noticed by the old director, who scolded him and suggested a new diagnosis.
The patient was indeed diagnosed with a severe heart malformation that required surgery!
Because of this, Shi Tao remembered it for life; the impression was very profound.
But how did Chen Cang know?
You have to know, with such films, without sufficient experience and a history of similar cases, you wouldn't normally think of it.
Looking at Chen Cang, Shi Tao was somewhat surprised.
Just then, Zhao Xing rushed in hurriedly, panting and red-faced. Seeing Director Shi Tao there, he suddenly became embarrassed.
Without dwelling on his embarrassment, Zhao Xing said to Chen Cang: "Director Chen, the patient hasn't left, has she?"
Chen Cang was taken aback: "What's wrong?"
Zhao Xing directly apologized: "This... Director Chen, I'm truly sorry. It was my fault, I was a bit negligent just now. After taking a closer look at the films, I realized I had been careless, driven by empiricism, sigh... I've prepared a new set of films and reprinted the report forms."
"Right, the patient hasn't left yet, has she? I consulted with a specialist, and this little girl might have a serious heart deformity, with a transposition of the great vessels. We must keep her here, complete the necessary tests, and not delay her treatment!"
As he said this, Zhao Xing's voice was urgent.
Hearing Zhao Xing's words, Chen Cang breathed a sigh of relief internally.
After Zhao Xing finished speaking, he looked at Shi Tao: "Director Shi, today's mistake was mine, and I will reflect on it."
Shi Tao was taken aback: "What mistake?"
Zhao Xing was immediately stunned; he had thought Chen Cang summoned Shi Tao to complain, but to his surprise, Chen Cang... had not mentioned a word about it.
With this thought, Zhao Xing felt even more embarrassed.
Upon reflection, he realized Director Chen had already given him enough face, but he himself had...
Alas!
At this point, rather than trying to gloss over the situation, Zhao Xing looked at Chen Cang and said, "Director Chen, the issue today was my responsibility. When faced with such a case in the future, I should not make the mistake of being empirical, and I certainly should not have tried to gloss it over. This was my negligence.
Director Shi, I will reflect seriously on my shortcomings after I go back and hope to receive Director Chen's forgiveness."
After finishing, Zhao Xing passed over the report: "Director Chen, after you left earlier, I got in touch with Director Xu Nan from the Shenyang Military Region General Hospital. He suspects that the protruding cardiac shadow is actually a misplaced artery, suspecting it to be a congenitally malformed heart!"
"So, Director Chen, we need to clarify the patient's condition as soon as possible. The girl is still young, and my mistake could delay her life!"
At this point, remorse was evident on Zhao Xing's face.
At the end of the day, he understood that he is still a doctor.
Compared to his own errors, the patient's health is more important, after all, it's about a seven- or eight-year-old girl!
Shi Tao had also come to understand the whole story.
With this in mind, Shi Tao sighed, "Director Zhao, you should really thank Director Chen!"
"If it weren't for him, you would have regretted this your entire life!"
In the calm visage of Chen Cang, Shi Tao sighed again, "Director Chen suspected it was a displacement of the major arteries combined with a cardiac malformation the moment he saw the film!"
Hearing this, Zhao Xing's eyes widened.
Could it really be so?
Chen Cang... wasn't he a surgeon?
A surgeon has such an understanding of imaging?
This Chen Cang... no, Director Chen!
Director Chen is really amazing, isn't he?
What can't he do?!
At this moment, Chen Cang shook his head and said, "It's fine, actually, this cardiac shadow is quite special, and most people wouldn't notice it. Director Zhao, you don't need to blame yourself."
Zhao Xing was not young anymore, being in his forties; Chen Cang knew that sometimes he could be impulsive, still too young, indeed.
Shi Tao then glanced at Zhao Xing.
"Director Zhao, I hope this incident serves as a warning for you. In the future, you should be more attentive. The path of medicine cannot tolerate carelessness. You should thank Director Chen more."
Zhao Xing nodded.
Before long, the echocardiography doctor arrived.
Chen Cang hurriedly brought the young girl in for the echocardiography.
As the exam was conducted, the echocardiography doctor grew increasingly astonished.
"Director Chen, Director Shi! The... the aorta is located in front of and to the left of the pulmonary artery, and there's a huge circumference of the pericardium visible beneath the pulmonary artery!"
"And... there's an abnormal septal defect, it appears to be an uncovered tricuspid valve membrane, this is an abnormal blood flow..."
After she finished, she continued, "This could be a patient with a developing SLL type physiological transposition of the great arteries combined with a septal malformation!"
"It's likely still in the developmental stage!"
Upon hearing this, everyone fell silent.
Indeed, it was so!
...
ps: Thanks to "輕於羽毛" and "蛮蛮独立日" for their generous rewards of 10,000, and also thanks to all the little friends who voted and subscribed.
Two in one, written together huh... don't mind it.