In fact, there is an internal organ hidden in each of our bodies that can produce "concentrated sulfuric acid", and that is the "pancreas".

It is hidden between the spleen and the duodenum. If it is accidentally damaged by the outside world, it will leak deadly "concentrated sulfuric acid" and corrode the surrounding internal organs. The mortality rate after the disease is as high as 52%.

As long as later generations of medicine are highly developed, in the 1980s, this number would have become 90% or even more.

If it were Africa in the 1980s, there would be almost no hope of survival.

"Pancreatic fistula" simply means leakage of the pancreas.

Pancreatic juice, which has a strong digestive capacity, flows into the abdominal cavity through loopholes, constantly corroding various tissues and blood vessels in the abdominal cavity like sulfuric acid.

The fragile blood vessels and intestines simply could not withstand its "attack" and were corroded into large holes one after another, eventually leading to large-scale bleeding in the stomach.

What’s even more frightening is that this attack can occur at any time. As long as the patient is alive and the pancreas continues to produce pancreatic juice, the damage will not stop.

This old black man is in the late stage of this stage. As the saying goes, even his stomach is rotten, and his survival is a miracle.

In his previous life, Chen Qi specialized in liver, gallbladder and pancreas, and he still has some experience in treating "pancreatic fistula".

But this kind of surgery that reaches level 4 cannot be solved by this temporary hospital in the refugee camp, or even by going to the Freetown National Hospital.

The refugee camp can only do some simple treatment, such as debridement, suturing, disinfection, and some antipyretics and antidiarrheal drugs.

Treatment of pancreatic fistula requires first plugging the leak in the pancreas, then anti-infection and nutritional support, and subsequent treatment requires almost always staying in the ICU.

Next, the holes in the duodenum, jejunum, and colon near the pancreas that have been corroded by pancreatic juice must be repaired. If they cannot be repaired, part of the intestines must be removed.

Finally, we have to plug the holes in the belly. It is impossible to expose the internal organs and intestines to the air for a long time. This is another big project.

The entire operation did not take more than half a year, and several stages of operations were impossible to complete.

Not only is it time-consuming, laborious and expensive, but the process is also quite thrilling. If there is even the slightest sign of trouble, the patient will die and all the efforts will be in vain.

Luo Wei saw Chen Qi in a daze and touched him quietly:

"Dean Chen, what should we do with this patient? Do we want to treat it? How to treat it?"

Gao Haishi has a different opinion:

"It can't be saved, even if it can be operated on, the price paid is too high, and it is simply not something these black people can bear."

Wang Jiliang was a little more bookish and said disapprovingly:

"As doctors, it is unjustifiable to choose not to save patients and let them die. It is our bounden duty to treat diseases and save people. Otherwise, what would we doctors do?"

Gao Haishi became anxious upon hearing this:

"Whether to save someone or not depends on the situation. Not saving someone when you have the ability to save him or her would be a lack of medical ethics. But now this patient is obviously in a critical condition. It's hard to say whether he can be saved. And how can we operate under such conditions?

What?"

For a moment, there was a lot of discussion in the tent, and the young doctors behind him were obviously divided into two groups.

One group thinks that they can try to rescue the patient, or at worst, bring him back to the Friendship Hospital in Freetown. Anyway, Director Chen can do anything.

The other group believes that resuscitation should be done in moderation, not to mention that the patient cannot afford the money at all, so who will pay the medical expenses then?

There is also a more cruel opinion, which believes that limited medical resources should be given to those in greater need. Such an old African man has lost his rescue value.

Chen Qi sat there and unknowingly thought of a big discussion that sparked a nationwide discussion a few years ago.

It happened in the summer of 1982 in Xi'an.

At the Fourth Military Medical University, Zhang Hua, a 24-year-old college student, was shopping when he met Wei Zhide, a 69-year-old manure digger who was fainted by the toxic gas in the manure pit while working and fell into a manure pit more than three meters deep.<

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In order to save Wei Zhide, classmate Zhang Hua jumped out of the cesspool without hesitation.

But in the end, he inhaled too much poisonous gas in the cesspit and died in the end without being rescued.

Zhang Hua's deeds quickly spread throughout the country and aroused widespread social attention.

Some people think that it was not worth Zhang Hua's death to save an old farmer who dug manure. After all, it is not easy for the country to train a college student, and it was in an era when college students were very scarce.

"Wenhui Po" received a letter from a college student, which said:

You should use your limited life to create value for the country that is greater than your own value, rather than exchange for the life of a 69-year-old farmer. It is always uneconomical to exchange gold for the same amount of stones.

Then began a big discussion that shocked the whole country. Newspapers, magazines, and even TV stations were discussing whether it was worth Zhang Hua's sacrifice to rob an old farmer?

Two different viewpoints began a fierce collision.

If you look at it from a life perspective.

The lives of ?Nian? and ?Nian? are both lives, and there is no distinction between ?Nian?

In terms of contribution to society.

Young people have more time to contribute to society, and may be more important, and young people have less demands from society.

However, it is a social animal and must integrate into society in order to exert its own value and contribute to society.

??Nian? To a certain extent, he is out of touch with society. He will not contribute to society, but will only ask for it from society.

Of course, this kind of debate is often about the public saying that the public is right, and the mother-in-law saying that the mother-in-law is right. It doesn’t matter what is right or wrong, it just depends on one’s own three views.

Similarly, doctors are often faced with the dilemma of "to save or not to save".

For example, a middle-aged man with a severe cough and severe weight loss went to the hospital for a checkup and found out that he had advanced lung cancer with multiple metastases throughout his body.

The patient was in great pain. Not only did he have a severe cough, he also had severe chest pain, and he was even scared to death.

However, the patient has a strong desire to live and hopes that the doctor will save him, ask for surgery, and ask for every possible way to save him.

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The problem is that the patient's family situation is not good, he does not have much money at home, and he does not have medical insurance.

Should you save such a patient or not?

If you don’t save him, let him go back and eat whatever he wants and think about it.

Doing this seems extremely inhumane and lacks medical ethics, and can even lead to "seeking death without saving".

At the same time, the dean will be unhappy. Why don't you accept such a "high-quality" patient? Why don't you make money? Do you not want this month's bonus, or do you want to get it if you are the best at the end of the year?

But if you are saved, let’s not talk about whether surgery can be done. Once chemotherapy, radiotherapy, and expensive drugs are used, the cost of treatment starts in the hundreds of thousands.

In the end, one person was left with nothing but money, his family was destitute, and he was in debt, making his family's life completely difficult.

If you are a doctor, do you want to save such a patient or not?

Give another example:

A pregnant woman gave birth, but the fetus failed to come out. At this time, an emergency cesarean section was needed.

However, family members have concerns, either because they think cesarean section is too expensive, or because they don't trust the doctor, so they don't sign.

On one side, a pregnant woman is shouting in the delivery room that the fetus's delay in delivery has caused intrauterine distress and may kill two people at any time.

If the family members refused to sign, the doctor could not proceed with the next step of treatment, and the legal procedures did not allow the doctor to directly perform a cesarean section.

You are an obstetrician at this time, can you save me?

You don’t save? You are a doctor who knows that if you don’t save the mother and the fetus, both the mother and the fetus will die. If you don’t save, where is your medical ethics? Where is your humanity? Where is your conscience?

But you saved someone, but the family didn't sign, and the end result was death because it took too long. Then you violated the diagnosis and treatment regulations and the wishes of the family. This is a proper medical malpractice.

Your family can file a lawsuit with you, and your doctor will have to pay compensation. (Real case)

If you meet a dean who doesn't eat, you may not be able to keep your medical license, and your life will be over.

In this situation, if you were a doctor, would you save me or not?

Give another example:

You are a 120 emergency doctor. After receiving the rescue call, you get in the ambulance and rush to the patient's home.

Then you are busy treating patients, and when it is very urgent,

Suddenly a neighbor barged in from the side and said that there was an asthmatic patient in his home who needed emergency treatment. He asked to borrow the oxygen tank and electrode defibrillator on the 120 car for use.

You are a doctor, do you want to borrow money?

You said you should lend out the first aid tools and machines. You are rescuing the patient yourself, so don’t you care about the patient in your hand? Who is responsible if the patient dies?

But if you say you don’t want to borrow it, well, that poor neighbor died in the end, and you, the 120 emergency doctor, just ignored death and acted improperly, and was eventually suspended and fined. (Real case)

Faced with such a dilemma, you are a 120 doctor. Do you choose to borrow or not to borrow? To save or not to save?

The same is true for the old black man in front of me.

You say you don't want to save it. You are a doctor. When you see that the patient's condition is so critical that he is about to die. There is obviously a possibility of surgical treatment, but you don't treat him? Where is your medical ethics?

If Chen Qi says to give up now, it can't be cured. Believe it or not, he will be despised by many junior doctors, which will destroy their confidence and consciousness in practicing medicine.

But if you want to treat it, the surgical conditions are not enough, the medicine is not enough, and the cooperative team is not enough.

Should we give all the limited medicines and medical resources to this old black man? For example, there are only a few antibiotics. If this old man uses them all, can others use them?

Another crucial point is, who will pay the money?

To save or not to save, this is also a dilemma.
To be continued...