Chapter 338: The first major level 4 surgery
The three of them came to Fatty Wang's barbecue stall, and a young woman greeted them with a smile on her face.
"Please take your seats! Feel free to call me if you need anything!"
"Give us a plate of grilled lamb skewers, a plate of peanuts, and a box of beer!" Doctor Xu took charge of ordering the dishes, all of which were Director Hu's favorites.
There are fifty kebabs on a plate, which should be enough for three people.
After he ordered, he seemed to realize that Director Hu Kan was not in good health, and changed his words, "How about three bottles of beer and a bottle of fruit drink?"
"Okay! Please take a seat, I'll bring it right over!"
The woman's dress and temperament were quite good, so she should not be a waitress.
It's probably the lady boss here.
"Girl, do you have fermented bean curd? Give us some." Director Hu Kan said to the woman.
"Um... sorry, I don't have that." The woman shook her head apologetically.
People usually drink alcohol when eating barbecue, and not many customers order peanuts.
She thought the guests at this table were very strange.
If she hadn't seen the three people's extraordinary attire and demeanor, she would have really suspected that they were deliberately causing trouble. After all, there were often some street urchins and social people drinking and causing trouble at the barbecue stalls in the night market.
"Xiao Zhou, go buy a bottle nearby! Your master likes this!"
Director Hu Kan said to Zhou Can.
"After so many years, Old Hu still remembers that I like to eat fermented bean curd! We should have been so careless all these years!" Doctor Xu must have been moved, and he took the initiative to hold Director Hu Kan's hand and supported him.
"Teacher, I'll go buy fermented bean curd first."
Zhou Can quickly let go of his hand, turned around and ran towards the supermarket not far away.
Leaving the two of them a chance to be alone allows their relationship to further thaw and warm up.
He is very familiar with the terrain around the hospital. This supermarket has bottled Lao Gan Ma, bean paste, and fermented tofu.
When Zhou Can bought the fermented bean curd and returned to the barbecue stall, he found that Dr. Xu and Director Hu Kan had obviously become much closer.
"Teacher, I wonder if this brand of fermented bean curd suits your taste?"
Zhou Can handed the fermented bean curd to Dr. Xu.
"Haha, you have really good taste. This brand is exactly what I like." After taking a look, Dr. Xu praised with a smile.
"Hey, Director Hu mentioned that you liked to eat fermented bean curd thirty-two years ago. I guess you must like the old taste. I asked the owner of the supermarket, and he said that this Grandma Chen's fermented bean curd is an old brand, so I chose it."
Zhou Can explained.
"That's thoughtful! Come sit down and eat together! The lamb skewers at this barbecue stall are the most authentic, and the taste is still the same as it was more than 30 years ago. The owner has changed, but the quality and taste of the meat have not changed."
Dr. Xu praised him and asked him to sit down and enjoy the delicious food.
At this moment, a large plate of lamb kebabs was placed on the table.
The proprietress came over with two bottles of beer and a bottle of fruit juice. She happened to hear what Dr. Xu said and happily replied, "I didn't expect that you are still an old customer of our shop from 30 years ago. I am so sorry! My father-in-law and mother-in-law used to run the business, but now that they are old, my husband and I have taken over the barbecue business."
"It's great. We old customers come back to eat and remember the past. Your barbecue stall has also grown from a small stall to a barbecue restaurant."
Dr. Xu sighed.
"Thank you for your support over the past few decades. I'm giving you a 10% discount on this table today. Please enjoy your meal and drinks!" The proprietress put down her drinks and walked briskly to entertain the next table of guests.
It can be seen that she was very happy to meet a table of old customers from thirty years ago.
The three of them ate and chatted. After Dr. Xu and Director Hu had established a good relationship, they turned the topic to medical skills.
"Old Hu, tell me how to combine a fast knife with a steady knife! I still find this a bit mysterious."
Dr. Xu has devoted his entire life to studying the quick knife technique and set the world record for the fastest surgery. His understanding and comprehension of the quick knife technique is probably unmatched.
He agreed with what Director Hu said about the problem of dragging the knife, but he did not believe that the steady knife and fast knife methods could be compatible with each other.
Water and fire cannot mix. This is a natural law.
"As for whether they are compatible, I am still only at the conceptual stage. If there is nothing wrong with my body, I may be able to further explore and verify it in practice. Now I can only let Xiao Zhou do this for me."
Director Hu Kan turned his gaze to Zhou Can.
Dr. Xu hasn't agreed to this matter yet, so Zhou Can doesn't dare to agree.
So he just lowered his head and ate the lamb skewers.
It's true, the taste is really good. No wonder many people still enjoy eating barbecue even though they know it's harmful to health.
Life is short, and most people think that enjoying life while it lasts is the best way to go.
"The pursuit of the ultimate speed of the knife is for the fast knife, while the pursuit of stability and smoothness is for the steady knife, which guarantees that there will be no mistakes to the greatest extent. The two seem to be like water and fire, two extremes, but the yin and yang, softness and hardness in Tai Chi are also two extremes. Tai Chi can achieve the balance of yin and yang, and both hardness and softness. I believe that the fast knife and the steady knife can also find a balance point."
"Before I got sick, I did some experiments. Seeking speed while maintaining stability will have some constraints, but it is not as incompatible as one might imagine. On the contrary, as long as the steady knife method is strong enough, it can well tolerate the negative effects of seeking speed. It is a bit like the sea accommodating all rivers. Whether it is a clear stream, dirty water, or even all kinds of garbage, the sea can accommodate it."
When Director Hu Kan talked about his discovery, his eyes were bright, not at all like the eyes of an elderly person.
People who have aspirations and beliefs will always have bright eyes because they have light in their hearts.
"tolerate?"
Doctor Xu's eyes lit up slightly. The biggest difference between him and Director Hu Kan was that his pursuit of medical skills was more narrow. This could also be seen from the people he accepted as his successors. So far, he had only accepted Zhou Can as his apprentice.
Director Hu Kan has many students all over the world. The entire cardiothoracic surgery department, and even some doctors who have received regular training or specialized training in cardiothoracic surgery, may have learned the steady knife technique from him.
Just watch cardiothoracic surgeons perform surgery.
Basically, stability is the main focus.
But it is also true that they perform the surgery so slowly it makes you vomit blood.
"Yes, it is tolerance. To be more precise, it should be the compatibility of the two. For example, if my steady knife skills are strong enough, I can try to combine them with certain fast knife characteristics. Similarly, if your fast knife skills are strong, you can also try to combine them with a certain degree of steady knife skills. If you have to quantify it, if your fast knife skills reach level 10, then you should be able to combine them with level 5 or even level 6 steady knife skills. Tolerance leads to greatness. As long as your original skills are strong enough, you can be compatible with other knife skills and seek common ground while reserving differences."
Director Hu Kan explained his insights and ideas in a very confident tone.
Zhou Can listened quietly beside him and already had the answer in his mind.
Because Director Hu's description of the profound level of these surgical skills, although obscure, makes sense as soon as one hears it.
All things in the world are interconnected, and the great truth is both clear and simple.
"It is undeniable that the idea you proposed is a good approach." Doctor Xu drank the beer in his glass in one gulp. "I must admit that I am not as good as you in medical innovation."
Having lost to Director Hu Kan again, it can be seen that Dr. Xu is a little depressed.
"I have no objection to Xiao Zhou learning the steady knife technique from you."
Dr. Xu finally opened his heart, let go of his zero-sum mentality, and was willing to let his only successor learn the steady knife method from Director Hu Kan. This also meant that he tacitly agreed that Zhou Can would become Director Hu Kan's successor.
For some people who have deep-rooted sectarian thinking, making this decision is not easy.
"Haha, I knew you would agree. Here, I toast you with this glass."
Director Hu Kan convinced Dr. Xu, and he was as happy as a child.
It was almost his obsession to make Zhou Can his successor. The main reason was that he couldn't find another successor as good as Zhou Can in such a short period of time.
No matter how outstanding a young doctor is, compared with Zhou Can who has a medical experience value system, it is still a case of people dying by comparison and goods being thrown away by comparison.
"You'd better drink the juice! Otherwise, if something happens, how can you teach Xiao Zhou in the future?"
Dr. Xu poured out the beer in Director Hu's glass and replaced it with juice.
"Thanks!"
Director Hu Kan raised his glass and toasted Dr. Xu, and the two clinked glasses.
"Xiao Zhou, pick up the cup! Are you blaming me for not asking for your opinion? I have already asked for your opinion, and now Xu Chen has agreed, so you should just go along with it!"
Director Hu Kan was really happy today. His face was flushed and the smile seemed to never cease.
Zhou Can was naturally willing to learn the knife-steadying technique from Director Hu Kan and have the best of both worlds.
Raise your glass and clink glasses with the two teachers.
"I respect both of you, my dear teachers! Thank you for devoting all your efforts to nurturing me and helping me grow. I have no way to repay you, so I will drink first to show my respect!"
Zhou Can tilted his head back and drank it all.
"Haha, this kid is a man who can do great things. He shows such courage even when drinking a glass of wine." Director Hu Kan now looks at him with eyes full of fondness.
Doctor Xu also seemed to be in a very good mood.
The knot in his heart that had been knotted for many years was untied, he reconciled with Director Hu Kan, and then he watched his apprentice possibly break out into a completely new path.
Everything is a great joy to him.
"Xiao Zhou, from now on, whenever you have time, come to the cardiothoracic surgery department and learn the steady knife method from me. I will also teach you all the advanced medical skills of the cardiothoracic surgery department. If you are too busy at work, you can also come to me after get off work, but you must stick to it every day, because my health is not good, and I am very worried that I will die before I can teach you."
Director Hu Kan’s physical condition is indeed very worrying.
The scary thing about heart disease is that it can take a person's life at any time.
Especially for patients like Director Hu Kan who have undergone two heart surgeries, the situation is even more dangerous.
…
The next day, Zhou Can first went to the pediatric department to check on the child with congenital heart disease, and then went to see Director Zhuang Sheng to discuss the patient's surgical plan.
Because he had already discussed it with the chief doctors in the cardiothoracic surgery department and Director Hu Kan was in charge, Director Zhuang and nodded immediately.
With Director Zhuang's level of expertise, he could naturally see that this surgical plan was extremely brilliant and comprehensive.
Even for the consideration of some details and the handling of potential dangers, there are complete plans.
The next step is simple: schedule the surgery and prepare the patient for the operation.
The anesthesiologist conducts a surgical risk assessment on the patient and signs an anesthesia risk consent form.
Director Zhuang directly handed the task of the surgeon talking to the family members to Zhou Can. He also told Zhou Can confidently that Zhou Can would be the surgeon for this congenital heart disease surgery, so he should be the one to talk to the family members.
Zhou Can had talked with family members before, but this was the first time he formally spoke to them as the surgeon in charge.
Fortunately, after the family members were "beaten by society" once, their trust in him has risen to a certain level.
The whole conversation process went smoothly.
Nurses and doctors will follow up on the specific preoperative preparations, while the hospital will coordinate the arrangement of the operating room.
…
In the operating room, Zhou Can, wearing a dark blue surgical gown, officially stood in the surgeon's position for the first time.
Director Hu Kan had been invited over and was sitting against the wall.
He could be given some guidance and help at the critical moment, which was also one of the reasons why he dared to preside over this operation.
Director Zhuang was willing to be his first assistant.
The entire surgical team revolves around Zhou Can.
In the past, Zhou Can envied other chief physicians for performing surgery, and longed for the day when he could also perform a major surgery as the chief surgeon.
When this dream finally came true, he realized that the responsibility on his shoulders was like an invisible mountain pressing down on him.
I didn't feel as proud and proud as I had imagined, nor did I feel elated.
Perhaps the only difference is that everyone in the operating room revolves around his baton.
After the patient is successfully anesthetized, the operation officially begins.
Zhou Can successfully established extracorporeal circulation and performed total cavopulmonary connection. The subsequent thoracotomy and heart surgery were also satisfactory.
The operation was half completed and nothing went wrong, so Zhou Can breathed a sigh of relief.
The preliminary surgical contents have been completed, try to stop the machine and see the effect.
As a result, as soon as the ventilator was stopped, the patient's arterial blood pressure dropped rapidly and could not be maintained at all, while the central venous pressure showed a high pressure rising trend.
Seeing this situation, Zhou Can felt a little panicked.
Anyone who performs the surgery would be panicked.
Because heart surgery is extremely risky and arterial blood pressure cannot be maintained, if the patient says he is cold, he will be cold to you.
"Xiao Zhou, don't panic! You will often encounter such sudden and unexpected situations during surgery in the future." Director Hu sat there with a calm tone.
This also gave Zhou Can some motivation to stay calm.
It’s like when we climb a rock wall, with or without a safety rope tied around our body, those are two completely different psychological feelings.
Having a rope tied around your body can make you feel a little more at ease.
When Director Hu Kan was the lead surgeon, he encountered an emergency and was also somewhat overwhelmed by the pressure. However, compared to Zhou Can, his mental strength must be much stronger.
After all, he is a veteran who has fought on the operating table for decades.
After Zhou Can calmed down, he began to look for the cause seriously.
Why did the patient's arterial pressure drop as soon as the machine was turned off? He decided to start with the high central venous pressure.
Time is life. Finding the cause of the disease under such extremely tight time and great inner pressure is definitely a huge challenge for him.
After careful measurement, he found that there was no obvious pressure gradient between the superior and inferior vena cava and the pulmonary artery.
This can rule out surgical anastomotic stenosis.
Could it be that pulmonary vascular resistance is too high?
This possibility is very high.
Zhou Can quickly thought about the test method in his mind. Now he only suspected that it was caused by excessive pulmonary vascular resistance. Whether it was really the cause, he needed to do some tests to verify it.
Opening a window in the atrial baffle can relieve venous hypertension and increase cardiac output.
He tried opening a window in the atrial baffle and using pulmonary vasodilators, but the problem was not resolved.
This problem had actually been discussed during the cardiothoracic surgery, and he had prepared a plan in this regard. However, after the plan was actually implemented, he found that the low cardiac output symptoms were not resolved at all.
Seeing that the child's condition was becoming more and more dangerous, Zhou Can made up his mind and had to remove the baffle connecting the inferior vena cava and pulmonary artery.
At this point, the operation was on the verge of failure.
Director Zhuang's forehead was already covered with sweat. The other members of the surgical team also felt something was wrong, and the atmosphere became tense and depressing.
At this critical moment, Director Hu Kan took action.
"This operation is on the verge of failure. The main reason is that the child's pulmonary blood vessels are not well developed and the pulmonary vascular resistance is too high. Come, do it according to my method..."
Director Hu Kan was like a stabilizing force. At the critical moment, he pointed out the reasons for the failure of the operation to Zhou Can and provided a solution.
…
After more than three hours, Zhou Can was so tired that he almost collapsed, and the child was pulled back from the brink of death several times.
The operation was finally completed successfully.
At this moment, the child's blood pressure has returned to normal, his heart beats strongly, and his respiratory function has reached an unprecedentedly good state. The cyanosis of his body is fading little by little at a speed that is almost visible to the naked eye.
Zhou Can was doing a postoperative summary and reflection.
The child's problem was far more serious than he had imagined. In addition to poor pulmonary vascular development, which led to high pulmonary vascular resistance, the child also had tricuspid atresia.
If it weren't for the on-site command of Director Hu Kan, a top cardiothoracic surgery expert, ten times the life of this child would have been lost.
Zhou Can felt like he had survived a life-or-death crisis. During the operation, his nerves were tense and all he could think about was how to perform the operation. Now that the operation was completed, in addition to receiving a lot of super high medical experience points, he also truly experienced the feeling of presiding over a major operation for the first time.
Just four words: extremely sour and refreshing.
