Chapter 373 - Occupational Exposure
Great Doctor Ling Ran
Chapter 373: Occupational Exposure
Xu Yongchang put his hands on his chest and looked at the ceiling with his eyes wide open.
The patient in the same room had been playing with his cell phone for a while, and he noticed that Xu Yongchang remained in the same position he did an hour ago. Feeling curious, he asked, “What are you looking at?”
“I’m taking a break.” Xu Yongchang’s lips were dry, but he did not show any intention to take a drink. He understood the principle of fasting before surgery. The white test paper from the Ling Treatment Group had explained it clearly. If a patient failed to fast, the operation would be postponed to meet the requirements of fasting before surgery.
The patient from the same room looked at the screen on his phone and raised his head before he said, “You don’t read or play with your phone, either? You don’t like it? Why don’t you take a nap then?”
“I can’t sleep.”
“You’ve got a point. You’ve been sleeping all day.” The patient in the same room laughed and ended the topic. Then, he lowered his head and said in his heart, ‘Crazy bugger.’
Xu Yongchang coughed, rearranged his position, and looked at the ceiling. His mind was filled with countless thoughts.
“Bed 42, has your family arrived?” The nurse walked in with a notebook in hand.
“They’re coming.” Xu Yongchang lay motionless. He did not want to show himself being too tired, but the action of sitting up could easily reveal his fatigue.
The nurse nodded and said, “Family members need to sign the informed consent form. Also, remember to ask your family to take the test.”
“Family members also need to take the test?”
“Of course. Otherwise, when you’re sleeping, what will you do if your family makes mistakes?” the nurse explained and reminded him, “When your family members come, get them to stop by the nurse’s station.”
“All right.” Xu Yongchang watched the nurse go before he took out his phone and sent out a text message.
Soon after, a middle-aged man in his forties walked into the room.
“Big brother,” Xu Yongchang called him. Then, he felt as if his words were stuck in his throat, and he could not speak.
“It’s all right. I’ll perform the procedure for you,” Xu Yongchang’s older brother spoke hurriedly. He asked a few questions and ran out.
When he reappeared, the nurse was behind him.
“Bed 42, get ready for surgery.” Nurse Niu, who was the oldest nurse among the nurses on duty that day, came in with a serious face. She began to make preparations.
Xu Yongchang saw the gloves worn by the other person, but he could not find the energy to move.
He felt tense, but also relaxed.
“Family member, please follow us.” Nurse Niu urged them to move again.
“Okay.” Xu Yongchang’s older brother lowered his head and followed them.
Nurse Niu led the group out of the room, but she did not head to the elevator immediately. Instead, she entered a meeting room not far from the elevator.
Xu Yongchang’s expression changed when he saw that. “Didn’t you say that I was going to have surgery now?”
“There will be a preoperative conversation.” Nurse Niu did not say too much. She then pushed Xu Yongchang into the room.
Xu Yongchang’s older brother had to follow them into the room.
In the room were Zuo Cidian and Ling Ran. They were sitting inside with their white coats on while they had Xu Yongchang’s medical case in front of him. They looked very serious.
Xu Yongchang saw that, and his expression changed slightly. “What is the meaning of this?”
“Mister Xu Yongchang, right?” Zuo Cidian did not have smile on his face.
“Yes, that’s me.” Xu Yongchang raised his chin.
“Mister Xu Yongchang, we have the results of your blood sampling from this morning. The report shows that you are HIV positive.” Zuo Cidian paused and asked, “You know what HIV is, right?”
“I know, it’s AIDS.” Xu Yongchang’s expression was indifferent and apathetic.
Zuo Cidian gritted his teeth and resisted the urge to scold him.
Hiding the history of AIDS was a huge threat to surgeons.
Situations where doctors would cut their hands while they held scalpels sometimes occurred while they were on the operating table. The most common situation was the tip of the needle piercing the doctor’s finger during a suture. It was just like how a woman who did needlework would often be pierced by the tip of the needle. Sometimes, a person did not necessarily avoid being injured just because he or she was skilled.
The difference in this situation was that if a doctor operated on an ordinary patient, the injury would just be an injury, and there would not be much of a problem for the surgeon.
However, the risk of occupational exposure was greatly increased when a surgeon operated on an AIDS patient.
Even without a wound, if the patient’s bodily fluids gushed out and contaminated the doctor’s eyes, the cornea would absorb the virus from the patient’s body into the doctor’s body
Why would a patient’s bodily fluids gush out of the patient’s bodies, you ask? Think of a large man squeezing the zits on his face. If the substance inside his zit could gush out, then bodily fluids gushing out from a patient’s body during invasive surgery was not really much of a surprise.
Although there were disinfectants and drugs such as zidovudine and lamivudine available after the surgeon experienced occupational exposure, a risk was still a risk. The doctors could tolerate the knowledge of working on a patient by wearing multiple layers of clothing after they learned of the patient’s situation. But if the patient hid his condition, it would mean that he was just exposing the surgeons to unnecessary risk.
Zuo Cidian used his experience of tolerating insults for twenty years to quell his anger.
Ling Ran looked at Xu Yongchang, but his countenance was much calmer as he asked, “Mister Xu Yongchang, since you have HIV, the surgical risk you face has greatly increased. Do you understand this fact?”
Xu Yongchang had envisioned a variety of scenes where he would be cursed, where his problem would be brought up to the hospital directors, and where he would possibly even be punished for it…
However, Xu Yongchang did not expect Ling Ran to be so calm.
After being stunned for a moment, Xu Yongchang slowly said, “I understand.”
“HIV-positive patients have much weaker recovery abilities than normal patients. Therefore, after you receive knee arthroscopic surgery, your nerve recovery may also become very slow. You may not even be able to recover, do you understand?”
“I understand.”
“Your heart, lungs, liver, kidneys, and other internal organs will face the possibility of perioperative organ failure. The probability of spontaneous diseases occurring in your cardiovascular system and cerebrovascular system is much higher compared with ordinary people. We cannot rule out the possibility of heart and respiratory failure… Do you understand?”
“I understand.”
Ling Ran said another bunch of stuff, and Xu Yongchang agreed to almost whatever he said.
It was only then that Ling Ran looked at Xu Yongchang. He asked, “Do you still want to continue with the surgery?”
“Of course…” Xu Yongchang was puzzled. He asked, “Are you still willing to do it for me?”
“We will wear a full set of protective clothing for the surgery. In addition, I will make appointments with surgical infectious disease specialists for consultations. This will result in a higher medical cost for you than the average person,” Ling Ran spoke in a relaxed tone and got up.
While Xu Yongchang was still in doubt, he noticed that Ling Ran was already gone.
Zuo Cidian was left behind. He reluctantly cleared his throat and said, “Family members, please come here as well. I’ll tell you what to pay attention to, and you will need to take a test. We haven’t made the test booklet for HIV patients, so you will have to write down the points yourselves. First of all, your surgery will be the last one for today. This will make it easy for us to do a thorough cleaning of the operating theater once we’re done…”
Xu Yongchang and his brother looked at each other and listened very seriously.
Not every hospital and doctor was willing to operate on HIV-positive patients, but HIV-positive patients often became sick. In the past, Xu Yongchang had to go to the Chinese Center For Disease Control and Prevention (CDC) or a designated hospital to be treated. In the present, he had a wider range of choices to go for medical treatment, yet he still got rejected by a large number of them.
The first most common suggestion was for him to go to another hospital, and the second most common suggestion was for him to go for conservative treatment.
For instance, Xu Yongchang’s knee had been injured for quite a long time. The recurrent inflammation was extremely trying for him to endure.
Despite that, the advice Xu Yongchang received was always for him to go for conservative treatment.
As a last resort, Xu Yongchang could only conceal his illness and go to Yun Hua Hospital.
“I… I’ve been prepared for the surgery since the beginning,” Xu Yongchang whispered as an explanation.
Zuo Cidian, however, did not show Xu Yongchang a pleasant expression. “You have your difficulties, but I have to uphold professional morality,” he said.
Zuo Cidian turned around and continued to explain the operation in a calm indifferent tone.
The best word to describe the situation in the operating theater would be chaotic.
The nurses and doctors in the operating theater did not need to hide their fears in contrast to the calmness they pretended to have in the meeting room.
In truth, the nurses’ emotions were still somewhat stable. After all, they would not come into direct contact with the patient, and their risk of occupational exposure was much lower. They also did not need to be too worried when it came to overall protection.
However, the risk the doctors faced was much greater.
If the surgeon had been an experienced attending physician or the associate chief physician of the Emergency Department, the surgeon might have felt calmer. But the Ling Treatment Group had resident doctors serving as their main force. They would not have been able to possess that sort of disposition.
It was especially so for the three interns who were there for their internship. When they saw the protective clothing, they shuddered.
Only Ling Ran checked through the operating theater methodically before he looked at the three interns and said, “As long as you wear the protective clothes correctly, the probability of being infected with AIDS will be very low.”
“How low?” Guan Fei’s teeth chattered.
Ling Ran thought about it and said, “I don’t know.”
“I…” Guan Fei showed despair in her gaze.