WHEN THE DOCTOR USES A HACK

Chapter 704: Chapter 704: A Difficult Choice (Additional Chapter 3 for Alliance Hierarch Tian Shang You Keng)

Chen Cang hastily said, “Can we get an ECG?”

The doctor cooperated promptly, and soon the test was done.

Chen Cang, looking at the ECG and comparing it to those from the previous days, gradually understood everything!

But Chen Cang did not say anything outright, as he still needed to further confirm the diagnosis he had in mind.

Thinking of this, Chen Cang hastily asked, “When the old lady was first admitted, was a cardiac auscultation performed?”

The doctor’s face flushed with embarrassment upon hearing the question.

Because it was already written in the admission records, but… it was basically just a template paste, meaningless.

Chen Cang looked at the medical record and then asked himself; of course, he knew what was going on, but he didn’t point it out.

Otherwise, how embarrassing would that be in front of the hospital director and the family!

The young doctor, grateful, glanced at Chen Cang and nodded, “Certainly, it was performed.”

Chen Cang didn’t have any doubts, because for cardiologists, that’s a routine procedure. Perhaps they were too lazy to write it in the record, but the standard admission procedures still had to be followed!

He continued to ask, “Oh, did you hear any murmurs at that time?”

The doctor, upon hearing Chen Cang’s question, furrowed his brow and, after pondering for a moment, shook his head, “No, everything seemed fine when she arrived.”

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Chen Cang asked, “What about yesterday? Did you auscultate? Were there any murmurs?”

The doctor did not hide the truth and said, “No murmurs yesterday either. Seeing the old lady’s condition, I considered acute left heart failure and used cardiotonics and diuretics, but… the symptoms did not seem to improve significantly.”

“We called the county hospital, but they were unsure and dared not transfer the elderly.”

At this point, the doctor also felt quite helpless.

But that was common enough. At the grassroots level, many hospitals are unwilling to take the risk when the diagnosis is unclear, not to mention an emergency patient with an acute myocardial infarction and unspecified complications.

If something went wrong, the patient’s five sons and two daughters would cause them trouble enough!

Upon hearing the attending doctor’s words, Chen Cang immediately felt the clues in his mind become clear.

At this moment, the director couldn’t help but ask, “Expert comrade, what do you think it is?”

Chen Cang, after pondering for a moment, said, “Based on the old lady’s ECG, with a persistently elevated ST segment, and no downward trend despite your medication, I suspect the patient has now developed a ventricular aneurysm!”

At Chen Cang’s words, the doctors exchanged glances.

Somewhat bewildered?

What is a ventricular aneurysm?

This term was practically unheard of for them at the primary care level.

Realizing this, their faces reddened with embarrassment and they let out a helpless sigh.

Chen Cang didn’t dwell on that issue, as it wasn’t their fault. He took them out of the patient’s room and into the doctor’s office, then said, “When I auscultated, I found systolic murmurs at the apex of the heart, with variable degrees of thrill, and according to what you said, there were no murmurs before. The source of these murmurs is quite clear, leading me to consider post-infarction ventricular septal rupture.”

“When the ventricular septal rupture occurred, the left to right shunting began, changing the normal hemodynamics!”

The attending doctor, curious, asked, “So… the patient doesn’t have heart failure?”

Chen Cang shook his head, “Not that there isn’t any, but when the hemodynamics changed, the cardiac output became insufficient and the blood flow altered, leading to the appearance of acute heart failure symptoms.”

After explaining, Chen Cang concluded with a serious expression:

“Looking at the current situation, the patient’s condition is critical, and she could die at any moment!”

At Chen Cang’s words, everyone around him was stunned.

The attending doctor was particularly confused; he might not have heard of this condition before, but Chen Cang’s last sentence was crystal clear to him!

The condition is critical, and death could occur at any moment!

This statement startled all the sons who had urgently rushed over!

“Doctor, you must save my mother!”

“Yes, Doctor, don’t worry about the money. We brothers will pool it together, just save our mom please!”

The hospital director was also taken aback at this point; he knew the patient’s condition wasn’t simple, but he hadn’t expected it to be so dangerous.

Thinking this, he hurriedly asked, “Expert comrade, what should we do now?”

Upon hearing this, Chen Cang began to ponder!

At this moment, he was the mainstay.

A primary care hospital might have never encountered a situation like this and become somewhat overwhelmed when they did.

An acute myocardial infarction leading to ventricular septal rupture—both dire conditions. Chen Cang had to provide an effective recommendation.

If they were to stay, there were simply no conditions for rescue, to say nothing of the other requirements; the township hospital didn’t even have a ventilator, let alone an extracorporeal circulation machine needed for surgery.

Thus, handling it here was not feasible at all!

The local county hospital didn’t even have a cardiovascular surgery department, and it was highly unlikely they had an extracorporeal circulation machine either.

Now, the only two choices lay before them!

To stay and wait for a miracle, hoping that the old lady’s vital signs would stabilize, but in such a condition with organic heart damage, the effects of internal medical treatment would be limited.

But if they were to transfer hospitals, how would they do it?

The condition was critical, the mountains high and the roads long; she could lose her life en route at any moment!

At this moment, both the hospital director and the chief doctor understood what Chen Cang meant.

However, the family members hastily said, “Doctor! We want to transfer hospitals, can we? Please, we’re begging you?”

“Right, doctor, please save my mother!”

“Seeing her suffer like this, we, as her sons, feel helpless and heartbroken!”

“Yes…”

Listening to the men’s pleas by his ear, Chen Cang sighed; the choice was not his to make, but theirs.

Thinking this, Chen Cang said, “We must definitely try to save her, but we need to think about how to do it!”

“The situation is like this: the elderly patient is in poor condition, advanced in age, with limited tolerance. Yet, she must now be sent to the province for surgery. However, I must tell you in advance that the success rate of the surgery for the elderly is quite limited!”

“Moreover, with the mountains high and the roads long, there could be life-threatening dangers during the transfer, as the disease itself is unstable, and its progression is like this…”

After Chen Cang explained everything, the five sons fell silent.

They began to discuss amongst themselves.

Taking the opportunity, Chen Cang called Director Li Baoshan.

The director’s opinion was also clear: to respect the wishes of the family.

At this point, Chen Cang actually wasn’t so troubled anymore.

The grandmother was very old, in her seventies, with a myocardial infarction and ventricular septal rupture. Under these circumstances, going to the operating table… to be honest, she might not be able to make it off.

The risks associated with transport were equally significant.

After calling the five brothers out, Chen Cang spoke candidly.

Hearing Chen Cang’s words, they all seemed disheartened, with the eldest brother even having tears welling up in his eyes.

Finally!

After a few minutes, the five men discussed and made a decision!

“We have to transfer!”

The eldest brother looked at Chen Cang, “Doctor, we need to transfer hospitals, we have to do it, even if something happens on the road, it’s better than just waiting to die here!”

“Not only transfer but also surgery! Even if the surgery fails, we still have to give it our best effort!”

Towards the end, the eldest brother’s voice was noticeably choked up, “As her sons, at this time, we all want to do our utmost so that we have no regrets in the future!”

Chen Cang took a breath and nodded, “Alright! I respect your decision; you… will follow the ambulance with us in a bit.”

The eldest brother did not hesitate, nodding his head; he was the eldest, and he had to take on the responsibility for the family. With their father gone, as the eldest brother, he was the head of the family.

It wasn’t acceptable for him to be indecisive!

In some rural areas, the concept of responsibility falling to the eldest brother and sister-in-law is still very strong; Chen Cang had only just learned that since the grandmother’s illness, it had been the eldest brother’s wife who had been continuously caring for her.

Watching this scene, Chen Cang couldn’t help but feel moved, this family, with the eldest brother and sister-in-law’s actions, were exemplary, beyond reproach.

Having reached a decision and preparing for the transfer, the daughter-in-law then said something that puzzled everyone,

“The elderly lady often gets car sick, will that be okay?”

Chen Cang frowned, how could it possibly be okay!

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ps: Thanks to “Heart with Buddha, Fear You” for the 10,000 reward, thank you.

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