Chapter 63: Furious Pete (5000 words) (Page 1/2)
This familiar scene immediately made David recall who this guy was.
A musician who played the trumpet, considered a celebrity in the jazz world.
After becoming paralyzed due to an accident, he was misdiagnosed with Amyotrophic Lateral Sclerosis, or ALS for short.
Now, his paralysis symptoms have been worsening, and he can't even play his beloved instrument anymore.
So, when he sought medical treatment, he always harbored a death wish.
He even later signed a DNR agreement, meaning that if his condition worsened, he would refuse any emergency measures and choose death with dignity.
In short, this guy named Giles was an extremely problematic patient, because a doctor cannot save a patient who is determined to die.
Just then, the sound of House and Cuddy arguing came from behind.
The general meaning was that House wanted to take over this case, but Cuddy told him that this case would be fully handled by the neurologist Pete.
This was because, after a preliminary diagnosis, Giles's reason for entering the emergency room was simply lobar pneumonia.
This illness is not difficult for most doctors.
The reason for choosing Pete as the responsible physician was because he was good friends with the outstanding neurology expert from Johns Hopkins who diagnosed Giles with ALS, who was also Giles's attending physician, Martin Hamilton.
So, Martin specifically requested Pete to take over his case.
However, it was clear that Pete did not intend to treat Giles's paralysis symptoms but wanted to follow his wishes and sign the DNR agreement for him.
So, after Giles finished signing the agreement, Pete walked out looking relieved.
When he saw David, House, and Cuddy, his brows immediately furrowed.
He now intensely disliked David and House, even feeling revulsion from the bottom of his heart when he saw them.
In his original plan, he would only deal with these two after his friend successfully became the new chairman of the hospital.
But now, it seemed there was an opportunity to antagonize them both.
He put on a fake smile and spoke to Cuddy:
"Cuddy, I'm new here and not very familiar with the department members.
But as you can see, I accidentally injured my hand yesterday.
So, I need someone to be my assistant, but I don't know who to ask for help right now."
Although Cuddy was also very dissatisfied with this doctor who had been thrust upon her by the board, she could only force a smile and accommodate him:
"Is that so? As long as the doctors are available, I don't object to them helping you."
Pete was waiting for this response. He looked at David:
"How about this, I know most other doctors are busy with important matters, so I won't waste their time.
Let this intern help me.
I think simple tasks like taking care of patients, this intern surely won't mess up, right?"
Cuddy glanced at David, who was an intern, and nodded in agreement:
"Of course, David, you will be temporarily transferred from the diagnostics department to work under Doctor Pete today.
Doctor Pete is a professional neurologist, you must be diligent, learn as much as you can—this will be very beneficial for you to get your medical license in the future."
Hearing that Cuddy had transferred someone under his supervision without his consent, House immediately said with irritation:
"Wait, since when can my staff be transferred to others at will?
What do I do when I need a differential?
What if a diagnosis is delayed?
If you ask me, you should just assign this patient to me for treatment, so that I can legitimately keep my staff on the case."
Seeing House complain, Cuddy turned around and said helplessly:
"House, I said, this patient's responsible physician is Pete.
Besides, David is just an intern, can't you make a diagnosis without him?
Or does his input directly affect your diagnosis?
If that's the case, then I have to reconsider whether hiring you was the right choice."
Seeing House still wanting to speak, Pete, who already had his agenda, immediately interrupted:
"House, this is my patient, you don't need to interfere, please stay away.
Otherwise, I will ask the patient to apply for a restraining order against you from the court!"
House swallowed the words he was about to say, turned around, and sneered at Pete with his intensely penetrating gaze:
"Your patient? Have you thought about finding the real reason for his paralysis?
Instead of helping him solve the problem, you sign a DNR agreement for him.
What kind of doctor are you?"
Pete was completely unfazed by this.
The patient has given up on treatment, and the doctor is still trying to persuade him to accept treatment? Isn't this just looking for trouble and making things difficult for himself?
"That's his own choice, as a doctor, you should respect the patient's autonomy!"
House slammed his cane down heavily:
"But he doesn't have to die at all! Have you considered that he might have Multifocal Motor Neuropathy?
You can completely treat him with intravenous immunoglobulin."
Pete replied coldly:
"You don't need to worry about how I should treat him, do I need to repeat it again—this is my patient, not yours!
David, start intravenous infusion of steroids and levothyroxine for the patient now, immediately!"
David raised an eyebrow, the fate of an intern is so bleak.
They don't even have the freedom to choose their assignments.
After all, Cuddy is still in charge of Princeton-Plainsboro for now.
Facing Pete's legitimate request, David couldn't raise any objections.
And it was obvious that Pete was targeting him.
It seemed he wanted to make David's workday as unpleasant as possible.
As expected, David wouldn't get any rest today.
Indeed, right after finishing the IV setup, Pete immediately ordered David around again.
However, he seemed to have actually considered House's suggestion and asked David to get immunoglobulin at a dosage of point-four grams per kilogram of body weight for Giles to inject intravenously.
After all, if House's suggestion really worked, the credit would go to Pete.
Thinking about House's frustrated expression after he successfully treated the patient using House's idea, Pete felt like he needed to go out and smoke a cigarette to celebrate.
While Pete was outside smoking, David looked at Giles, who was lying on the bed looking defeated, and whispered:
"I don't think you have ALS."
Giles's expression changed slightly, and he turned his head to ask:
"Who are you?"
"I'm David, an intern in the diagnostics department."
Hearing that David was just an intern, Giles chuckled bitterly. He knew he shouldn't have gotten his hopes up.
"Is that so? Is this part of your training? Learning to comfort a dying patient?
Making him rekindle hope for life, and then subjecting him to various unpleasant tests?
Well, that's not necessary, I've already signed the DNR agreement, you can just sit there and play on your phone and wait for me to die."
David understood that with his current lack of reputation and standing in the medical field, he couldn't convince him.
So, the next sentence David said invoked House's authority:
"Dr. House has the same opinion as me."
Seeing David mention House, Giles's face finally showed a look of interest.
He hadn't heard of David, but he had heard of this brilliant diagnostician, House.
"Oh, I've heard of this guy, they all say he's an obsessive asshole."
David smiled:
"I don't deny he's an asshole, but he does have unique insights into diagnosing illnesses.
Since he said there are other possibilities, your illness is definitely not ALS.
I suggest we redo the MRI to see the specific situation."
Hearing David say this with such certainty, even Giles, who was already resigned to death, felt a slight tremor in his heart.
Indeed, if David had used speculative words like 'maybe' or 'possibly', Giles would have scoffed at it.
But David spoke so definitively, it couldn't help but make Giles feel a glimmer of hope again.
What if... it really was a misdiagnosis?
Suddenly, a voice came from outside the door:
"Hey, David, what are you doing?! Chatting? Are you done with your work?
Take these soiled linens away quickly.
What are you still doing standing there? Hurry up and get to work!"
David reluctantly stood up, just as he was about to leave with the dirty linens.
Giles, who had just been talking to him normally, suddenly started gasping for air, making choking sounds.
Then he tilted his head and lost consciousness.
And the oxygen saturation on the monitor was rapidly decreasing—Giles was showing symptoms of respiratory failure!
Pete roared in surprise and alarm, "David, what did you do?!"
Facing Pete's attempt to shift blame, David spread his hands and dropped the linens on the floor.
"I have been administering medication to the patient according to 'your' orders."
"So, should we perform emergency treatment on him now?"
Pete's expression was conflicted, but he finally said,
"No, he has signed the DNR protocol, and we have no right to perform any resuscitation on him."
"However, after he dies, I will find out whose mistake caused this incident."
David understood Pete's implication very well.
The subtext was that Pete was preparing to make David take the fall for this incident.
Then, he would announce to everyone that the patient died due to the intern's improper procedures.
David smiled indifferently. With Pete watching, as an intern, he really couldn't perform resuscitation against the DNR protocol.
But he couldn't, which didn't mean House couldn't.
David put his hand into his pocket and sent a text message to House.
Soon, House, limping with his cane, appeared at the doorway of the ward.
Pete frowned immediately when he saw the uninvited House.
"What are you doing here?"
House ignored Pete and asked David with a grave expression,
"How long has it been?"
"Ten minutes. It should be respiratory failure symptoms caused by the immunoglobulin."
Hearing David's assessment, House turned his head to look at Pete.
"Did you add immunoglobulin treatment for him?"
Pete looked at House, who had turned the tables, with disbelief and said in surprise,
"Didn't you suggest this treatment plan? You should be primarily responsible for his death from immunoglobulin."
House directly shut him down with a cold sentence,
"This is your patient, and you screwed everything up."
"Besides, he's not dead yet. David, intubate him! Establish an artificial airway!"
Pete immediately intervened.
"You can't do this, he signed the DNR protocol!"
Only then did House understand why David wanted him to come.
He handed his cane to David, directly opened the supply cabinet, took out a disposable endotracheal tube, and prepared to act.
Seeing that Pete still wanted to stop him, David quietly positioned the cane under Pete's feet.
Pete, who was only focused on stopping House's procedure, didn't notice what was beneath his feet and stumbled, falling flat on his face!
More importantly, his injured right hand instinctively tried to break his fall.
He could even clearly hear the cast on his hand crack again!
The severe pain caused Pete, who was lying on the floor, to keep gasping for air, making an audible contribution to global warming.
Of course, in this state, he could no longer stop House from performing emergency treatment.
Before long, Giles's condition stabilized. After connecting him to a ventilator, his life was no longer in danger.
Pete, who had just gotten up from the floor, pointed his trembling hand at House and said,
"You're finished. You will not only receive a court injunction, but your medical license will also be revoked!"
House was indifferent to Pete's empty threat.
"Is that so? Then go ahead. The hospital has always kept fifty thousand dollars set aside for me to hire a lawyer."
"It would be a waste not to use this money."
Hearing House's answer, Pete's chest heaved violently with rage.
Are people so brazen now?
Why is this House the same as David, not afraid of his threats at all?
Could it be that these people have nerves of steel?
What was even more infuriating was that David was behind him, pretending to be concerned.
"Doctor Pete, the cast on your hand seems to be bleeding through. Are you okay?"
"How about you lie on the gurney and let me examine you?"
Seeing David making sarcastic remarks behind him, Pete was both furious and flustered. He opened his mouth and stuttered for a long time, unable to form a complete sentence.
Then he only felt darkness before his eyes, and under the assault of rage, he actually passed out.
Neither David nor House had any intention of performing emergency treatment on Pete, who was lying on the floor.
House looked at David.
"Hey, David, you wouldn't want me, a cripple, to squat down and give him emergency treatment, would you?"
David shrugged, indicating that he couldn't help.
"I'm just an intern. What do I know about emergency treatment? How about we call a nurse?"
The two looked at each other and tacitly let Pete lie on the floor for a while longer.
Fainting from anger indicates that Pete may have cerebrovascular issues.
However, this is not critical. Even without emergency treatment, Pete will recover after a while. They can just use this time to give Giles some treatment that he is unwilling to undergo.
As for Giles's wishes?
What wishes can an unconscious patient have?
Moreover, House has already violated the DNR protocol. Compared to that, taking him for tests against the patient's wishes is a minor infraction.
After the two jointly took Giles for angiography, the reawakened Pete could not stop the established facts that had already occurred.
The furious Pete immediately called Giles's family.
Then House immediately received a court injunction prohibiting him from being within fifty feet of Giles, and the plaintiff filed a lawsuit against House.
In other words, House might be facing jail time.
But House showed no concern about this. He just asked David to take the angiogram to Chase and Cameron to analyze together and find the problem as soon as possible.
With the joint efforts of the three, it didn't take long to find something abnormal in the angiogram.
Cameron immediately exclaimed,
"It's really a blood clot. House is right, his arm paralysis has nothing to do with ALS."
House also appeared at the doorway of the lab at this time.
"What's the diagnosis?"
"It's a cerebral clot. The arm paralysis is due to the blood clot."
"So we just need to administer tissue plasminogen activator or heparin, and there's a high chance of dissolving the clot."
"No, heparin cannot be used for treatment."
Suddenly, David raised an objection, and everyone's eyes turned to him.
Chase, who had just suggested using heparin for treatment, also looked at David with a puzzled expression.
It's standard protocol to use this drug to treat blood clots, so why not?
David, enduring everyone's questioning gaze, organized his thoughts and said,
"Because he's a trumpet player, his lungs are severely compromised due to the paralysis."
"So if heparin is used for treatment, it may cause pulmonary hemorrhage, and he won't be able to play his beloved trumpet in the future."
"I suggest using surgical thrombectomy to remove the clot, which is better for the patient."
"This can avoid lung damage, but surgery has risks."
"So if we do this, either we cure his arm paralysis, or the patient will die."
"But based on my interaction with him, I believe he will choose the latter."
House considered it carefully. David's reasoning was indeed very sound.
But the surgical risk is high, and this choice must be left to Giles himself.
"Is the patient awake? David, inform Giles of the risks."
...
When Giles, who had woken up from unconsciousness, saw David entering again, he managed a weak smile.
"I heard that House violated the DNR protocol and forcibly resuscitated me? Then he's probably in big trouble."
David smiled and nodded.
"That's right, he has already received a court summons to appear in court."
"But that's not the point. The point is that Dr. House performed several tests on you while you were unconscious."
"The test results show that your arm paralysis is not related to ALS. Your arm paralysis is because a cerebral blood clot is preventing blood from flowing to the area of your brain that controls your arm."
"So we just need to dissolve it or remove it, and you will regain function in your arm."
Giles didn't show any excitement. He just calmly asked,
"Are there any side effects?"
"If you use the dissolution method, your lungs may hemorrhage, and you may not be able to play trumpet in the future."
"And with surgery, there are no side effects, only one risk, which is either a cure or... death."
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