White armor

Chapter 518: Born as a member of Xiehe, died as a dead person of Xiehe!

"Of course, this is just a differential diagnosis," added Boss Chai.

Luo Hao: "It's just that the possibility is higher."

Boss Chai: "The images on the CT scan may also be artifacts."

Luo Hao: "More tests are needed to confirm."

The old man and the young boy were talking to each other. Chen Yan's eyes were a little blurry. He seemed to see their figures overlapping and merging into one.

Time seemed to have never left any traces on Mr. Chai, and Luo Hao also seemed to have experienced the baptism of time long ago, retaining peak physical strength despite being full of experience.

Gradually, Chen Yan understood some of the clues.

Chen Yan finally understood why Professor Luo usually spoke and acted so cruelly. This should be the result of Boss Chai's words and deeds.

The top expert, the compiler of textbooks, and the vice president of the Academy of Engineering was actually clear at first and then vague in his diagnosis.

This was something Chen Yan never expected.

Even though this behavior is standard conduct for doctors, Chen Yan still finds it unacceptable.

In his imagination, shouldn't Boss Chai be a man of his word who can give a definite diagnosis after just one look at the film, like he did at the beginning?

What a dog.

"Is it necessary to cleanse the intestines?" Boss Chai turned his head to look at Luo Hao.

"Boss, no, the possibility of parasites is quite high. I agree with you on this point. A cleansing enema will be enough. Let's do a colonoscopy to take a look."

Boss Chai stopped talking and looked at Chen Yan.

Chen Yan had unknowingly twirled his beard and was studying the CT scan.

Is there something wrong with the film? No problem, I have reviewed it at least three times, there is no misdiagnosis.

But why are they...

Only when Mr. Chai looked at him did Chen Yan let go, inadvertently removing a strand of his beard.

"Mr. Chai."

"Go and give the doctor's orders." Boss Chai glanced at the time. "What time does Zhuzi get off work?"

"Five o'clock." Luo Hao replied with a little regret.

"Oh, that's no problem. There's no rush. When you deliver the patient, take me around and tell me about the functions and uses of the new robot."

Chen Yan seized the time and got busy.

He personally watched the nurses carry out all the medical orders.

Boss Chai seldom visits the clinic in person as he has already retired. More often than not, Boss Chai is like a memorial archway, just there for future generations to admire.

Chen Yan will definitely not let down this opportunity for clinical guidance.

Even the endoscopy room had to be called one by one by Chen Yan, who requested an operating room for emergency endoscopy.

43 minutes later, Chen Yan brought the patient to the operating room.

"Now clinical doctors are all cattle and horses. In the old society, when people were starving, they couldn't even get enough to eat, so how could there be food for cattle and horses? Boss, I heard that too."

"You complain a lot, just say what you want to say, don't be sarcastic."

Soon after Chen Yan made the call, he heard the voices of an old man and a young boy coming from the corridor.

"After working in the clinic for a long time, especially when being woken up in the middle of the night, you will always feel grouchy. You can't show it at the time, but it will eventually settle in your heart and become part of your work routine."

"Weren't you going to talk about what kind of store will open near the hospital in the future? How come you got off topic? You're even better at interrupting than an old man like me."

"Boss, I was just saying this. You said I complain a lot. Let me explain."

Chen Yan raised his hand unconsciously, pinched his beard, and stroked it strand by strand.

The relationship between Professor Luo and Boss Chai is much closer than he imagined.

This conversation pattern is very much like a younger generation returning home from a long journey, chatting with grandpa and telling him about what he has seen recently.

It's simple and casual, with no purpose, just chatting and keeping the old man company.

This……

"I saw in the group that there are a lot of coffee shops near Zhejiang Medical University. When they are hungry, cows and horses eat things with caffeine. It is said that they can eat less and work more. Now doctors have to buy coffee before making rounds to stay awake. Cows and horses provide similar things at their own expense."

"The store opens so early?"

"Yes, they provide coffee for clinicians. The first cup of coffee comes out at 7 o'clock in the morning. It is said that 60-70% of their daily turnover is sold during this time in the morning."

"The people who bought it are all doctors from Zhejiang Medical University."

Boss Chai hasn't been to Zhejiang Medical University for many years. Even if he had been there, he wouldn't have been able to see such detailed information.

"Oh? Is the quantity so large? I didn't see any at the entrance of our Union Hospital." said Mr. Chai.

"The rent of the land in front of the Union Hospital is too expensive, and we can't even recover the cost. In 2023, Zheyi Coffee sold 36 cups of drinks throughout the year, with 1200 orders per day. A chief physician spent more than yuan at Zheyi Coffee in a year."

"So many."

"Its boss seems to have some connection with the people at Zhejiang Medical University. The store just opened. Guess what the first big order will be?"

"Emmmm, the order from the union, giving coffee to employees on their birthdays? That's not right." Boss Chai seemed a little hesitant.

"Hahaha, boss, they also sell all kinds of baked goods, namely cakes. The cakes given to employees on their birthdays are all from them."

"As for the trade union, all they do now is distribute things that we can't use and we have to pay money every year." Mr. Chai also began to complain.

As they were talking, the two of them had already arrived at the door of the operating room.

Chen Yan's hand trembled, and he pulled off a strand of his beard. He bowed quickly, "Mr. Chai, you are here."

"Well, it's pretty fast. Director Chen is good." Boss Chai smiled and gave an approving smile.

The two no longer talked about the coffee shop in front of Zhejiang Medical University, nor did they continue to talk about how the shop got started because it sold thousands of birthday cakes every year.

Luo Hao was quick and agile and began to prepare the things needed for the operation.

This time, Luo Hao did not avoid suspicion as usual. He just whispered a few words to the doctor in charge of the operation in the endoscopy room, then put on his clothes and gloves and started the colonoscopy.

"Eh? Xiao Luohao, what you just said seems to be a pun."

"Ah?" Luo Hao was about to have surgery. When he heard what his boss said, he turned back in shock for a moment, but then narrowed his eyes and said, "Yes, Zheyi Coffee is pronounced the same as Zheyi Coffee."

"Yi" is taken from the Cang Geng in the Book of Songs, which says that his feathers are shining brightly. It's a homophone and has a cultural connotation, which is good." Boss Chai said, "Okay, let's stop here and start the operation."

What is this? Chen Yan did not understand the exchange between Boss Chai and Professor Luo Haoluo at all.

After the colonoscopy, Luo Hao chatted with the patient while staring at the TV screen and looking at the things around him.

Because the intestines are not cleaned sufficiently, loose feces can be seen in the intestines, but no one cares about it.

"Your face and body are not the same color. Your face must have been sunburned. Where did you go with your family during the holidays?"

"I went to the plateau and visited the Potala Palace." the patient replied.

"Oh, is it fun there? I heard that young people go there and get IV drips in the hospital during the day, and go clubbing with oxygen tanks at night."

Dancing with an oxygen tank in hand?! This was the first time Chen Yan had heard of such a thing.

Isn't that courting death? Young people nowadays are courting death in this way? Altitude sickness, that's altitude sickness.

"I didn't. I went with my parents, but they wouldn't let me. They said they wanted me to see the blue sky over there to purify my soul."

"Has it been purified?"

"No, especially after I knew that many things there were made of human skin, I felt a little disgusted."

"Your values ​​are correct. Not bad." Luo Hao suddenly stopped and said, "Boss, take a look."

There is a white area in the patient's intestines.

The white color is very light and looks like a pseudomembrane adhering to the intestinal wall.

"Well, considering the past history, it should be beef tapeworm."

Past history?
What past history?
Chen Yan was stunned.

He has been through many battles and can be said to be the kind of experienced old doctor and expert that ordinary people can imagine.

But he could understand the communication between Luo Hao and Mr. Chai, but he didn't know why.

Does the patient have a history of beef tapeworm?

Even if the white piece is not the pseudomembrane of the intestinal lining but a tapeworm, the pork tapeworm should be the most common one.

"Mr. Chai, how do we determine whether the parasite in the intestine is beef tapeworm?" Chen Yan bowed and asked humbly.

"Xiao...Dr. Luo just asked about your medical history, didn't you hear it?" Boss Chai turned his head and glanced at Chen Yan.

"Dancing while holding an oxygen tank?" Chen Yan blurted out.

"No, Director Chen." Luo Hao took over the topic, "Tapeworm, you know, some of the yak jerky on the snowy plateau is made from raw yak meat that has been dried in the sun, which may cause beef tapeworm disease."

“Since you suspect it’s a tapeworm, you need to ask if anyone has been there.”

"I just asked, if you go there, the time will probably match. Especially if you go with the elderly, you will most likely come into contact with local specialties. Getting off the bus to take pictures and buy local specialties is also a habit of the elderly."

"!!!"

Chen Yan was really confused this time. He changed his mind and asked, "Professor Luo, why is it not pork tapeworm?"

"As for pork, we basically cook it before eating, so the chance of getting sick is low, and the market has a monitoring department. Although it's not much work, we still have to do something."

"Dr. Luo, don't be so sarcastic. How come you have learned so many bad habits so soon after arriving in the clinic?" Boss Chai scolded.

"Yes, yes, yes." Luo Hao responded obediently. He did not perform any operation or clamp the tapeworm with forceps, but continued to push the colonoscope inside.

"You've never heard of eating raw pork jerky, Director Chen."

So that's how it is. Chen Yan was a little confused and nodded.

"Bean pork is very rare now. If the pig farmers near my home produce bean pigs, they will be very worried. The pork can only be kept for our own consumption to avoid waste."

"..."

Chen Yan was silent. It turned out that Professor Luo was not chatting just now, but asking about past history.

Although it was a leading question, the other party had a purpose and hit the nail on the head, so I have nothing to complain about.

But why didn’t Professor Luo remove the “pseudo-membrane” but continued to insert the colonoscope inside?

If you don't understand, just ask. Chen Yan and Luo Hao don't have to be shy.

"Professor Luo, why don't you remove the tapeworm?"

"For intestinal tapeworms, the head segment must be removed. If it is torn off, there is a high probability that it will revive."

Chen Yan had only performed surgery to remove pork tapeworms, and not many times, so he knew little about the relevant knowledge.

I didn't expect there were so many stories here. "It's rare here, but common in the snowy areas. I heard about it from Boss Xia, and I got it myself..."

After all, the patient was not under general anesthesia. Luo Hao only said half of what he was saying, and the rest was self-evident.

"I saw in the test results that the patient's eosinophilia is not high."

"Generally, the tapeworm rate in beef is not high, which is slightly different from the tapeworm rate in pork," said Luo Hao.

As the colonoscope moved inward, it gradually reached the location of the appendix.

The patient had undergone an appendectomy, the local anatomical structure had changed, and the appendix cavity was not visible.

But the intermittent white "pseudo-membrane" ends here.

"Boss, it turned out that they drilled into the appendectomy site. No wonder there is pain in the right lower abdomen." Luo Hao said.

"Brother, what is that?" the patient asked.

"It's a tapeworm, a parasite. It got stuck in the sutures from your previous appendectomy, and that's why you've been having pain in your lower right abdomen."

"There is no diverticulum. I think it's just a coincidence." Boss Chai said calmly, "Take it out for testing. It will be fine after two days of medication."

"Eh."

Luo Hao responded obediently, and then began to tap the ileocecal region gently with forceps.

Chen Yan knew that there must be a reason for this “click”. Professor Luo Haoluo had just said that he wanted to “knock” out the head segment of the tapeworm, but he didn’t expect that he would actually “knock” it out.

After knocking it, the white color began to move. Luo Hao operated the colonoscopy forceps in his hand and grabbed a piece of white "pseudo-membrane".

Then the colonoscope was moved back little by little, and the white "pseudo-membrane" could be seen to be continuous under the lens.

The reason why it looks discontinuous when viewed in the mirror is that a part of the "pseudo-membrane" is tightly attached to the intestine and looks like one piece. It is difficult to observe the difference between the tapeworm and the intestinal wall with the naked eye.

As the colonoscope continued to move out, Chen Yan's hand gradually touched his chest.

He is now certain that he was mistaken. It is indeed a tapeworm, not a pseudomembrane.

It’s just that the tapeworm is a bit long. Luo Hao’s colonoscope has already moved out for some distance, but the body of the worm is still being lifted up.

This is too long.

The longest pork tapeworm Chen Yan had ever seen was only 10-20cm long. He took out a tapeworm that was nearly 20cm long and took a photo as a souvenir.

But the beef tapeworm in front of us is at least 50cm long and is still spreading.

"How can it be so long!" Chen Yan muttered to himself while twisting the heart-protecting hair.

"The longest tapeworm is about 100-120cm long. I have seen a tapeworm that was about 150cm long. Unfortunately, it was at a lower-level hospital that time and I forgot to tell the nurse that it had been thrown away. No clinical data was left, so it cannot be counted." Boss Chai said with some regret.

"I estimate this to be about 90cm-100cm. Boss, are all beef tapeworms in the snowy regions this long?"

"No, it must be a coincidence."

Luo Hao was chatting, but his hand speed did not slow down as he "pulled" the beef tapeworm out.

One day a complete beef tapeworm appeared before my eyes.

"Please lay out a blue sheet." Luo Hao said.

The nurse immediately followed the doctor's instructions and spread a blue sterile sheet on the ground. Luo Hao then placed the beef tapeworm on it and straightened it so that Mr. Chai could see it.

Just as Luo Hao expected, the beef tapeworm was about 100 cm long.

"Go back and eat more raw pumpkin seeds." Luo Hao said as he arranged the beef tapeworms.

"Brother, are you talking to me?" The patient looked at the worms he had pulled out of his body, and asked in confusion when he heard Luo Hao talk about raw pumpkin seeds.

"Yes, I'm telling you, and I'm also telling Director Chen."

"Is it true that raw pumpkin seeds can cure parasites?" Chen Yan asked blankly.

"Of course it's true. Raw pumpkin seeds are basically found in Chinese herbal anthelmintics. There's also betel nut, but it has too many side effects. It's not good for a little girl to eat betel nut, so forget it."

Boss Chai acted as if he didn't hear Luo Hao's medical advice and took out his cell phone to start taking pictures.

One-meter-long beef tapeworms are extremely rare, and even Mr. Chai has rarely seen one.

"Dr. Luo, please take good care of this worm," said Boss Chai. "After the laboratory tests are completed, it will be sent to the Union Hospital in good condition after being processed."

"Boss, my family is a medical university..."

"What do you mean by your medical university? You haven't even been to the 912 Incident yet, and you don't consider PUMC your home?! Photos, PPTs, and specimens must be kept in PUMC Medical College. Your medical university, your medical university, you belong to PUMC in life and you'll be a dead person of PUMC in death!"

Boss Chai spoke in a very decisive manner and left no room for negotiation.

Luo Hao just said it casually and immediately agreed to it.

Chen Yan knew that this was to be used as a clinical specimen and told to students later. In this story, perhaps he would also appear as a background.

It’s just that the background isn’t so glorious.

But who would have thought?
I thought the patient was faking illness and it was a psychological behavior, but I didn't expect to remove a one-meter-long beef tapeworm from his intestines.

"Director Chen, should I explain this to the patient's family?" Luo Hao politely asked Chen Yan for his opinion.

But combined with the conversation between Luo Hao and Boss Chai just now, it was not difficult for Chen Yan to find that from now on, this beef tapeworm became Luo Hao's treasure and would not leave his sight.

Professor Luo never thinks highly of himself and always completes tasks assigned by his boss without compromise.

It would be great if the doctors under his command had this awareness. Chen Yan felt a little regretful.

The next thing is simple, it’s just a matter of dealing with the endgame.

The little patient had a normal colonoscopy and he didn’t even need to rest after it. He just skipped away.

But Chen Yan still forced her into a wheelchair and pushed her out.

After all, it is an operation and one must have the awareness of a post-operative patient.

"Mr. Chai, what medicine do you think is more suitable for postoperative use?" Chen Yan still "humbly" asked Mr. Chai for advice.

"Anti-inflammatory treatments like these should be given for a few days. This amount of time is not a big deal. In addition, the raw pumpkin seeds that Dr. Luo mentioned should be given, plus three days of oral magnesium sulfate. In addition, betel nut should also be taken for a period of time. The girl doesn't smoke, so it's not a cure. Dr. Luo is overthinking it.

Three days, no addiction, eat it! ”

"Okay, okay, it's a combination of raw pumpkin seeds + betel nuts + magnesium sulfate." Chen Yan repeated.

As I recall, my teacher seemed to have mentioned this type of treatment in the parasitology class when I was in school thirty years ago.

It’s just that it has never been used before. Today, it was Mr. Chai who was instructing on the use of the medicine. Chen Yan seemed to have gone back several years and became a student sitting in the classroom listening to the lecture.

Chen Yan perked up and wrote down the prescription.

"Dr. Luo's technique is good. Generally speaking, only about 1cm of tapeworm can be removed." Mr. Chai explained.

“?!” Chen Yan was stunned.

"Let me put it this way. Pumpkin seeds and betel nut act on the worms in sections, one at the front and one at the back, paralyzing the worms. Add in magnesium sulfate and they'll be excreted in one go."

"Of course, according to Dr. Luo's surgery, it shouldn't be that troublesome, but it's better to be cautious and give it a few days."

"Okay, okay." Chen Yan nodded repeatedly in agreement.

"If you encounter similar patients in the future, you can also use this combination of drugs. The principle is similar, but parasitic diseases are relatively rare now, so most clinicians have returned them to teachers."

Old Chai smiled, and Chen Yan felt a pain in his heart, as if he had just pulled out a tuft of heart-protecting hair.

The patient just happened to be palmed by Mr. Chai, but unexpectedly something went wrong. The old man gave a definite diagnosis and asked Professor Luo to remove the tapeworm intact.

After sending the patient back, Luo Hao and Boss Chai also left to watch the Yuntai operation.

Chen Yan got everything he needed, including a photo with Mr. Chai and the resolution of a patient who was misdiagnosed.

Everything is perfect.

"Dong Dong Dong~"

Just as Chen Yan was admiring the photo of himself and Mr. Chai, there was a hurried knock on the door.

Before Chen Yan could say anything, Director Shi from the endoscopy room pushed the door open.

"Where's Professor Luo?"

"what?"

"Where are the bugs!"

"..."

When Chen Yan saw Director Shi yelling in a hurry, he felt something was wrong.

"It's just a worm. Why are you in such a hurry?" Chen Yan said, "Xiao Luo took it out. As for the worm, Mr. Chai said it should be sent back to Union Hospital intact for future teaching purposes."

"Where are they?"

"Why are you in such a hurry? Come, sit down and talk."

Director Shi hesitated for a moment, but reason prevailed over emotion.

He also knew that if he went over like this, Xiao Luo would probably just say a few perfunctory words to him. After all, accompanying Boss Chai was more important.

After figuring it out, Director Shi sighed deeply.

"What's wrong with you, Director Shi?"

"Oh, don't mention it." Director Shi said, "You don't understand."

I don't understand?!

All the hair on Chen Yan's body stood up, as if Director Li had encountered a wild dog.

"It's true. I have removed parasites, but never completely. Parasites... how should I put it? It's not an exaggeration to say that they are fragile. If you use a little force, the parasite will be torn apart. It has never been removed completely. At least, I can't do it."

"Well, it's disgusting that you said parasites are fragile. Change the adjective." Chen Yan said disdainfully.

"Carving patterns on tofu? Anyway, the connections between the segments are very fragile. They will break if you apply a little force. You can only take them out piece by piece."

"!!!"

Chen Yan opened it with his hands, but he didn't expect that there were so many things hidden under the surgery performed by Professor Luo.

"I just want to take a look and ask Xiao Luo for advice on how to perform the surgery and how to remove the parasites." Director Shi sighed, "I have something to do today, so I'll put aside everything I'm doing and come back to take a look."

"You should not be able to see the bug anymore. Xiao Luo should have soaked it in formalin. Boss Chai wanted it. Xiao Luo must be afraid that you would see it in your eyes and not be able to pull it out." Chen Yan said with a smile.

"Huh? I can't."

"That won't work either. Professor Luo just mentioned my medical school, and Boss Chai cursed at him, making Professor Luo spit blood."

At this point, Chen Yan vaguely remembered what Boss Chai said: When you are alive, you belong to Union Hospital; when you die, you belong to Union Hospital.

For a moment, I was yearning for it.

(End of this chapter)