Chapter 310 -0294: Navigation
“Schedule a DSA examination for the thoracic spinal cord blood vessels for Mr. Guo.” Lin Mingyuan advised Dr. Huang privately.
Lin Mingyuan now had a clear understanding of the Guo Jingyao’s next treatment plan. He had no doubts about Yang Ping’s suggestions, his memory of the Sanbo Hospital Academic Conference was still very clear.
“If anyone has differing opinions, please speak up. I support Dr. Yang’s thoughts. I recommend we proceed with the DSA scan to diagnose definitively.” Lin Mingyuan announced the discussion’s conclusion aloud.
“I agree and fully support Dr. Yang.” August raised his hand, his face flushed and excited.
Milton’s facial muscles twitched a few times, he hesitated, slowly raised his hand, and accepted the decision.
A young Chinese doctor managed to change the discussion’s outcome with just a few words, negating their previous dialogue. Kobayashi Takeshi reluctantly accepted this, but couldn’t counter. He couldn’t always argue with “lack of sufficient evidence” as an excuse. So, he had to raise his hand in agreement.
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The other doctors around the round table in formal attire loosened their ties, pretended to drink water, and whispered to the people next to them. In due course, everyone raised their hands.
“I haven’t seen the patient yet?” Yang Ping realized that there had been no arrangement for him to see the patient clinically during the meeting’s discussion.
Before the meeting, around eight-thirty, other specialists were arranged to see the patients in the inpatient department, and then attend the meeting.
However, Yang Ping and Director Zhu weren’t informed and did not receive relevant notifications.
“Make the arrangements right away—” Dr. Huang immediately called the ward’s resident doctor.
When the consultation meeting ended, Dr. Lin and Dr. Huang accompanied Yang Ping to see Guo Jingyao, and naturally, the other doctors also went along.
Although everyone had seen the patient before, the analysis of the condition had now completely changed.
Guo Jingyao was staying in Yingge Hospital’s best suite, measuring about three hundred square meters, with excellent natural light. The suite included a patient’s room, living room, conference room, caregiver’s room, guard’s room, and nurse’s room, with all necessary furniture and appliances included.
The in-charge doctor was also of Chinese descent, and the nurse was a Malaysian lady. They guided everyone to the patient’s room.
Guo Jingyao was sixty years old, yet he seemed to be in his prime. His hair was slightly gray, but he was spirited and energetic, with few wrinkles on his face, looking just like a man in his forties.
“Mr. Guo, this is Dr. Yang, who we’ve invited from China. He is a top expert in the field of orthopedics. He would like to examine you now.” Dr. Huang introduced Yang Ping to Guo Jingyao in English.
“Hello, Dr. Yang. Thank you for your efforts.” Guo Jingyao greeted Yang Ping in Chinese as they shook hands.
As he went to school in a Chinese school in Malaysia during his childhood, he could naturally speak Chinese. Although he wasn’t fluent, he could communicate sufficiently.
“Do what you need to do. I will cooperate.” Guo Jingyao then switched back to English.
As always, Yang Ping carefully inquired about the history, performed a physical examination, and carefully reviewed the previous examinations one by one.
He examined carefully following the spinal surgery protocol. All skin segments and muscle segments were examined carefully. There was a reduction in lower limb skin sensation, muscle strength in most muscle groups was just at level one, and for some muscle groups, the muscle strength was at level zero. Some superficial and deep reflexes had decreased as well, and pathological signs such as the Babinski sign couldn’t be provoked. With muscle strength so weak, surgery was imminent!
The meticulous German man, August, stood by Yang Ping’s side the entire time. Once Yang Ping finished the examination, stood up, and handed the reflex hammer back to Dr. Huang, August immediately took over and handed it to Dr. Huang.
“How is he, Dr. Yang?” August asked cautiously.
Indeed, regarding various titles and designations, people in European and American countries prefer to directly address someone as “Doctor,” as they believe it to be the most honorable title.
“I suggest we immediately arrange for a DSA, to obtain a clear angiographic image. Delay will cause some blood vessels to occlude, leading to spinal degeneration. Then, permanent paralysis might truly occur. What’s more dangerous is that as the spinal cord edema continues to progress upward, if it affects the respiratory muscles, it will severely impact the breathing in the end…”
Various knowledge points connected logically in Yang Ping’s mind, forming a clear picture of the disease’s development.
“Dr. Huang, I implore you to execute this immediately!” August took a deep breath. He felt as if he was back in Munich where he could issue orders.
After issuing the order, a strong sense of guilt surged within August’s heart. As an authority in spinal surgery, he had fallen into the disease’s trap and couldn’t escape. If not for the arrival of this Chinese doctor, the patient would have unwittingly ended up paralyzed forever, and the truth would never have been uncovered.
The conclusion that paralysis was caused by the surgical damage to the spinal cord would have been part of the final case discussion record, becoming a conclusive diagnosis. The chief surgeon would also be scrutinized and investigated for potential errors. The conclusion they all deemed as a given two hours ago now seemed ridicules.
Have similar mistakes been made in the past without his awareness? August shivered at the thought.
“Do no harm!”
This is the first rule for doctors – to use medical skills to help patients, not to use them to harm patients.
Although August did not harm the patient, he almost delayed the patient’s treatment due to his ignorance.
If everyone had just stubbornly stuck to their own point of view, arrogantly dismissing the young Chinese doctor, the harm might have occurred.
Indeed, the more knowledge one has, the more one realizes one’s ignorance.
“Thank you, Doctor Yang,” August involuntarily said.
“Save time, immediately assess the anesthesia risks, send for Radiology and imaging diagnostics for DSA,” Dr. Huang understood the implications of Dr. Yang’s words.
“Those variant arteries are extremely difficult to select. I’ll need to be there throughout, to provide anatomical guidance for the chief surgeon,” Yang Ping solemnly proposed.
Without his guidance, the intervention doctors would overlook these arteries, simply following the standard anatomy spine blood supply for angiograms.
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Milton was still skeptical. He didn’t have much concept of this supposed triple manifestation case. How could Dr. Yang have such thorough research? It was unreasonable. Was Chinese medicine really that advanced?
The British are more conservative than one might imagine. Many elderly Brits have never left the country. Their impressions of China often remain stuck in the era of queues and foot-binding, deeply influenced by the glory of the once-thriving British Empire.
Prejudice can cloud one’s vision, making it impossible to see things as they really are. Milton was now troubled by his prejudice.
From beginning to end, Kobayashi Takeshi thought Yang Ping was making a farce. He waited to see how he would conclude it, but now, how could this be a farce?
If we consider the speech in the conference room as a farce — after all, it was nothing more than words — now he was personally taking the field, directing interventional doctors to select blood vessels. Which doctor would treat the patient as a farce? It also shook Kobayashi Takeshi, and he began to think about Guo Jingyao’s condition.
Regardless of the opinions of these big shots, Dr. Huang only listened to Lin Mingyuan.
Leaving the ward, Yang Ping seemed to have become the center of everyone’s attention. That’s the nature of technical fields: either you can or you can’t, and it becomes obvious as soon as you show your hand.
“I ask for everyone’s understanding. We can’t have too many people in the interventional surgery room, there are only a few spots. Dr. Yang, Dr. August, Dr. Milton, and Dr. Takeshi, will accompany me into the interventional surgery room. Other doctors will be accompanied by Miss Li, to await in the Radiology and Imaging conference room. I’m very sorry!” Dr. Huang announced the list of personnel allowed into the interventional surgery room.
The number of people allowed to observe in the operating room is limited, and must comply with hospital infection regulations. The Yingge Hospital, a hospital certified by the International JCI, enforces stricter infection control.
Once, the British Prime Minister Cameron visited a hospital in London. The hospital authorities found that Cameron and his entourage failed to comply with the hospital infection control procedure. In front of the camera, they shouted, “Get out!”, ignoring that Cameron was Prime Minister.
This is the spirit – I am the boss on my turf, and you’re banned if you violate the rules.
The process at Yingge Hospital was very smooth and Guo Jingyao was quickly transferred to the interventional surgery room.
“Dr. Yang, tell us anything we need to be aware of,”
Dr. Lin brought Yang Ping into the interventional surgery room, while Director Zhu accompanied Yang Ping to the door of the operating room and waited outside.
“We need the best interventional doctor on stage!” Yang Ping only had one thing to say.
“Our hospital’s Dr. Zhou, a student of the American Interventional Master Raymond Nolan—” Dr. Huang introduced.
Everyone changed their shoes, washed their hands, put on masks, hats and lead clothing, and entered the operating room.
This interventional surgery room is a standard 100-level hybrid operating room with a very high specification.
After satisfactory anesthesia, patient’s position was set, routine sterilization and placement of sterile linens were accomplished, then Dr. Zhou performed femoral artery puncture, his movements adept and standard.
Dr. Zhou’s technique was indeed good. These doctors earned high salaries, each of them being the breadwinner for their families, living in villas and driving luxury cars. In private hospitals like Yingge Hospital, the relationship between doctors and the hospital was not one of employment, but of cooperation.
Doctors performed surgeries and all the fees from the surgery belonged to the doctor, while the hospital only made money from bed places, nursing, etc. Therefore, doctors who could operate in private hospitals were highly skilled. They were not short of money and focused on dedicating themselves to medical research.
“Do I start selecting as per usual?” Dr. Zhou asked.
“Hmm, let’s start as per usual!” Yang Ping agreed.