"Old Chen, how is this patient's condition? Is it serious?" Liu Banxia asked after the test results were all out.
"Sigh... it's always what you fear most that cos to pass," Chen Xuehai lanted. "Let's go talk to the family together. I'm not sure if they'll understand what I'm trying to say. If we recomnd surgery now, the risk is quite high."
Liu Banxia glanced at him but said nothing, following him to speak with the patient's family.
"Doctor, how are the results?"
As they entered, the patient's family mbers quickly surrounded them.
"Let's step outside to talk. This isn't sothing that can be explained in a few words; the situation is rather unique," Chen Xuehai said.
The expressions on the family mbers' faces imdiately grew tense. They understood that "unique" likely ant dangerous; otherwise, doctors wouldn't usually discuss such matters away from the patient.
"Let first explain the patient's detailed condition," Chen Xuehai began once they were outside. "The patient has had bypass surgery before. This fall reinjured his left chest. As a result, the grafted blood vessels from the bypass have also been affected, forming a pseudoaneurysm."
"A pseudoaneurysm occurs when the wall of a blood vessel tears, causing bleeding. However, the blood is contained by the surrounding tissue instead of flowing out freely, forming a hematoma. This hematoma is what we call a pseudoaneurysm."
"Currently, this pseudoaneurysm is well-contained. But, because these outer tissues lack the resilience of a blood vessel wall, it could rupture at any mont."
"Doctor, in that case, can we proceed with another bypass surgery like before?" an anxious family mber asked.
Chen Xuehai nodded. "Indeed, that's the only option. However, there's another issue: the patient is elderly and has already undergone one bypass surgery. His blood vessels are fragile, which makes the operation extrely risky."
"Doctor, are you saying there's no hope? That we should just... wait for him to die?" a family mber asked, alard.
"I can only inform you of the potential outcos," Chen Xuehai explained. "To save his life, surgery is necessary. However, if we operate, the patient's chances of success are not very high."
"One complicating factor is the patient's fragile blood vessels. If a second bypass is perford, we might not find suitable vessels, and a long segnt of artificial blood vessel would be needed as a substitute."
"Another factor is the patient's overall physical condition, which isn't optimal right now. This surgery will also be very long, adding to the significant risk."
"President Liu, my next surgery is about to begin. For now, this aneurysm doesn't seem too severe or overly large. How about you stay here and help answer the family's questions?"
Liu Banxia nodded. "Alright, you head to the OR. I've got things covered here."
"Dr. Liu, what should we do then?" the patient's family asked, turning to Liu Banxia.
"Frankly, for us doctors, this kind of situation is a real headache; it's a genuine dilemma," Liu Banxia said.
"Without surgery, when the aneurysm ruptures, we might not even have a chance to intervene. However, it would allow the patient to live comfortably for so ti, provided he avoids excessive emotional stress."
"As for surgery, based on the patient's current condition, the chances of success are not high. It's sowhat of an unwritten rule in dicine: while the ultimate decision often rests with you, for surgeries with a high probability of success, we usually give a clear dical recomndation to proceed."
"I understand how you feel; making such a decision is incredibly difficult. But as Dr. Chen just explained, we can't simply go ahead with surgery without fully informing you of the details."
"You should discuss this carefully amongst yourselves. Even if it were , it wouldn't be an easy decision. I can also assure you that if you do choose surgery, Dr. Chen will do his utmost."
With that, Liu Banxia nodded to the family, gave Huang Bo a aningful look, and they both stepped away.
It was an agonizing choice, equally harsh for the doctors and the patient's family. But that was the stark reality; there was no easy middle ground.
The patient's family longed for him to recover and continue enjoying life. The doctors shared this wish; no surgeon ever wants to lose a patient on their operating table.
"Teacher Liu, if you were to assist Teacher Chen, would there be a better chance of success?" Huang Bo asked tentatively.
Liu Banxia frowned and shook his head. "It's hard to say. The crucial factors are the condition of the patient's blood vessels and his overall physical health. It's uncertain whether he could even withstand such an operation, so it's truly difficult to predict."
"The most conservative approach would be to remain hospitalized. Then, when the aneurysm ruptures, we attempt a final rescue. But can you call that living?"
"And this aneurysm... if he's unlucky, it could rupture with any sudden excitent. If he's fortunate, he might hold on for another three to five months, perhaps even seven or eight."
"You've learned sothing truly significant today. As doctors, we frequently face such agonizing decisions. Sotis we can weigh the benefits against the risks, but other tis, we genuinely have no good options."
"Your al is still waiting in the cafeteria; go get sothing to eat. There's no telling what this afternoon might bring. You can take so ti to reflect on what happened today, see what you can learn from it."
Huang Bo nodded, his spirits low.
He had been the one to admit this patient, and at the ti, he'd thought the old man was fortunate. There had been no car from behind, and the fall hadn't seed too severe. Two fractures, yes, but those would heal with ti. But what was the reality? A pseudoaneurysm had ford. The chest pain back then wasn't just from the fractures; it must have also been from the pseudoaneurysm. And for this patient, he could do absolutely nothing. Both Liu Banxia and Chen Xuehai were top doctors in the Ergency Center. Their judgnt was sound and unlikely to be mistaken.
Liu Banxia was also in a somber mood. He had only just returned to the Ergency Center and hadn't been there long when the patient's family caught up with him.
"Dr. Liu, can it be proven that my father's current pseudoaneurysm was caused by the car accident?" the patient's daughter asked.
Liu Banxia frowned thoughtfully. "I can't give you a definitive answer right now. May I consult Dr. Chen in the operating room? After all, I'm not a cardiothoracic surgeon."
"Thank you, Dr. Liu. We're not trying to extort anyone. If we do choose surgery, the cost will be very high, won't it? We just don't want to place too heavy a burden on our family," the patient's daughter said.
"I understand your concerns. That's why, to be certain, I need to ask Dr. Chen. He's the expert in this area and can provide a professional opinion," Liu Banxia said cautiously.
He didn't dare make such a definitive statent. Even though, looking at the scans, he could tell that the pseudoaneurysm had ford after the bypass grafts were displaced by the blunt chest trauma, his judgnt wouldn't be considered definitive now that the patient had been transferred to cardiothoracic surgery. Any assertion from him at this point would carry legal liability. This involved far more than just the cost of this potential surgery. If the family chose to forgo treatnt and the patient died, the compensation amount would be far greater than just the surgical fees.
The patient's family didn't press Liu Banxia further on this. They had witnessed the earlier discussion and understood that while Liu Banxia was a leader in the Ergency Center, he wasn't a cardiothoracic surgeon.
After checking the OR schedule, Liu Banxia inford his team and went directly to Chen Xuehai's operating room.
"Dr. Chen, will my speaking now interfere with your operation?" Liu Banxia asked.
"No problem. It's a routine thoracoscopic thyctomy, not overly complex," Chen Xuehai replied.
"The patient's daughter just consulted , asking if we can confirm that this pseudoaneurysm was caused by the car accident," Liu Banxia quickly relayed.
"We can't give a definitive answer. Our assessnt is that the blunt trauma caused displacent of the bypass grafts. However, we cannot determine if there was any impact prior to the car accident that might have contributed."
"That's as much as our diagnosis can state. If they pursue legal action, the final judgnt will be up to the courts."
"The patient's injuries would need to be formally evaluated. I didn't examine them in great detail earlier. However, based on the bruising, my personal opinion is that it resulted from a single impact."
"But we're doctors, not forensic examiners; they'll have to consider that themselves. So, what is the family thinking? Are they leaning towards surgery?"
Liu Banxia shook his head. "It's impossible for them to decide so quickly. It would be remarkable if they have an answer by tonight. For now, let's leave it at that. I'll go update them."
"Hold on," Chen Xuehai called out. "If they do opt for surgery, I want you as my first assistant. You have more experience, quicker hands, and you can help manage any unexpected complications."
"Er... I've never perford a bypass surgery. Linlin is perfectly capable too," Liu Banxia said with a wry smile.
"I'll be second assistant," Liang Xiaolin stated decisively.
"Alright, alright. We still don't know what the family will choose. I'll go speak with them first," Liu Banxia said and hurried out.
"Are you really going to let that kid scrub in?" Wang Lei asked curiously.
"I have to. He tornts everyone else all day; it's my turn to tornt him a little," Chen Xuehai said with a laugh. "But I am genuinely concerned about potential ergencies. That kid has incredibly fast reflexes. If there's major bleeding, he can clamp it in ti. Not everyone possesses that ability."
Wang Lei nodded. "That's true. When he used to eat at my place, he was always lightning fast at snatching food from the table."
Hearing Wang Lei's deadpan remark, the others in the operating room chuckled.
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