NOVEL NEXT Chapter 34
Chapter 33 – Pancreas
During the lunch break, the flow of people in the emergency hall decreased slightly, and only two consultation rooms were opened in the ultrasound room of the emergency center.
Behind the green curtain, Lu Yinxi and Jian Qing stood side by side, Yan Miaomiao lay on the bed, showing her belly: “I didn’t eat much this morning, and Director Jian caught me before I even ate a vegetable!”
The female doctor on the noon shift put coupling agent on her belly: “Director Yan, stop shouting, I haven’t even drank my saliva since morning, and I was dragged here to work by you just after I ate instant noodles.” !”
Yan Miaomiao gave her a supercilious look: “I took care of you a lot in the outreach department back then, but now I am reluctant to serve the people. Do you have a conscience? How did you learn imaging? Did you fail a course? “
The female doctor hissed a few times: “Shhhhhhhhhhhhhhhh, I haven’t failed a subject, I’ve passed all the exams, be quiet, quiet quiet, I’m going to do it, come on, let me see through your liver, gallbladder, pancreas, spleen, and kidneys at a glance!”
The three doctors in the consulting room are all alumni from Jiangzhou University.
Working in the school’s affiliated hospital, the circle of relationships goes around, and I can’t get around alumni and friends of alumni.
The immediate supervisor may be a senior senior from the previous sessions, the director of the department is a senior senior from decades ago, and the newly recruited doctor is a student who has been taught by himself…
Sometimes the employees of this hospital have hemorrhoids or have to circumcise their skin. They have a minor operation in this hospital. Within a few days, almost everyone in the hospital will know it, and will smile and say a kind greeting when they meet.
Therefore, some employees are not willing to use knives in this hospital, and would rather travel thousands of miles to other hospitals to generate income for other hospitals, so as not to be surrounded by classmates and alumni of this hospital, and have to take off their pants to serve as teaching materials for their own students, which is extremely embarrassing.
The ultrasound doctor operated the probe and stuck it on Yan Miaomiao’s upper abdomen: “The students are all going to take a lunch break now, or let my little apprentice start practicing, look at your liver, your pancreas—”
Speaking of pancreas, she suddenly elongated her voice, let out a groan, and then fell silent, her teasing expression suddenly became serious, her eyes widened, her head leaned a little closer to the display screen, and her right hand holding the probe rested on Yan Miaomiao’s belly. Move around.
Yan Miaomiao raised her head, wanting to take a look at the display screen: “What’s wrong with my little pancreas?”
Jian Qing folded her arms, and stopped her expressionlessly: “Don’t move around.”
Yan Miaomiao was murdered, and lay down muttering: “It’s so fierce, I invited you to dinner just now, why didn’t I feed you well…”
“What little pancreas, I’m still an aunt…” The ultrasound doctor was still teasing, but his expression was no longer relaxed, and he let go of the probe, “Let’s go to the ultrasound department to ask Director Wang to show you, and then do some other examinations by the way. “
Almost all the people who come to the emergency department to sit on the front line in shifts and contact patients are young doctors, and the directors are in the ultrasound department of the base camp.
Yan Miaomiao sat up, and Lu Yinxi pulled out a tissue for her. She took it with thanks, wiped the gel on her belly, and asked, “What’s the problem? I have to call your leader to see it? You are not good at learning. “
The ultrasound doctor glanced at Jian Qing: “Director Jian, did you see it?”
Jian Qing looked at Yan Miaomiao, and said calmly, “The head of the pancreas occupies a place.”
Pancreatic head occupying space means that there is a mass in the pancreatic head part of the pancreas, which may be benign or malignant.
If it is benign, it is good to have a minor operation to remove it; if it is malignant, the probability is cancer of the head of the pancreas.
Pancreatic cancer is a type of pancreatic cancer.
Pancreatic cancer, known as the “king of cancers”, has a five-year survival rate of about 1% to 3%. It has an insidious onset, no obvious symptoms in the early stage, rapid progression, high degree of malignancy, poor treatment effect, and poor prognosis. , 8 out of 10 patients are at the advanced stage, and cannot be operated on; even if they are hospitalized, they can hardly survive 6 months; even in the early and middle stages where surgical treatment is feasible, after surgical resection, there is a very high probability of recurrence.
Today’s medical methods are helpless against this cancer. Even the most popular immunotherapy in recent years, which is effective in relieving many cancers, has little effect on pancreatic cancer.
There was a moment of silence in the small consulting room.
The ultrasound doctor pushed his glasses, broke the silence and said comfortingly, “I don’t look like a vicious person, Director Yan, don’t scare yourself.”
You can only say this in front of acquaintances.
In medical care, prudence always comes first. Before seeing more test results, no one dares and cannot make promises and guarantees with patients.
Whether it is malignant or not can only be confirmed by seeing the pathology results. Pathology is the gold standard for tumor diagnosis. The results of blood tests and imaging tests can only be regarded as auxiliary examinations and auxiliary judgments.
Yan Miaomiao’s face turned pale, and her expression froze for a few seconds, then she smiled and looked at Jian Qing: “Hey, old classmate, you are familiar with these things, what inspection do you need to arrange? I did it all at once. It’s a benign early mow. Don’t worry, it’s malignant, it might be cancer of the head of the pancreas, I think it’s still in the early stages—no, no.” She lowered her eyes, smiled, and shook her head in denial, “I’m only 32 years old, I don’t smoke or There is no genetic history of drinking alcohol, at most staying up late and staying up a little bit more, it can’t be cancer… Never mind, let’s get checked first…”
Doctors know more about diseases than ordinary people.
And because I know more, I know how terrible it is.
She has experienced many lives and deaths in the emergency department. When dealing with the death of patients, she is occasionally numb, but when she learns that a serious illness may befall her, she still cannot face it calmly and cannot be fearless about life and death.
Doctors are not gods, but human beings, and people will panic about diseases.
It’s an instinctive reaction engraved in our genes.
There are specializations in the surgery industry, and the larger the hospital, the more detailed the divisions and the more refined the specialization.
Sometimes after staying in the same specialist post for a long time, you may not know as much as rotating doctors about knowledge points that have not been used for a long time in other disciplines.
Emergency medicine is complicated, with a wide range of horizontal knowledge, but not deep vertical learning. When facing special diseases, it is still necessary to entrust them to specialist treatment.
The digestive system is not the part that Jian Qing is most familiar with. She invited the Department of Oncology, Department of Hepatobiliary and Pancreatic Surgery, Department of Gastroenterology, Department of Imaging, Department of Ultrasound and other related departments for multidisciplinary consultation. The chief’s office rushed to the MDT consultation room and took the lead in organizing the consultation.
Yan Miaomiao did not participate in her case discussion, she chose to stay calm in the ward.
When you are sick, the most difficult thing to endure is the period of time waiting for the test results.
Anxiety, prayer and pleading, regret and reflection, self-examination and self-blame, thousands of thoughts rushed to my heart.
Yan Miaomiao sat on the bed that Jian Qing arranged for her, looking back on her life over the past thirty years.
She has good academic performance since she was a child, and she is very popular. She is a brother and sister everywhere, but her family background is not very good, and her biological parents favor boys over girls. She was abandoned in the hospital shortly after she was born, and a couple who could not have children picked her up. When I went back, she ate and drank like her own daughter and raised her for offerings, and she was admitted to the best medical university in the country.
It’s a pity that other people’s daughters graduated from college in their early twenties to earn money to be filial to their parents. Those who study medicine, even if they study the fastest eight-year program, are several years longer than others. Not much money. She also chose the hard and tiring emergency department. She was never home all year round, and she couldn’t spend time with her family for years.
The adoptive father and adoptive mother are not well-educated, and often poked her in the head and scolded: “You are not as good as my adopted Mimi. Mimi still doesn’t spend the night outside, and she knows how to go home after being fed by other people. What about you! Wings If you are hard, you will not stay at home, and before you get married, you will become water that is thrown out!”
The scolding turned out to be scolding, and the adoptive father and adoptive mother still brought chicken soup dumplings to the department during the holidays, and they would not go home until they saw her pouring them down with their own eyes.
Last time, there was a drunken person making trouble in the emergency department and slapped her on the face. Her adoptive mother just came to the hospital, and when she saw it, she pulled her behind her like an old hen to protect her, and swung her arms forward to fight desperately. , beat the man until his nose was bruised and his face was swollen, and he was almost imprisoned. When she came out of the police station, she dragged her to the leader of the emergency department to ask for an explanation without saying a word, and asked the leader to change her daughter to a safer department.
Yan Miaomiao didn’t know what would happen to her adoptive parents if she really got pancreatic cancer?
How would she say it? How could she bear to say it? Let the white-haired parents send the black-haired ones? Let her parents take care of her when they are old?
Tons and tons of guilt weighed on her heart, Yan Miaomiao didn’t have time to think about herself, didn’t think about the various treatment options, took out her mobile phone, opened the mobile bank, counted the deposits, and thought that if she really got cancer, she would simply die , Pancreatic cancer is not easy to cure anyway, don’t spend money on it, people are gone, it’s not easy for the old couple in life, the money is left for them to take care of them…
Thinking about it, she thought that she was not a bad person and had never done anything immoral. On the contrary, she saved many lives by saving lives. How could God let her get cancer?
Or the most difficult pancreatic cancer?
Did you stay up too late? Did you eat too much instant noodles? Was it inherited from her biological parents?
She swears that if it is not cancer, she must live a regular life and rest in the days to come, eat less instant noodles, exercise, and develop good living habits.
Teachers, colleagues, and students in the hospital took turns to visit and comfort Yan Miaomiao.
Yan Miaomiao refused to show weakness in front of others, rubbed her eyes, pulled herself together, and responded with a smile.
The work in the emergency department is very busy, too busy, and there is no time for infighting, so several colleagues in the department look as good as wearing a pair of pants.
The director of the emergency department stood in front of Yan Miaomiao’s hospital bed with his hands behind his back, circling three times to the left and three times to the right. An old director who was almost fifty years old finally got red-eyed with anxiety, and sat by the bed and said, “I delayed you!”
Yan Miaomiao yelled loudly: “Don’t intervene! What you said is like we have an affair. Why did you delay me?”
The old director was heartbroken: “Your illness is caused by the exhaustion of the emergency department. I shouldn’t have left you in the emergency department. You are a good student in the 18th year, and you have better development. I have pinched you—”
Yan Miaomiao interrupted her: “What’s wrong with the eight-year program? Who said that the eight-year program can’t come to the emergency department? It’s all about curing diseases and saving lives, and there is a distinction between high and low? You bought my heart with a bowl of instant noodles back then. I stayed in the emergency department, and now they say they have delayed me! I’m not dead yet, don’t be a bitch! Cry for me?”
The old director was stunned by her yelling, he slapped the hospital bed, and yelled back: “Then I’m not a woman, I’m still a man?”
Yan Miaomiao also knows how to respect teachers, shrank her neck, lowered her voice, and comforted the old director: “Look, our emergency department can mobilize thousands of troops in the hospital. Which department should I call, and which department would dare not come?” ? When I come to the emergency department, don’t I just want to be quick and neat, I like to stand on the edge of life and death to challenge, I like to take care of a patient, like her internal medicine—”
Pointing at Jian Qing who had just entered the door: “Slowly check the ward, write the medical records slowly, search the literature slowly, procrastinate, and find fault with writing the medical records well. I don’t like it when I come alone!”
Jian Qing looked down coldly: “I can still save a few people.”
The old director of the emergency department defended his shortcomings: “She speaks childishly, don’t mind.”
“She is older than me.” Jian Qing still had a cold face, “Your blood biochemistry, blood routine, and tumor markers are all normal. According to the results of imaging examination, the boundary of the lesion is very clear, with calcification on the edge, no cystic change, Necrosis, no peritoneal effusion and enlarged lymph nodes, the initial judgment is a low-grade malignant or benign tumor, and the MDT discussion result is likely to be a neuroendocrine tumor, which can be cut. Of course, it cannot be 100% sure, and the qualitative diagnosis still depends on the pathological results , the surgery side recommends surgery, see the postoperative pathology, you transfer to the hepatobiliary and pancreatic surgery department.”
Neuroendocrine tumors, except nails and hair, may occur in various parts of the body, most likely to occur in the digestive system, the digestive system, and the pancreas is the most likely to be affected.
There are three stages of pancreatic neuroendocrine tumors, G1, G2, and G3. Among them, G1 and G2 stages are less malignant and grow slowly. They can be regarded as tumors. G3 stage is the most malignant and can be called cancer.
When Yan Miaomiao heard this, she immediately jumped up from the hospital bed, and regardless of Jian Qing’s white coat, she hugged Jian Qing and screamed: “Old classmate, when I was in school, I shouldn’t have scolded you for being cold-blooded and ruthless! My angel!”
Jian Qing ruthlessly pushed her away: “Pack up your things and give up the bed.”
In the office cubicle in the second tumor area, Lu Yinxi borrowed a microwave oven to warm up Jane’s meals.
Jian Qing took Yan Miaomiao to check, and worked all day without eating or drinking.
Lu Yinxi didn’t remember Yan Miaomiao’s role in the original book, or in other words, in her only memory, there was no such character as Yan Miaomiao.
Maybe Yan Miaomiao has little relationship with the male and female protagonists, so there are not many scenes, or there are none at all.
Unlike He Bei.
In the original book, He Bei and the heroine Chu Yan are childhood sweetheart neighbors, and Chu Yan has a crush on her. After she died, Chu Yan was depressed for a long time, and finally the heroine pulled him out of the shadows and was with him.
Now that this plot has been changed by Lu Yinxi, and it affects the whole body, Lu Yinxi began to worry that He Bei did not die, and if Chu Yan and He Bei were together, what would happen to the heroine in the original book?
What she changed was the plot and the fate of others.
But no matter what the emotional drama is, she feels that human life should be the most precious.
There’s nothing wrong with saving a life.
Similarly, she prayed for Yan Miaomiao, praying that it would not be a vicious result.
One flower is one world, one leaf is one Tathagata, maybe this world really is a certain space-time and a certain universe that exists like the real world.
“Have you eaten?” Jian Qing pushed open the small door of the office cubicle, walked in, and interrupted Lu Yinxi’s meditation.
“I’ve eaten.” Lu Yinxi brought out the hot food, “Hurry up and eat something, what’s the result of Dr. Yan’s examination?”
“It may be a pancreatic neuroendocrine tumor. It can be operated on, and some can be saved.”
“That’s good.”
I am used to seeing death in the hospital, and not dying has become the minimum bottom line requirement.
The oncology department seldom feels the pleasure and sense of accomplishment of the cure. The happiest thing here is that the patient’s lesion has become smaller and disappeared, and the second is that the patient is not cancer at all, and he can be saved.
Jian Qing lowered her head to eat.
Lu Yinxi stared at her eating, frowned slightly, and asked, “Don’t you look at the dishes when you eat?”
“Will you poison me?” Jian Qing picked up a few eggplants and put them in the bowl.
An eggplant heart that Lu Yinxi had painstakingly arranged was destroyed in an instant.
She shut herself off and stopped talking.
She will never play romance with Jian Qing again.
It’s like playing the piano to a cow.
While eating, Jian Qing opened the clinical trial research plan of HE-A114: “I will have a patient who wants to know more about it. It is the patient you screened out last time. Would you like to stay and take a look?”
Lu Yinxi immediately came out of his autism, nodded and smiled and said: “Okay.” Then he opened his mind, “In the end-time movies and TV shows, your cancer clinical trials are usually the source of biohazard, first give animals Injection, animals bite people, or criminals directly inject people, people turn into zombies, then people bite people, and then the whole world is in chaos, and the challenge of survival begins.”
In fact, out of the laboratory, the clinical application of drugs has passed the review of checkpoints. In reality, the possibility of a zombie-type biohazard is almost zero.
Jian Qing didn’t destroy Lu Yinxi’s fantasy, and followed her words: “There will be a patient who needs medicine later, and I will take you to see if it looks like a biochemical crisis.”
Lu Yinxi nodded like a chick pecking at rice, throwing Jian Qing’s incomprehensible style out of the blue.
According to ethical requirements, when testing on patients, the patients must obtain informed consent and sign an informed consent form.
When the scientific research assistant brought the patient and his family over to discuss what to know, Jian Qing was just filling his stomach.
The patient is a middle-aged man in his fifties, surnamed Chen, who lives in the countryside. The previous treatment has almost used up all the family savings, and he has borrowed all that can be borrowed. His condition has not improved, and he really has no money to continue. After the treatment in the provincial capital, he is planning to prescribe some painkillers and wait for death slowly at home.
This time, I was told that I could participate in a clinical trial and get free examination and drug treatment, but the effectiveness of the drug could not be guaranteed. As soon as I slapped my thigh, I thought of being a dead horse as a living horse doctor, so I came to have a try.
Jian Qing briefly introduced the content of the experiment, and then asked the patient to ask questions.
The wife of the man surnamed Chen asked: “Doctor, can you guarantee the effect of the treatment?”
“No. Although there are a few patients who have achieved certain results, everyone’s constitution is different. Some people may have smaller lesions after taking this medicine, and some people may progress faster after taking this medicine. I treat it every day. He will be evaluated every month, and once the progress is found to be too fast, the medication will be stopped immediately.”
The man surnamed Chen asked: “Will I die after trying this medicine?”
He always felt that he was a drug tester in a TV series, and if he was not careful, he might die.
“Probably not.” Jian Qing opened the agreement of the clinical trial, “but there is no absolute clinical trial, we have bought insurance for you, once you die or become disabled due to the drug in the clinical trial, your family will be compensated .”
“I don’t want to continue to test the drug, can I quit?”
“Yes, you can quit anytime, anywhere without any reason.”
“Is it all free?”
“It’s free, and your round-trip transportation expenses can also be reimbursed, but some medical expenses, registration fees, more than ten or twenty yuan, may not be reimbursed.”
The couple looked at me and I saw you and were silent for a while.
Jian Qing asked, “Is there anything else I need to know?”
The man surnamed Chen shook his head as if making up his mind: “It’s gone, just try it, a dead horse is a living horse doctor!”
Anyway, I can’t escape death in the end. Even if the medicine I take doesn’t work, at least I can have a free checkup to relieve the burden on my wife and children.
Research assistant Xiao Huang took out the informed consent form: “Uncle Chen, sign the informed consent form, after signing, we will issue a new medical card for you, and we can start to arrange for you to check. , as long as you officially participate in the experiment, if you fail the inspection, we will not charge this inspection fee.”
The assistant will take care of the rest. After Jian Qing finished the conversation, he took Lu Yinxi to the ward to see the medication of the HE-A114 clinical trial subjects.
“That’s 001.” Jian Qing motioned to Lu Yinxi, “The first test subject in the country.”
To protect privacy, the names of patients entering clinical trials are erased and referred to by numerical codes.
The patients participating in the clinical trial are no different from those receiving ordinary chemotherapy. They are all lying on the hospital bed, hanging on the bottle, and receiving infusions.
It’s just that the loser is a new drug with unknown efficacy.
Jian Qing looked at 001 with a hint of relief in his eyes: “His lesions have shrunk a lot, and this time the curative effect evaluation has reached PR.”
PR, partial response, the product of the maximum diameter of the tumor and the maximum vertical diameter decreased by 50%, and other lesions did not increase, and lasted for more than 1 month.
Listening to Jian Qing’s sharing in a soft voice, Lu Yinxi gently touched Jian Qing’s right hand with his lowered right hand.
The two hands touched each other briefly, hot and cold.
Lu Yinxi couldn’t help stretching out her little finger, and hooked her little finger quietly.
She was sharing her joy with her again.
In that joy, mixed with pride, gratification and self-satisfaction.
Her Dr. Jane is a doctor, teacher, and scientific researcher.
Sometimes, doctors, teachers, and scientific research are just jobs, not glamorous identities, not lofty feelings, but just a step-by-step job to support the family.
Sometimes, curing diseases and saving lives is an ideal at the beginning of medical school; scientific research, research and exploration of an unknown field, and building bricks and tiles for the palace of medicine are the beliefs that intellectuals stick to.
People who have been beaten by society will not be angry with books and talk about their feelings, ideals, and beliefs. They will only say that “the study of medicine is stable, the money in the oncology department is good, there are few disputes between doctors and patients, and it is easy to publish papers.”
But Lu Yinxi really felt the sense of faith hidden in Jian Qing’s heart.
From the moment when Jian Qing met her eyes and shared joy in the last row of hundreds of people at the academic conference in City C, she felt it.
In the real world, she once read a novel. In the book, under the interference of aliens, some physicists on earth mistakenly believed that physics did not exist, and all current physics research was meaningless, so they all chose to kill themselves.
She didn’t understand it very well at that time, but now that she is on the scene, she understands it somewhat.
Scientific research, the starting point and destination of research are human beings after all.
If the self is not real, if the human being is not real, if none of these things exist, what’s the point of medical research?
This world is not real, you are just a character in a book – once this idea is confirmed, it is enough to destroy the belief of any scientific researcher.
She would never say that.
It is said that he only went to work on the seventh day of the lunar new year. This afternoon, Lu Yinxi delivered the meal, but he didn’t go home, and stuck behind Jian Qing, acting like a little tail.
After get off work in the evening, Lu Yinxi went for a jog on the playground of Jiangda campus. Jian Qing put his hands in his pockets and walked slowly around the playground, occasionally glancing at Lu Yinxi’s direction.
A retired old professor took Samoyed for a walk around the playground. When he saw Jian Qing, he waved his hand and said, “Little Jane, come to exercise? Young people want to exercise more. Look at the Samoyed that my wife bought for me. Isn’t it cute? Since With it, I have to take it out for a walk every day.”
Jian Qing nodded and called to the teacher, boasting solemnly: “It’s cute.”
He looked at the Luyin Creek where it was.
Now she also takes people out for a walk every week.
On the fourth day of the Lunar New Year, the playground was sparsely populated.
When Lu Yinxi ran the first lap, he passed by Jian Qing and said intentionally or unintentionally: “Doctor Jian, I also like cats very much.”
Jian Qing’s eyes were cold, she glanced at her, and said: “It will lose hair, so you are not allowed to raise it.”
Lu Yinxi snorted softly, turned his head, and continued to run around.
Does she want a cat?
No, she wants to go to a cat cafe.
On the second lap, the two met again. Lu Yinxi slowed down and asked, “On the first day of the Lunar New Year, the woman who went to the cat café with you on a date, does she like someone?”
Jian Qing lowered her head and kicked away the stones at her feet: “She just broke up last month.”
Lu Yinxi snorted coldly: “Didn’t you say you weren’t dating last time? Why didn’t you deny it this time?”
Jian Qing was stunned for a second, raised her head, and said seriously: “Then you ask the question again.”
Lu Yinxi turned her head away and ignored her.
On the third lap, Lu Yinxi came to her side again: “What shall we eat tonight?”
Jian Qing thought for a moment and asked, “Zhajiang noodles?”
“Spice me up!” Lu Yinxi laughed and ran away.
On the fourth lap, the sky was completely dark, and the campus, which was saving electricity, was finally willing to turn on the dim lights.
The light can only shine on the outer runway, Jian Qing walks on the dark inner side, unable to see the expression on his face clearly.
When the distance between the two was close, Luyinxi diverted from the outside to the inside, blending into the darkness together.
A gust of wind blew by, and Jian Qing heard the familiar sound of running, waiting for Lu Yinxi’s usual question.
This time Lu Yinxi didn’t say anything, just passed her by.
Jian Qing’s eyes were glued to Lu Yinxi’s back.
Lu Yinxi ran a few meters away and suddenly slowed down.
The night was dark and dark, her heart was beating violently, she clenched and loosened her fists, loosened and clenched again, and finally made up her mind, summoned up her courage, turned around and asked, “Jian Qing, do you have someone you like?” ?”
The author has something to say: After the Chinese New Year, continue with the hospital plot~~~
Thanks to the little angels who voted for me or irrigated nutrient solution during 2021-02-1800:34:37~2021-02-1905:22:02~
Thanks to the little angel who cast the rocket launcher: Muran 1;
Thanks to the little angel who threw the mine: Zhibei Tour 1;
Thanks to the little angels of the irrigation nutrient solution: 178 bottles of Yue Cha; 39 bottles of ; 20 bottles of Li Xiaojin; ; 3 bottles of Jiji in cool season; 262956192 bottles;
Thank you very much for your support, I will continue to work hard!