"Dr. Liu, we agree to the fecal transplant. Can we do it today?" the patient's daughter asked after so consideration.
"Well, Doctor Wang should explain this. I know a little about the project, but he's the one in charge," Liu Banxia replied.
He could have answered on Wang Chao's behalf, of course, but that might look like he was trying to take credit. Wang Chao wouldn't mind, but Liu Banxia himself had to be mindful of such things.
"We'll admit the patient today, then conduct so intestinal checks and preparations. The earliest we can do the transplant is the day after tomorrow," Wang Chao said.
Although this was still an experintal treatnt thod, it was extrely good news for this family.
Everyone's expression had relaxed considerably; after all, there was still hope. If things remained as they were, the days ahead would undoubtedly be incredibly tough.
"President Liu, you're really finding work for , huh?" Wang Chao remarked.
"Don't deny it, you're quite interested too, aren't you?" Liu Banxia asked with a smile.
Wang Chao nodded sincerely.
"Then give it your best shot. Who knows? Maybe you'll succeed," Liu Banxia encouraged.
"Here's what we'll do: I'll treat you to pig trotters at noon. After all, you've brought a very high-quality patient. How significant do you think the impact would be if this is successful?" Wang Chao asked curiously.
"The impact would be imnse, so you must be thorough in collecting the patient's data," Liu Banxia replied, his expression turning serious. "I was just thinking, if this is successful, it might be the world's first. Imagine the impact!"
"President Liu, why hasn't anyone tried this before?" Wang Chao asked.
"Cases of auto-brewery syndro are rare. Many patients might have died in accidents before even being diagnosed," Liu Banxia explained. "In current treatnts, the condition can still be controlled with dication. There are even overseas cases that have been cured with drugs. Therefore, dication is the first choice for treatnt."
"Even if we do find other patients with auto-brewery syndro, dication would still be the primary option. Fecal transplantation carries certain risks. We're only attempting it as a last resort when no other options remain."
"Just focus on doing your best; don't overthink it. Ah, Old Chen's here. The ergency patient from this morning doesn't seem to be doing too well."
Following Liu Banxia's gaze, Wang Chao saw Chen Xuehai and Zhang Xiao walking towards them.
"Have the test results co out?" Liu Banxia asked.
"Yes, the cerebral infarction isn't too severe. It's all up to Old Chen now," Zhang Xiao replied.
"I thought you ca over because we needed to do a joint surgery. Old Chen, what are the surgical indications?" Liu Banxia asked.
"It's pretty much as predicted from the ultrasound: it's too large. After discussing it with Zhang Xiao, we thought it would be better for you to inform the patient," Chen Xuehai said.
"Exactly! President Liu is the best at handling these situations. He just helped us admit another patient," Wang Chao added, exaggerating slightly.
"Wang Chao's appointnt as chief resident should be finalized the day after tomorrow. The patients on the night shift will be in good hands then," Liu Banxia said quietly.
How could he just watch Wang Chao enjoy himself? He couldn't let him off that easily.
"Alright, let's be serious. How about you go talk to them?" Chen Xuehai suggested.
"What's making you so hesitant?" Liu Banxia questioned.
"It's a challenge I want to take on. But I'm afraid I might inadvertently mislead the patient while explaining the procedure. The surgery is extrely risky, so I have to rely on you," Chen Xuehai confessed.
"Ah, I suspected as much. I'll be the bad guy, then. Let's go," Liu Banxia said, taking the CT scans from Chen Xuehai.
This was a common dilemma many doctors faced. When it ca to operations with low success rates, they often felt an urge to try. However, dical ethics demanded that they prioritize the patient's decision, creating a small internal conflict. Chen Xuehai was now entrusting this delicate task to Liu Banxia. That was why Liu Banxia had called himself the "bad guy."
When they arrived at the patient's bedside, his family mbers were also waiting there. After nurous tests, the patient's condition had considerably improved.
"The situation is rather complex, but I'll get straight to the point. The cerebral infarction you experienced is different from typical ones. Usually, they're caused by thrombosis, but yours was caused by a tumor embolism," Liu Banxia stated straightforwardly. "He has a large myxoma in his heart. Fragnts of this tumor can break off, enter the bloodstream, and cause vascular embolisms.
"This myxoma is growing quickly and is already quite large. Surgical intervention carries a high risk and a low success rate. Therefore, after consultation, we've determined that waiting for a heart transplant is the best course of action."
"Doctor, how long will we have to wait for a transplant?" the patient's wife asked.
Liu Banxia paused briefly before responding, "That depends on luck. There's a standardized transplant allocation process, so we can't predict when one might beco available."
"If I need a heart transplant, does that an my own heart is failing?" the patient questioned.
Liu Banxia nodded. "Myxomas are different from other tumors because fragnts can break off. Yours is not only large but also irregularly shaped, which increases the chances of this happening.
"According to our assessnt, if another fragnt breaks off and causes an embolism, it could be fatal. This leaves us with two main options: wait for a heart transplant, or proceed with surgery.
"Both options carry significant risks. To be blunt, with surgery, you might not survive the operation. Or, we might open your chest only to find the tumor is inoperable, in which case we'd have to close you back up.
"If the surgery is successful and the tumor hasn't spread to surrounding tissues, the prognosis would be very good. However, opting for surgery involves many unknowns that can affect the outco."
The family fell silent. Liu Banxia had made it clear: it was a gamble with life and death. If they were lucky, the disease could be cured. If not, death on the operating table was a distinct possibility. Choosing to wait for a heart transplant, however, ant an uncertain wait. If another embolism occurred in the anti, death was the most probable outco. As Liu Banxia had clearly explained, fragnts of the tumor could continuously break off and cause blockages anywhere.
"Doctor, I choose surgery, instead of waiting for a heart that may or may not co," the patient spoke after about five minutes of consideration.
"Are you sure? Don't you want to discuss it with your family?" Liu Banxia asked.
The patient nodded seriously. "Don't misunderstand because I decided quickly; I've thought this through rationally. Even though you didn't spell it out, I had a premonition and considered this possibility. I just didn't realize it would be this severe.
"When I think about it, waiting for a heart doesn't guarantee how long I'll live. What happened today could happen again tomorrow, the day after, in a week, ten days, or a month.
"Every day from now on would be spent waiting to die. If it's truly malignant, then there's no point in surgery anyway. During the operation, you'll be able to get a general idea, won't you?"
"Yes. While not as definitive as a pathological exam, we can make an educated guess," Chen Xuehai answered this ti.
"So, even though a heart transplant seems like an option, for , it feels like there's no real choice," the patient said. "The only way that would work is if a suitable heart becos available right before my surgery, and those ahead of on the list can't take it. That's how it works, right?"
Chen Xuehai nodded again.
"So, I'll go with the surgery," the patient stated. "If I live in constant fear, my family suffers with every day. It's better to face this head-on than draw out the suffering. If this is my fate, then so be it.
"Before the surgery, I can get my affairs in order. Doctors, I'm entrusting my life to you. I'm still young; I still have a chance to fight."
"Alright. We'll admit you to the hospital imdiately. We'll do the pre-operative checks today, and the surgery will be first thing tomorrow morning," Chen Xuehai said.
Since the patient had thought it through so clearly and rationally, there was no need to delay. He had considered everything. His myxoma wasn't like a stage three or four cancer. For those patients, even surgery doesn't significantly extend their lives. If this had been one of those patients, Chen Xuehai wouldn't have hesitated to advise against surgery, sparing him the suffering—much like the esophageal cancer patient Liu Banxia had diagnosed. Why subject soone to such an ordeal?
"Sigh... I was initially puzzled why they remained so calm even when I ntioned a heart transplant. Old Chen, what are your odds for this?" Liu Banxia asked.
"Optimistically, less than thirty percent," Chen Xuehai replied candidly. "We'll only know the true state of his myxoma once we open him up. If it's straightforward to operate on, that's better. Otherwise, the surgery will be more difficult and riskier. How about it, will you be my first assistant tomorrow?"
Liu Banxia shook his head vigorously. "Although I'm very curious about this surgery, I won't be scrubbing in. I'll watch from outside. If this surgery is a success, that would be fantastic."
"That's my thought as well. Given his rational decision, I have to give it my absolute best," Chen Xuehai said. "This is a demonstration of their trust in us, and we must live up to it. Could you speak to the anesthesiologist for ? Ask for Wang Lei."
"Certainly. Your surgery will get top priority. I'll speak to Old Wang," Liu Banxia agreed.
This surgery was currently the most critical one in the Ergency Center, and it was imperative to create the best possible conditions for it. Furthermore, this surgery was a personal challenge for Chen Xuehai.
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