Chapter 953 The Disappearing Femur

Dean Xia now knows everything about Ou Lianfeng. This honest man did not lie in his self-report. To be honest, before the investigation results came out, Dean Xia was a little skeptical. How could such a ridiculous thing happen? It was a little unbelievable.

But now the investigation team he sent out put a thick stack of investigation reports on his desk. He couldn't help it, so he cursed.

Ou Lianfeng's financial situation does meet the conditions for the relief fund of Sanbo Hospital. Dean Xia decided to start the relief procedure and subsidize Ou Lianfeng's subsequent lung lavage, lung replacement and other operations. This cost is not a small amount, and it may easily reach hundreds of thousands of dollars.

Dean Xia was thinking about Ou Lianfeng's matter when his cell phone rang. It was the old leader of the provincial department, who was going to retire in a few months.

"Xia Changjiang, you don't let me worry about it. Did your hospital diagnose a patient with pneumoconiosis recently?" The old leader asked.

Dean Xia knew something was wrong when he heard it: "Yes, the patient's name is Ou Lianfeng."

"It's this patient. You still know about this. I thought you didn't know. This should be a private suggestion made by the doctor in your hospital, right?" The old leader's voice was a little hoarse because he had been suffering from a cold for many days.

Dean Xia had no intention of evading: "This is all my suggestion. It has nothing to do with the doctor. The doctor just followed my instructions."

"Your suggestion? You are good at protecting your child. You don't know the principles of occupational disease diagnosis, do you?" The old leader said angrily.

Dean Xia reported truthfully: "I know this is against the rules, but this case is a bit special. The patient went to the local occupational disease prevention and treatment center for treatment. The doctor required the patient to provide proof of work in the original unit before a diagnosis of pneumoconiosis could be made. However, the original unit refused to provide these proofs, so the patient fell into a vicious circle and ran around everywhere. Other hospitals did not have the diagnosis qualifications, and the local occupational disease prevention and treatment center with the diagnosis qualifications was unwilling to diagnose. It was clearly pneumoconiosis, but they just refused to diagnose it. What do you think the patient should do? He can only go to the operating table to open his chest and check his lungs. Who would use such an extreme method if he was not desperate?"

"Xia Changjiang, you are a great man. Is this within your authority? You are violating the rules and you will be punished. Now the other provincial department has issued an official document asking us to explain and punish the hospital that violated the rules!" The old leader's tone was very heavy.

Dean Xia thought for a moment and said, "Xia Changjiang will bear all the consequences alone. It has nothing to do with other people. Just punish him as he should. Even if he is dismissed, I will accept it without any complaints. I know that this matter has exceeded my authority, but it cannot pass my conscience. Really, if we don't take over this matter, this patient will never have the opportunity to get a diagnosis of pneumoconiosis in this life."

"Dean Xia, what do you mean? Do you think I dare not punish you?" The leader was furious.

Dean Xia said quickly: "Old leader, I am telling the truth, really, I am willing to accept any punishment."

There was a violent cough on the phone, and Dean Xia said with concern: "Old leader, your cold is not healed yet? It has been delayed for so long, do you want to come to our place for a check-up?"

"It's okay, it's just a minor cold. My health has been getting worse in recent years. Okay, don't show your heroism. This matter will definitely be punished. This is a violation. The penalty notice will be sent to your hospital, but it will not be reported. The diagnosis has been issued, so just issue it. No matter who the doctor who made the diagnosis is, don't ask. Since you are the only one who bears it, I will criticize you alone. It's too unreasonable." The old leader hung up the phone with a cough.

"I am willing to accept the punishment!" Dean Xia breathed a sigh of relief.

Soon, the old leader called again: "How is the patient now? Can the problem be solved? Do you want me to help coordinate? I don't want this matter to bother me again."

"Thank you, old leader, we can solve it ourselves." Xia Changjiang said gratefully.

"Okay, pay attention to the way and method of doing things, and be compliant and legal. Don't violate the policy regulations, and of course don't go against the conscience of being a doctor." The old leader said a few words and hung up the phone while coughing.

Dean Xia called Dean Sun over and told him what had just happened.

"What should we do?"

Dean Sun said worriedly.

"If they punish you, I will take responsibility for it. The doctors must not be affected. They did nothing wrong. They just fulfilled their duties as doctors."

Dean Xia said firmly that during the years when Dean Xia served as the dean, he had not embezzled or accepted bribes. As the saying goes, if you have no desires, you will be strong. You can walk upright and stand upright. He is not afraid of storms at all.

"We agreed that we would share the responsibility. How could I let you bear it alone? This is the responsibility of our Sanbo Hospital leadership team. It has nothing to do with clinical doctors. Their behavior was made with our knowledge and consent."

At this point, Dean Sun could only fight with Dean Xia.

"Old Xia, this is a big deal. I think it will have a big impact on you. I think Sanbo Hospital cannot do without you. Now is the critical time for development. I will take care of this matter. I will say that it has nothing to do with you. I took the lead without your knowledge?"

President Sun said helplessly.

Dean Xia waved his hand: "No, how can I let you take it alone? I have reported everything to the provincial and ministerial leaders. From the tone of voice, it should not be a big deal. At most, a punishment will be imposed."

"That's good!"

Dean Sun was relieved.

——

At this time, Yang Ping was participating in a routine case discussion in the doctor's office of the Surgical Research Institute. A strange case attracted everyone's attention.

This X-ray is very strange. The entire right femur is only the proximal and distal ends. The femoral shaft in the middle is completely gone. The lonely steel plate from the proximal end to the distal end crosses the empty middle, forming a weak bridge.

"What is the point of this operation? The defective bone in the middle is not treated? What's the use of a steel plate bridge?"

Zhang Lin now has the demeanor of a great professor. The occasional swear words do not expose his vulgarity, but show the bloodiness of a cultured person.

"Simple bone grafting may not work in this case. We need to find a whole section of allogeneic femoral shaft to replace the defect. Even if we go to the bone bank in Shanxi to select it in person, it is difficult to pick such a good and complete femoral shaft. Moreover, even if there is such a good allogeneic bone, how can we crawl over it if it is so long? The best method should be Ilizarov's bone lengthening technique. Theoretically, this does not involve nerves and blood vessels to extend together, and it can be done no matter how long it is."

Xiao Wu pointed to the strange X-ray and expressed his own opinion. This is a case discussion for the whole department. With so many interns, regular trainees and graduate students watching, how can we not come up with something?

Professor Zhang and Professor Lu of the Institute of Surgery were calm and talked at this time.

"Have you seen the medical records? Look at the medical records carefully before speaking." Song Zimo's tone was a reminder.

The two teachers lowered their heads and slid on the tablet in their hands. They were careless. The patient had a simple right femoral shaft fracture, and then used percutaneous technology to fix the locking plate. There was no abnormality in the first postoperative X-ray during hospitalization. After discharge, the patient never followed the doctor's advice for reexamination and sat in a wheelchair. The X-ray reexamination one year later was like this. The femur disappeared.

After reading the medical records, the two looked up, looking at a loss. What's going on? How could the femur disappear and only the two pitiful ends were left?

At this time, many students focused their attention on Zhang Lin and Xiao Wu, waiting for their amazing performance, preferably a long and eloquent discussion, from the cause, pathophysiology, pathology, diagnosis, treatment and prognosis.

But now the two brothers are like being choked, looking at each other, unable to speak, never seen this disease, don't know what it is.

If it were other things, he could still talk nonsense, but this is medicine, a serious case discussion. If he talked nonsense, he would not only be scolded by the professor, but also ruin his reputation for life.

"Did you have any other diseases in the past?" Xu Zhiliang asked.

"He was healthy in the past and had no other diseases. This time, the right femoral shaft was fractured due to a car accident. The X-rays before and after the operation were normal. After being discharged from the hospital, the patient did not follow the doctor's advice for a follow-up examination. Half a year later, he wanted to walk with the assistance of crutches, but gave up walking because of the pain. Since then, he has not walked on the ground. As long as he bears a little weight, he will feel obvious pain. After a year, the patient felt that he could not walk, so he went to the local area to take an X-ray. This is the film. The femoral shaft has magically disappeared." Song Zimo continued to add medical history.

Everyone looked at this magical X-ray. They really had never seen such a situation. How could the femoral shaft disappear? Even if it did not heal after the operation and the fracture end was absorbed, it would not be said that the entire femoral shaft disappeared. At most, the fracture gap became wider.

"This is a patient from the Municipal People's Hospital. Now the patient is arguing with the Municipal People's Hospital. They say the doctor stole the bones to sell for money. What's more coincidental is that this patient accidentally checked only one kidney. The patient's family now believes that the doctor stole the kidney as well and is making trouble with the hospital. Dean Chen is in a headache, so he asked us for help. It would have been fine if the bones were missing, but now even the kidney is missing. The media followed suit and recorded a documentary, saying who stole the patient's kidney and bones. Now the Municipal People's Hospital is being roasted on the fire." Song Zimo turned around and said to Yang Ping.

Yang Ping looked at it and said, "Print out the urinary system examination pictures."

Song Zimo printed out the pictures of the patient's kidneys, ureters and bladder. His examinations included both color ultrasound and CT. The color ultrasound images were not shown much in the report, so Song Zimo printed out the CT pictures.

Yang Ping took a look and found that this was not a lost kidney, but a solitary kidney, which means that the patient was born with only one kidney, so he said: "This is a typical solitary kidney, born with only one kidney. Has he ever had a color Doppler ultrasound or CT scan of the urinary system?"

"The Municipal People's Hospital has not found the patient's previous imaging pictures, so it is very passive in public opinion. A media outlet is now making a long article to hype this matter, saying that a black-hearted hospital stole kidneys and bones, and the patient's kidneys and femurs magically disappeared. Why don't these writers clarify the basic facts? This kind of thing happened more than once or twice, and even if it is later discovered that these reports are false, the forgers do not have to bear any responsibility. How can this be possible?"

Song Zimo was very confused because many similar reports were far from the truth. For example, it was clearly the second toe that was freed to reconstruct the thumb. This is a classic operation to reconstruct the thumb after the patient's thumb was injured. However, the media reported that the patient only had a finger injury, but the unscrupulous doctor performed the wrong operation and connected the toe to the finger. The patient also said to the media calmly that he knew nothing and only realized that the doctor had performed the wrong operation when he woke up and found that the toe was connected to his hand.

How could such an obvious smear be broadcast in the media? Song Zimo couldn't understand.

"It's not that they don't know, but they pretend not to know. You can't wake up a person who pretends to be asleep. In today's words, for the sake of traffic, they don't care about the truth. They just say whatever attracts attention. The underlying logic of most things is economic reasons. For example, the fake news you mentioned is all for traffic and money. You said that this patient didn't know what surgery he had done. Why do you say that? He pretended to be stupid to cooperate with the media. He knew that he might get a sum of money in the end. If you think about many things from the underlying logic of the economy, it's not that complicated. In fact, it's very simple. Let's not talk about these. Let's talk about the condition."

Yang Ping's tone was very calm, and he brought the topic back.

"There is no doubt about this kidney. This case is definitely a solitary kidney. The difference between a solitary kidney and a kidney removed is very obvious. You can read articles on this topic when you have time. Think about the missing femur. Our mastery of the diagnosis of common and frequently occurring diseases is only the basis. We also need to learn the diagnosis of rare diseases. The diagnosis of rare diseases tests the doctor's knowledge. We don't have to have seen some diseases before we can diagnose them. Reading about them in books and literature can also serve as the basis for diagnosis. The diagnosis process of the first case of AIDS in my country is a classic case of diagnosis of rare and unknown diseases. You can go and read this story."

Indeed, when the Union Hospital diagnosed the first case of AIDS, the doctor lacked clinical experience with the disease. All the knowledge came from papers in international journals. At that time, there were no diagnostic methods and reagents. The doctor used the existing experimental equipment and conditions to design the diagnostic method himself and finally obtained the first diagnosis of AIDS.

Now this magical case of missing femur is a rare disease or unknown disease for everyone. It requires strong clinical thinking to obtain a diagnosis.

"This patient has been to many hospitals, but the cause of bone loss has not been found. Some hospitals said that amputation is likely to be necessary, so the patient and his family are very scared. Director Chen introduced the patient to us to see if we can find the cause."

Song Zimo projected the patient's X-ray on the projector again.