The two lumps in her neck grew to a size larger than a goose egg, but she still refused to have surgery and almost lost her life. 62-year-old Ms. Zeng still looks back on it with horror. If it wasn’t for the general surgeons of the Sixth City Hospital who gave her and her husband a thorough analysis and persuasive advice, she and her husband might still have resolutely refused surgery. Thirty years ago, Ms. Zeng had an operation for a thyroid nodule. Then a few years after the surgery, Ms. Zeng’s neck gradually thickened, and later she could even feel the obvious lump. She began to move from one major hospital to another in Shanghai to seek medical attention. The doctors thought that Ms. Zeng’s thyroid nodules were more likely to be benign. However, whenever it came time to decide whether to operate, the doctor’s words always discouraged Ms. Zeng and her family. Because there are more sensitive nerves in the head and neck, doctors point out that complications from surgery can be significant, and in addition to lifelong medication, they can cause symptoms such as convulsions, which can seriously lead to life-threatening asphyxia. Ms. Zeng and her husband always ignored the necessity of surgery due to the fear of complications, so they hesitated every time they went to the doctor to face the doctor’s recommendation of surgery and have been afraid to receive surgical treatment. However, the tumor continued to grow bigger and bigger day by day. For more than twenty years, the two small lumps have become big as goose eggs! Later, these two tumors even affected Ms. Zeng’s sleep, and she always felt difficulty in breathing and could not lie down. So they came to the Sixth People’s Hospital affiliated to Shanghai Jiaotong University and enrolled in the specialist clinic of Dr. Zhang Pin, chief of general surgery. “The CT and ultrasound results showed that Ms. Zeng had bilateral nodular goiter with adenoma formation, and a general 3-4 cm thyroid tumor is considered to be huge, but Ms. Zeng’s two tumors were 10×8 cm in size, larger than a goose egg. They were even bigger than goose eggs! In addition, the ultrasound also suggested that the mass was calcified, which is one of the clinical features of thyroid cancer. Further CT scan revealed that due to the compression of the huge thyroid tumor, Ms. Zeng’s trachea was severely narrowed, with the narrowest part being less than 0.7 cm in diameter (normal is 2-3 cm), which meant that Ms. Zeng was likely to suffer from asphyxia due to tracheal blockage, which could be life-threatening if not rescued in time. To put it bluntly, Ms. Zeng was likely to “just walk away”. Director Zhang patiently explained the situation to Ms. Zeng and her husband, and when they understood that this so-called “benign tumor” could be fatal, the idea of the two people rejecting the surgery began to waver. Out of consideration for the complexity of the surgery and the possibility of serious irreversible complications, the treatment team led by Director Zhang asked the leaders of the hospital medical office to convene a consultation with experts from the departments of general surgery, otorhinolaryngology, anesthesiology and intensive care unit (ICU) to jointly formulate a treatment plan. We also prepared a plan and equipped with corresponding resuscitation measures. However, after the decision to operate was made, difficulties ensued. The first one was the difficulty of anesthesia. Because Ms. Zeng’s trachea was too narrow, anesthesia could not be performed as usual. Under the guidance of Professor Jiang Wei, director of the Department of Anesthesiology, Dr. Qin Huili, deputy chief physician, finally decided to perform tracheal intubation under the guidance of fiberoptic bronchoscopy. In addition, because the special part of the operation was in the neck, with many blood vessels and nerves distributed, and the patient was operated for the second time, the normal anatomy had been mutated, and the adhesions caused by the first operation had changed the direction of blood vessels and nerves, so this operation might lead to serious complications, such as the removal of the mass might involve the large blood vessels in the neck, which would cause intraoperative hemorrhage and be life-threatening once; there was also the possibility of intraoperative damage to the The parathyroid glands may be damaged during surgery, causing the patient to have convulsions due to low calcium. This puts high demands on the doctors’ skills and is a test of the patients’ trust in them. So, experts from several departments met again and again and finally decided on a strict surgical plan. The surgery was performed as scheduled. Director Qin chose a thinner catheter over the fiberoptic bronchoscope and safely inserted the trachea under the guidance of the bronchoscope, creating the conditions for the surgery. During the operation, Director Zhang found that Ms. Zeng’s huge mass occupied almost the whole thyroid gland, and there was a trachea of about 5 centimeters in length that was obviously collapsed and the structure of the cricoid duct had been destroyed due to the prolonged compression of the huge mass. In other words, once the tumor was taken out, the trachea would be obstructed again due to the collapse of the structure. As soon as Director Zhang removed the tumor, Dr. Hongliang Yi of the Department of Otolaryngology, who had been preparing for the surgery, immediately performed a tracheal suspension for Ms. Zeng, pulling the collapsed trachea onto the muscles on both sides of the head and neck. The suspension was only a temporary solution to the problem of tracheal collapse, and it would take about a week for the normal formation of the airway sinus tract before the tube could be removed, which would mean a completely successful operation. Once the formation is unfavorable, another stent will need to be placed for Ms. Zeng to ensure smooth breathing. Therefore, this subsequent week is also extremely critical. As a member of the consultation group, Professor Zhou Ming, director of ICU, and Wang Aizhong, deputy director of ICU, paid considerable attention to the operation, although the operation had been successfully completed, but the later monitoring was related to the effect of the operation, not to mention that Ms. Zeng’s tracheal intubation could not be removed yet, which required more efforts from the medical staff. The patient’s condition required more effort. One week later, the experts unanimously concluded that Ms. Zeng’s tracheal sinus tract was formed normally, so after the tracheal intubation was removed, Ms. Zeng was transferred to the general ward for further observation. She was soon discharged from the hospital without incident. “I still look back with some fear, I’m really grateful to the doctors of the Sixth Hospital.” Ms. Zeng’s husband, Mr. Chen, burst into tears when he mentioned the incident. “If the experts at the Sixth Hospital had only emphasized the sequelae of the surgery, like the previous doctors, then we would have refused to operate, and then my partner would have ……” Chen choked up again, “This is medical ethics! ” Indeed, the doctor’s guidance concerns the decision of the patient and his family, which is also a reflection of the doctor’s responsibility.