Chapter 52: Tumor Beyond the Safety Line, Call for External Assistance (4000 words)
One hour later, David returned to the diagnostics department.
Dr. Nolan, who had been waiting, clearly had an impatient expression on his face.
He was the ER physician on duty last night, and theoretically, after dealing with the female patient with deep vein thrombosis, he could go play golf with friends.
Then he could head home, take a hot shower, and sleep soundly.
As a result, House had gone off on him and gotten into an argument.
Not only that, but House had also sarcastically prevented him from discharging the patient.
Now he was being called for a differential diagnosis!
With bloodshot eyes, he was on the verge of losing it. If there was no evidence showing the patient actually had a problem...
...he would definitely file a complaint with Cuddy about House's behavior this time.
So when he saw David arriving late, Nolan didn't look pleased at all.
To him, House was being sarcastic and condescending, but this David Wells was the one who called him out directly.
If House hadn't been there, he would have definitely torn into David for being so ruthless.
House didn't expose him directly, but an intern dared to speak up and bypass him completely?
House must have given him way too much confidence!
Unexpectedly, David completely ignored Nolan's hostile glare and simply handed the ultrasound report to House.
"Sorry I'm late. I arranged a full workup for the patient.
But due to the patient's lack of cooperation, I didn't have the authority to administer sedatives.
So the blood work wasn't completed, and for now, only an ultrasound was barely done.
The results aren't good. There's a substantial lesion in her liver. In my assessment, this is a tumor—a hepatic tumor.
We can basically conclude that she has cancer."
Hearing David's conclusion, everyone present changed expression.
A liver tumor? Then the patient's hepatic function is essentially compromised.
In other words, if she had been discharged earlier, the patient wouldn't be far from death.
Before House could speak, David continued:
"Also, I learned from her son that she eats fast food burgers without any vegetables for all three meals every day.
This lifestyle has continued for years, which proves she hasn't been getting sufficient Vitamin K from vegetables.
And Vitamin K deficiency is the cause of the patient's deep vein thrombosis and also the reason for hepatic cirrhosis.
So what we need to do is not only supplement the patient with Vitamin K, but also choose to perform a liver transplant or remove the tumor.
But there are two pieces of bad news. First, it's nearly impossible for a patient like her, with even occasional alcohol consumption, to get UNOS approval for a liver transplant.
Second, this tumor is substantial. Its diameter is a full 5.8 centimeters, which exceeds the safety margin for resection."
Having finished the diagnosis in one breath, David took the coffee from Cameron's hand and drank it, using the caffeine to keep his mind sharp.
Thus preventing reversed sentence structure or illogical thinking.
After listening to David's assessment, Dr. Nolan, who was standing nearby, was already too shocked to speak after David's continuous analysis.
He quietly glanced at the report in House's hand.
There was indeed a lesion in the liver.
In other words, this entire diagnostic workup from David confirmed that the patient did indeed have a serious problem!
If he had discharged the patient this morning, he would have been in real trouble!
If the patient's family were to file a malpractice suit because of this, he could very likely lose his medical license!
Because it was he who, without conducting a proper workup, directly judged the patient to be fine based solely on his own assumptions!
If it hadn't been for House... he would probably need to hire a lawyer right now.
Thinking of this, the anger in Nolan's eyes when he looked at House disappeared, replaced by gratitude.
This House had literally saved his career!
House didn't pay any attention to Nolan's thoughts. He was just frowning in concentration.
What David did was actually quite thorough. From patient communication to initial data acquisition, it provided House with substantial information to confirm.
Based on the information currently obtained, the diagnosis made by David was completely sound.
But although they theoretically had two options, everyone knew that administration would never approve a liver transplant for someone with alcohol use.
And House had never been a physician known for his surgical skills.
So there was only one path before them.
"5.8 centimeters? Looks like we need to use unconventional means to make it a bit smaller."
Everyone naturally understood what 'making it smaller' meant.
Generally, tumors only grow and cannot shrink.
But a hepatic tumor is an exception.
They could inject 20 milliliters of ethanol with a concentration exceeding 95% into the liver to cause cellular dehydration.
Thus causing the tumor cells to shrink from water loss.
However, this procedure was definitely off-protocol.
If anything went wrong, no one present could escape liability.
So for a moment, no one dared to respond to House.
Just as everyone fell silent, Nolan, with the idea of returning the favor, suddenly spoke:
"Although the surgeons at our hospital wouldn't agree to remove such a large tumor for the sake of their success rates.
But I know a highly respected oncological surgeon from another hospital.
His laser ablation therapy cauterizes while cutting, preserving as much healthy liver tissue as possible.
This is crucial for the patient's post-operative recovery.
As for whether you want to bring in an outside consult, it's your call."
Hearing Nolan's suggestion, House paced back and forth several times with his cane.
"Nolan, who's this oncological surgeon you know? Is he reliable?"
Nolan scrolled through his phone for a while, found a photo, and handed it to House:
"You've probably heard of him too—Robert Romano, one of the most renowned surgical specialists in the area.
The only drawback is that hiring him is very expensive.
But if sufficient compensation is offered, he'll definitely take on this surgery."
House raised an eyebrow, showing recognition.
They were all people in the medical field—just as House was famous in diagnostics.
Robert Romano was equally famous in surgical procedures, though that was when he was younger.
"Oh, so it's him. But I heard the patient has been applying for assistance programs, so she probably doesn't have enough savings to afford this surgery.
Let's still follow my method—shrink the tumor so our chief of surgery agrees to operate."
Hearing House's words, Cameron's brow immediately furrowed:
"We can't just let her die, can we? How much does this surgery cost? I can contribute what I can afford."
Chase, who was silently observing Cameron, smirked and was about to show off his financial resources when David spoke first:
"It's fine. No matter how much this surgery costs, I can cover it.
We don't need to risk going off-protocol.
But I have one request—I want to observe this surgery.
Even scrubbing in to assist is fine."
Chase, who hadn't spoken yet, was slightly stunned. In his understanding, David was still that student who worked part-time jobs to pay for medical school.
He had heard of Dr. Romano's reputation.
His skill was excellent, but his fees were also notoriously astronomical.
It's impossible for him to agree to this surgery without several hundred thousand dollars.
Even for Chase, this much money was significant.
Just now, he wanted to impress Cameron, which was why he was willing to spend a fortune to win her admiration. Otherwise, he wouldn't just hand over that much money to help a stranger.
If it was like this even for him, then how could this David Wells casually say something like 'covering the cost'?
Where could David get that much money?
Even if David said he was taking side jobs...
...he couldn't earn this much money from any number of side gigs all at once.
Could it be that David was involved in something illegal?
Worry appeared in Chase's eyes as he looked at David. In his experience, none of those who had dealings with organized crime ended well.
If David really was doing illegal work, then he probably shouldn't be surprised to hear news of David's sudden death someday.
Compared to Chase, who knew some background information, Dr. Nolan, who didn't know much about David, instantly assumed David was a trust fund kid in disguise.
Nolan believed that only someone from a wealthy family could casually say they could cover any amount of money.
And in America, money and influence have always been closely linked.
Remembering his hostile attitude towards David earlier, Nolan immediately wanted to repair the relationship between them.
His previous hostile expression instantly vanished, replaced by a friendly smile, and then he praised:
"Dr... Dr. Wells, right? You truly have a compassionate heart.
It's because there are physicians like you that patients in this world have hope.
I'm sure you'll be blessed for your generosity.
As for your request to observe the surgery, please rest assured.
Since you're the sole sponsor of this procedure, Dr. Romano will definitely agree.
So without further delay, for the sake of the patient's health, how about I contact him now?"
Dr. Nolan's last sentence was directed at House.
House nodded:
"Contact him. The sooner the tumor resection is performed, the better the post-operative recovery will be.
Delaying it will only make the patient's condition deteriorate."
Soon, with the hospital's coordination, Dr. Robert Romano, who received the promise of substantial compensation, immediately departed from his hospital.
To show respect, most of the available physicians and nurses from Princeton-Plainsboro lined up at the main entrance under administrative arrangement to welcome him.
After all, Dr. Romano's temper was as legendary as his surgical skill.
The hospital was also concerned that he would refuse the surgery if he was even slightly displeased.
So the moment Robert Romano stepped into Princeton-Plainsboro Teaching Hospital, everyone saw this distinguished but aging top surgical specialist.
However, David in the crowd suddenly found Dr. Romano somewhat familiar. After thinking carefully, he remembered that this guy was also an old acquaintance of his.
And Robert, walking between the two lines of people, also seemed to sense something and looked toward the crowd, just happening to spot David standing behind House and looking at him. He was immediately stunned.
Because David was actually the young physician who took over from him to operate on Viggo back then!
How could this guy be here too?
Come to think of it, if it hadn't been for David back then, he probably wouldn't have survived to see today.
So to him, David was equivalent to a lifesaver!
Excitement immediately showed in Robert's eyes, and he was about to walk toward where David was.
However, he suddenly stopped, a look of confusion appearing in his expression.
This hospital has David Wells, and they still need to pay top dollar to hire him?
Isn't this ridiculous?
He's supposed to operate with David watching? How is this different from demonstrating amateur hour in front of an expert?
Robert, feeling confused, quietly asked Dr. Nolan, who had invited him.
Only then did he learn that David was just an intern here, and that David was even assigned to scrub in and assist him.
Upon hearing this news, Robert instantly became furious!
This hospital is absolutely wasting precious talent!
They're only making such a surgical prodigy a diagnostics department intern?
And having him assist me?
Such talent could completely perform surgery independently!
Such an arrangement is criminally wasteful!
If David was given the position of attending surgeon, how many people could David save?
Everyone looked at Robert, whose face suddenly showed anger, and immediately felt somewhat confused.
They had long heard that Robert Romano had a terrible temper, but they didn't expect it to be this volatile.
Robert had clearly only asked who the young man looking at him was.
And he ended up flying into a rage?
Could it be that this intern Dr. Wells had somehow offended Romano before?
Thinking of this possibility, Dr. Nolan quickly waved his hand, signaling David to leave quickly and not stay here to provoke Romano.
If Robert got angry and left, then no one would perform the hepatic tumor resection.
But David stood there as if completely oblivious.
Anxious, Nolan was practically bouncing, almost explicitly shouting, 'Get out of here before you anger Romano!'
Then the direction Robert was walking in further confirmed the suspicion in Nolan's mind.
This Robert Romano was actually striding directly toward David!
Nolan's heart sank. He inwardly thought, 'This is a disaster,' and quickly pursued, forcing a smile and saying:
"Dr. Romano, the OR is this way. We've already started anesthetizing the patient.
We should be able to begin the procedure shortly."
Robert impatiently swatted away Nolan's hand that was blocking his path:
"I know, I know. It's just that I have an acquaintance here—I need to say hello to him first. It won't take long!"
Seeing Robert confirm that David was an acquaintance, sweat dripped down Nolan's forehead.
Now this is perfect—it's confirmed.
Saying he's an acquaintance, but in reality, there must be bad blood between them, right?
That's why Robert would directly ignore the generous compensation and still want to confront David.
Looking at Robert's angry expression, Nolan felt he had screwed up royally.
Forget it, let the chips fall where they may. Anyway, David is the sponsor, and if the two have a grudge, then this surgery is basically cancelled.
Nolan, whose attempts at intervention were ineffective, followed behind Robert with an expression of complete resignation.
He originally thought that using his connections to bring in Robert would make House appreciate him.
And House wouldn't be as sarcastic toward him next time.
As a result, the final outcome is likely to be ruined by this 'trust fund kid' intern.
House frowned as he watched Robert walking straight toward them, then slightly shifted position and stood in front of David.
No matter what, David was his assistant, and he wouldn't let others push him around.
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