Chapter 324 320. An unprecedented challenge

Author: Hao Xifeng

Chapter 324 320. An unprecedented challenge

The daily work of an apprentice like Gustav is not easy. He needs to contact customers and appraisers for his teacher Bernard, arrange the order of auctions, and prepare auction catalogs.

Only at small auctions with little reputation could he go on stage and bang the hammer under Bernard's care.

If he hadn't taken Bernard's words seriously before and thought that making connections was still far away from him, then after experiencing the auction, he had sorted out all these childish ideas and packed them away.

The skull.

Now that most of the auctions of Ingres' paintings have ended, the auction center has entered a period of steady rest, and Gustav, who has been busy for more than half a month, also has a long-lost vacation.

He didn't memorize many auction skills, and his mind was filled with scenes of Kawei talking to the two queens. He tossed and turned all night long, and didn't fall asleep until seven in the morning.

Compared to others who are theoretically advanced, Gustav is an absolute activist. Otherwise, he would have followed the development path given by his father, studied hard, followed in the footsteps of his two brothers, and entered the University of Zurich to study economics, philosophy or

law.

After graduation, you can become a part of the management department of your family's private bank, or you can choose to start your own company and try your luck.

But he is obviously unwilling to succumb to other people's plans. He has his own artistic ideals.

Although he was judged to have no relevant talent by a certain painter A, a certain musician B and a certain sculptor C who were invited to his home when he was 7, 10 and 12 years old respectively, and his ideals were shattered one by one, Gustave still hoped for his future.

The work can be closer to the artwork.

This is not his first time going abroad. Before coming to Paris, he had already been to New York and London due to his poor high school academic performance.

In the eyes of ordinary people, this has no internal logical relationship, but in the eyes of his father, it is a completely different idea. He feels that if he does not go out for a walk now, Gustav will probably stay in Wen, canton of Zurich.

After spending my whole life in the small town of Tetur, I will never have the opportunity to go abroad to broaden my horizons.

Who would have known that these two recreational trips allowed Gustav to find his life goal.

He is by no means qualified to manage a bank, and the business scope of his own small private bank is not enough to show off his talents. If he wants to do it, he must do something that can change the world. Since he cannot lead the trend of world art, then he can become a world-class influencer like Bernard.

A middleman for art prices.

This is what he thought and what he did.

After two years of studying at the Divinity School of the University of Zurich, he successfully dropped out of school, and after much hard work, his father had to write a letter to his old friend [1].

Send yourself to Drouot for "experience".

At ten o'clock in the morning, Gustav woke up after only sleeping for three hours.

His mind did not become calm due to sleep, but the person's appearance became clearer. Unable to suppress his thoughts, he got up, put on clothes, did a simple wash, stuffed half a piece of bread into his mouth, and went

Rush to the hotel where Kawi is staying.

Bernard asked Gustave to get to know Kavi, but the "knowledge" he understood was by no means simply knowing that this person existed, or having a deeper understanding of this person's character and habits. Or just to open up news channels and

He simply plugs it into his personal network, and waits for a special time in the future to pull it out to chat and squeeze out information resources.

Gustave's "acquaintance" is to become friends with the other person, at least the relationship between his father and Bernard.

In short, he has deeply realized the importance of making friends with Kawei.

It's a pity that Gustav had his own ideas and drive to do things, but lacked poise and carefulness. After the auction, he relied on the far-fetched reason of returning the receipt and asked for Kavi's residence address, but

But I never thought that the other person is a very busy person with very little free time.

"I'm sorry, Dr. Kawei is not in the hotel right now."

"Where did he go?"

The waiter shook his head helplessly: "I don't know. Dr. Kawei's itinerary is personal privacy, and we have no right to interfere."

"Then" Gustav took out a note pad, wrote a paragraph neatly with the pen at the front desk [2], and then handed it to the waiter, "If he comes back, please give this note to him.

"

Leaving messages is very common in hotels. The waiter habitually raised his hand to take the note, but stopped in mid-air. His eyes were a little panicked, and he hesitated and didn't know what to say.

Gustav just felt strange and didn't pay attention, thinking that he didn't hear clearly. Just when he was about to say it again, a man in black suddenly appeared next to him: "Who are you? Why are you looking for Dr. Carvey?"

"What does who I am have to do with you?"

Almost as soon as he answered, Gustave subconsciously realized that something was wrong. The other person was wearing strange clothes and behaving strangely. He didn't speak French very fluently, and his eyes were making him look back and forth, which made him very uncomfortable.

But before he could change his words, the other party patted the waiter on the shoulder and left.

what's the situation?

Gustav was a little confused by the accident. Seeing the strange look on the waiter's face, he asked, "Who is that person? Is he from the hotel?"

"I am not sure as well."

"That's weird." Gustav's eyes flickered back and forth between the man in black and the waiter, without delving further. "By the way, when will Dr. Carvey be back? If it's the afternoon, I can be here."

Wait a minute."

"This" the waiter was stunned, and quickly replied with a smile: "I don't know exactly when he will come back, but I will hand over the note when he comes back."

"Okay then, trouble."

On the other side, Kavi had already left the University of Paris, got into a taxi, and rushed to the Palais-Dieu Hospital.

The mother's sudden labor also caught him off guard. After listening to Wan Wang's description, he couldn't help but ask: "Why did you go into labor just one night later?"

"We don't know. She is in good health, and her fetal heart rate and fetal movements are also normal." Shanwang reviewed her medical records and said, "Even the fetal position is a normal head position. It was still there during the examination last night.

It’s not in the basin yet.”

Kawei had asked before, so he naturally knew the position of the fetus, otherwise he wouldn't be so surprised: "Forget it, these are not important. What is important is how long it has been since you discovered it."

"I found out it was 9:30, and now it's 10:13. It's been almost an hour."

"After all, this is the third child. We are still far away from the hospital. It seems that it is too late." Kawei changed his mood and basically gave up the fantasy of surgery. "The next thing to do is how to keep the baby during normal delivery.

At the same time, hemorrhage was contained."

Clinical practice is not about memorizing medical books. It is difficult and important to temporarily change your judgment and put it into practice immediately.

This requires great courage and self-confidence, but at this moment Kawei made this judgment not because of self-confidence, but simply because the cesarean section itself has lost its meaning.

From a time point of view, the birth of the child is certain. Once the child enters the birth canal, it will become very easy. As long as the child enters the birth canal of a multiparous woman, it is equivalent to getting on the highway, and a natural birth is much faster than a cesarean section.

Next, we will divide it into three situations based on bleeding.

The first is that there is not much bleeding, which is almost impossible, but it is indeed a possibility. If this happens, it does not mean that the mother is safe. It also depends on the separation of the placenta. Only if the placenta is completely separated,

Only when your vital signs are safe can you rest assured.

The second type is a huge amount of bleeding. The child bleeds more than 1000ml right after birth. The situation is extremely critical, but there is no need to think too much. Just open the abdomen and enter. If the bleeding can be stopped, the bleeding can be stopped. If the bleeding cannot be stopped, the uterus can be cut off directly to cut off the source of bleeding.

.

The third type is also the most troublesome for Kawei. On the surface, the amount of bleeding seems to be stuck in the middle between the two, more or less, and the key vital signs have not fluctuated much.

Opening up a laparotomy is inherently risky, and we should not blindly open up a laparotomy just because the previous surgeries were all successful. But if we don’t do a laparotomy, and the amount of bleeding is very ambiguous, our heart rate and blood pressure may suddenly drop, and we want to rely on the simple medicines we have in hand to save our lives.

It's simply a fantasy.

At this time, you need to judge the situation carefully. If you make one wrong step, you may make the same mistake every step after.

Kawei leaned on the back of his chair and looked out the window. There were not many cars on the road at noon, and the distance between the two places was not long. He used the little time he had to quickly go through the possible situations and plans, and finally at 10:30

We arrived at the preparation room of the surgical theater before.

It has now been 1 hour since the mother went into labor.

"How is it?" This was the first sentence Kawei said after pushing the door into the room. After hearing the mother's cry, the second sentence came immediately after, "How is the bleeding?"

"About 400 ml, there are blood clots, I just vomited once, it was what I ate last night." The person who reported the report was Kallen. Others gathered around the mother to stop the bleeding and deliver the baby. "The vital signs are pretty good, the blood pressure is 124.

/76, heart rate 93."

Kawei breathed a sigh of relief, at least now it seemed that the amount of bleeding was not too much, and his team had opened two intravenous channels, one for infusion of normal saline + oxytocin, and one for infusion of anticoagulated autologous blood.

But these are not enough. There is a crucial thing in the entire labor process. As long as this thing does not come out, the so-called treatment has not even stepped on the starting line: "I remember that she had central placenta previa, and the placenta should come out faster than the baby.

Earlier, it's been an hour now, has the placenta come out?"

Kallen shook her head, her expression extremely ugly: "No."

Sure enough, without Kawei's medical treatment, the 400ml bleeding volume was just an illusion. As long as the placenta did not come out, the bleeding would not stop and the baby would not come out.

"In fact, children too"

Only then did Kawei realize that the mother's cry just now was not because of pain, but because the baby she was 37 weeks pregnant with was gone.

The placenta connects the child and the mother. If placenta previa bleeds massively, not only the mother's blood but also the child's blood will be lost. As long as the treatment is slower, or even if it is dealt with in time, stillbirth will occur due to ischemia and hypoxia.

Now that the fetal heartbeat has disappeared, the bleeding is severe, and the placenta is adherent and cannot be delivered, there is no need to wait.

Kawei walked to the bed, passed by the others, and touched the mother's belly with one hand. His face became more and more gloomy: "The uterus is not contracting well, so go and prepare. I will perform a cesarean section immediately."

"good."

"By the way, prepare the uterine hemostatic band. There will be a lot of bleeding later. And let those who prepare the blood come in quickly and start the blood transfusion now."
To be continued...