Three

1

PE (Periosteal elevator).

Retractor.

Water.

More pressure.

Lights out, microscope in.

- Hi.

- Hi, good morning.

Uncle Chung, 73 years old.

A psychiatry inpatient.

He fell down

and suffered from syncope, head injury.

We did a CT scan

and found intradural

hematoma in the left brain

with mass effects and a mid-line shift.

We did a craniotomy.

Today is day 5 of post-op.

Limbs are functional, vital signs stable.

A febrile, walking well.

He will be discharged after

the stitches come off.

Yes.

Good.

Thank you very much.

Did we do a post-op CT scan?

Yes, on day 1.

Contusion in the left temporal lobe.

Scan him again before he leaves.

OK.

A, B, C, D!

- 1, 2, 3, 4...

- Enjoy the food. Goodbye.

Happy!

Merry Christmas!

The patient remains in a vegetative state.

Vital signs normal, afebrile.

Can we move him to Recovery?

How far along on the waiting list?

No. 4. He still has to wait.

Mr. Hung, 27 years old.

5 weeks ago, his legs were weak

and his hands exhibited signs of paralysis.

The MRI shows,

an extensive cervical spinal cord tumor.

We did a laminectomy for

subtotal excision...

You were so confident

when you coaxed me into having the surgery.

Surgery involves risk.

The doctor studied your condition

and made a call.

Shall we?

What did the intra-op frozen section show?

Astrocytoma.

Was the section clear?

Somewhat, but inconclusive.

I felt it was operable.

Have you considered

closing after the biopsy,

and use radiotherapy afterwards?

Radiotherapy can only slow down

the tumor's development.

But the symptoms have popped up.

His quality of life is compromised.

It will only get worse.

He's young-

Surgery gives him a better

chance for normal life.

Surgery gives him a better

chance for normal life.

Normal life?

I can't move!

Rm Paralyzed!

It has only been 3 weeks.

In some cases,

it takes 3-4 months,

or even up to 6 months to see improvements.

What about physiotherapy?

We want to build up his trunk muscle,

to help him sit better.

But his morale is poor.

He won't even try.

There's still hope.

It won't be easy.

We know how you feel.

But please show some respect.

Rubbish doctor!

It's all your fault!

Calm down!

She doesn't want to see

you like this either.

She's equally upset.

I could have played it safe.

But that wouldn't have solved the problem.

I took a chance, for your own good.

Next.

Excuse me!

How many thugs getaway?

Did the operation fail?

Excuse me!

Police! Get out of the way!

A 228

Catergory 2

Dr. Shek.

Officer, please remove the handcuffs.

Transfer him.

1, 2, 3, go!

Sir, what's your name?

What's your name?

How did you get hurt?

Penetrating injury.

He was shot.

Send him to Resuscitation.

Does it hurt?

Does it hurt?

- Legs are fine.

- BP and pulse?

BP 136/80, pulse 76.

- NSQ1 (1 hour drip).

- Shan, set up a drip.

Get ready to turn him over.

Neurosurgery

Gunshot wound to the head.

GCS10.

ICU:

We're ready. Check his head.

OK:

- Ready?

- OK

1,2,3.

Wound in the right temporal lobe.

No exit wound.

No raccoon eye. No battle sign.

Do a CT scan.

Move.

A fat woman asks a doctor

how to lose weight.

The doctor suggests horseback riding.

A week later, 100lb is gone...

from the horse.

I'm fine.

Thank you.

You're very capable.

You're the associate consultant

at such a young age.

It was just bad luck with this patient.

I don't believe in luck!

I came to Hong Kong at 17.

I learned Cantonese and English,

got into medical school

and became a neurosurgeon.

None of it is luck.

I know you work hard.

Just take it easy.

Lives are in our hands.

It's a matter of life and death.

We're professionals

but not everything is within our control.

We can only do our best.

People say that all the time.

But they don't even know what it means.

I have patients waiting.

Vital signs and

GCS stable, pupils normal.

Show me the scan.

OK:

The CT scan shows

a foreign body in the left frontal lobe.

According to Dr. Chow's notes

and what the scan reveals,

this is probably a bullet.

There are fractures near the entry site

and soft tissue swelling here.

And over here...

hemorrhaging and edema

along the bullet path.

Lucky him. No significant

hydrocephalus or mid-line shift.

Lucky devil!

At 11 am, the police rounded

up the suspects in Kwun Tong

and shots were fired.

The image shows the inspector

who shot leaving the scene.

During the operation, a suspect was injured

and sent to Victoria

Hospital for treatment.

It is believed that the suspect is

connected to an armed robbery last month.

Miss, no photo please.

The public has the right to know.

No more freedom of the press in Hong Kong?

Too crowded.

Take the next one.

HN 157399034

ID UJ8742387

What kind of surgery?

Craniotomy to remove foreign body

and debridement.

We have consent from 2 medical officers.

They signed off on it.

OK.

Thank you.

The Ward C5 patient is here.

- OK

- Excuse me.

Ward 1, come get the patient.

We're putting you under now.

Try to relax.

Take a deep breath.

Why did you let them in?

They insist on watching.

I don't want anyone to interfere.

Take a deep breath.

Remove his handcuffs and get out.

I must keep an eye on him.

He's a killer.

He's under anesthesia.

Remove the handcuffs. Get out.

Sir, you can't do this.

Sir, you can't do this.

Don't give us a hard time.

Sir, you can't go in.

Sir, please come out.

I don't want surgery.

Sorry.

You need to move to the hallway

and make room for other patients.

You've been here for 6 months.

The doctor says you're fine.

Don't occupy the bed.

Don't look back!

It's bad luck!

I bought food for everyone.

They haven't had lunch.

Don't know how long the surgery will take.

Nonsense.

Throw it away.

Yes, Sir.

Fatty.

Go.

You're lucky.

The bullet went into your head

but didn't do any critical damages.

Your bodily functions are not affected.

But the bullet is a foreign body.

If we don't remove it,

it may cause hemorrhaging,

pus, and infection,

and may kill you.

SIG P250, 9mm Parabellum, hollow point.

Not too penetrating but destructive.

Bang!

I should be a dead man.

How could I have survived?

How could I have survived?

The next 6 hours are critical.

Your condition may deteriorate suddenly.

By then, it'll be too late to operate.

I suggest you do it now.

There was a chicken on a farm.

Every morning, the farmer would feed it,

until it

became fat.

The chicken thought the

farmer was a good man.

One morning, the farmer came as usual.

But he didn't feed it. He killed it.

Because it was Thanksgiving!

The chicken relied on induction.

As a result, it died.

I didn't make up the story.

A philosopher called

Bertrand Russell wrote it

in his 1917 book Problems of Philosophy.

As a doctor,

it's my responsibility to remind you.

But it's your call.

Think it over.

Do we have chicken tonight?

- No!

- Russian chicken?

- No!

- Gourd tonight?

No!

No?

Then I'm dead.

I'll sue you!

I will definitely sue you!

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