Chapter 907: Taboo

Ling Ran slowly stood up and spoke calmly in front of a group of department directors and associate chief physicians, “The patient is 37 years old… He feels bloated, experiences gastroesophageal reflux, vomiting, but did not pay attention to it… He has received subtotal gastrectomy and lymphadenectomy…”

A multidisciplinary team discussion would have had the related departments sit together as they held a discussion centered around the patient. Each department would take turns in discussing the issue. This discussion mode was started by Mayo Clinic, and the discussion itself consumed a lot of manpower. Mayo Hospital had even purposely built a new multidisciplinary building in order to save as many human resources as possible…

China did not have luxurious facilities like Mayo Clinic, and hence, when they used the multidisciplinary team discussion mode, they could not help but be uncertain during the discussion.

For the regionally best hospitals like Yun Hua Hospital, while they wanted to embrace these futuristic medical treatments, at the same time, they felt that it was a waste of time to make everyone sit together. Therefore, during the discussion, they trembled like a dog whose only purpose was to butter up to its owner, and when they were given a chance to butter up to someone, they would tremble so much that they could not even stand straight.

There were almost no consultation fees given to doctors in the country either. Hence, the application for MDT was always in the negative, since the fee senior doctors from eight departments sitting together for an hour long discussion would usually not even amount to 200 RMB, and that cost did not include the hidden cost of inviting the senior doctors from various departments over for an MDT discussion.

In a hospital like Yun Hua Hospital, usually, MDT discussion would be promoted by the doctors themselves, and it was not a compulsory procedure.

The MDT organized by the Emergency Medical Center this time was not looked forward to by other departments. Everyone was just trying to follow the flow and try to muddle along. When they saw Ling Ran speak, they were too lazy to even open the documents in front of them.

There were only so many things about hepatic metastasis from gastric cancer. The department directors and associate chief physicians in the room were familiar with this disease. It would be very easy for them to say something formal.

After a few minutes, the associate chief physician from the Medical Imaging Department who was the second to speak was even more tired. He said with a moderate tone, “The patient’s CT scans show that the walls of the lesser curvature of the stomach below the cardia has become thicker… The CT scan shows low-density shadows inside the liver. The level of alpha fetoprotein which was used as the combined tumor marker was not high, and the carcinoembryonic antigen can be considered as metastatic nodules, and we can diagnose this as hepatic metastasis from gastric cancer…”

The associate chief physician from the Medical Imaging Department could practically be said to have only said conventional words, and he sat down right after he finished talking. For him, such meetings were really a waste of time. If it were not because of Old Huo, he could not even be bothered to come and report this in the academic conference hall.

The associate chief physician from the Oncology Department coughed and prepared to stand up.

At this moment, Ling Ran said, “Low-density shadows at the liver’s CT scan? Is it okay to stop here?”

The associate chief physician from the Oncology Department was shocked. ‘We’re already starting to criticize each other? Why is Ling Ran the one starting it?’

Even Huo Congjun was shocked. ‘Why is the Medical Imaging Department being criticized first? They are part of our friendly forces…’

Huo Congjun tried to smooth things over and said, “Our Doctor Ling might be a bit too strict sometimes… Ling Ran, our colleagues from the Medical Imaging Department are truly rather busy…”

“Didn’t you see high-density shadows? There are high-density shadows at the borders of the tumor. There is even obvious fluid-fluid level signs here…” Ling Ran shook his head. “The patient has received contrast-enhanced CT scan, and the high-density shadows over here showed that the metastases have eroded the blood vessel, these symptoms must be explained…”

The associate chief physician from the Medical Imaging Department lowered his head and kept searching for information.

He had actually prepared himself mentally before he attended today’s MDT meeting. If he were accidentally criticised by people like Huo Congjun, he would just surrender and take in all the comments.

Since the Medical Imaging Department was just an auxiliary department, normal doctors would not be looking to cause them trouble.

However, what he did not expect was that the first critic was from Ling Ran, and it was directed on technical issues.

‘Technical skills?!

‘I can’t pretend to be ignorant when it comes to technical skills!

‘The Medical Imaging Department also has its own baseline!’

The associate chief physician roared in his heart…

The status of the auxiliary department was already very low in the hospital. Departments like the Medical Imaging Department only obtained their average bonus because of their technical skill. Although it was not to the extent that they thought that their department would not survive without them, in truth, they did have that sort of thought in their heads.

Therefore, challenging the technical skill of the Medical Imaging Department was equivalent to offending them.

The associate chief physician from the Medical Imaging Department quickly flipped the information in the file and was prepared to randomly find some information to oppose Ling Ran first.

Sadly… There was only limited information, and he had not made sufficient preparations.

The associate chief physician from the Medical Imaging Department made his resolve, took out the raw scan, and analyzed it on the spot.

He was a man who was experienced in reading films for over thirty r years. Even though some of the important parts were so blurry that they looked as though they had been pixelated, he could still find the real image through the layers of images!

“The center of the lesion has some dots enhancement. From this, we can tell that it is related to the blood supply of the hepatic artery…” The associate chief physician did not want to keep everyone waiting. He just pretended he could tell something as he analyzed the scan. He said it slowly, as though it was very important.

Ling Ran looked disappointed and said, “Just that?”

“The dot enhancement at the center of the lesion is still quite rare. So, doctors—”

“It’s useless whether you can tell it or not.” Ling Ran interrupted him, completely unconcerned with what the associate chief physician said. He then said, “Now, you should focus on the calcification of the lesion. It’s over here…”

Ling Ran went straight to the side of the table and pointed at the scan in front of the associate chief physician and tapped it lightly twice.

The associate chief physician wore his glasses and put the scan further away from him. It was only at that moment that he saw the small dot Ling Ran mentioned.

“Can you see that now?” Ling Ran asked.

“Yes… multiple calcified fine dots. This is a characteristic of liver metastasis…” the associate chief physician from the Medical Imaging Department said with a softer voice.

It was not because he could not see it before, but because he did not analyze the scan carefully before he came here.

The Medical Imaging Department had to analyze scans for the entire hospital, and they had to analyze countless films every day. The associate chief physician might not be able to touch normal scans on usual days.

However, since he was now at an MDT, it would be unreasonable if he said he did not analyze the scan before he came here.

The associate chief physician was as tame as a kitten when he saw Ling Ran’s serious expression.

He was used to the critics by other experts. However, he was not used to Ling Ran’s criticism as he was still young. As long as he adjusted his mentality and treated Ling Ran as an expert, he would not feel that bad after being criticized.

Surgeons usually had bad tempers, and they always criticized other people. As an auxiliary department, they should already be used to all the scoldings. For those who did not, they could only hide their aggrievance while they pocketed the insults thrown their way.

Now that he was an associate chief physician, he was used to being someone with a low status. At this moment, the associate chief physician smiled shyly and was as carefree as a middle-aged thief recognized by the public in a bus. Everyone thought that he should feel embarrassed, but he was the one who did not think so.

“Let’s continue.” When Huo Congjun saw that the associate chief physician had started to ignore everything around him, he reminded Ling Ran not to waste any time on him.

At the same time, Huo Congjun could not help but use a new perspective to judge Ling Ran.

It was nothing to criticize and scold an associate chief physician from an auxiliary department. Huo Congjun had criticized them countless times. But what was more impressive was that he had actually criticized the department from the angle of technical skills.

In Huo Congjun’s memories, when departments like the Medical Imaging Department talked about their skills, they would usually be very slick about it and not allow anyone to criticize them, remaining as stubborn as hob meat. But now, when he saw them being criticized by Ling Ran in terms of skills, he felt so good.

“Next, Digestive Surgery Department?” Huo Congjun looked to the right. There was a doctor sitting with his back facing the door over there. He was another weakling who did not even know how to choose his seat.

The Digestive Surgery Department also sent out an associate chief physician, and he was as nervous as someone who was partaking in theft for the first time ever in his life.

Everyone could understand what was going on if they were scolded by Old Huo. But if their technical skills were tested, it would be very awkward… or rather, they should feel awkward about it.

The associate chief physician of the Digestive Surgery Department stared at Ling Ran, and he suddenly remembered the gastrectomies Ling Ran performed. He felt his stomach clenching down on itself tightly, and could not help but complain in his heart.’Since Ling Ran’s gastrectomy skill is better than mine, what is the point of me coming for today’s meeting? Why didn’t I make full preparation before coming here?’

“Associate Chief Physician Ding?” Ling Ran did not want to waste time, so he urged him to speak.

“Why not… we have Department Director He from the Department of Hepatobiliary and Pancreatic Surgery speak first…?” Associate Chief Physician Ding from the Digestive Surgery Department was like an elementary school kid who had not memorized his text and had someone else take the bullet for him.

He Yuanzheng was already very anxious. He immediately jumped when he heard this, as though the fat on his butt had just taken a cattle prod, and he said, “Why should I speak first? This is a patient from the General Surgery Department, right? Let the General Surgery Department speak first.”

Before the meeting, Wei Qing had been unyielding, but when he looked at Ling Ran now, he remembered the way Ling Ran performed his surgeries, and he could not help but say, “This is not a patient from the General Surgery Department…”

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