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[Episode 20]

In summary

Lin Sen has begun to have complications caused by the mediastinal tumor.

He has shown signs of difficulty breathing

choking while eating, and Horner's syndrome.

We cannot rule out the possibility of the tumor being malignancy.

It needs to be promptly diagnosed

in order to avoid the possibility of spreading to other organs.

The surgery must be done right away. The sooner, the better.

We agree with immediate surgery, but...

Dr. Lu is not suitable to be lead surgeon at this time.

Why don't you ask another doctor?

Regarding this...

This patient's parent agreed to the surgery

on the premise that Dr. Lu is the lead surgeon.

It is quite normal that a family member has blind faith in a certain doctor.

But is there not another doctor in our Thoracic Surgery

that can do this surgery?

It is your job to explain this to the patient, isn't it?

The reason the family did not ask for another doctor is because

the patient's tumor is relatively large.

Most surgeons would not choose to do this surgery by thoracoscopic resection.

For a tumor of this size

in our hospital, currently only Lu Chen Xi can guarantee

the surgery can be completed using this method.

If the open-chest surgery method is used

postsurgical chest pains cannot be avoided.

Chest pains arising in a percentage of patients after surgery

is a residual effect that is difficult to avoid after open-chest surgery.

But when comparing chest pains and full removal of a malignant tumor

which is more important?

You are an expert.

You understand even more clearly.

Of course I understand.

I am not just a thoracic surgery expert.

I am also a patient who suffers the torment of postsurgical chest pains.

I am the same as Lin Sen's mother.

We both suffer from postsurgical chest pains that are difficult to cure.

She even became severely depressed as a result.

When she discovered

her son needed open-chest surgery also because of a mediastinal tumor

she fell apart completely.

She committed suicide with her son in tow.

Lin Sen was saved.

His mother... has already passed away.

That is why the child's father insists on having Lu Chen Xi

remove the tumor by thoracoscopic surgery

to reduce the occurrence of postsurgical chest pains by the greatest extent.

It is not blind faith.

It is trust.

And he has no choice but to do so.

Eat some more.

No, take it away.

The circumstances of the patient's family is rather unusual.

We can understand that.

There are many benefits to choosing thoracoscopic resection.

As Director Fu said, it reduces post-op surgery pains by the greatest degree

can effectively avoid damaging nerves, and so on.

However, Dr. Lu is not the first to do such a surgery.

There are many cases of doctors trying and succeeding at it.

Chief Lan of Central Hospital's Thoracic Surgery

has also developed such a program.

I signed the approval.

It's all right if nobody else in Renhe can do this surgery.

I'll personally invite Chief Lan to do this surgery.

Central Hospital started this program

after Lu Chen Xi had been doing thoracoscopic surgeries

for a year already.

Their earliest trainings used recordings of Lu Chen Xi's surgeries.

Lin Sen's tumor is truly relatively large.

There are extremely few doctors who can do this surgery by thoracoscopy.

Having started practicing it later does not necessarily mean less skilled.

There is not necessarily a correlation.

We're all just learning and studying from each other.

Central Hospital has been working on this project for over a year now.

I believe that as long as our doctors have high fundamental standards

I don't believe we won't be able to find a few specialists on par with Dr. Lu.

In regards to thoracoscopic resection of mediastinal tumors

- Lu Chen Xi is-- - Old Fu.

You are the director of Renhe Hospital.

Can you say you know the level of all Thoracic specialists in the hospital?

How about this?

I'll call Chief Lan and hear his opinion first.

No need to.

Give me a minute. I'll be done reading soon.

Thank you.

In recent years, I've held a position

in the Thoracic Academic Board.

I have been following the academic direction and development

of cutting-edge techniques in thoracic surgery.

I can't say I am aware of everything.

But at least I have some right to speak on the matter

so please listen to what I have to say.

Please take a look.

"Thoracic Surgery", page 27.

A review on the open-surgery method for mediastinal tumors in the past 10 years.

"Study of Pain", page 20.

Discussion and research into chronic chest pain after open-chest surgery.

"Thoracic Oncology", page 15.

The advantages and abuse of thoracoscopic surgery.

These articles can prove that of the many methods available

thoracoscopic surgery is the method

with which postsurgical chest pains can most likely be avoided.

However, it requires a rather high demand of

the operating surgeon's knowledge, skill, and judgment.

Of course, when the patient's tumor is rather large

using this method to complete the surgery

and being able to completely avoid damaging any nerves

isn't achievable by just any surgeon with experience with thoracoscopic surgery

These are the minutes for this year's Thoracic Surgery provincial conference.

The data from page 4 to page 10 shows

11 groups from 8 hospitals in Jialin City

all began studies into thoracoscopic surgery.

Every group has reached a certain quality

but for the patients that Lu Chen Xi operates on herself

from follow-up studies of 97 cases in three years

the average size of their tumors

exceeded those of all the other surgical groups.

The difference is statistically significant.

Moreover...

Not one case had postsurgical chest pains.

Certainly, not everything depends solely on the surgeon's surgical skill

especially during such a sensitive time.

But taking everything into account, I still believe

Lu Chen Xi is the best choice for Lin Sen's surgery.

This is not just for the sake of a healthy recovery without chest pains

but also to allow this family that has suffered such great tragedy

to once again obtain happiness.

All right, these were my personal opinions.

Director, President, and Interim Director Yang

please make the final decision.

Hello?

Look over here.

- That is our newly constructed... - It's Sir Xiu.

They're not short-staffed like this side, are they?

Sir Xiu.

Xiao Lu, you must be more mature now. You can't be like a student anymore.

I know. Thank you, Sir Xiu.

Allow me to introduce.

This is Professor Zhuang Shu.

This is Renhe's former hospital director

and honorary chairman of Thoracic Academic Board

Professor Xiu Min Qi.

I know him.

Four years ago, at the annual Thoracic Surgery Conference in Singapore

I saw Dr. Zhuang's live surgical demonstration.

At the time, I was thinking the younger generation has surpassed us.

Professor Zhuang had been practicing medicine far less than I had

but his level had far surpassed us seniors already.

Very nice to meet you, Professor Zhuang.

You are too courteous, Director Xiu.

Professor Zhuang, you were a bit impetuous.

Even if you like to protect the young, you shouldn't take everything on.

Responsibilities should be clearly distinguished.

One should only bear the responsibilities that lie with them.

You are right.

Responsibilities should be clearly distinguished.

Those who shouldn't be held responsible should not be unjustly blamed.

Your efforts will be needed a little longer for Lin Sen's surgery.

In times like these, it's even more important that mistakes aren't made.

I understand, Sir Xiu. I will prepare thoroughly.

I'll be waiting for your good news.

Goodbye, Professor Zhuang.

- Goodbye. - Goodbye, Sir Xiu.

It's thanks to Director Fu and Sir Xiu that

you don't have to bear the responsibility.

And they even told the superiors to let us operate on Lin Sen.

I've been wondering how you would look with a hat on.

Not bad.

I was worrying on my way here that you would find me ugly.

I don't.

Has your relationship improved?

He still won't accept me as his father.

But he's talking to me more.

We've also discussed being friends first. It's quite nice.

Look, he's wearing one too.

He's not as handsome as you.

He can't go in. He has to stay here.

If he's not with me, I'll be a little scared.

But he has to stay outside.

He will wait for you here.

You'll go inside for a nap and when you wake up

you'll see him when you come out.

I promise.

If I now say I'm worried, I'm afraid Dr. Lu will be unhappy.

But Lin Sen's tumor is so large. I'm really--

It's true the larger the tumor is, the higher the demands on the surgeon

but the good thing is Dr. Lu's skill in

thoracoscopic resections of mediastinal tumors

is acknowledged by everyone.

We are confident.

I trust you two.

What are they talking about?

Are they talking about my illness?

Adults always like to show off with words that are difficult to understand.

That's the senseless world of adults.

But, my first time in the operating room

I felt it was like a wonderful fairy tale world.

There are various sorts of strange machines

and a big light made up of lots of small suns.

I'll show you.

That's called a surgical lighthead. I've watched television dramas.

How come you know so much?

I've never seen a real one though. Let's go.

What about him then?

Lin Wei!

What is it?

Wait for me here with him.

I'm going in for a look and then coming right out.

Okay.

Then I'll wait for you here with Mao Mao.

His name is Dou Dou. You can call him Dr. Dou now.

All right. Dr. Dou.

Let's go.

When Liu Ling was found

she had already lost consciousness due to blood loss.

Medical personnel at the scene tried their best to resuscitate her

but Liu Ling ultimately died due to excessive blood loss.

She was pronounced dead at 6:40 p.m. yesterday.

This is the basic overview of the situation.

We have already represented Renhe Hospital

in expressing our deepest condolences to those mourning the deceased

and expressed our deepest sympathies to the family of the deceased.

Concrete plans for compensation are currently under discussion.

We will now take questions.

Go ahead.

Hello, I am a reporter for Jialin Evening News.

There are people online who claim

that because Liu Ling was a mistress and the man's wife was once a doctor here

a Dr. Lu and other medical personnel here

had humiliated and showed disdain for the deceased

while she was receiving treatment here

and that is what led to her suicide.

I'd like to ask if that is true.

We will not answer any questions that involve the deceased's privacy.

It would not comply with regulation and is unethical.

We are going to explain to the media what we have come to understand

which are the facts of this incident.

Someone online pinned the blame of Liu Ling's suicide

onto Lu Chen Xi, the doctor who treated her and her child.

That is a misrepresentation of the truth, or a fabricated rumor.

We have sufficient evidence to prove that

her suicide was not caused by our medical personnel.

Renhe Hospital firmly defends the rights and honor of our medical personnel.

Any ill-intentioned slander and insult will absolutely not be tolerated.

We reserve the right to pursue legal action.

Dr. He, what is the situation?

We're ready.

Let's begin.

Sterilize.

Scalpel.

Liu Ling's premature baby has a congenital disease

and could possibly be disabled or die prematurely.

Treatment would be long and challenging.

Liu Ling herself was also afflicted with an ailment that required surgery.

That was the physiological reason.

As for mentally

everybody knows women recuperating after childbirth are mentally frail

and depression could easily arise.

During the most critical moment of her life

what she lacked was the affection, care, and hopes

that ought to have been provided by family and loved ones.

According to our understanding, these were important reasons for her suicide.

And as doctors

we did not provide adequate psychological counseling.

Of course, there are some things that involve patient privacy

that we cannot meddle in too much.

There are many patients now

who have high hopes and demands of doctors and medicine.

Patients not only need treatment, but also mental comfort.

It is something they earnestly need.

Yet, for surgeons who are often overworked

it is very difficult for us to do this perfectly.

I admit we have not done well enough in this aspect.

Seeing that Dr. Lu Chen Xi overlooked the patient's mental health

during the course of treatment

and has issues with communication

the hospital has decided

to take disciplinary action against Lu Chen Xi

with one year probation, suspension of duties for one month

and deducting a half year's bonus.

Director Fu, does that mean

this doctor that has issues communicating with patients

is going to continue staying at Renhe?

As far as I know, Lu Chen Xi is still currently in surgery.

Is this the so-called suspension of duties?

Can you explain this, Director Fu?

Careful, synchronize with me.

Okay.

Follow me here.

Go.

Keep going.

Good, good.

Dr. Lu is indeed currently performing

a thoracoscopic resection of a mediastinal tumor

because the surgery must be done immediately.

Otherwise, once the child's tumor spreads and metastasizes

it would turn life-threatening.

I don't want to speak too much in theory regarding this matter

so please allow me to use an actual case

to tell everyone how significant this surgery really is.

- Director Fu? - Director Fu?

What's going on?

What is he doing?

Director Fu?

What are you doing?

Let me be.

What is he doing?

That's...

Two years ago, after open-chest surgery

I unfortunately became one of a small number

to be afflicted with severe chronic chest pain.

The pain and subsequent irritability and powerlessness

was difficult for me to bear.

I continuously tried various ways to relieve the pain.

None of the results were ideal.

My state of mind, which initially was rational acceptance

later turned into impatient chaos, and even despair.

After I became a sufferer, that's when I truly understood

that even a hospital director who possesses an abundance of

medical knowledge and medical resources

is unable to rationally face

the mental stress wrought by this ailment.

I continuously increased my drug dosage

gradually forming a dependence on medication

and leading to clinical depression.

Several times, the idea of suicide arose.

These scars left behind on my chest by cigarette butts and scalpels

are the cruelest proof.

The thoracic cavity adhesions are quite severe.

I'll need to first separate the tissues.

Face left.

Left.

Left.

Don't move.

We should be seeing his tumor now.

A little more to the left.

Stop.

That's it.

Get started.

Stay steady. I'm going to begin.

Okay.

My physical and mental condition

could no longer withstand high-intensity clinical work.

I should be getting therapy to fight off depression and wean my drug addiction.

However, I was unable to accept this reality

and continued to force myself to carry on.

I wanted to leave behind a perfect end to my professional career.

Not long ago, there was a patient who needed a lung transplant immediately.

When the patient's family requested that I be the lead surgeon

I took my chances and accepted the request.

During the surgery, my chest pain suddenly flared up.

I was unable to continue.

I was lucky Professor Zhuang of the Thoracic Surgery Department was there.

He used his excellent medical skill

which far surpasses what mine was at the peak of my career

to successfully complete the surgery.

Yet, in the following interview

I once again wished to protect my image as an expert

and did not speak the truth.

I stole Professor Zhuang's surgical achievements

and obtained false glory.

But in the end...

I am unable to continue lying to myself.

I have dishonored the word "doctor".

I have betrayed the trust that patients and students had in me.

Regardless of whether everyone sympathizes with me or not

my mistakes cannot be covered up.

Besides applying for an early resignation

I ask that all my honorary titles be withdrawn

and for my profile and picture to forever be removed from Renhe's wall of honor.

Director Fu, we can discuss this later.

Yes, don't make such a rash decision.

That's not necessary. It's decided.

I once thought of using a scalpel to forever put an end to my shame and pain

but in the end, I was still a coward.

A scalpel in my hand is to be used for saving lives.

Now...

I am unworthy of holding it.

It should be left for the truly good doctors.

And Lu Chen Xi is precisely an example of such a good doctor.

She does have some faults

but she is far more outstanding than many doctors at Renhe, including me.

The thoracoscopic resection of mediastinal tumors

that protects nerves located between the ribs from damage

that she is currently performing

is currently the most effective and optimal method.

In the past three years, among patients she operated on using this method

the rate of occurrence of postsurgical chest pain

is zero.

The condition of the tumor is not as we had anticipated.

This artery here has a deformity.

Take care to prevent bleeding.

I know.

I will peel bit by bit.

This might take longer than expected.

No rush. Take your time.

To cultivate a good doctor like this

is very, very difficult.

If we let go of a doctor like this and never allow her to operate again

then whether it is to the hospital or to patients

it will be an enormous loss.

[Name: Fu Bo Wen, Position: Hospital Director]

Fu Bo Wen, who has been struck down by postsurgical chest pain

will now be leaving this place.

And Dr. Lu Chen Xi, who uses a scalpel to conquer postsurgical chest pain

will be staying here

staying in surgery

staying for all the patients suffering from thoracic diseases.

I ask everybody to trust that

this outcome we strive for is worthy.

Very good.

You've avoided all the arteries.

There blood loss volume is very low.

After this surgery, I won't be back for a month.

Don't get distracted. Continue.

[One month later]

Lin Sen's recovery is ideal.

But you must still be careful if you'll be flying long-distance.

Despite the fact that the past few days, you've been...

taking time off and resting, you still came to take care of Lin Sen.

I really appreciate all you've done.

No need to speak so carefully.

It's only proper that punishment be dealt when mistakes are made.

In any case, although Dr. Lu's thoracoscopy is highly difficult

it yields a good result.

Postsurgical chest pains are probably unlikely to occur.

You can rest at ease now.

I can. Of course I can.

I really never imagined the surgery could be so successful.

Lin Sen, you're leaving the hospital.

Aren't you going to thank Dr. Lu and Dr. Zhuang?

There's no need to.

This kid... That is so rude.

Dad, there are no words that can express my gratitude.

That's right.

Your recovery is our greatest reward. Thanking us isn't important.

Lin Sen, I want you to know that although I was your lead surgeon

I didn't do it all by myself.

There were many uncles, aunties, and two grandpas

who put in an effort for the sake of your health.

I can't say I understand fully, but I get the gist of it.

That's good enough. You'll understand in the future.

Goodbye, Lin Sen. Don't forget to come back to visit me.

I definitely will. Bye, Sister Chen Xi.

- Bye, Uncle Zhuang. - Bye.

Bye, darling. Bye.

- We're taking off now. - Bye..

The weather sure is nice.

It is.

Want to go do something relaxing since we both have time?

You haven't slept well in the past month.

Relaxing a bit will help you sleep.

How do you know I haven't slept well?

I heard you.

Why were you eavesdropping on me in the middle of the night instead of sleeping?

You would cook a midnight snack

or play games, or watch American dramas, all without using headphones.

It was impossible not to hear.

I'm sorry.

It's fine.

You've been under too much stress lately.

It's understandable if you can't sleep well.

My body clock is a mess now. I get sleepy when it's daytime.

- I'm going home now. - Don't.

I'm taking you somewhere. I guarantee you'll get a good night's sleep tonight.

All right.

The specifics are in the documents you're holding.

You just need to follow them.

All right, let's end the meeting here.

Director Yang, there's one more thing.

I'd like to invite you to move into the director's office next week.

It's unreasonable that you're in a chief's office, isn't it?

Yes, Director Yang. It's time to move.

That's not necessary.

I've been in this office for so many years.

I'll be uncomfortable elsewhere.

Besides, I am just an interim director.

My main duties are still those of a chief.

I really don't have any idea about executive work.

If there's someone fit for the job, I'll surely step aside.

If I move there now, I'll have to move back here later.

It's so much trouble.

You're too modest, Director Yang.

Don't call me Director. Call me Chief.

Remember that. Chief.

Sure, sure.

Chief Yang, Director Fu will be retiring soon.

He's even submitted his resignation.

Isn't it just a matter of time before the role is fully yours?

Yes, you're just missing a written appointment notice.

Isn't that right?

Director Fu may have resigned, but he is our senior after all.

I was afraid the hospital would be affected

so that's why I took this temporary appointment.

It is truly a difficult job.

If you call me by that title

people will think our relationships are superficial and have a bad effect.

When it comes down to it, we're all first-line staff.

Saving lives is he must crucial.

Whether I'm director or not, really doesn't matter.

All right, that's all for today.

Come see me if anything happens.

- Okay, I'll be going now. - Bye.

Hello?

Student Yang Zi Xuan, let's have dinner tonight.

Today? I'm busy today.

What are you busy with all day?

It's a special situation tonight.

Push your appointments. Let's have dinner.

It's just interim hospital director.

I'm really not free tonight.

Tomorrow. I'll eat with you tomorrow.

Bye, Dad.

Sorry, I was on the phone with my dad.

Old Hu, how is it? You've been looking so long.

What's your assessment?

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