Hospital is a very special place, and all kinds of sad and helpless things happen every day, especially the emergency department.
Emergency Department
Emergency night shift, Dr. Song started from the succession, and the 120 ambulance came one after another like running water, making Dr. Song and his team busy. After finally pumping for a while, Dr. Song was about to drink a sip of water, but the flashing blue light stopped at the gate again, and then pushed down a weak/panting and fever-ridden old lady.
After understanding, the old lady has had hypertension , coronary heart disease , diabetes for many years, and her blood sugar control has been poor, and many complications have occurred: diabetes nephropathy , and she has been regularly hemodialysis 2 years.
Learned about these medical history Dr. Song realized that he had encountered a critical illness again today, and couldn't help but take a closer look. When the heart and lungs were auscultated, they found that both lungs were covered with damp rosy. It seemed that heart failure and were already shown at this time. At this time, the old man who followed him told Dr. Song that he had been undergoing regular dialysis, three times a week, and there has been no dialysis in the past week.
After asking about the medical history, I also had a simple physical examination. Dr. Song initially diagnosed: acute attack of coronary heart disease and heart failure . So the symptomatic treatment was given. But one thing is, what's wrong with the patient's fever? Could it be lung infection ?
Doctor Song was worried and carefully stopped the diagnosis. When I was approaching the old lady for a discontinuation, Dr. Song still smelled a foul smell even though he was wearing two layers of masks. What's going on with
?
Doctor Song lifted the patient's quilt and saw that severe necrosis and gangrene had occurred in the patient's right lower limb, and the surface was filled with a rotten odor.
Gangrene of the right lower limb
"This foot is so serious, when did it start?" Dr. Song hurriedly asked the old man.
"Two weeks ago, I came to the hospital for a look. I said it was diabetic foot , but it has been repeatedly cured. I said it was an amputation." The old man said helplessly. "But the old woman disagrees."
Diabetic foot, one of the serious complications of diabetes patients is due to neuropathy and vascular lesions caused by long-term diabetes, severe ischemia and necrosis at the distal end, and has a high recurrence rate. It is very difficult to treat and can easily lead to amputation and death.
It seems that this is not gangrene for a short period of time. Now that it is so serious, a serious systemic infection has occurred. It seems that it will not work without surgery.
Thinking of this, Dr. Song raised his voice and said to the old man: "It has been more than half a month since I came last time. The old lady's feet are so necrotic, why are they here now?"
The old man suddenly felt very aggrieved and helpless: "I have said that she has been talking about her many times, but she just doesn't want to come. I can't resist her and I have always insisted on going home to apply medicine to treat her."
"Last time, did no one tell you that if you don't have surgery, will you be in danger of life?" Dr. Song continued to question.
"I said that when I came last time, the doctor told me that I would need surgery, but she said that the wound would not grow well after the operation, so she refused to be able to operate." The old man said helplessly.
After hearing what the old man said, Dr. Song didn't know what to ask anymore. I just told the old man that the old lady was very ill at this time and needed to be admitted to the intensive care unit . Then he issued a payment form, told the old man that he needed to pay, and told her that more fees might be needed later.
rescue outdoor
In fact, Dr. Song understands very well that an old lady in her seventies has so many underlying diseases, coupled with gangrene of the right lower limb and systemic infection, this hospitalization will definitely cost a lot. Not to mention the money, there is still some saying whether the old lady can withstand the surgery.
At this time, Dr. Song went into the emergency room again and saw that the old lady had undergone symptomatic treatment after being admitted to the hospital, her mental state was much better. I can already answer the doctor's question. Seeing Dr. Song coming, the old lady said weakly: "Doctor, I don't want surgery, I don't want surgery..."
"If you don't have surgery, your disease will not be cured!" Dr. Song approached the old lady's ear and said earnestly.
"I know everything you said. The doctor told me before. I don't want surgery. I want to go home. I don't want to drag him down. There is a patient in the family who needs his care... Please help me call him in." The old lady said as if she had used all her strength.
Doctor Song suddenly understood something, and a burst of sadness surged onto the tip of his nose like waves. Dr. Song's nose felt sour: It's another helpless and sad family, no wonder he never saw his children come.
Later, Dr. Song invited several departments to consult. Among them, the Nephrology Department said that the patients now have too many underlying diseases and are in serious condition, so they are not suitable for hemodialysis. It is recommended to treat ICU. After consultation in the intensive care unit, it was said that the ICU bed was full and needed to wait for the bed. After the orthopedic doctor's consultation, he said that the operation needed as soon as possible, but he still had to stay in the ICU after the operation... After the consultation of
, Dr. Song walked out of the emergency room and saw the old man squatting on the ground and was about to speak. Unexpectedly, the old man spoke first: "Doctor, can you pay less this time? I will pay the rest tomorrow?"
Dr. Song looked at the payment notice in the old man's hand. He knew that those were just basic medicine costs, and the old lady's treatment costs may be astronomical for the old man.
sad old man
But as a doctor, I can't give financial help. The only thing I can do is to minimize the costs and stabilize the old lady's condition in the most effective and cheapest way.
"The old lady is very ill and may have to be admitted to the ICU, which will cost a lot later. And now the ICU is full of beds..." Dr. Song couldn't bear to continue talking.
"Please you must save her, I will find a way to do it." The old man held Dr. Song's hands and said a little excitedly.
"Save it will definitely be saved, but you know, the emergency room expenses cannot be reimbursed, which is very expensive. Now the ICU also has to wait for the bed, otherwise you can go to the next hospital to be hospitalized, so that the reimbursement will be more. When our ICU has a bed, you can transfer it." At this time, Dr. Song began to find ways to save more money for the elderly.
Doctor Song knew that the current situation might be a dead end for the old man, so he patted the old man on the shoulder and asked her to go in and persuade the old woman.
At this moment, another ambulance parked at the door. The door opened and pushed down a patient with cardiac arrest . The doctor in the ambulance was crossing the patient for cardiopulmonary resuscitation.
"Cardous arrest, prepare for defibrillator..." the head nurse over there shouted. Dr. Song didn't have time to think too much and immediately defected to the next "battle" and didn't care about the conversation between the old man and the old lady.
After Dr. Song finished his work, more than an hour had passed. Only then did he notice that the old man and the old lady had left at some point.
I originally thought that the old lady would follow her advice, go to the next hospital for hospitalization and then go to the hospital for surgery, but accidentally heard from the nurse that after the old man persuaded the old lady, the old lady insisted on giving up the treatment and going home.
Doctor Song looked out the window and silently recited in his heart: The sage is unkind and regards the people as straw dogs. However, a doctor is a benevolent person, and a benevolent person loves others.
