Introduction: In the medical circle, general medicine has always been despised by other professions, "full but not specialized", "general but not refined" is synonymous with it, but there is no absolute, there is no shortage of doctors with a high level in the field of general medicine, they are knowledgeable and knowledgeable, and they can solve the practical problems of patients better than specialist doctors. One such general practitioner is described in the novel "Medical Road Huan Hai".
Of course, where there are people, there are rivers and lakes, and hospitals are not pure land. The pursuit of fame and profit, flattery and bullying, power and money trading, and erotic temptation are not new, but no matter how chaotic other things are, the bottom line of treating diseases and saving people is what every hospital and doctor has always adhered to and has never wavered.
Source: Yimaitong
Author: Little Pie
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A retrospective
The patient died after surgery, and the family still objected after receiving more than 70 yuan in full compensation, saying that the hospital "did not find a tumor during the operation, but forcibly removed 5 healthy organs from the patient", and demanded that the chief surgeon be held criminally responsible, and finally, the chief surgeon was sentenced to 2 years for the director of hepatobiliary surgery.
01
The so-called blessing is incomparable, and the disaster is not a single line, whether it is an individual or a unit, bad luck is like an aura, which has always been shrouded in one place and cannot be dissipated.
Director Wei of the Department of Hepatobiliary Surgery had just entered prison, and the Rheumatology and Immunology Department of Lengshui People's Hospital was involved in a lawsuit, and it was a first-class accident.
A patient with rheumatoid arthritis who received methotrexate for a week died of severe bone marrow suppression, granulocytopenia, lung infection, septic shock, and finally respiratory and circulatory failure.
Methotrexate is one of the most commonly prescribed drugs in rheumatology and the most prescribed rheumatology drug in the United States, especially in rheumatoid arthritis.
Side effects of methotrexate include gastrointestinal reactions, bone marrow suppression, and pulmonary fibrosis, and 5 to 10 mg of folic acid taken orally 24 hours after injection can reduce the occurrence of side effects.
Methotrexate is routinely administered to patients with rheumatoid arthritis, and it is understandable that some patients experience side effects after use, but this accident is not a general drug side effect, but is caused by negligence on the part of medical care.
The preparation of methotrexate is 2ml: 50mg, and the regular doctor's order should be 8mg (0.3ml) twice a week, but the doctor mistakenly prescribed 8ml twice a week, resulting in 16ml a week, or 400mg, which is 25 times the normal dose.
The doctor mistakenly prescribed 8mg to 8ml, and did not find it for 1 week, and when the nurse checked the doctor's order, she could not find a serious deviation from the regular doctor's order.
As a nurse who has been working in the rheumatology and immunology department for a long time, she is not familiar with the basic dosage of the department, which eventually leads to serious medical accidents.
The medical certificate is described as follows:
After the medical superdose of methotrexate, the patient developed severe bone marrow suppression, a sharp decline in granulocytes, septic shock, and finally death from respiratory and circulatory failure. In addition, the medical monitoring was not in place, and the changes in the patient's condition could not be detected in time, and the patient's methotrexate was administered for 1 week before the blood routine was rechecked. When the patient has bone marrow suppression, the rescue treatment of the doctor is not timely and effective, and the rescue drug - leucovorin - cannot be used in time.
At first, the attending physician admitted to the family that he was negligent, used the wrong dose of drugs, and induced the family to persuade the family not to do the autopsy, and after the family agreed not to do the autopsy and signed, the department unanimously said that the patient's leukocytopenia was caused by a serious infection, and this behavior was really trying to cover up.
The expert group believes that the medical negligence of the doctor in using methotrexate in excessive doses of the patient is the main reason for the rapid deterioration of the patient's condition and eventual death.
02
The attending doctor of this accident is called Leng Miao, is the niece of Director Leng Chunhan, Leng Miao is an undergraduate student of Lengshui Medical College, medical employment is very involuted, and the destination of ordinary undergraduates is generally a county-level hospital, but because of the help of Director Leng, Leng Miao was lucky to enter the municipal hospital, and he also studied as an on-the-job graduate student during his work, and graduated successfully last year.
After Leng Miao's accident spread in the hospital, the attitude of the hospital leaders towards Director Leng Chunhan began to be estranged, Leng Chunhan obviously felt this change, originally Director Leng was a popular candidate for vice president this year, but after this incident, she knew that it was in vain, at least in the past two years, her career was going to be forced to press the pause button.
This accident not only hit Director Leng hard, but also affected the future of Director Zhang of the Rheumatology Department, because Leng Miao is not only a staff member of the Rheumatology Department, but also her in-service graduate supervisor is Director Zhang, and this master-apprentice relationship is also facilitated by Director Leng Chunhan.
Since then, Director Zhang has lost a good face to Leng Miao, and he also has a grudge against Director Leng Chunhan, although Leng Miao is cautious and walking on thin ice every day, Director Zhang still finds fault with him for unwarranted reproach and abuse, and even personal attacks, and every time he is in full view of everyone, making Leng Miao make a fool of himself in public.
03
One day, Director Zhang instructed Yang Song to prescribe thalidomide 25mg qn to a patient with systemic lupus erythematosus, Yang Song was Leng Miao's senior doctor, and he did not convey Director Zhang's oral medical instructions to Leng Miao, resulting in the second day of ward rounds, Director Zhang did not find the drug "thalidomide" on the patient's medical order, because it was a patient of Leng Miao, Director Zhang immediately became angry.
Thalidomide was developed to treat morning sickness, so it was called "reaction arrest", but it was stopped because of a wide range of fetal teratogenesis and the appearance of "seals", and it was once sealed for a long time. However, in the following years, it was found that thalidomide has a special effect on ulcers caused by rheumatic immune diseases, and thalidomide 25mg qn for 1-2 weeks can have a significant effect on mouth ulcers caused by rheumatic immune diseases, and then once every other day, once a week, until it is stopped. The next time an ulcer appears, it is equally effective to reapply and there is no resistance.
"Leng Miao, dead people can't make you remember for a long time! The doctor's order will not be opened! You're such a pig brain! Why didn't you prescribe thalidomide, why?! Director Zhang spat at Leng Miao.
Leng Miao stood in the corner of the ward round team and trembled with fright, she remembered that Director Zhang did not give her a medical order for "thalidomide", "Did I really forget ......" Leng Miao began to doubt herself.
"Yang Song, did I say yesterday that I would prescribe thalidomide to the patient, and let you convey it to your front-line doctor Leng Miao!" Director Zhang turned his head and asked Yang Song.
Yang Song was at a loss, his eyes were a little fluttering, although he was a little unbearable, he still chose to fall into the well, and said: "I should have told her, she forgot!" ”
When Yang Song said this, he was obviously a little lacking in confidence.
"I ...... I...... I don't remember Mr. Yang conveying your dictation to me...... Teacher Yang didn't tell me......" Leng Miao finally mustered up the courage and argued tremblingly.
Yang Song stood aside, his eyes flashed, his face flushed, he was ashamed for a moment, and he was embarrassed to refute.
"Because you're a pig's head! You're demented! Do you remember your name? Let me test it to see if you have Alzheimer's, what is 100-7? Hearing Leng Miao's rebuttal, Director Zhang followed up with an output, even though everyone present understood that this matter was likely to be Yang Song's fault, but Director Zhang didn't care about right and wrong at all, he just wanted to rectify Leng Miao.
100-7 is a routine question often used by neurologists to test elderly patients with dementia.
Leng Miao began to sob, her lips trembled, tears swirled in her eyes, she raised her head, trying to hold back the tears, but the tears of grievance still burst out like spring water, overflowing her face.
"Cry what cry! Win pity with tears! Who is the pity of the patients you have died? Don't follow the rounds, get out! "Director Zhang's mouth is as sharp as a knife's edge, and he kills people's hearts.
People are not sages and sages, people are not machines, sometimes they are negligent, although Leng Miao's carelessness has caused serious consequences, but this is not her subjective will, if after deep reflection, know that mistakes can be changed, scientific guidance and give her a chance, Leng Miao has the opportunity to become an excellent doctor. It's a pity that there is no if, under the blow of Director Zhang's stormy personality, Leng Miao committed suicide by jumping off the building.
Past reviews of the hospital survival record "Medical Road Huanhai" series:
➤Chapter 1: The 10,000-year-old who was not treated by the director quarreled with the director's "eyeliner" because of a newcomer|Hospital Survival Record
➤Chapter 2: Dr. Geng Zhi unveiled the shortcomings of his peers in front of the patient! This is miserable, and the director is angry...... Hospital Survival Record
➤ Chapter 3: The junior doctor is hated and retaliated against by the director after he openly opposes the director's diagnosis and treatment decision...... What happened next overwhelmed him
➤ Chapter 4: "Harm people's lives, don't deserve to wear this white coat!" "What happened to a pregnant woman who was compensated 30,000 yuan after beating the doctor angrily? Hospital Survival Record
➤ Chapter 5: Strange Things! The "lame" doctor, who was not good at business and was ridiculed by patients, actually "returned to his hometown" under the arrangement of the leader
➤ Chapter 6: The Good Doctor was complained by a patient, and this time, his "sworn enemy" actually helped him out, what happened? |Hospital Survival Record➤Chapter 7: "There is a director who buys insurance from me, and his pre-tax income is more than 800,000"! Looking at his 120,000, the old doctor wanted to cry without tears|Hospital Survival Record➤Chapter 8: The patient frequently had low potassium, and the doctor in charge of the bed was anxious, who knew that the old doctor only looked at the patient's appearance and found out the cause|Hospital Survival Record➤Chapter 9: After a new director came to the department, at the reception banquet, everyone had their own thoughts...... |Hospital Survival Record➤Chapter 10: The director of the Department of Obstetrics and Gynecology lost his fertility function after remarrying! After learning the reason, he decided to take revenge on his ex-wife|Hospital Survival Record ➤ Chapter 11: Disaster is not a single line! After his son fell ill, Director Leng also fell ill, and the former strong woman collapsed and wanted to commit suicide...... |Hospital Survival Record➤Chapter 12: The ruthless director has changed his temperament and rejuvenated his appearance, what happened? |Hospital Survival Record➤Chapter 13: The patient has refractory hypertension + low blood potassium, and the doctor in charge has no clue, who knows that the old doctor only asked two questions, and then found out the cause|Hospital Survival Record➤Chapter 14: The nurse who lost weight had hematuria and proteinuria, and when she was at a loss, it was the doctor who was scolded by her who saved her|Hospital Survival Record➤Chapter 15: No tumor was found during the operation, but the patient's 5 healthy organs were forcibly removed? After the hospital compensated 700,000 yuan, the family was still dissatisfied, and the doctor was finally sentenced to 2 years
To find out what's next, listen to next Sunday's breakdown!
This novel is purely fictional, and any similarities are all coincidences.
Editor-in-charge|Yiyi
Cover image source: Visual China
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