HPDBC Chapter 16 Abstract and Concrete!
Chapter 16 Abstract and Concrete!
Chen Zhuoan and Su Xiheng were walking hand in hand on the street.
Shashi in June is very hot, with a dry wind blowing in your face and no coolness at all.
The road the two were walking on wasn't a main road, but a narrow alleyway leading from Xiangya Hospital toward the dormitory building.
It has everything: hole-in-the-wall restaurants, internet cafes, and pharmacies.
Actually, this place isn't suitable for a walk, and it's not romantic at all.
Both Chen Zhuoan and Su Xiheng's palms were sweaty, but Chen Zhuoan just couldn't bear to let go.
Su Xiheng felt Chen Zhuoan's grip, both strong and gentle, and tried to pull away twice but failed: "Aren't you hot?"
Chen Zhuoan's wrists and sleeves were soaked with sweat, but this time he chose selfishness: "I don't care, I just want to hold my wife's hand today."
He had held this hand for eighteen years, but one day it was suddenly lost.
It took Chen Zhuoan twenty years to realize how uncomfortable it was.
That's the 'emptiness' in your palm!
This emptiness was so profound that Chen Zhuoan later underwent a series of surgeries in an attempt to fill it.
If he had the chance to hold Su Xiheng's hand again, Chen Zhuoan felt like he had become "addicted".
You should at least take as many as you want at once.
People come and go in the alley.
There were also young couples, family members seeking medical treatment, and even nearby residents...
Chen Zhuoan held Su Xiheng's hand, his eyes casually scanning her up and down.
The chubby cigarette vendor on the right was clutching a disposable plastic cup, giving off a thieving vibe.
They look like comical people with cirrhosis.
About fifty meters to the left, on the second floor, a tall, thin young man leaned against the door smoking, holding a cigarette in his left hand, coughing and touching his chest with his right hand.
They are a group of people who look like they have spontaneous pneumothorax, which is quite amusing.
Looking at her side, Su Xiheng walked slowly and gracefully. Despite her excellent figure, her eyes subtly gleamed as she looked at the food on either side.
They look like the comical group of people who can eat without gaining weight but suffer from "indigestion".
In her previous life, Su Xiheng became a complete foodie after graduation, yet she still wasn't considered fat.
At 1.75 meters tall, she weighs only 102 pounds. Her heaviest weight was during her pregnancy, when she weighed only 120 pounds...
Chen Zhuoan noticed that Su Xiheng was interested in the dried orchids, so he said, "These dried orchids look pretty good, I'll go buy some."
Su Xiheng advised, "Hey, we've just eaten."
Chen Zhuoan mimicked Su Xiheng's appearance from his memory, taking her hand and saying, "I want to eat."
"Alright then..."
"You've been corrupted by me too." Su Xiheng's eyes were cryptic, and she chuckled as Chen Zhuoan's little foodie tendencies were about to awaken.
Chen Zhuoan didn't mind Su Xiheng's joke.
The two had just finished paying their bill when they suddenly heard a commotion in the distance.
Holy crap!
"Dude, what's wrong with you? Wake up."
"Don't sleep here, the ground is cold."
"Sleeping is not allowed here."
There were already quite a few people in the alley, and immediately some people rushed in that direction.
Someone shouted, "Someone has fainted here! Is there anyone with medical knowledge here?"
Are there any doctors off duty?
Upon hearing this, Chen Zhuoan instinctively grabbed Su Xiheng's hand: "Let's go... let's go take a look."
Su Xiheng's body was slightly stiff, but Chen Zhuoan still managed to pull her along.
The two jogged to the edge of the crowd.
Lying on the ground was the tall, thin young man Chen Zhuoan had seen earlier. His hair was dry and yellowish, with mud on the strands.
It's probably been a while since it was washed.
At this moment, he covered his chest with both hands.
He arched his back, mouth wide open, speechless... his eyes filled with despair.
His forehead was covered in sweat.
The crowd stirred.
A young medical student is shouting:
"Call 120 immediately!"
"Even an ambulance probably can't get here?"
"Quickly perform chest compressions."
"What kind of chest compressions are you talking about? You need to do chest compressions until there's no breathing or heartbeat."
"He's doing great now!"
Someone nearby wanted to go up... but was stopped by a noisy professional debate!
Finally, Chen Zhuoan pulled Su Xiheng to the inner circle.
Two boys stepped out from the crowd.
"Cyanosis of the lips, oxygen deficiency, distended jugular veins... emaciated body; this is probably spontaneous pneumothorax..."
"Did anyone bring a stethoscope?"
But no one answered him.
Perhaps someone brought it, but it can't be brought in from outside.
Therefore, the boy had to bend down to perform a physical examination and percussion.
The percussion sound is crisp and clear.
"It's a pneumothorax, and the trachea is also displaced!"
"This is probably still a tension pneumothorax!" the boy concluded readily.
His companion, presumably, asked, "What should we do then?"
Tension pneumothorax occurs when air enters the pleural cavity from the alveoli or the outside, making it impossible for air to escape.
The pressure inside the cavity keeps increasing, which can cause the lung to flatten!
When the pressure inside the chest cavity exceeds the external atmospheric pressure, breathing becomes extremely difficult.
It could suffocate a person in a short time; immediate rescue is necessary!
It is an extremely dangerous type.
The boy who made the diagnosis began instructing his companion: "Go to the clinic and buy a large syringe, the kind with the thickest needle."
"Buy another disposable IV set, as well as medical tape and medical alcohol."
"Okay, I'll be right there, the clinic isn't far." His classmate immediately slipped out of the crowd.
The boy quickly looked at the shopkeeper next to him: "Boss, bring me a clean mineral water bottle and pour half a bottle of water into it."
The shopkeeper didn't delay and didn't ask the boy for money.
The boy took the mineral water bottle and placed it beside him for later use.
……
After Su Xiheng and Chen Zhuoan stood still, Su Xiheng whispered, "They want to perform a thoracentesis and prepare a water-seal bottle closed drainage device."
Chen Zhuoan nodded and explained in a low voice, "Yes... but it's like taking off your pants to fart, completely unnecessary!"
"I don't know where he learned those crooked methods, so he's misunderstood the technology!"
"what?"
"Why?" Su Xiheng was stunned for a moment, then turned to look at Chen Zhuoan with a puzzled expression.
Chen Zhuoan didn't reply to Su Xiheng; he just stood with his hands behind his back, watching the boy's actions.
Seeing that the boy had indeed chosen the mid-clavicular line as a reserve puncture point, it became clear that he had indeed read some books.
However, being the kind of half-baked person who hadn't really understood the book, I couldn't help but point out, "If you're going to do a puncture, why are you keeping a bottle of mineral water next to you?"
The boy looked down, continuing to observe the boy who was having difficulty breathing, and said, "If you don't understand, don't talk."
"I don't have time to explain to you."
Chen Zhuoan: "..."
Since the other party had already said that, Chen Zhuoan was too lazy to reply.
He believed the boy could indeed relieve the emergency, but he estimated that once the professionals arrived, they would give him a severe scolding.
His companion returned shortly afterward.
The boy quickly splashed alcohol, targeting the second midline of the clavicle in the intercostal space. Then, as expected, he tore open the outer packaging, picked up the IV tubing, and cut it.
Furthermore, they even threw one end of the IV tubing into a half-filled mineral water bottle.
Chen Zhuoan then squatted down, grabbed him, and scolded, "Get out of the way! What you're doing is only delaying the rescue!"
The boy was immediately stunned, then became extremely indignant: "How did that delay the rescue?"
Chen Zhuoan completely ignored him.
He threw away the IV tubing that the boy had prepared, and then took the syringe and thick needle.
The soft stopper inside the syringe was pulled out, and then half a tube of mineral water was poured into it.
Then, he handed the syringe and needle to the boy together: "To learn something, you have to learn it thoroughly. You have to do it this way. Now you can put it on!"
The boy froze.
"Huh?"
"Inject water into the syringe?" The boy swallowed hard a few times.
Chen Zhuoan remained squatting, gesturing for the boy to begin: "Start dressing? What are you waiting for?!"
He could have just watched the guy do that ridiculous thing.
However, Chen Zhuoan still didn't get entangled with the young people.
He's a seasoned clinician, so of course he can understand the basic principles of closed thoracic drainage.
Being a junior intern isn't easy; we can't let him do something good that turns out badly, and then get yelled at by the clinical staff...
The core of closed drainage lies in the sealing principle, which can be achieved simply by using the water seal principle.
He haphazardly threw the IV tubing into a mineral water bottle, which, while solving the problem, also created more trouble.
Of course, considering the other party's youth and lack of clinical experience, Chen Zhuoan did not blame him.
If this were a seasoned clinician, Chen Zhuoan would probably have launched into a tirade.
"Oh well!"
The boy seemed a little nervous, as if the teacher were standing next to him.
However, Chen Zhuoan could tell that this boy did have some professional skills.
His needle-holding posture was very standard, and his movements were decisive.
As soon as the needle pierced the skin and reached the pleural cavity, the mineral water in the syringe tube started gurgling.
Countless bubbles surged and rose continuously.
This is the high-pressure gas inside the pleural cavity being released wildly.
The tools used are very simple, just a small plunger syringe, nothing else!
Upon seeing this, Chen Zhuoan immediately stood up.
Su Xiheng looked at him incredulously: "Huh?"
"Let's go, our dried orchids will be ready soon."
Chen Zhuoan touched his stomach, making a clear sound, and then took Su Xiheng's hand and started to walk out.
The crowd gradually dispersed, and most people looked at Chen Zhuoan with incredulous eyes.
Su Xiheng lowered her head nervously, feeling under their gaze.
Chen Zhuoan was so focused on feeling the sweat on Su Xiheng's palms that he completely made his way out of the crowd.
A few minutes later, the Xiangya Hospital rescue team arrived.
When the men in green uniforms saw the syringe stuck in the patient's chest, they breathed a sigh of relief.
Tension pneumothorax.
Old Deng was there.
"Hey bro...which department are you in?"
"That was efficient."
The boy stammered, "Teacher, I'm an intern, a fifth-year student."
Two men in green uniforms were setting up a stretcher, lifting the patient while asking, "You're only a fifth-year college student?"
"Did you make this thing?"
"What the heck are these IV tubing and mineral water bottles?" He looked at the discarded IV tubing and 'mineral water bottle' next to him!
"Where did you guys get all this equipment from?" the young man asked, his voice full of complaints.
"Didn't your teachers teach you that you only need to use mineral water bottles as water seals when you don't have syringes?"
"It is only necessary to use a scalpel to cut open the skin of the chest when there are no syringes or needles available."
"I've run into several idiots using water bottles..."
"If you don't know how, then don't mess around, okay?"
The boy's face turned red and then pale as he was scolded.
Of course, he didn't do that, so the person in green didn't press him further.
The group of men picked up the young man and left.
The puncture and degassing is only the first step in the rescue. Further meticulous treatment in the hospital is needed before the patient's life can be completely saved.
The crowd gradually dispersed after the people in green left.
However, their playful noises had taken on a playful tone.
"That young man is a pro..."
"Of course!"
"Being a doctor requires both skill and intelligence."
"Studying by rote won't work."
These are the voices of medical students discussing something.
The boy and his classmate looked slightly embarrassed.
However, his classmate comforted him, saying, "Fan Fan, don't be sad. You were doing it to save the patient."
"You just haven't learned that part of the content, it doesn't mean you're not qualified enough."
Fan Fan glanced around.
At that moment, he saw the young man who had been pointing at him standing opposite a girl, holding a disposable red bowl.
The two people simultaneously fed each other with disposable skewers, their smiles radiant, oblivious to everything else.
It was as if their world had shrunk to just the two of them.
I tried my best to save him, but I almost messed things up.
The other party, however, didn't take it seriously at all...
Furthermore, the other party seems to be quite young.
The shopkeeper suddenly said, "Young man, you're actually very talented and brave."
"That doctor wasn't insulting you; he was just complaining."
Fan Fan looked embarrassed, immediately packed his backpack, and walked away into the distance of the alley.
Fan Fan's classmates followed suit.
……
After Su Xiheng and Chen Zhuoan finished eating the dried orchids, they threw away the trash.
Su Xiheng stopped shyly, letting Chen Zhuoan wipe her mouth, but her voice was hesitant:
"Everyone's watching!"
Chen Zhuoan's actions and expression were serious: "If I give someone a kiss, other people will just watch."
"You are my wife."
Su Xiheng grinned, even she herself felt that her words were too cloying.
She quickly changed the subject: "That patient just now, could you save him?"
"Hmm, no big deal!" Chen Zhuoan tossed aside the tissue and then grasped Su Xiheng's hand.
Su Xiheng asked in confusion, "Then why didn't you make a move?"
"You know perfectly well that person is inexperienced."
Chen Zhuoan: "First, he understands pneumothorax, finds the location accurately, and his operation is also quite good, so he can save lives."
"Secondly, intervening without reason will only cause trouble. The only goal is for the patient to survive; I have no need to steal the spotlight."
"Third, if a patient causes him trouble, I can save him; if a patient causes me trouble, he can only watch helplessly."
Su Xiheng was surprised: "The patient is causing him trouble, and you can save him?"
Chen Zhuoan nodded confidently: "Definitely!"
If he makes a mistake, Chen Zhuoan can correct it.
He made no mistakes, the patient survived, and that was a good deed. Even if the patient tried to argue, Chen Zhuoan had more than a dozen ways to shut him and his family up.
"That?"
"Why is it bad to put a syringe needle into a mineral water bottle?" Su Xiheng asked again.
Chen Zhuoan: "It's very simple, it's just inconvenient to move..."
"Those people at the 120 ambulance are obsessed with saving time; if anyone dares to delay them, they'll curse their ancestors for eighteen generations!"
Su Xiheng: "..."
"You know so much." Su Xiheng's eyes suddenly brightened.
Although she was confident that her boyfriend was outstanding, that kind of outstandingness was abstract, unlike what she felt today.
Su Xiheng asked, "Then how did you determine that the other person wasn't a clinically experienced practitioner?"
"Would a seasoned clinician still perform this procedure when given the necessary resources?"
"They're either immoral or stupid."