Ok here come CHAPTER 2
Part OneThe surgery just finished. The operating room is filled with blood;
the heart, vein and anesthesia monitors, all connected to the patient,
flashed red signals and beeping sounds. The room in chaos is then
quickly tidied by an old lady. This is one of Guan Xin's normal busy
days as an anesthesiologist. She went out of the operating room and
meets Qiu Qing Cheng who thanks her with a grin. Guan Xin smiles in
response. She draws out from her pocket today's operation reservation
chart and makes a mark. Operating rooms 1, 2, 3, 5, 9 and 10, six rooms
altogether; the nurses and residents working within it; and the patients'
safety are all her responsibility. She looks at the forms. At eleven thirty,
only several scheduled operations have not been marked, and these are
only minor operations. Guan Xin thought, this will be a rare opportunity to
be happy in her dull and busy day as an anesthesiologist. But she was wrong.
"Dr Guan, OR 9 needs you urgently."
Guan Xin heard her name broadcasted and realized the urgency. OR 9 is
undergoing a Hysteroscopy*. It is for diagnosing or changing a different
membrane in the uterus for treatment. The course of operation is usually
not complicated, the obstetrician is faced at the girl thingy and a mirror is
inserted inside through the cervix then goes into the uterus, after the Saline
is put inside, the uterus mirror can be observed within the glutted uterus.
Findings from the uterus mirror indicate that sometimes the membrane is
stuck, the surgeon can also do simple separation, removing it through the
uterus mirror. In fact, women who undergo Hysteroscopy are mostly young
ones and those who do not have chronic diseases. It doesn't require general
anesthesia. Simple anesthesia on the vein would do.
Guan Xin moves toward OR 9 at a fast pace, but she doesn't really feel nervous
at all. She thought that it would be a very safe operation due to the skills of
Professor Xu Kai Yuan, who is currently the Medical College President. He is a
very meticulous obstetrician. Since his post as president of medical college, he
no longer performs dangerous major operation. Waiting only until she's close
enough to OR 9, one of the nurses rushes out and shouts at her in an extremely
agitated voice: "Dr. Guan, faster, CPR!" She realizes the seriousness of the patient's
condition.
"I'm going in with you."
Qiu Qing Cheng is about to go out of the OR, but he quickly turns around after
hearing CPR. Guan Xin's face is no longer calm. She quickly rushes into the OR
where she finds the anesthesiologist standing at the patient's head, linking the
oxygen mask while another hand is pumping the oxygen bag constantly. Surrounding
the operating table are medical personnel who frantically turns the patient to the
side, filling in the hard board for first aid. Afterwards the patient is turned over in
the lying position.
Qiu Qing Cheng quickly jumps onto the operating table and kneels at the right side
of the patient, intending to begin a heart massage. Guan Xin's sight sweeps off the
data monitors quickly. She couldn't see a normal wave form for heartbeat in the
ECG (electrocardiogram), only a trembling straight line. Guan Xin says, "my God,
VF (Ventricular Fibrillation, the ventricle quivers)". The patient's BP is only 2OmmHg
and the monitors cannot read any diastolic pressure or a pulse. The patient will be
near death if he's not able to circulate blood. The situation is grim. Qiu Qing Cheng
is still doing a heart massage.
"Inject Adrenaline 1 cc and Xylocaine 100 mg, and get some sodium bicarbonate
and calcium chloride ready." Guan Xin takes over, sending out a succession of orders,
"give me a throat mirror, prepare to incubate." She prioritizes to set up a safe and
reliable incubation, while calling on the staff, "you notify all residents of this ward,
even nurses who has not seen the OR, ask all of them to come over to OR 9." she
tells the nurse. Dr. Guan takes over the throat mirror and within seconds inserts it
in the trachea's correct position, "Suction!" she shouted.
Guan Xin feels that she's losing the patient. The patient's heart is already giving her
thousands of headaches. She closes her eyes and arranges herself. She gives the
oxygen bag to the other anesthesiologist, and sends out orders again: "Push the
ECG here, now!" she saw a nurse, "You! Help me set up a central vein pipe from
one of the veins, and open an artery pipe. Test the artery blood gas. I want the
arterial pressure and continuous central venous pressure seen on the monitor."
More and more people are getting inside the OR. Guan Xin injects another dose,
"adrenalin 3 cc, 10 cc calcium chloride, 60 cc sodium bicarbonate." Qiu Qing Cheng
stops the heart massage after the first aid medicine is injected. He sees the monitors
switch back to the emergency state. It seems that the patient's body has not reacted to
the First Aid being done. "How come this is possible?" Guan Xin shakes her head
inconceivably. Qiu Qing Cheng remains silent and jumps onto the operating table
again, continuing the heart massage. Another nurse prepares a syringe filled with
5 cc Adrenalin and asks: "Are we going to inject again?" Guan Xin nods. Her eyes
not leaving the monitor. She looks at it in disbelief and says, "am I being fooled?
" Guan Xin mutters under her breath.
"How many cc do we inject?" the nurse asks Guan Xin. 1 cc is equivalent to a bottle
of adrenalin.
"All of them." Guan Xin says as she glances at Qiu Qing Cheng who also answers
the same. It is the fourth electric shock now. Guan Xin applies a conductive ointment
on the board, and gently spread the boards into the patient's chest, near the armpit.
This is to let the electricity flow straight to the heart.
"Prepare for the fourth electric shock, adjust voltage to 250 (the highest voltage).
Everybody leave the room." The sound of electricity begins as it touches the patient's
body. Those who are present watched the electrocardiogram to see if there are changes.
After the shock, the monitor presents several unusual fluctuations. The screen showed
some progress for a while, but disappointingly it went back to a trembling straight line again.
Another nurse was assigned in massaging the heart. Guan Xin puts down the electric
shock board, unable to contain her depression with the situation. The anesthesiologist
gathers all the data on the central vein, blood pipe drawing suction and hands it over
to Guan Xin. These reports only reflect a secondary data of the first aid, it cannot help
identify why it ended up like this.
"What did really happen here?" Guan Xin asked the anesthesiologist assigned to assist
the surgery. The nurse answers with a frightened expression: "After the operation,
everything was still normal. I saw Dr. Xu pull out the mirror from inside the uterus.
The electrocardiogram suddenly showed an unusual picture on the monitor. We were
about to deal with it but the heartbeat suddenly went down. 40 beats/min, then it
jumped to 30+ then 20+. I hurried to call a doctor, when I turned around, it became worse."
"Before the cardiac arrhythmia took place, were the BP, blood oxygen and breathing
of the patient normal?" Guan Xin asked "Everything was very normal." The
anaesthesiologist nods and says nervously, "It was really scary, in just a matter
of seconds, we didn't even have time to help" Be calm, be calm, Guan Xin tells
herself. She can't think of a reason why this would happen.
"Dr. Guan," calls Dr. Xu who was sitting quietly in a corner, as he watched the others
do first aid, "what really happened?"
"We still don't know" Guan Xin shakes her head, "I only know that there is a heart
failure, I have never encountered such a thing."
"What do we do now?"
"I asked Qiu Qing Cheng and the rest of the cardiac surgeons to work on temporarily
connecting an artificial heart regulator. Let's see whether it can come back to life,
" Guan Xin said.
"I think the most important thing right now is to let her heart beat again."
Dr. Xu asks Qiu Qing Cheng who is already standing beside him, "What are the
chances if we do this?"
"This is the last method, nothing will be worse than this.' Dr. Qiu shrugged. He kept
silent for a moment then suddenly thought of something worse, "The patient's relatives.
Dr. Guan and Dr. Xu, you might as well inform them on the patient's state before
installing the heart beat regulator, just to let them be prepared for whatever outcome.
"Prepared for what?" Dr. Xu asks. Qiu QingCheng casts a look at Dr. Xu while he
continued preparing for the regulator wire and stopped speaking about the situation.
***
Deng Nian Wei does not like sitting in the hospital's waiting area, but he has no other
choice. Zhu Hui Ying told him that it is only a very simple minor operation. She hasn't
told the rest of the family. Deng Nian Wei has done a lot of undertakings and unsuccessful
investments. He owes a lot of debt but Zhu Hui Ying saved him from all of this mess.
When he was doing business, the only one who praised him was Zhu Hui Ying. She
worked at a pub, 2 years older than him and was divorced twice. Not long after they
knew each other, Zhu Hui Ying was determined to finish her career in the pub and
live with him. Her family did not agree to the marriage. Because she has her own
house and enough money, they thought that Deng Nian Wei was just after her money.
She was married twice but due to habitual abortion she bore no child. Deng Nian Wei
thinks that this also messed up her life inside the pub. But he never brought up the
past with her. They hope there will come a time when they'll be able to have their
own children. That's the most important thing for them.
"Zhu Hui Ying's relatives." Hearing a medical personnel call Zhu Hui Ying's relative,
he went to the direction of the sound. He is not used to such call, but he has signed
on letter of consent of operation, notarized and filled out on the blank space that
indicates husband in the relationship column.
"Are you a relative of Zhu Hui Ying?" after the nurse confirms she introduced two
doctors in green aseptic clothing (scrubs) to him, "this is Dr. Xu of Gynecology and
Obstetrics, and this is Department of Anesthesia's Dr. Guan, they have something to tell you."
"Mr. Deng," Dr. Xu takes off his gauze mask, they met each other before.
"During Zhu Hui Ying's operation, something went wrong during anaesthetizing,
I ask the Department of Anesthesia's Dr. Guan to explain this further.
"What happened?"
"I'm very sorry, ' Guan Xin takes off her gauze mask too, and directly tells him
the cause: "Because Zhu Hui Ying's special response to anesthesia, it has caused
a sudden heart paralysis, and became more complicated when water accumulated
in the lungs, at present we're still undergoing first aid." After hearing a bunch of
medical terms, Deng Nian Wei becomes speechless due to astonishment. He is not
sure what on earth really happened to Zhu Hui Ying. "How is she right now?
" Deng Nian Wei asked.
"We are doing our best to rescue her."
Rescue her? Zhu HuiYing told him that this is a very simple operation. Deng Nian
Wei felt that his heart is being squeezed by a pair of huge hands. For a moment,
he did not know how to react. "How could such a thing happen?" he muttered.
"It may be the reaction to the anaesthesia, at present we are not sure either."
"Do you inject narcotic drugs without knowing the dosage?"
"It is not a question of the dose of the anaesthesia"
"Then where did it go wrong?"
"Perhaps it is her body's unusual reaction," Guan Xin reacted. "As of now we still
don't have an idea how to solve this."
"But she came into this hospital with a healthy body." Hearing a lot of unclear,
uncertain things made Deng Nian Hui disappointed, there is something not right in this.
"We are very sorry." Dr. Xu pats his shoulder, "but I guarantee you that we will
do our best in doing first aid on Zhu Hui Ying, if there will be further news, we will
notify you at once." Both disappeared within the automatically controlled door at
once, just like when they unexpectedly appeared in front of him. Then he thought
if that conversation really happened. He walked up and down beside the door of the
Operating Room, his anger raging on.
How could this happen? They have dreams to fulfill? It has been difficult for them to
survive until today, it was as if there was a big pair of scissors who's cutting up their
life into nothing. He has no time to be angry. What will be the result of the first aid? Must I
notify Zhu Hui Ying's family? How will I explain the letter of consent of that operation?
How about the checks issued recently? Too many questions pour into him endlessly.
_____
*Hysteroscopy is not part of the routine workup for infertility. However, it is appropriately
indicated at the time of laparoscopy for the evaluation of unexplained infertility,
as it not only can identify a possible etiology for the infertility or recurrent miscarriage but
also can treat it at the same time (Corfman, 1988)
--http://www.cgmh.com.tw/intr/intr5/c6700/OBGYN/f/web/Hysteroscopy/
End of Part One
source: Bai Se Ju Ta ~ The Hospital by Hou Wen Yong,
http://www.angelibrary.com/index.htmlEdited by sienyan of f4pilipinas
Translated by and Credit to yanaliao of f4pilipinas
@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@
CHAPTER 2
Part TwoAnother nurse is in charge of the heart massage while Qiu Qing Cheng is adjusting
the heart beat regulator, "I have already turned up the voltage in full, there is still
no response from the heart," he told Dr. Xu as he approached the operating table,
"her cardiac muscle is totally ruined, like it's been exploded by a bomb, neither of
it remains functioning." Xu Kai Yuan knitted his brows slowly.
"The pupil has a weak response," Guan Xin inspected the patient's eyes, "Usually,
what we do is bring the patient to the Intensive Care Ward after first aid and that's
where we announce the patient's death."
"There's no other way?" Guan Xin and Qiu Qing Cheng looked at Xu Kai Yuan as
he paced back and forth. At last he reached a decision to notify the patient's relatives
and asks the Special Ward to take care of the patient.
Dr. Xu told Guan Xin to prepare the history of anaesthesia that was done before
the operation. He said that there might be something that was overlooked or
mishandled. Guan Xin nods and goes back to the OR to look for the intern who
took note of the medical history. She noticed she wasn't there so she asked around
where she went. She asked the remaining nurses to fix the scribbled notes that
contains all the medicine that has been used plus the dosage of each.
"Don't sign on the forms, I won't drag you into this, if I'll be imprisoned, don't forget
to bring some delicious food and share it with me."
"Thank you Dr. Guan" said the nurse.
She went and found the intern sobbing. Guan Xin told her to be strong. She said she
lost hope and doesn't want to study anesthesiology anymore. Guan Xin said that it's
always like that and it's not her fault.
***
Guan Xin, Qiu Qing Cheng and Dr. Xu are inside Huang Zhi Xiong's office, still wearing
their scrubs. President Huang Zhi Xiong holds the Presidential position in a Medical College
for three years and holds the Secretarial position in this office for almost 10 years now.
"How is it going in the Intensive Care Ward?" Xu Kai Yuan slowly asked
"They have tried the heart beat regulator, but there was no response, they're still
massaging the heart until now, waiting for us to announce her death."
The surgeons discussed on how to tell the relatives about the patient's death.
Right now, it's possible that the relative cannot accept this fact, because he kept
asking the staff, revealed the secretary.
"Do you have any suggestions?"
"I'm still uncertain" Secretary Huang said, he tried to recall some medical tragedies
that happened before, "After announcing her death, the other relatives will come
and ask more questions, then there will be bigger trouble."
"Then do you have any suggestions?"
"We must do our best to pacify the patient's relatives and then help them deal with it."
Secretary Huang added, "We can exempt the patient from all hospitalization costs."
"But the hospitalization cost is not that high," Dr. Xu expressed. "Let's wait and see,
maybe they will be able to accept this fact, but I think the probability is not that big,
we have to think of the worst. First is propose a compensation, next if the negotiation
for compensation cannot satisfy the relatives, they may file for a lawsuit."
"File a lawsuit?" Dr. Xu thought.
Dr. Xu asks Guan Xin if the anaesthesia could have caused a complication to the
patient's heart because he never saw that kind of drug used before in his other surgeries.
"Diprivan" Guan Xin says that this is a very safe medicine and has been tested many
times. There was no report she knows of that the medicine has anything to do with heart
failure.
Dr. Xu asks if it's possible that Zhu Hui Ying was allergic to this kind of anaesthesia.
Guan Xin says that she already thought that it might be possible but the complications
are not that terrible because 1-2 minutes before the patient went down, her ECG was
still normal.
"It may be an acute heart attack? ' Xu Kai Yuan looked at Qiu Qing Cheng. "According
to the ECG and age of the patient, the probability is not high." Dr. Qiu shook his head
and said: "I attended the first aid the whole time and I just connected her to the breathing
machine. I don't think acute heart attack was the cause of death."
"It seems the only way to find out what went wrong is to dissect the patient." Dr. Xu said.
He asked more about other possibilities like lung artery gas embolism. Qiu Qing Cheng
said that there is also this possibility.
Secretary Huang suggested negotiating with the family members. Compensation and
funeral expenses are usually what the doctors pay for. The compensation expense
includes how it merits the patient's family and if the doctor is at fault. It depends on
the situation, if the compensation is not that high, most of the doctors chip-in and the
hospital shoulders a part of it. Guan Xin stops them and says that she is not willing to
compensate because she has done nothing wrong. Secretary Huang convinces her
not to consider it as compensation but a moral compensation and justice for the patient
because she walked into the hospital without any sickness at all. Guan Xin disagrees
and says she doesn't think that compensating the death of a patient is justified if the
hospital ends up giving money for compensation.
Dr. Xu cuts into the conversation and says they're just exchanging opinions and are
open for suggestions. Since the patient's family needs to be informed, he decides to
let Secretary Huang inform the patient's relatives. He will only announce that the patient
is dead, but the details are to be discussed at 2pm. The meeting is adjourned and everybody
will be back at 1pm to confirm what to tell the relatives.
After everyone left the office, Secretary Huang asks Dr. Xu if the probability of gas embolism
is high, Dr. Xu is not sure. Secretary Huang thinks that this case is a high risk for a lawsuit.
It would affect Dr. Xu's name and what he's gained during his years as a surgeon.
He added that Guan Xin is very sure that she didn't fail in anaesthetizing the patient
and is very firm about it. Dr. Xu says that she came when the first aid was being done,
and he doesn't believe she made a mistake. She anaesthetizes patients 6-7 times a
day and she's not in the operating room all the time. Secretary Huang replied that
the court will not be bothered what situation she's undergoing, one can insist that she
really did something wrong and put her under pressure.
***
Qiu Qing Cheng and Guan Xin walks out of the elevator. Dr. Qiu reminds Guan Xin
not to announce the patient's death until Dr. Xu arrives. Guan Xin asks Dr. Qiu:
"Do you want to ask me something?"
"Just an intuition," Qiu Qing Cheng said.
"You know I need someone else's opinion right now. What is it?"
"Okay." Dr. Qiu walks slowly and seriously tells her: "I feel that from now on,
you must be on your own. Do not trust other people easily."
Guan Xin stops and stares at Qiu Qing Cheng, wishing he would elaborate.
"I only have this intuition," he laughs. "You know, some people have this
weird intuition."
"I think I know what you mean. Thank you." They both move forward and talk
a bit. Then Guan Xin said: "What you said earlier, does that includes you?"
"I'm just here to help," he says, "just like how you helped me a while ago while
Chen Xin Yu was undergoing surgery. People need to help each other, right?"
3:10. All of them are inside the ICU preparing to turn off the oxygen. Deng Nian Wei
was just standing in front of Drs. Xu, Guan Xin, Qiu Qing Cheng and the other nurses.
"Can I be left alone with her for a while?" Dr. Xu nods and leaves Zhu Hui Ying's bed.
A nurse pulls the curtain for privacy. As Guan Xin and Qiu Qing Cheng turns around,
they hear a huge cry that almost shook the ground. The cry was so woeful and long
then it slowly became a man's sob.
***
"Good morning!," the nurse smiles sweetly at Xin Yu. She checks and changes
her IV. "Let me see the rate of blood flow and test this Port A Cath," the nurse
fixes the position of the dextrose bottle. It's been a while but she can't see any
blood flowing through the tube. Xin Yu sees the nurse frowning. "What's the matter?"
The nurse puts back the dextrose bottle into place and adjusts it to the highest rate.
The flow changes its rate, but it didn't make a continuous flow. "What's the matter?"
Chen Xiao Yu asks again. "It looks like the Port A Cath is not working well. This was
just implanted yesterday, it shouldn't be like this." She uses a syringe to suck the liquid
from the bottle and tries to inject it directly to the path going to the central vein.
"Nurse, last time, the doctor who looked like Zhi Tian Yu Er (Japanese actor)?
Where is he? Why didn't he come by and visit me?"
"Oh, Dr. Su Yi Hua?," the nurse replies as she tries to fix the Port A Cath.
Chen Xiao Yi nodded.
"Why are you asking for him?"
"Can you help me get his autograph? I want my classmates to see it."
"If you told me earlier that you wanted his autograph, I should've told him to
embroider his signature on your skin," the nurse laughs. "I'm serious." Chen Xiao Yi
pouts. The nurse checks the rate of the liquid. "It's still slow." She tries putting down
the bottle on the floor for a while, but some blood came out. "So now what?" asks
Xin Yu. The nurse answers back, "I don't know, maybe it's a few blood drips left in
the Port A Cath."
"Ai yo! I said when will Su Yi Hua come here and visit me?"
"Miss, you just rest here the whole day, your Port A Cath won't have any problems.
Dr. Su has many patients and is very busy. How could he have time to come and
give you his autograph?"
"So you mean, if this thing doesn't work right, he would come and visit me?"
"Oh please. My dear, the president is coming this afternoon to visit you.
Everybody's been nervous and busy. Let me finish my job, okay?"
"It's not my fault. I told him not to come but he always does. I can't do anything."
The nurse asks her to lift up her arms and down again, to test the rate of the drip.
Then she asks her to move her body forward and take a deep breath. No matter
what position she puts her on, the drip is normal. She checks her medical form
and notes all is normal. "All positions are normal. 8/16, 8:30 am, Port A Cath testing,
status: NORMAL."
"Ai yo, everything's normal?" Chen Xin Yu pouts, "Is there any hope it's broken?"
***
Inside the conference room, the surgeons discuss Chen Xin Yu's operation.
The X-ray is presented and they start to discuss on when to start the 2nd stage
of chemotherapy. It will be appropriate to pursue it that afternoon if not for the
high fever that Chen Xin Yu is having right now so Xu Da Ming is asking everybody's
opinion on this.
Dr. Zhao asks, "So what is this 38°C fever that occurred?" The room fell silent and
Xu Da Ming didn't bother to say anything either. "Okay, so Internal Medicine Dept.
doesn't have anything to say about this, how about Professor Tang," Dr. Zhao turned
to his side, "isn't it the Surgery Department's problem?" Tang Guo Tai was speechless
and glares at Qiu Qing Cheng. Qiu Qing Cheng stands up at once, "Dr. Zhao, to all the
professors and my colleagues, I'm pleased to discuss with you how Chen Xin Yu's
operation went and how she will recover from this. Chen Xin Yu's surgery lasted 2 hours.
We have successfully implanted the Port A Cath into the veins. As of now everything is
normal and working well."
"We all know that part and you need not elaborate," Dr. Zhao raises his hand to
stop him from talking, "I want to know if the fever is due to infections while she's
under surgery?"
"If there is an infection due to the surgery then we can see that the leukocyte will
increase rapidly, but the blood work doesn't indicate this," he pointed at the monitor,
"Come to think of it, I helped Professor Tang finish this operation. I can guarantee,
Professor Tang's surgery is perfectly clean, has very high professionalism, it is impossible
to incur infections."
"What Chen Xin Yu has is LEUKEMIA, leukocyte is definitely very low, it's hard to
increase rapidly."
Xu Da Ming stands up from his seat, and grabs the microphone, "I want to ask you,
what DO YOU think of the 38 fever?"?" Maybe the professor doesn't have much
experience, but 2-3 days after surgery it is normal to have a fever."
"Fever after surgery is not a big problem, you don't need to brag about this,"
replied Dr. Zhao. Xu Da Ming is about to burst with anger.
"Now I want to ask you, you know that if there's an infection after surgery and we
follow through with the chemotherapy, the immune system will be continuously weak,
don't you know how complicated the result will be?"
"He already told you, it's not an infection!" Tang Guo Tai slapped the table and
butted in. His voice raised, "What's the use of calling him to attend this conference?"
"So I have to call you instead of him? The problem has been laid on the table with
a lot of questions but no answer. Everybody knows it wasn't you who operated on
Chen Xin Yu. You just asked your subordinate to do it."
Xu Da Ming strongly affirmed, "Whatever clean and perfect, high professionalism?
you need not put it on the screen and be proud about it." At the same time, both
of them stood up and glared at each other.
"Please, I beg both of you to sit down. Please sit down," Dr. Zhao made a stop
gesture, brushed his brows, "I'm retiring in a few days, I beg you please. If you
all want to fight I don't care. I called for both of you today, so we can help each
other. Whatever happens, I'll be responsible." Tang Guo Tai and Xu Da Ming fell
quiet, they both sat down. Silence filled the room.
"Regarding this afternoon's chemotherapy, does anybody want to share their opinion?"
Dr. Zhao asks.
Su Yi Hua wasn't listening to the argument a while ago. He was looking at Chen Xin Yu's
chest x-ray clipped at the board and noticed a V-chip. He felt that the V-chip's location
is not right. "Why is it like that?" he murmured to himself. The x-ray shows the implanted
Port A Cath's circle injected on the platform. The platform is connected to the perfusion
tube, it stretches through the subclavian vein, entering the vena cava. The main point
is that it will keep sticking to the right side of the heart. In Chen Xin Yu's x-ray, the
perfusion tube is inserted to the vena cava but it stops there. The perfusion tube's
distance to the heart is still far. The perfusion tube must be at the superior vena cava's
inner portion which is very near the right side of the heart, wherein continuous flow is
possible. Injected medicine's dilution will be much quicker, which in turn lessen complications.
The current position is exactly at the subclavian vein's blood passage to the vena cava.
Due to this it can slow down the rate of blood flow. Blood platelets will easily pile up
with other blood clutter in the blood vessel wall. If a very strong chemical agent enters
through this perfusion tube, it faces exactly the superior vena cava's blood vessel wall.
It can produce many factors that will affect this wall, then the solidification of the blood
rate. In the long run, blood vessel embolism is possible.
The history of this kind of implantation is not that long. The world needs more expertise
on this. This opinion is taken from this month's issue of a European Medical Magazine.
After Su Yi Hua read the article, he immediately gathered his medical records and found
out that 92% of these cases cause complications, same as the Magazine's article.
"Now we're in trouble." Su Yi Hua suddenly blurted out.
"Dr. Su do you have any opinion about this?" Dr. Zhao saw an anxious expression on Dr. Su.
"I think before we undergo chemotherapy, the Port A Cath must be arranged
and implanted again. If we use it now, it can lead to complications in the future.
" Su Yi Hua stood from his seat. "What?" Qiu Qing Cheng almost stood up.
"Dr. Su has many experiences in this kinds of cases," Dr. Zhao said, "can you
explain it further."
Dr. Su explained the whole situation and everybody kept silent for a moment.
"So you mean, if this continues it might lead to a complication?"
"I can't confirm a hundred percent, but the percentage is really high."
"How long until the complications begin?"
"According to my accumulated Port A Cath researches, a normal implantation's
risk of complication is within a week to a month."
"Dr. Tang, you did the surgery on this," Dr. Zhao asked, "What do you think?"
"If Su Yi Hua is bothered that he wasn't able to perform this surgery,then there's
no problem. If you feel that you have better skill, that's fine too. You can take
Chen Xin Yu to the operating room, take off the one I implanted, then implant a
new one. If you think that you'll be happy this way, I have no problem with that.
I can lend you my name as the Head of the Surgery and call for a Press
Conference, I'll even congratulate you for a job well done." Tang Guo Tai
controlling his temper as he said. "Don't forget to find a good committee if you
want to report to the President, I won't be giving you pointers during this conference."
The atmosphere became cold. Su Yi Hua with everybody else stares at Xu Da Ming.
"This is the Surgery Department's problem, we respect the head of this department
on his decision. I don't want to cause any more trouble like the last time." People
at the room laughs. Xu Da Ming continues: "If the Surgery Department doesn't
want to take off the tube, then there's a good explanation about it. I just want to
be assured that if there will be problems in the future they will be the one's responsible.
I don't have anything more to say."
After the conference, Su Yi Hua cannot control his anger and caught up with Professor Xu.
He asked: "Professor Xu, you called me to join this press conference. Yet you didn't
even insist in implanting those tubes again. You obviously know that if this continues,
Chen Xin Yu will be in trouble!"
"I know!" Xu Da Ming nodded.
"Why?" Su Yi Hua said anxiously, "Why didn't you insist on it?"
"Let me tell you a story," Xu Da Ming stopped walking and turned around to Su Yi Hua
and smiled, "There was once this person who repairs cooking pots in the Province of
China. A chef broke his pot and asked him to repair it. The repairman scratched off
the charcoal underneath the pot, and while the chef is not looking he dug a deeper
crack into the pot. After the pot was cleaned with charcoal, the chef saw that the damage
was bigger than he thought. He thankfully replied: "If not for you, this pot wouldn't be
of use anymore." After mending the hole of the pot, the chef was very happy. He gave
the repairman a bigger sum of money because he was very satisfied. Have you heard
of this story? This is what the elders called "Pot Mending Approach".
"Pot Mending Approach?"
"Have you thought that if the implantation did not have any complication at all and
the treatment went well, then we should congratulate Chen Xin Yu, the President and
everybody."
"What if there are complications?" Su Yi Hua asked.
Xu Da Ming did not answer and walked away smiling, leaving Su Yi Hua
dumbfounded.
***
The President enters Chen Xin Yu's room and sees her sleeping. "Do you want to
wake her up?" the Special Private Assistant asks. The President made a silent gesture.
He kept looking at his watch then walked outside the room. Aside from the security,
Mr. Wang, Head Security, General Ding, Head District Police from the President's office
are all outside. "Mr. Wang, what do I have for 3 o'clock?" The President asked.
"Mr. President, you have a Press Conference with the Justice Department's Director Ke
and Secretary Huang."
"4 o'clock?"
"You have to meet with the Medium-Small Scale Venture representative."
"I want to remain at the hospital this afternoon and look after Xin Yu, help me
rearrange my afternoon schedule." The President says, "I want to be alone with
Xin Yu, her chemo starts this evening."
"You can rest at the adjoining room, I'll look after Xin Yu," The President told the
nurse, "I will call you if you are needed."
The President sits alone on the couch and looks at Xin Yu. The sunlight enters the cold
room of the 15th floor, Chen Xin Yu turned side ward. The President takes her daughter's
hand and places it under the covers. He felt her hands became softer and weaker after
undergoing many medical treatments. He looks at his daughter's face. The chemo she's
undergoing, the heartbreaking torture as she undergoes these treatments, the President
was regretful. He was never a good father.
He recalled the night when her mother ran off in anger. Xin Yu had some complications
due to chicken pox and her fever reached 40?, her body convulsed. It was raining
that night. Amidst the guards standing watch, he rushed outside to bring Xin Yu to the
hospital. Every government hospital did not want to accept the patient when they heard
it's her daughter. Luckily one of the guards made a guarantee that made the hospital
accept Xin Yu.
On the stairs with the investigator, they had a cigarette. The investigator said that
his situation is very vital. He might end up in prison anytime (due to political reasons).
As he smoked a cigarette, he heard his baby daughter crying while she was being
injected. It made him realize that life is pointless if one cannot even save his child.
He broke down and cried under the rain. He was able to survive prison by living
through all of his daughter's memories.
The President remembers that he was under his 22nd day of fasting when Xin Yu's
aunt brought her to him. Time has passed by. His little doll has now turned into a
bashful preschool student. She was sitting at the lounge. She looked at his father
and asked: "Why would you do this?" He doesn't know how to answer back, so he
asked: "Do you love papa?" the little girl nodded. "Are you willing to believe papa?"
she nodded again. "Papa promises you, what Papa is doing is right, you will know
when you grow up."
From that day on, he always dreams about his daughter having a high fever, convulsing,
waking him up in the middle of the night. When he wakes up he starts to cry. This child
is the only thing that makes him weak. He realized that he must continue to live for his
daughter and prove himself to her. The nurse comes back breaking his train of thought.
The nurse checks and listens to her heartbeat, waking her up. The nurse says that
everything is fine and after 2 more bottles of Saline injection, she will be starting her
chemotherapy. The President nods and smiles at the nurse who left at once.
"Are you up?" the President asks Xin Yu.
"Yes." Xin Yu nods and stares at the empty room. No reporters, no presidential
staff, it's like a dream come true. "How long did I sleep?"
"From the time I walked in."
"You were here all the while?" The President just laughs.
"What time will the chemo start?"
"Tonight." The President replies. "It's late, you have to leave," Xin Yu says
after awhile.
Xin Yu sees her father's expression. She hugs him and with a brave smile
says: "Xin Yu's old enough, she can take care of herself!"
"Papa knows." The President holds Xin Yu's hands, he contains himself not
to worry, "Papa knows."
End of Part Two
Source: Bai Se Ju Ta ~ The Hospital by Hou Wen Yong,
http://www.angelibrary.com/index.htmlEdited by sienyan@f4pilipinas
Translated by and Credit to yanaliao@f4pilipinas
-------------------------------------------------------------------------------------------
CHAPTER 2
Part 3Dr. Xu Da Ming was talking to Dr. He who did an essay. He said that his essay is
very meaningful but he needs improvement on his English. Dr. Xu took note of
the terms that didn't go well with his essay and told him to review it. He congratulates
him and says that receiving this essay, he has a big possibility of being promoted.
He told him to keep up his good work (Jia You!) because there are 6 candidates for
the 2-slot position available.
"Oh by the way, are you married Dr. He?"
"No." Dr. He replied in remorse.
"Then, can you do me a favor, if it's okay with you?"
"What is it Professor?"
"I have a friend, she's now at Huang Wei Ming's. It's at Chang An West Road.
She had just undergone Dilation & Curretage surgery. Would it be okay if you
send her home?"
"Must I take the ambulance?"
"No need, she's not that serious. Just tell her you're my friend. Use your car and
drive her home. Will that be okay with you?"
"It's fine."
"Are you sure?"
"Positive."
"I'm doing this favor for a friend. Just drive her straight home. Can you do that?"
"I understand." Dr. He nodded like he's been given a priceless gift and is very thankful
for it.
Dr. Xu enters his office and sees Wang Shi Jian (President's secretary) looking for him.
"I think there won't be a problem. You can go and see her this afternoon." Xu Da Ming
said. Wang Shi Jian bows and says, "I owe you this one."
"Don't mention it. It's my pleasure." Xu Da Ming laughs, "Do you want to call that
Miss Shi and maybe comfort her?"
"We still have future commitments," Wang Jian Shi said, "I believe that she is smart enough."
Xu Da Ming walks to his table and takes a report and a tape recorder from his drawer.
"Since you're already here. I have to tell you something about Chen Xin Yu. I need to
negotiate something with you. This is the video of Xin Yu's surgery this morning. The
reporters took the coverage." He turns to the VCR player as he explains this to Wang Shi Jian
and puts in the video. The shrieks of the Head Nurse, Xu Da Ming and Tang Guo
Tai's fight is on the screen. Wang Shi Jian remains silent as he watches the video.
Afterwards, he asks, "Why did this happen?"
"Even though this is a hospital, there is a lot of politics going on inside."
"Political problems?"
"Dr. Su the surgeon, you met him yesterday right? The President even met him."
"Yes."
"He is the best in implantation of Port A Cath in Taiwan there's no doubt about it. But,
Tang Guo Tai is not happy with those I recommend under his department and those who
are better than him. He's anxious to get this operation done by himself. The problem is
that the surgery he performed has a high risk of complication. When Dr. Su Yi Hua saw
the x-ray of Chen Xin Yu he was positive that there will be a complication."
"So you mean it was not Dr. Su who performed the surgery?"
"No. Yesterday Tang Guo Tai called for a Press Release." Xu Da Ming said, "You know that
if the implantation do not go well, it can cause the patient's life."
"Death?"
"The body's bacteria and SVC obstruction will all lead to bleeding, therefore causing a
person's death. All of these are possible."
"Then why didn't you tell them that?"
"That's why I said it's a political problem. Tang Guo Tai is the head of the Surgery Department.
The Operating Room is his responsibility. And the complications have not yet occurred.
I don't understand if they really don't know how severe the situation is, or they just want
to gamble with my intuition as well."
"How you guys gamble is not my problem. But the main problem here is Chen Xin Yu's the
President's daughter."
"That's why I said this is a political issue. I think you understand this."
"A political issue?" Wang Shi Jian is silent for a while, then he raises his head and says,
"Director Zhao is near the end of his term. Your hospital needs to choose a new director.
Has anyone been chosen?"
Xu Da Ming nods. "I understand." Wang Shi Jian replies.
***
They called for the resident doctor to check up on Chen Xin Yu. "I'm sorry," the doctor says
to her. "I have to open the lights and observethe drip."
Chen Xin Yu holds out her hand and looks at the doctor, a nurse and her special nurse groggily.
"Are you alright?" the doctor asks her. She nods, but she looks very pale and weak.
"Since 8 o'clock, the dextrose has not been flowing normally," the nurse says, "we were
worried we wouldn't be able to give her medicine for today. So I asked you to come and
see her." Besides the dextrose, there were bottles and bottles of medicine for injection.
They were all injected to a 3 in 1 head clipped on the tube.
"It looks like the rate of flow is slow." The doctor adjusts the clip and puts it on the floor to
check on the blood flow. After awhile, there was still no blood circulating in the Port A Cath.
"No blood circulation?" He thought for a moment, "Let me see the medical history
sheet, what time did you discover that the blood is not circulating?" The nurse on duty replied:
"Ru Juan examined it around 8 in the morning, it is listed: [there is blood circulation, the flow
is a little slow, Status: Normal]."
"Maybe there's too much medicine that passed through the Port A Cath and it clogged the
passage." The doctor returns the dextrose back to its original position. "Push that medicine
rack towards me. Let's try to force the medicine in. Maybe the pressure can push away the
clog." The nurse pushes the medicine rack towards the doctor. He tries to put
pressure as he injects the medicine. He does this several times. "The flow is speeding up,"
he announced, "but I don't think there is blood circulation. Help me write it down on the Medical
History Sheet."
"Do you want me to inform Dr. Xu about this?" The nurse asks.
"Non-continuous flow of drip is no big deal. I don't think you need to tell him." The doctor
glances at his watch, "I think this flow rate can only last until tomorrow's chemo." He says
as he closes the lights and the nurse pushes the medicine rack away.
Chen Xin Yu weakly turns her body. She doesn't feel well. "Spittoon please?¡¨ she weakly
says. The nurse quickly passes it to her and watches as she vomits. The special nurse helps
her in panic. She lightly pats her back. In a while the spittoon is filled. They
immediately change it for another one. Chen Xin Yu's tears are mixed with her vomit. Her eyes
and nose are all red. It's like she vomited everything she had.
"Please take the basin away." Xin Yu says, "I'll keep vomiting if I smell it." The nurse is still uneasy,
she says, "Do you want me to call your father, or Uncle Wang? He said that if there's something
wrong I should call them."
"No," Xin Yu says, "It's usually like this. I've experienced it before."
"Don't you really want me to call your father to be with you?" Xin Yu puts a finger on her lips
and say "Help me adjust my bed. I can't sleep. I want to watch TV." The Special Nurse did so
and opened the TV. "Do you want me to open the lights?"
"No," Xin Yu said, "I feel like vomiting when it's too bright."
She felt better after vomiting. The Evening News is on the TV. It looks like the President is
very busy. He went back to the presidential office, welcomed a visitor, then went to an evening
dinner. Chen Xin Yu smiles.
***
Qiu Qing Cheng quickly dashes to the cafeteria and buys a burger and coffee. He goes back
to his office and sees Ma Yu Fen inside waitingfor him. "Assistant Director Qiu," her face beams
with a smile,"You've been working too hard. It's a pity nobody gives a d**n. Theyjust let you
eat some crap." Qiu Qing Cheng smiles. "Have you seenBoss Tang's news?"
Ma Yu Fen walks to the door, locks it gently and walks back to Qiu Qing Cheng's desk and sits
on it, "Was your boss happy?"
"He was and that's what matters. I'm okay with it." Qiu Qing Cheng grabs his food, "Didn't we
agree that if there's nothing new, you won't be coming here?"
"Ta ta ta ta?¡¨ Ma Yu Fen sings as she pulls out a video tape from her bag and waves, "Do you
want to take a look at this?"
"What's that?" Qiu Qing Cheng says as he takes a bite. Ma Yu Fen walks to the VCR and plays
the video tape. It's the same tape that Dr. Xu has. The nurse waves her bloody handkerchief
and then the scene of Dr. Xu and Dr. Tang fighting. Qiu Qing Cheng watches in disbelief. "Oh
my god!," he exclaims as he takes another bite. The fight scene lasted
for 3-4 minutes. Qiu Qing Cheng said, "So that happened while I was inside the operating room?
" Ma Yu Fen nods as she moves toward the VCR and retrieves the tape.
"So the news you were talking about a while ago is this news?"
"Don't worry. Don't give me that look of shock. I won't be endangering your boss's career in
this hospital." Ma Yu Fen moves toward Qiu Qing Cheng and waves the tape right at his face.
"So tell me, doesn't this baby cost me a very nice dinner, or a romantic midnight snack?"
"Thanks!" Qiu Qing Cheng laughs as he grabs the video tape.
"Not too fast," Ma Yu Fen grabs the video back, "The head of the news department's Chang Yi Fen
wants to do Tang Guo Tai a favor, don't forget to say thank you." He saw that Ma Yu Fen is holding
a VHS tape. He thought that a cameraman uses a betacam to record the news, it must have been
lots of work to transfer all of these to a VHS.
"So I presume that Xu Da Ming also got a copy of this video tape." Ma Yu Fen smiles.
"I'm off work at 7pm tonight. Pick me up okay. I have an important thing to announce."
"What is it?" Ma Yu Fen didn't say anything. She gently sits on Qiu Qing Cheng's thigh and blows
air beside his ear. "Hey, this is my office." Qiu Qing Cheng tries to stop her but his face did not
escape Ma Yu Fen's quick move on him. "Hey."
"It's you who made me like this." Ma Yu Fen still continued. She hugs him tightly and opens the
buttons of his shirt, her hands brushes through his chest.
"Hey, we can't do this here."
"I don't care, tonight?7:30 p.m." Ma Yu Fen insisted, "You must call home and say you'll on
leave tonight, or else I won't leave."
"I give up on you." Qiu Qing Cheng sighs, he turns to his phone and dials. With Ma Yu Fen still
on his lap, he tries to dial his house number, "Mei Xi, it's me. I have an urgent matter tonight.
" Ma Yu Fen can't hear what he's saying on the phone. "Meeting. Yes, maybe it will
be a little late." Qiu Qing Cheng says, "I don't know what time." At the same time she whispers,
"Tell her you won't go back forever."
End of Part Three
Source: Bai Se Ju Ta ~ The Hospital by Hou Wen Yong,
http://www.angelibrary.com/index.htmlEdited by sienyan of f4pilipinas
Translated by and Credit to yanaliao of f4pilipinas
Thanks to mahalkosiken of onlyf4
-----------------------------------------------------------------------------------------------
CHAPTER 2
Part FourThat night, Qiu Qing Cheng and Ma Yu Fen ate at a French Restaurant. They ordered a bottle
of Chateu Haunt Brion 86. Ma Yu Fen insisted on eating at this restaurant for its ambiance.
Her superior, Chang Yi Ru is promoting her to news anchorwoman. She wants her to think
about it. To be a news anchorwoman is every reporter's dream. That's why it's worth it to
have someone you care about celebrating with you. Given their reasons, they try not to be
together in one place. In this romantic restaurant, Qiu Qing Cheng keeps on shifting his eyes,
afraid of meeting someone he knows. "If you see someone you know, tell them I'm doing an
interview. What are you afraid of?" Ma Yu Fen said.
"What's good in interviewing me."
"About the rivalry within your hospital; Department of Internal Medicine and Department of
Surgery, the big battle of the century: What do you think? Exciting isn't it? You're the General
of theDepartment of Surgery, why wouldn't somebody want to interview you?"
"I think you're the News Department's number one super general."
"We're even." The man playing the violin approaches their table, playing to the tune of the movie
Godfather. Qiu Qing Cheng rememberedone scene in the movie, when Al Pacino was forced to
kill New York's head gangster and escape to the Island of Sisley, for the benefit of his gang,
Those were the best days he had away from killing and chopping off people. When he married
he also had the time of his life. The time of his life, Qiu Qing Cheng thought.
"I'm really glad someone important to me is celebrating with me tonight." Qiu Qing Cheng raises
his glass to Ma Yu Fen, "Congratulations! I wish luck to the world's most beautiful
anchorwoman."
"You have to promise me, when you are to be promoted as head of the Department of Surgery,
we have to do the same." Ma Yu Fen said. Qiu Qing Cheng nodded, glasses clinked. "I will be
waiting for that day tocome." Ma Yu Fen said.
As they drank the wine, there was laughter. After dinner, they both walked to the car park.
Ma Yu Fen's face is red, but she still feels very high. "I don't know why, but I feel like dancing.
" She walks toward the front and raises her foot and starts spinning. When Qiu Qing Cheng
approaches, she stops and says, "I wish we can always do this." They both walk, Qiu Qing Cheng's
hand inside his pocket, unable to reply. "What are you thinking?" Ma Yu Fen asks
"Nothing," Qiu Qing Cheng said, "I just think, if you accept your job as a news anchor, you'll
create commotion when you walk down the streets. Things won't be the same."
"Then I won't accept that job. I'd rather stay with you." Ma Yu Fen holds his hand. They walk to
his car, and get inside. He hasn't had time to pull out his keys yet when Ma Yu Fen slips to his
chest. "Tell me, you don't want me to accept the job as an anchor." As he starts the engine,
he can hear Ma Yu Fen's breath on him and feel her body heat too.
"Just tell me. I'm willing to give it all up." Qiu Qing Cheng can still hear the song of [Godfather]
in his head. There are many things that occur instantly. He doesn't know what to say, the two
were silent. After Qiu Qing Cheng started the engine, Ma Yu Fen slowly
drifts away from him and sits straight. Qiu Qing Cheng sees her crying. "Hey, didn't we just agree
on a happy celebration tonight?"Qiu Qing Cheng asked.
"I'm sorry." Ma Yu Fen takes a tissue and wipes her tears and says,"Can we go to
Yang Ming Shan?"
"Yang Ming Shan?"
"I don't know why, but I want to go there tonight." She smiled.
It starts to rain and the di-da sound of raindrops can be heard on theroof, it can be heard
clearly in the motel room. Ma Yu Fen turns around and climbs to Qiu Qing Cheng's chest.
Qiu Qing Cheng remembered another night as quiet as this during their trip to Tokyo,
there was a conference there and at the same time Ma Yu Fen was also there. They both
had a good time going to the spa. They dined together and got a little tipsy. As he sends
her back to her hotel, Ma Yu Fen said: "Make love to me." Qiu Qing Cheng remembers that
night, that's what she said.
"When you get home will your wife ask you to do it?" Ma Yu Fen asks.
"Why do you ask?"
"Don't laugh at me like I'm crazy," Ma Yu Fen laughs, "When I think of your wife hugging
you, I can't stand it." Qiu Qing Cheng sits straight, takes out a cigarette and lights it. She
also sits up and takes the cigarette from him. She whispers to him, "Can you not go
home tonight?" Qiu Qing Cheng lightly kisses her on the cheek and smiles as he pats her head.
"Where are you going?" Ma Yu Fen asked.
"Taking a shower." She quickly grabs his hand and says, "Don't go, I want it tonight."
She smiles, "and please could you not put protection tonight? I want to feel the real thing.
" He smiles as he turns to her with an astonished look. "Don't worry, tonight's safe," Ma Yu Fen
raises her leg and grabs his waist.
Qiu Qing Cheng's mobile rings while he is still in the shower. He grabs the phone and answers
it. It is Secretary Huang. He insists that the director wants to speak to him tonight and he
must go to the hospital immediately. The unfortunate loss of a patient that afternoon is the
topic of discussion. Director Xu will be waiting for him no matter what. Qiu Qing Cheng turns
off his mobile and tells Ma Yu Fen that he needs to leave. "If you want to leave, don't make
some excuse for me." Ma Yu Fen retorted.
"Why would I make up excuses? It's really urgent," Qiu Qing Cheng puts on his coat, "didn't
we agree that we'll celebrate once I get promoted? I need to go for it now!" Seeing that Ma Yu Fen
has not changed her mood, he approached her and hugged her, "Come on smile."
"I hate you." Ma Yu Fen smiled. "Don't hug your wife when you get home, understand?"
***
Qiu Qing Cheng rushes to his office. He sees the lights are open. Besides Director Xu and
Secretary Huan, Public Relations Director Cai Qing Piao is also present. They got introduced
by Xu Kai Yuan, Director Cai is helping the case of Zhu Hui Ying. Her body now lies in the
morgue and a 500,000NT medical discount is also given to her. Director Cai also donated
100,000NT to her family. Zhu Hui Ying's father has passed away and only her mother received
the donation. Deng Nian Wei on the other hand was being accused by Zhu Hui Ying's sister
because if not for him her sister would not undergo such operation.
Later that afternoon, a friend of Zhu Hui Ying called in and said he wanted a compensation of
8 million NT dollars. Director Xu expressed that if they give in to the compensation, then it
means they admit that it was their fault that the operation went wrong. They decided to keep
on observing the reactions of the family members and keep
cooperating with them. Then Qiu Qing Cheng asked: "Is the anesthesiologist coming to this
meeting?"
"I think that with your situation, you and Dr. Guan can talk easily. Maybe you can convince her
with this matter." S
...the thing about his hair...eemmmm..I read from the press report (but cannot remember in what press report) it been said that actually Jerry wanted to cut his hair short for the role...and then again the fans have protested again his decision...the fans luv his hair even want to sign a petition so that Jerry didn't cut his hair...so not to make a big fuss about the fans protest and the petition... Director Cai has compromise that the cutting need to be done but not that tooo short... 
