Chapter 375 - 250: Singin’ in the Rain

Chapter 375: Chapter 250: Singin’ in the Rain

Major pharmaceutical companies lobbied like crazy to have pain defined as the fifth vital sign.

When faced with emergency pain, especially without the aid of imaging equipment, doctors developed a streamlined process that relied heavily on painkillers.

Oxycodone, fentanyl, and morphine were treated as cure-alls.

The focus was on suppressing symptoms first, not finding the cause.

The nurse had already aimed the needle at the old man.

Just then, Jiang He stepped forward and grabbed the nurse’s wrist.

He said in a cold voice, "If you inject him with that, he’ll be dead in five minutes."

Carter turned, saw who it was, and his irritation instantly peaked.

It was this Chinese doctor who had completely ruined his carefully planned career path and even made him lose face in the centennial auditorium.

’If it weren’t for him, I wouldn’t even be here today. I wouldn’t need to be sucking up to the other doctors to earn brownie points. I would’ve made an excuse and gone home to lie down ages ago!’

Carter stood up and said sternly, "Dr. Jiang, this isn’t a lecture hall. This elderly man suffered a blow to his abdomen and is in agony. I am providing him with standard pain management. What right do you have to obstruct my emergency treatment?"

Jiang He released the nurse’s wrist, took a step forward, and let him have it:

"Pain management? Do you even know how to be a doctor without opioid painkillers? Shouldn’t you determine the pathological cause before administering opiates? Huh, genius doctor?"

Carter’s expression turned serious. "You have no idea what’s happening here! He’s in severe abdominal pain. If we don’t relieve it immediately, he could die of pain-induced shock. You’re committing murder!"

"Murder my ass."

Jiang He couldn’t be bothered to waste any more words on him and knelt on one knee beside Grandmaster Chen.

He placed four fingers flat on the old man’s upper right abdomen, with his thumb pressed at the junction of the lateral border of the rectus abdominis and the costal margin.

In a low voice, Jiang He said in Chinese, "Deep breath."

The old man inhaled instinctively.

The moment the old man breathed in, Jiang He applied slight pressure with his thumb, pushing upward.

"URGH—"

Grandmaster Chen let out a muffled grunt. His inhalation stopped abruptly, and his body curled into a ball.

Jiang He withdrew his hand, stood up, and said over his shoulder:

"Positive Murphy’s sign, accompanied by mild jaundice. The freezing temperature of the lobby, plus the stress response from being knocked over by the crowd, triggered his pre-existing biliary tract disease. This is a classic case of acute biliary colic. Understand?"

Carter was stunned.

Though he was overly reliant on equipment, he was still an attending physician at Hopkins. He could certainly understand the name of a basic physical examination finding.

But he still wasn’t convinced. "So what if it’s acute biliary colic? Doesn’t biliary colic still require pain relief?"

As a top expert who had reached the pinnacle in the field of hepatobiliary and pancreatic surgery, the ignorance of this American doctor before him had crossed a line.

"Are you a fucking idiot? You actually wanted to give a patient with acute biliary colic an IV push of morphine? Carter, did you buy your medical license?"

Carter froze for a second.

He had just been speaking out of anger.

Now that Jiang He had reminded him, he vaguely recalled it.

He was about to open his mouth to explain.

But Jiang He cut him off:

"Any first-year medical student knows that opiates are contraindicated for biliary tract diseases! Wen Xuyang, tell this genius from Hopkins, loud and clear, why!"

Wen Xuyang, who had been standing to the side fuming, immediately roared when Jiang He called his name:

"Because opioid drugs, especially morphine, cause severe spasms and constriction of the sphincter of Oddi! That’s basic medical knowledge!"

Jiang He picked up where Wen Xuyang left off, pressing him relentlessly. "Did you hear that? What is the fundamental cause of biliary colic? It’s biliary obstruction caused by an impacted gallstone! It’s a sharp increase in biliary pressure!"

"The moment you push that morphine, the sphincter will lock up completely. You would have turned an impacted stone into a gallbladder rupture..."

"Worse, the bile could backflow into the pancreatic duct due to the immense pressure, directly inducing severe acute pancreatitis!"

"Remember those idiotic questions you asked me at the conference about severe acute pancreatitis?"

"I’m asking you now, with severe pancreatitis plus a ruptured gallbladder, under the current medical conditions, isn’t the mortality rate one hundred percent?!"

"I’m asking you, were you trying to save him, or were you trying to murder him?!"

"Between the two of us, who is the one committing premeditated murder?!"

"Think about it. If you have any basic medical ethics left as a doctor, you’d better fucking think about it!"

Jiang He was furious, and as he spewed profanities, his voice was naturally quite loud.

Several foreign colleagues nearby heard the commotion.

They stopped what they were doing and looked over in shock.

Carter suddenly felt hot.

He was breaking out in a sweat all over!

Everything Jiang He had said was basic medical knowledge.

Morphine being contraindicated for biliary colic was an absolute contraindication listed in textbooks.

It was just that, having spent so long in the privileged environment of Hopkins, he had grown accustomed to methodically formulating a plan only after receiving a detailed CT report. He was used to the emergency department’s streamlined process of stabilizing patients with painkillers first.

A moment ago, in his exhaustion and frustration, he hadn’t bothered to distinguish the nature of the pain and had instinctively wanted to solve the problem with morphine.

If Jiang He hadn’t stopped that syringe just now...

Carter didn’t dare to think any further.

He knew Jiang He was right.

With that one injection, the old man absolutely would not have made it until the ambulance arrived.

Carter: "I..."

He couldn’t bring himself to say the words of apology.

Admitting his own mistake wasn’t hard, but admitting it to a Chinese doctor was just too difficult. Far too difficult.