Chapter 48
Chapter 47 – Double Cancer
Jian Qing opened the webpage for viewing images, and asked, “Does the director usually smoke?”
There are no-smoking signs everywhere in the hospital, but many office directors and even hospital leaders have ashtrays on their desks. Every time people from the health supervision station come to check, they have to hide them in advance.
Director Yan’s teeth and fingernails are yellow, and his body smells of cigarettes all the year round, and he smells like a smoker.
He said, “I have been smoking for more than 20 years.”
“I told you to quit smoking a long time ago and you didn’t quit! You should!” Director Yan’s wife patted him on the shoulder forcefully, her voice was crying.
Her eye sockets were very red and swollen, as if she had been crying for a long time.
Seeing the family members who were used to crying after asking questions, Jian Qing didn’t stop to comfort her, and focused on looking up the video data.
While checking, asked: “Have you had any other cancer history?”
Director Yan said, “No.”
On the computer screen, black and white images scrolled, and there was a ground-glass nodule in the lower lobe of the left lung, with a diameter of about 8 mm.
For small pulmonary nodules no larger than 1cm, doctors usually order patients to follow up for 3 to 6 months, and they will not easily open the chest for surgery.
Jian Qing zoomed in on those nodules and found that the nodules were spiky, and there was a tiny blood vessel attached to the edge of the nodules.
Jian Qing beckoned Lu Yinxi to come over to have a look, pointed to the small blood vessel and said, “This little thing is transporting nutrients to support this little nodule.”
Lu Yinxi scolded it in a low voice: “Eat the inside out!”
Jane smiled lightly.
Burr-shaped, with blood vessels, and director Yan’s smoking history of more than 20 years, it is indeed more likely to be malignant.
She read Director Yan’s chest X-rays over the years and observed the small nodule in the lower lobe of the left lung.
The clarity of X-ray film is far inferior to that of enhanced CT, but it can also be vaguely seen that this small nodule existed three or four years ago, and its growth rate is relatively slow.
It can be seen that it does not look like a cancer metastasized from the nasopharynx, but rather a primary lung cancer, and it may be a slow-growing non-small cell lung cancer.
Of course, this is just a guess based on experience, not an actual diagnosis.
The diagnosis of cancer depends on pathological examination.
Numerous cells gather together irregularly to form a lesion.
The so-called pathological examination is to cut out a piece of tissue of the lesion through puncture or surgery, send it to the pathology department, and the doctor in the pathology department will stain and slice it, and observe and analyze the shape and degree of differentiation of the tissue cells under a microscope, so as to judge The benign and malignant of a whole lesion.
If cancer is the rebel army in the body, pathological examination is like picking out a row of soldiers from an army suspected of mutiny and putting them in a prison for torture and interrogation to confirm whether the entire army is a rebel.
Jian Qing asked some more questions, and then concluded: “Director, don’t think too much, there are two situations now, one is what you guessed, nasopharyngeal carcinoma is advanced, with cervical lymph node metastasis and lung metastasis; Nasopharyngeal carcinoma and lung cancer are double primary cancers, but the tumors in the nasopharynx, neck, and lungs are very small, and they may all be early stage, with a high cure rate. I need to make further differential diagnosis. Now, first Admitted to the hospital, I will prescribe some examinations for you, and arrange a multidisciplinary consultation tomorrow morning.”
For a person like Director Yan, her superior, Hu Jianjun, will definitely take action in person, and the chief directors of various departments will also lend a helping hand. As the first doctor in this hospital, she needs to have her own judgment, but it is not up to her to make a decision on the treatment plan. It is to be discussed by a multidisciplinary team before deciding which department to treat.
Director Yan and his wife stood up to thank them, and thanked them again for what happened yesterday.
Director Yan’s wife, Aunt Xu, hesitated and said, “Little Doctor Jian, otherwise, let Lao Yan live in the same district?”
Last night, she heard from Lao Yan that he had notified and criticized Dr. Gong in the second tumor district. Now that he lives in the second district, it is hard to avoid embarrassment.
Jian Qing said: “Vice President Hu is in charge of the entire tumor center, but the most direct jurisdiction is the second district.”
Sometimes, many patients come to see Jian Qing, not because of her strength, but because of the famous teacher behind her, Hu Jianjun.
Hu Jianjun’s expert number is not easy to get. He spends half a morning in a week for consultation, and usually he can’t get in the queue for a month, and he has to buy it from scalpers.
Famous doctors are not easy to see, but young disciples under the famous doctors are easy to see.
Hang Jianqing’s number and be admitted to the hospital by Jianqing. Jianqing’s immediate boss, Hu Jianjun, will have a look at the final treatment plan, and will definitely ask him to take care of any difficult and miscellaneous diseases.
Director Yan knew his wife’s worries, so he made a decision and said, “I’m not afraid of being crooked. If I’m wrong, I’m wrong. If I’m right, I’m right. It’s no big deal. I came to see Dr. Jian today, and I just believe her, so I live in the second district!”
Jian Qing issued a hospitalization order, and personally took Director Yan and his wife to go through the admission procedures.
When entering the second tumor area, the doctors and nurses on duty were all surprised, and they gathered around to ask about the situation.
Jian Qing told Zhang Yue: “Zhang Yue, if you come to the hospital, take a picture of these materials with your mobile phone first. Mr. Hu is not off work yet, so I’ll take them over to show him.”
Zhang Yue responded immediately, and moved a stool for Director Yan and his wife to sit down.
Jian Qing wanted to find Hu Jianjun, but it was inconvenient to take Lu Yinxi with her, so she asked her to go home first.
Lu Yinxi said, “I’ll be waiting for you in the hospital.”
Jian Qing said, “Then go to the cafeteria to have dinner first.”
Lu Yinxi hummed, opened the drawer, and stuffed a small bread into Jian Qing’s hand: “Eat something first.”
Jian Qing tore open the bag of noodles, and ate while walking.
The ward at night is much quieter than during the day.
Director Yan, with gray temples, sat on a chair, repeating his past medical history and personal situation. His wife looked at him with tears in her eyes.
Lu Yinxi took a few more buns. Director Yan will take a blood test as a rule later in the meeting, and she still can’t eat, so she puts it in the arms of Director Yan’s wife: “Aunt Xu, eat something to pad your stomach.”
Aunt Xu wiped away tears from her eyes: “Good boy, where can Auntie still eat?”
Cancer patients are in pain, so why are their families riddled with holes?
Lu Yinxi said: “Auntie, you must take care of your health now.”
Cancer is not a hardship for a patient alone, but a hardship for a family.
There is a long way to fight cancer, and this tug-of-war has just begun.
Aunt Xu is a smart person, she understood what Lu Yinxi said, and she didn’t refuse anymore.
Lu Yinxi handed her another bottle of milk, and explained in detail what items she would bring from home when she was hospitalized, where the hospital cafeteria was located, which remote passages could be used to get to the second tumor area, and what time was the elevator traffic During the peak period, there will be a security check at the entrance of the elevator during the peak period, and you must show your medical card before you will be put up…
At the end of the hearing, Aunt Xu held Lu Yinxi’s hand, called out good boy several times in succession, and said, “You must be a good doctor in the future, Auntie, if I don’t have only one daughter, I will definitely let you be my daughter-in-law! “
Lu Yinxi shook his head with a smile, and changed the subject.
Just because she is not a doctor now, it is very handy to release these kindnesses. If she really becomes a doctor, how can she have enough time for everything? It will also be more tiring than others.
Lu Yinxi waited in the ward for an hour before Jian Qing came back from Hu Jianjun.
As soon as she came back, she went to Director Yan’s bedside to discuss: “Director, there are a few vacant beds in the cadre ward. Vice President Hu asked if they should be transferred to the cadre ward?”
There is no bed available in the tumor area 2 for the time being, and an extra bed number is given.
There are certain restrictions on the number of beds in each department in a public hospital. The number of beds in each area is determined by the overall arrangement of the Health and Medical Commission. There may be only 4 to 50 regular beds in a department, but there are hundreds of people who need to see a doctor. In order to meet this as much as possible For the medical needs of hundreds of people, an extra bed number outside the establishment has been set up.
Most of them could not be admitted to the ward, and could only pull a hospital bed and make do in the corridor.
Director Yan waved his hand and said, “I’m not a big leader or cadre in the province or city. What do I live there for? I just sleep in the corridor, and it’s fine. Don’t drive your patients out of the hospital just to make room for me. , My body can hold on now, better than all of them.”
Jian Qing nodded yes.
After returning to the office, she said to Zhang Yue: “Deputy Hu said that the rural insurance fund of our department exceeded the limit last month, and the bed turnover rate assessment failed. Some patients in our group who are in stable condition will be urged to leave the hospital tomorrow.”
Zhang Yue stopped writing the medical records and sighed, “Well, we are the ones who withheld the money, and we are the ones who got scolded.”
The doctor on duty laughed at himself and said: “The leaders of the medical insurance bureau said to the patients, ‘Don’t worry about hospitalization, there is a medical insurance fund to cover you’, and told us, ‘Control the medical insurance costs, we don’t care about the excess, and the hospital pays for itself’, we drive away the patients. , the patient hacked us. Hey, those officials have exhausted all the good words, and we are the ones to blame!”
In the hospital, when the beds are very tight, the medical staff will urge the patients to leave the hospital.
The patients and their family members who were expelled from the hospital felt that they were all expelled from the hospital before they were in good health. Naturally, they would have resentment, and they would naturally vent their resentment on the medical staff.
Large hospitals with concentrated medical resources are bound to undertake more treatment tasks. Limited beds and limited medical resources must be used on as many people as possible.
In the final analysis, many doctor-patient frictions are the contradiction between the growing demand for medical treatment and the serious shortage of medical resources, which is passed on to the front-line doctor-patient conflicts.
Jian Qing didn’t say anything, and walked over to rub Lu Yinxi’s head: “Get off work, go home.”
Lu Yinxi was reciting his lines silently. Hearing this, he turned his head and asked about the situation: “How is it? Is it advanced nasopharyngeal carcinoma with lung metastasis?”
Jian Qing said: “I can’t be sure, but it’s consistent with my guess. The one in the lung may be early lung cancer.”
Double cancer is a relatively rare clinical case, but if this possibility is ignored, a certain part is treated as metastatic cancer, and the wrong treatment plan is used, it is very likely to delay the disease.
Whether it is nasopharyngeal cancer or lung cancer determines the follow-up treatment plan, so Hu Jianjun’s first task for her is to arrange pathological examination.
Before the pathological diagnosis, it can only be judged by imaging data and personal experience, and misjudgment may still occur.
When the lights are on, the streets are full of traffic.
From the hospital to the way home across the road, the two walked many times.
Sometimes they stand side by side, sometimes standing side by side; sometimes Lu Yinxi babbles to share the day’s events, and Jian Qing occasionally responds with a sentence or two; sometimes both of them are silent, but they don’t feel embarrassed.
Walking side by side today, Lu Yinxi was talking about Director Yan and his wife again: “I heard from Aunt Xu that she and Director Yan fell in love freely. They fell in love behind their parents’ and school’s backs when they were in college. I I remember that college students were not allowed to fall in love in those days…”
She spoke with great interest, and Jian Qing was afraid that she would not pay attention when crossing the road, so she approached her, shoulder to shoulder, and the backs of hands touched from time to time, and finally just took her hand and crossed the road.
“After graduation, Director Yan told his family that he had a partner and wanted to get married. His family did not agree that he and Aunt Xu were together, saying that Aunt Xu was a big landlord who had been criticized and fought. The family status is not good, which will affect the future. Official career, Director Yan said, “I don’t want an official career, I just marry her”, and was pointed at by the family and scolded for nothing. Unexpectedly, people like Director Yan would risk their lives for love when they were young. Ask the world what love is …”
Jian Qing didn’t follow in praising love, thinking to herself, how could this kid dig up so many old things in just one hour?
She solemnly warned: “Cross the road, don’t chat.”
If it was half a month ago, Lu Yinxi would think that the person next to him was not romantic and could not speak sweet words, but now, the thought in his heart is: If she does not understand style, it is good that I understand, she does not speak sweet words, I say just fine.
How can you like someone so much? She actually felt that she could do whatever she wanted, and was willing to accept her true and complete good and bad…
After crossing the zebra crossing, the heavy traffic is left behind.
Lu Yinxi forgot to let go of her hand, Jian Qing’s eyes drifted over, and she glanced at her, but she didn’t let go of her hand, she continued to hold her hand, and walked home side by side.
The author has something to say: Well, you didn’t wait, did you? I fell asleep halfway through coding last night, and now I wake up early to write, good morning everyone~~~
When I was writing this chapter of the emotional scene, I suddenly thought that in the 40th chapter, the dream boat next door has already confessed to being in the same bed, kissing, and so on, and this unsatisfactory couple is still holding hands… So, take the initiative to go straight If you embrace a beautiful woman, you can only keep probing if you are reserved and boring. Of course, if the world is full of straight balls, there will not be so many emotional tree holes to submit and share. Please analyze whether this sister likes me
Thanks to the little angels who voted for me or irrigated nutrient solution during 2021-03-13 23:59:21~2021-03-1405:58:41~
Thanks to the little angel who threw the grenade: 1 reading book;
Thanks to the little angel who threw the landmine: meat bun, 1 Neroban;
Thanks to the little angels who irrigate the nutrient solution: 1 bottle of Moshang Gongzi Yebai, Shijiu, Laobai, and Wangyue Ningxiang;
Thank you very much for your support, I will continue to work hard!