"Everyone, the situation of our first patient is very special. She has been affected by chemotherapy, which led to osteoporosis and myocarditis. She is now still on amiodarone in the ICU; otherwise, her heart might not be able to withstand the surgery," Liu Banxia said after calling everyone together for the consultation.
"Director Xu, if spinal decompression and fusion surgery is to be perford on the patient, we will need your help. Dr. ng, Dr. Chen—one of you is a cardiologist and the other is a cardiothoracic surgeon—do you have any ideas that could help the patient’s heart pull through?"
Chen Xuehai rubbed between his eyebrows. "If we insist on performing the surgery, there is so possibility. I’ve encountered similar cases abroad; we could try temporarily using angiotensin-converting enzy inhibitors and β-blockers."
"However, the pressure on Director Xu will be great. These two drugs may not provide support for long after administration, and their effects vary from patient to patient."
"In so cases, they only last for two hours; in others, not much more than three. Moreover, during the surgery, we must monitor the patient’s heart condition at all tis. If anything goes wrong, we need to stop the operation imdiately."
"Two hours..." Xu Peichen frowned. "To be honest, I’m not sure I can do it. Even three hours is barely enough. We must clearly explain to the patient that the surgery is very risky."
"Ah... I know, but I’m really worried that the patient will beco paralyzed," Liu Banxia said with a bitter smile.
"If she were older, I wouldn’t say much, but she’s still so young. She just suffered from breast cancer, and now she’s in danger of becoming paralyzed. Her future will be hard."
"You’re trying to guilt into this," Xu Peichen said, shaking his head.
"If the patient didn’t have osteoporosis, I could be a bit more aggressive, which would save so ti. But now, just a fall has broken pieces off her spine, so I have to be extra cautious during surgery. And if we operate, Chen Xuehai should be in the OR with . If the patient’s heart does have a problem, we can handle it promptly. Otherwise, we might face a situation we can’t recover from."
"Thank you, Director Xu. Dr. Chen, can you spare the ti?" Liu Banxia again looked pitifully at Chen Xuehai.
"Alright. If the patient agrees to the surgery, I can assist Director Xu," Chen Xuehai said. "I’m quite puzzled, why are you so nervous today?"
"It’s because this is a patient an intern of ours diagnosed. I think this patient is likely the most special one to her," Liu Banxia said.
Chen Xuehai looked at him, nodded, and said nothing more.
He understood now. If this patient was successfully treated, it would not only help the patient but also the intern.
When he had co over, he’d seen Xu Yino constantly looking in their direction; this patient must be hers.
"Alright, we have a preliminary plan for the first patient," Liu Banxia said. "Director Xu, please think about a few contingency plans. I’ll also be in the operating room with you."
"Okay, I’ll go out and take a good look at the scans," Xu Peichen nodded.
"The second patient is here. Dr. ng knows her condition. Dr. Chen, please take a look at the file," Liu Banxia continued. "We just received news that her temperature has risen another 0.1 degrees and is close to the threshold. Her school counselor ca, but it’s just the counselor. The girl’s family seems to be rather poor; she studied diligently for the scholarship. Regarding the expenses, I can apply to the hospital. The key is how to make the dication effective and control the spread of the virus."
"Old ng consulted when she was in the ICU. There were no other options. It’s too late; whether we can save her depends on luck," Chen Xuehai said, shaking his head. "Don’t assu all myocarditis cases are the sa; viral myocarditis is inherently very dangerous. Actually, my thoughts are pretty much the sa as Old ng’s. Let’s not wait. Let’s use the last resort now."
"Yes, we’ve considered all possible thods. Rather than waiting, it’s better to act now. With Dr. Chen monitoring in the operating room, I’ll keep an eye on this patient in the ICU," ng Qingfan also nodded.
"Thank you, both of you," Liu Banxia said sincerely. "Without you two, these patients would have had no hope at all today."
"Why are you being so formal with us?" ng Qingfan said. "I haven’t felt this passionate in years. I have to say, it’s quite thrilling. Leave that college student to . Doctor Zhu and I will give it everything we’ve got to save her."
"Teacher Liu, how did the discussion go?" Xu Yino asked, hurrying to Liu Banxia’s side as he ca out of the small eting room.
"The communication with the patient and her family is up to you. Angiotensin-converting enzy inhibitors and β-blockers can be used in combination to temporarily stabilize her, but there are risks. You must explain these clearly to the patient’s family. Whether the patient chooses to undergo surgery or to play it safe—even if it ans paralysis—is her decision. Rember, this is very important. Even Director Xu said the success rate for this surgery isn’t high, and the chance of complications is significant."
Xu Yino bit her lip and nodded forcefully.
She knew the patient’s condition very well. Liu Banxia had spoken so earnestly; it ant the risk of this surgery exceeded their previous estimates.
All surgeries have risks. This ti it involved the spinal cord, and this patient’s condition was so special.
Liu Banxia also let out a long sigh. This was all he could do.
He had pressured Xu Peichen and Chen Xuehai during the consultation to ensure they would give their utmost effort, but whether to proceed with the surgery still depended on the patient’s choice.
In less than twenty minutes, Xu Yino rushed back. She didn’t say anything, just nodded vigorously at him.
"Good. You’ll assist in the OR too," Liu Banxia said.
After that, he notified Xu Peichen and Chen Xuehai and arranged for an operating room. He wanted to go directly into the OR himself, but another batch of patients had just arrived in the ergency center.
Liu Banxia was troubled. He was really worried about the patient being wheeled into the operating room. He also took a mont to ask about the college student in the ICU upstairs; she was temporarily stable but still needed constant monitoring.
Although sowhat distracted, he focused on debrident and suturing. His title as the "Prince of Debrident" in the ergency departnt wasn’t unearned, as this work didn’t require much complex thought.
His hard work paid off. In just over two hours, he had dealt with all the patients in the ergency center needing debrident and suturing.
"Go on, your heart’s already in the operating room," Zhou Li said with a chuckle.
Liu Banxia grinned, gave a few quick orders, and sprinted towards the operating room.
More than two hours had passed. If the surgery was going well, it should be nearly finished. The fact that no bad news had arrived yet was a good sign.
When he entered the operating room, Xu Peichen was still operating, while Chen Xuehai and Wang Lei stood to the side, intently watching the monitors.
"Teacher Liu, the patient’s osteoporosis is severe, which is making the surgery very difficult," Xu Yino quickly reported. "Director Xu is amazing. When he realized the bone couldn’t be secured, he decisively opted for a rib graft, wasting no ti."
"The situation isn’t good. These bones look like they belong to soone in their seventies or eighties," Xu Peichen said while operating.
"Director Xu, we need to hurry. The ejection fraction has dropped again," Chen Xuehai added.
Hearing this, Liu Banxia grew nervous. This was the exact situation he had feared. Fortunately, the operation was nearing completion.
BEEP. BEEP. BEEP... BEEP. BEEP. BEEP...
To everyone’s surprise, just when they thought the patient could hold on a little longer, the monitor started alarming.
"Director Xu, tachycardia! I need to start resuscitation," Chen Xuehai said urgently.
Xu Peichen nodded and withdrew his hands.
Liu Banxia’s heart sank. Tachycardia was difficult to manage even in healthy individuals, let alone in a patient in such poor condition. This made treatnt all the more challenging.
There was nothing they could do right then except watch Chen Xuehai perform the resuscitation.
"Even though we’ve stabilized her, given her current state, it’s unlikely she’ll last until the end of the surgery," Chen Xuehai observed. "My personal suggestion is to stop the operation and send her back to the ICU to stabilize. Otherwise, it’s truly too risky. Another episode could be fatal."
"But...if we do that, she’ll be permanently paralyzed!" Xu Yino blurted out, unable to contain her emotions.
"Dr. Chen, can we stabilize the patient’s heart here, now?" Liu Banxia asked, looking at Chen Xuehai.
"We could try," Chen Xuehai said, furrowing his brow. "We can perform a cardiac catheterization to assess her heart. If feasible, we could install a ventricular assist device. That would take about half an hour. The device could be evaluated for removal later, but I’m worried the patient won’t last that long."
"If it’s you, I believe you can do it in 25 minutes. What do you think?" Liu Banxia asked.
"If possible, the spinal wound can be packed with a sterile dressing. Let’s address the heart first. I only need half an hour to finish up here," Xu Peichen chid in.
The surgery had progressed this far; he truly hoped it wouldn’t be in vain. He, too, wished for a perfect outco.
"Alright, let’s do it!" Chen Xuehai nodded vigorously.
There was no ti to lose. The surgical plan had changed: save the heart first, then address the spinal injury. Otherwise, even if her paralysis was prevented, a failing heart would render it all pointless.
Every movent was made with utmost care. Liu Banxia watched anxiously from the side. This change in surgical plan was also a huge risk.
The patient’s spinal cord was already exposed. Even with the protection of a sterile dressing, Chen Xuehai’s maneuvers during the cardiac procedure might cause compressive damage to the spinal cord.
This responsibility would fall squarely on Xu Peichen and Chen Xuehai.
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