Chapter 269: Drinking Poison to Quench Thirst
The next day, Tuesday afternoon, Yu Zhiming received the diagnosis from the middle-aged Taoist priest, which was mainly nickel and other heavy metal poisoning.
As for the possible source of the poisoning, according to the Taoist himself, he once camped in an uninhabited place with clear water and beautiful scenery, and practiced for two or three months.
At that time, I drank mountain spring water from a small spring every day.
Yu Zhiming was also told that the hospital had notified the local geological exploration department to go and take samples for testing, and perhaps a nickel mine could be found.
Yu Zhiming also learned from Teacher Qi Yue that searching for mineral deposits through local diseases was an effective method of mineral exploration in the early years.
At around 6:30 in the evening, after completing the rapid screening for gastric and liver cancer in 50 volunteers of the Very Early Cancer Project, Yu Zhiming hurried to the general surgery department.
He accepted Dr. Wang Jiangyue's invitation and came to assist her in completing a kidney transplant operation.
Yu Zhiming knew that this was a learning and practice opportunity specially given to him by Dr. Wang, and he appreciated it very much.
This is the first time he has participated in a human organ transplant operation since he started practicing medicine, and he is very excited and looking forward to it.
So, after Yu Zhiming finished his scheduled work for the day, he rushed to the general surgery department as soon as possible.
However, Yu Zhiming did not see Dr. Wang in the office. When he asked, he found out that he had gone to the ward.
He rushed to the ward again and saw Dr. Wang Jiangyue who was explaining the operation to the patient. He also saw the patient who was going to have surgery tonight and the kidney donor.
The patient is a 35-year-old man with advanced uremia, which has caused both kidneys to lose basic function. He has relied entirely on dialysis in recent years.
The kidney donor was the patient's 60-year-old, thin father who had just completed his retirement procedures a month ago.
Yu Zhiming knew that, generally speaking, during a kidney transplant, the patient's original kidney does not need to be removed. The patient is essentially gaining an extra kidney through the transplant.
Most transplanted kidneys are placed in the patient's right iliac fossa, connected in parallel next to the original kidney, to take on the function of the kidney.
The reason why the original kidney is not removed is because there is a small chance that the function of the original kidney will slowly recover through a long period of rest and recuperation.
Another possibility is that with the advancement of medicine, methods of restoring kidney function have been developed.
Of course, not all kidney transplants do not require removal of the original kidney.
About ten percent of kidney transplants require removal of the original kidney due to inflammation, tumors, or other factors.
Yu Zhiming walked into the ward and stood quietly by while thinking about the knowledge related to kidney transplant surgery and the surgical process.
Wang Jiangyue caught a glimpse of Yu Zhiming out of the corner of his eye.
She nodded slightly to Yu Zhiming as a greeting, and then turned her gaze to the patient and his father again.
"The operation is expected to take about two and a half hours if there are no unexpected circumstances."
"Do you have any other questions?"
The patient, his father, and their accompanying family and friends all shook their heads.
"Okay, let's get ready for surgery."
Following Wang Jiangyue's words, the attending physician, resident doctors, interns and others standing behind her came forward to the patient and his father and began to prepare them for entering the operating room.
Yu Zhiming came to Wang Jiangyue's side and said, "Doctor Wang, thank you for giving me this opportunity to learn and practice."
Wang Jiangyue chuckled and said, "Doctor Yu, you're welcome."
"I also have to thank you for coming all the way here to assist me in the surgery despite a hard day's work."
"Director Cui specifically told me that Dr. Yu's surgical skills are quite proficient, on par with those of the excellent attending surgeons in our department."
Wang Jiangyue praised him again, "Doctor Yu, I'm really surprised that you're both proficient in both internal medicine and surgery."
Yu Zhiming said modestly, "That's just Director Cui flattering me. I learned my surgical skills at the county hospital, and I'm only more proficient in performing minor level one and two surgeries."
"But I haven't experienced anything as grand as a kidney transplant."
Wang Jiangyue chuckled and said, "A kidney transplant isn't a big deal. It's just one of the most common organ transplant surgeries..."
"Hey, wait a moment!"
Wang Jiangyue suddenly stopped the assistants who were about to take the patient and his family out of the ward, and looked at Yu Zhiming.
"Doctor Yu, could you please give the patient's father a physical examination? He's quite old, and his physical indicators barely meet the donation criteria."
Yu Zhiming nodded, asked the patient's father to lie on the bed, and gave him a full body examination.
During his inspection, he actually found a problem.
When Wang Jiangyue saw Yu Zhiming's face, which showed an expression of having made a major discovery, her heart skipped a beat.
It seems that this operation cannot be performed tonight.
Amid the worried gazes of everyone in the room, she called Yu Zhiming to the corridor outside and asked in a low voice.
"cancer?"
Yu Zhiming nodded and replied, "Doctor Wang, his stomach doesn't feel well. It's necessary to do a biopsy to confirm it."
Wang Jiangyue sighed softly and said, "You said you didn't feel well, so it's definitely stomach cancer."
"Alas, we can only look for another donor..."
Human organ donation includes large organs such as kidneys, liver, heart, lungs, pancreas, small intestine, as well as tissues such as heart valves, skin, bones, and corneas.
The medical standards for donating different human organs and tissues are different.
According to my country's medical regulations, large organs such as the kidneys and liver must be excluded from systemic or infectious diseases that pose a fatal threat to the recipient, including malignant tumors (excluding intracranial tumors), infectious diseases, severe hypertension, etc.
If a cancer patient donates a major organ, there are considerable risks to the recipient.
Such profound organ donation cases have occurred more than once in medical history.
Yu Zhiming had seen a similar case analysis with tragic consequences in a medical journal.
Four patients who had received lung, left kidney, liver, and right kidney transplants developed breast cancer of similar histological types within 16 months to 6 years after surgery.
The organs of these four recipients all came from the same donor, who was not diagnosed with breast cancer at the time of donation.
Unfortunately, three of the four recipients died from metastatic breast cancer.
Only one right kidney transplant recipient survived after the transplanted kidney was removed and undergoing immunization, chemotherapy and other measures.
Later studies revealed that the donor was probably in a very early stage of breast cancer, but it had not yet been detected.
However, through organ transplantation, the cancer cells in the body were passed on to the four recipients.
More than one case has shown that cancer cells are too cunning and good at hiding, and they can suddenly cause trouble and endanger human health.
In view of this, the organs of cancer patients must be carefully evaluated before determining whether they are usable.
In the case of the patient's father, if he is diagnosed with stomach cancer, his kidney cannot be transplanted to his son...
Yu Zhiming followed Wang Jiangyue back to the ward and heard her announce that tonight's surgery was cancelled and the patient's father would undergo a comprehensive gastric examination tomorrow.
Yu Zhiming saw the undisguised disappointment on the patient's face, and the complicated look he cast at him...
Wang Jiangyue personally saw Yu Zhiming off from the general surgery department.
The two stopped outside the building. Wang Jiangyue said with a look of relief, "Doctor Yu, it's a good thing we invited you here. If the transplant surgery was completed and the father was diagnosed with stomach cancer, he would be in great trouble."
"This is a big problem."
Yu Zhiming sighed softly and said, "My discovery has led to the cancellation of the transplant surgery. The patient and his family may not think this is a good thing."
"After all, contracting his father's metastatic gastric cancer through a kidney transplant is only a possibility, not a certainty."
"It's not easy to find a suitable donor kidney nowadays."
Having said that, Yu Zhiming was not sure whether he had done a good thing.
Given the patient's physical condition, if no donor kidney is found in the next few months, he may not be able to hold on.
After receiving his father's kidney transplant, even if he was unlucky enough to get metastatic gastric cancer, with proper treatment, it would not be a luxury for him to live another three to five years.
There is also a significant possibility that you will not develop metastatic gastric cancer.
Wang Jiangyue seemed to see what Yu Zhiming was thinking and said in a deep voice, "Doctor Yu, the patient and his family only think about the immediate needs, not the future."
"This is like drinking poison to quench thirst."
"That person still has several immediate family members. Besides, it's possible that other sources of kidney donations could be found in the coming months."
After a pause, Wang Jiangyue continued, "If in a year or two, this father and son, one with stomach cancer and the other with metastatic stomach cancer, come back to cause trouble for our hospital."
"From the perspective of our hospital and doctors, we should just follow the rules and regulations and not take any risks..."
Yu Zhiming hummed, then asked, "Doctor Wang, how many young doctors are you supervising now?"
“Three attending physicians and three resident physicians!”
Wang Jiangyue replied, then asked with a smile, "Doctor Yu, do you have someone you want to recommend to me?"
Yu Zhiming smiled awkwardly and said, "I have an ordinary friend named Bao Guan, who graduated from Peking University Medical School and just started working this year like me."
"She is very interested in general surgery."
"if……"
Wang Jiangyue interrupted cheerfully, "A friend recognized by you, Doctor Yu, must be excellent in every aspect."
"Just tell her to come directly to me."
Yu Zhiming quickly explained, "Doctor Wang, she and I are just ordinary friends. Don't think too much about it."
"My idea is that if it's convenient for you, Dr. Wang, please take some time to give her some pointers and observe her."
"If her abilities and other aspects meet your standards, then that would be perfect."
"If you don't like it, there's no need to force it."
Yu Zhiming said slowly, "I just want to ask Dr. Wang to give her a fair competition and a chance to show herself."
"If she herself is not strong enough, forget it."
Wang Jiangyue said seriously, "Doctor Yu, I understand what you mean."
"I'll give her a chance to investigate..."
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(End of this chapter)
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