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Path of Medicine With a System-Chapter 232: Snip!
Zhang Fan shook his head as he told the patient, “Relax, and don’t worry. I’m just going to inspect just where exactly the object is right now.”
“Okay!”
Zhang Fan gently inserted his lubricated finger into the patient’s anus. “Okay, I can feel it. The problem is that the object’s fracture is still somewhat sharp,” Zhang Fan told Lu Shuyan as he performed the digital rectal examination.
“Then what should we do?” Lu Shuyan inquired.
“Let me think!”
Zhang Fan didn’t dare to stimulate the anus and the surrounding tissue too much, because there was already swelling. If the swelling became even worse due to additional stimulation, that would make things more troublesome.
Normally, the human body’s intestines and soft tissue would still have a certain degree of hardness and flexibility. It wouldn’t be anything to worry about even if something such as a soft rubber dildo became stuck inside the anus. However, things would be really different and problematic if there was also swelling—that would cause the tissue to thicken and the cell walls to become thinner. This would also lower the hardness and flexibility of the tissue.
So, in order to remove a foreign object from the anus, it would be necessary to first expand the anus, and then remove the foreign object by using tissue forceps. Additionally, in this type of scenario where the foreign object was fractured, the fractured portion couldn’t be allowed to touch the nearby swollen intestinal tissue.
“Firstly, I can confirm that there is indeed a foreign object in the intestine. Secondly, this object has an obvious fracture which might injure the intestinal walls. Thirdly, this foreign object might enter the sigmoid colon due to intestinal contractions. Fourthly, there is a possibility that attempting to remove the object from the anus will end in failure as the object enters the sigmoid colon due to intestinal contractions. If the object enters the sigmoid colon, it will no longer become possible to remove the object without using surgery. That will mean that an open surgery will be required in order to squeeze the object out of the intestine!” Zhang Fan informed the two women about his diagnosis. The truth was that there really was a possibility that it might not be possible to retrieve the broken dildo from the anus. Additionally, the intestine would constantly contract, and as time went on, nobody would be able to make guarantees about what might happen.
“I refuse to have surgery! I’ll be so ugly with a scar left behind on my stomach! No surgery!” The beautiful woman on the examination table started panicking. Tears started pouring out unstoppably, messing up her originally pretty face.
“Then what should we do now?” The black leather jacketed woman also started panicking.
“I will prepare the surgery agreement paperwork now. Both of you should sign it,” Zhang Fan told them.
“I refuse! No! NO!!!” The female patient was truly exploding now. She started screaming at a very high octave. Zhang Fan’s ears really hurt. The beautiful patient’s face now became rather indistinguishable.
She had been using many different colors of makeup. Due to all her tears and emotional turmoil, black and red mixed together with her tears, large eyes, exaggerated expression, and other complex colors. Zhang Fan suddenly felt as if he was watching a comical clown on television when he saw her current face.
“Don’t scream. If you keep screaming, when your abdominal pressure contracts, that will only absorb the object deeper into your intestine, making it impossible to retrieve,” Zhang Fan hurriedly told the patient while she was catching her breath. She had been screaming far too loudly about not wanting surgery!
“But I truly don’t want to have surgery~!” The patient’s voice was now far quieter after she heard this. She whimpered as tears kept streaming down from her darkened eyes.
“Right now, it’s not at the level of a surgery. However, this counts as an invasive treatment method that has the possibility of injury or further unintended consequences, which is why it must be treated similarly to a surgery with agreement paperwork. Understood?”
“Oh!”
“Oh!”
It was likely that the two women hadn’t really understood what Zhang Fan just said. Zhang Fan whispered to Lu Shuyan, “Watch over them and make sure that nothing happens! I’m going to go print an agreement form.”
“Okay,” Lu Shuyan whispered back in agreement after glancing at Zhang Fan. In China, any patient who entered a hospital and was accepted by a doctor for treatment would enter into a so-called unofficial medical contract with the doctor. China’s government placed a great deal of importance on this medical contract. If anything at all happened to the patient during this time, the doctor and the hospital wouldn’t be able to avoid responsibility. This was why Zhang Fan had to be extra careful.
To give a simple example, if the female patient suddenly fell off of the examination table and died for some reason while Zhang Fan was busy printing the agreement form, then the doctor would be held 80% responsible. If there were zero witnesses, then things would be even worse for the doctor. That was why the profession of doctor was such that the older the doctor became, the more cautious they would become.
Zhang Fan told Wang Zipeng about the situation and critical points. The latter then went to the gynecology department office to print out the necessary paperwork. For the time being, Zhang Fan didn’t want to go back and face the patient. He simply leaned against the wall and emptied his mind. Earlier, he had felt that the situation was slightly awkward and funny, but now that he thought things over more carefully, he felt that the patient must indeed be feeling really uncomfortable.
“Bro, it’s ready.” Wang Zipeng brought the agreement form to Zhang Fan.
“Okay. I’ll be going in again now. You can go back to the proctology department to rest for a while if you want. It’s not like there’s anything for you to do here.”
“It’s fine, Bro. You should hurry with your work.” This was the misfortune of Wang Zipeng not doing well on his medical license examination. He really regretted not studying harder!
Zhang Fan then went back into the patient examination room. Lu Shuyan glanced at Zhang Fan, but didn’t say anything. Humans were really complex creatures. Those who wanted to reach the top would definitely never submit to all the rules and those above them, yet the majority of people would also involuntarily draw closer to those who were strong or above them.
“This requires the patient’s signature as well as a family member’s signature.” Zhang Fan handed a pen and the agreement form to the patient who was still on the examination table.
The patient mumbled complaints under her breath as she signed it. Zhang Fan then glanced at her signature before asking her, “What about the family member’s signature?”
“Can she sign it? She’s my friend.” The patient referred to the manly-looking woman.
“Yes. Then you should sign this form as well.” Since this counted as an emergency checkup, the requirements weren’t that strict. If a real surgery had been required, then a friend’s signature wouldn’t have been allowed.
“Right here?” The black leather jacketed woman pointed at a part of the form.
“Yes.”
She swiftly signed her signature.
“Prepare lidocaine and a rectal spreader,” Zhang Fan told Lu Shuyan.
“We don’t have any rectal spreaders in the gynecology department!”
“I’ll have Doctor Wang bring one over from the proctology department, then.”
Some time later, Wang Zipeng arrived with a rectal spreader. Zhang Fan told the female patient, “I’m about to attempt to remove the foreign object from you now. It might be a bit uncomfortable. Please bear with it. If you really can’t take it anymore, then tell me, but you absolutely can’t move around. Do you understand?”
“Understood! Doctor, please take things as slowly as you can! I know that this will be painful.”
“Okay!” Zhang Fan almost broke out into laughter even though he had been doing his best to keep serious.
After diluting the lidocaine, Zhang Fan prepared to begin the local anesthesia. “Doctor, you absolutely must be gentle!” The female patient’s beautiful face was currently ruined by all her tears. Right now, she looked more like a panda!
“Yes, of course,” Zhang Fan agreed. He then turned to the black leather jacketed woman. “Could you please help support her a little?”
Zhang Fan began local anesthesia with lidocaine around the anus. How could this pain be described? At any rate, this was a really uncomfortable type of pain, especially since the anesthetized area was quite a sensitive place to begin with. The female patient was definitely feeling quite a bit of discomfort.
After the anesthesia took effect, Zhang Fan told Lu Shuyan, “When I finish expanding the anus, help support the rectal spreader.”
“Okay.”
Zhang Fan slowly entered the patient’s anus with his finger. He did his best to stimulate her intestines as little as possible in order to prevent any edema from occurring.
“Support the rectal spreader,” Zhang Fan told Lu Shuyan as he adjusted the overhead light to look inside the patient’s anus.
‘This damned dildo is even the glow-in-the-dark type!’ Zhang Fan couldn’t help but mentally curse at what he saw! Luckily, the dildo was also covered in many small bumps and spirals, which gave it a great deal of friction. Otherwise, since it had a sharper shape in front and rounder shape behind, it would have easily entered the sigmoid colon with intestinal contractions.
“Don’t move!” Zhang Fan told the patient in a really stern voice.
The female patient was feeling rather uncomfortable with her anus being spread open by the rectal spreader. This was only natural. However, the broken-off dildo was cylindrical in shape, and was also lubricated. It wouldn’t be that easy to grab it with the forceps. If the patient kept moving around, that would make it impossible for Zhang Fan to grab the dildo with the forceps, which was why he used an especially stern tone.
Zhang Fan slowly used the tissue forceps to try grabbing on to the dildo. However, it was too slippery, so he was unable to grab it successfully with the forceps. “Doctor Lu, press below the patient’s bladder and squeeze down towards the intestines. Your movements absolutely must be gentle and slow as you apply pressure.”
“Okay!” Lu Shuyan used one hand to hold the rectal spreader and her other hand to slowly apply pressure below the patient’s bladder.
“Ack!” The patient couldn’t help but utter a strange sound as she continued to lie on the examination table.
The patient actually started peeing from the pressure around her bladder! Zhang Fan couldn’t be bothered with this right now. He took advantage of the pressure on the dildo to swiftly and accurately pinch the dildo at the fractured location with the forceps.
Zhang Fan slowly moved the dildo. The female patient was feeling great discomfort due to Lu Shuyan applying pressure below her bladder, having the rectal spreader forcefully spread open her anus, and also with Zhang Fan having one hand against her thigh for self-support. Of course the patient would be in great discomfort. This probably wasn’t even much different from torture!
Zhang Fan slowly moved the dildo. The broken off portion was neither large nor small. It was just slightly smaller than the intestine’s diameter. Entering would be easy, while exiting would be really difficult. Additionally, Zhang Fan didn’t dare to use too much force pinching the dildo, as it was made out of soft rubber. He was afraid that he would accidentally break it. When it came to removing a foreign object from the intestine, it could only be attempted once or twice within a short period of time. Attempting any more than that would stimulate the intestine too much and possibly cause the swelling to worsen.
Zhang Fan slowly moved the dildo. When it was about to reach the rectus venous plexus, Zhang Fan suddenly loudly shouted, “Relax your muscles, hurry! Relax them as if you’re on the toilet! Act as if you’re about to poop!”
The female patient couldn’t even be bothered about her discomfort anymore, as Zhang Fan’s tone was far too severe. He sounded as if he was about to hit her. She was scared of what would happen to her if she didn’t obey him.
Zhang Fan slowly moved the dildo. Finally, the dildo reached the anus, which was the narrowest portion that it would need to go through. Zhang Fan was now breaking out into a nervous sweat because he knew that if his hand shook even slightly, the dildo would directly drop back into the intestine.
Zhang Fan slowly moved the dildo. At the moment that it was about to emerge, Zhang Fan used his other free gloved hand to swiftly grab onto the broken part of the dildo.
The dildo was cylindrical, as well as covered in lubricant, digestive fluid, and other viscous liquid. The dildo was also rather elastic. He almost didn’t manage to grab onto it. At that moment, Zhang Fan began to drip cold sweat.
The dildo was soft. When he tried to forcefully grab it, it actually seemed like it was about to retreat back into the intestine. There wasn’t enough friction, since Zhang Fan was wearing gloves. Upon seeing that the dildo was about to fall back into the intestine, Zhang Fan used every single bit of energy he possessed to forcefully grab onto the dildo.
Zhang Fan squeezed with such force that he actually flattened the broken rubber dildo. He didn’t dare to let go or move his hand. He was afraid that if he moved, the dildo would slip and fall back in again.
“Needle holder!” Zhang Fan felt as if all of his goosebumps were now out. He was so stressed that even his voice was much lower than usual.
“Here.” Although Lu Shuyan was unable to see what was going on from her position, she could tell how tense and careful Zhang Fan was right now. Lu Shuyan held onto the rectal spreader with one hand while she slowly handed the needle holder to Zhang Fan with her other hand.
*Clip!*