Summary of Medical Experiences This Year

Resting in the trunk

Let's briefly summarize this medical experience.

During the Qingming period in April, my father was diagnosed with kidney stones, and later with peritonitis. Due to the almost non-functional right kidney and severe hydronephrosis, the doctor suggested removal. During the surgery, I was suddenly called in, and I was anxious, thinking that something unexpected had happened. But when I went in, I realized it was a false alarm. The lead surgeon had made an incision in the abdomen and found that the peritonitis had caused severe adhesion of the intestines and other organs. Continuing the surgery recklessly could damage other organs and endanger life. So I was given a choice: to continue the surgery or to stop the nephrectomy and switch to a nephrostomy. The latter aims to drain the accumulated fluid and observe the recovery of inflammation before further treatment. I chose the latter.

In September, we came for a follow-up visit to examine the recovery of the kidney and determine whether surgery was possible or if the nephrostomy tube could be removed. The responsible physician from the previous visit was away for further training, so there was a different doctor this time. Therefore, before the examination, I fully informed the new doctor of the previous results and the recovery situation over the past few months.

As usual, the doctor ordered a full set of tests. A few days later, the results came out and I was informed that the kidney's recovery was not ideal. It was still a non-functional kidney, but the doctor did not recommend removing it because a history of peritonitis has a significant impact on the surgery. Once peritonitis occurs, the intestines will stick together, and even after the inflammation subsides, they will not separate. If intestinal leakage occurs during the surgery, it would be like a bottomless pit and could even be life-threatening. He suggested that I maintain the current situation or try my luck at a higher-level hospital, although there is also a chance that they may not be able to proceed with the surgery.

I was surprised by this conclusion. Firstly, I didn't realize the extent to which peritonitis affects surgery. Secondly, knowing that there was a history of peritonitis, they did not have the confidence to perform the surgery and delayed it for so many days. The former can be understood as my lack of expertise in this area, but I can't understand the latter. Later, I figured out something: the doctors who are more familiar with the situation cannot make many decisions, while the doctors who can make decisions are mostly unfamiliar with the situation. This period of contact has once again strongly reinforced this fact. Unfortunately, this situation is quite common.

During the morning rounds, the associate chief physician only briefly attended, listened to the responsible physician's simple introduction of the conditions of each bed in the ward, and hardly interacted with the patients or consulted about their conditions. The most obvious example was during one of the rounds when I asked about the surgery time. He told me it could be on Friday, but shortly after, the responsible physician came to inform me that surgery was not recommended because his superior realized that it would be more complicated after seeing the peritonitis history. Obviously, he may not have even looked at the report before, or there may have been a miscommunication from the responsible physician.

Perhaps the higher the rank, the more patients they are responsible for, and they cannot attend to every detail. However, as the final decision-maker and surgeon, their understanding of the patient's situation is very one-sided. You should know that besides the reports and the verbal communication from the responsible physician, there are many potential situations. Moreover, in the case of realizing the complexity of the surgery, there was not even one occasion to inquire further and explore other possibilities. I was very surprised and unable to understand this.

Finally, based on the repeated recommendations of the attending physician and consultation with other experts, combined with my father's unwillingness to seek treatment elsewhere, we decided to maintain the current situation for now.

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