Surgery Godfather-Chapter 562 - 510: Poor Little Guy

Yang Ping sat down in front of Li Zehui’s desk, Marshall handed over the case file. Yang Ping didn’t browse the paper case but looked at the imaging pictures first.

This was a shared office. For easier information exchange, each doctor had a desk equipped with a computer, printer, and an electronic screen for viewing images.

On another floor, some of them had private offices, but most of the time, they preferred to work here.

The doctors in the office gathered around, standing nearby. They were curious to see if an orthopedic surgeon was truly proficient in cardiac surgery.

The quality of the electronic viewing screen was excellent, the image was crisp, and any reflection had been eliminated.

"Doctor Yang, can you provide a detailed interpretation of this patient’s heart ultrasound?" Doctor Dodge appeared behind him at some point.

Li Zehui glanced at his senior. Was this a test for his guest?

The electronic screen displayed several categories of images including standard X-rays, cardiac catheter angiography, surface ultrasound, and three-dimensional CT reconstructions.

Yang Ping’s mouse hovered over the cardiac ultrasound image category. He clicked to open the images within, revealing dynamic ultrasound images of the heart.

The right side of the heart, the large blood vessels, the central septum, and both lungs were clearly displayed.

Reading cardiac ultrasound images requires a high level of expertise. Many thoracic surgeons couldn’t understand these images and instead rely on expert sonographers to interpret them.

However, top cardiac surgeons often conduct ultrasound examinations on patients themselves and interpret the images on their own.

This cardiac ultrasound map was produced by both Dodge and Li Zehui, the quality of the image very high.

Pointing at the image, Yang Ping said, "This is a rare case of a right-sided heart, or more accurately, all his thoracic and abdominal organs are reversed. On top of having a right-sided heart, the poor little guy also has a congenital heart defect: the Tetralogy of Fallot. It includes a defect in the interventricular septum, pulmonary artery stenosis, aortic overriding, and right ventricle hypertrophy."

Yang Ping pointed out the areas of deformity one by one and explained the basis for his judgement.

This was a mirror-image heart. Identifying such abnormalities was extremely difficult.

"There’s a mass under the aorta that obstructs the flow of blood, possibly a rhabdomyoma. Its position is extremely dangerous. Blood cannot flow smoothly and may even form a vortex. If you think you can open the thoracic cavity to remove it and perfectly correct the deformations of the heart and large blood vessels, it’s impossible. Here, there are also adhesions, the anatomy is unclear, the blood vessel walls are underdeveloped, these will pose significant obstacles during surgery. The image quality is poor, I need to do another cardiac ultrasound."

Yang Ping’s interpretation was spot-on, it didn’t seem like a cross-disciplinary orthopedic surgeon speaking. But his last sentence stirred up discussion among the doctors present.

This was an ultrasound done by Doctor Dodge himself. Could there be a problem with it?

"Doctor Yang, could you give us a reason why you want to redo the cardiac ultrasound?" a doctor couldn’t help but ask.

Yang Ping was simply stating the facts without meaning to offend. He didn’t even know who had produced the ultrasound images.

Since the question was asked, Yang Ping explained, "This ultrasound didn’t take into account the distinct anatomical characteristics, they still used conventional methods to collect the images, and a lot of crucial information was missed. The potential of ultrasound wasn’t fully realized, it doesn’t provide enough support for surgical decision making."

"Well, I would really like to see Doctor Yang redo the ultrasound." Dodge picked up the conversation.

Li Zehui gave Doctor Dodge another glance. This American from the east coast was rather arrogant, often looking down on others.

But as long as he didn’t embarrass the guest and kept the discussion normal, Li Zehui wouldn’t intervene.

Especially in surgery, particularly cardiac surgery, long-term accumulation is needed. Nobody can leapfrog over it, even if they are a genius.

Dodge believed that Li Zehui had given Yang Ping the information in advance. That’s why Yang Ping was able to interpret the cardiac ultrasound images so smoothly.

Even Dodge himself had spent several days with Li Zehui at the time to review all the tests in order to diagnose the case. It was hard for him to believe that Yang Ping could glean so much information from a single ultrasound.

How could he possibly make all these judgments just based on the ultrasound?

Afterward, Yang Ping also interpreted the rest of the images. They were in-depth, logically clear, and refreshing to hear, but he didn’t manage to convince this stubborn American from the east coast whose obstinacy was beyond imagination.

"In such a case, if surgery is done hastily, it is destined to fail. Using conventional surgical methods for tumor removal or correcting the Tetralogy of Fallot deformation would simply hasten his death. We need to find a unique approach to have any chance of success." Yang Ping released the mouse and looked up at Li Zehui.

"So---what should we do?"

Professor Li didn’t understand what Yang Ping meant by a unique approach.

After a moment of thought, Yang Ping said: "Let’s go see the patient first."

Under Marshall’s guidance, everyone arrived at a separate ward.

Considering the child’s low immunity, Li Zehui had arranged for him to be in this isolated negative pressure room.

All of the patient’s expenses were covered by the Red Cross, so there was no issue with money.

The little guy was lying in bed, wrapped in the hospital’s baby blanket. He was very small, not looking like a six-month-old infant at all. His nostrils were connected to an oxygen tube, and he had an IV drip attached to his body.

At the corner of the wall, a man was squatting on the ground, his eyes slightly dull - he appeared to be an Arab.

"Does he speak English?"

Yang Ping asked.

Professor Li shook his head: "He is mute but his hearing is very good. He understands Arabic, and this lady can help to translate."

An Asian woman stepped forward, signifying that she could translate.

Yang Ping assessed the man briefly, he was extremely thin, like someone who had been starving for a long time. There were several bandages on his body, the thenar of his right hand had a thick callus, and the right side of his large T-shirt was slightly open, showing a broad callus trace at the clavicle area.

This man must have held a gun and fought in a war; Yang Ping had this feeling.

"This is the child’s father. He and his wife brought the child from Yemen. He went through the war zone, passed through the desert, and then sneaked across the border into Saudi Arabia. His wife was shot and killed when crossing the war zone. His condition has been in a very bad state ever since." Professor Li’s tone was sympathetic.

Yang Ping extended his hand: "Hello, I am a doctor from China. Perhaps I can help this little guy."

The translator lady immediately translated Yang Ping’s words. He seemed to understand, immediately standing up from the ground, wiped his hand on his body before shaking hands with Yang Ping, showing a great deal of tension as they shook hands.

"It’s okay, I’m a doctor," Yang Ping comforted him.

The man merely nodded, without saying a word.

"Let me take a look, may I examine him now?"

The man nodded, then went to the side of the bed to untie the headscarf. His movements were very gentle and skilled, even more proficient than most young mothers. He made unclear sounds from his throat, as if he were comforting the child.

When the headscarf was completely opened, Yang Ping was utterly shocked by the sight before him.

The child’s body was extremely thin, essentially just skin and bones, like an infant skeleton covered with a layer of skin.

If it was non-medical personnel, they would definitely feel extremely uncomfortable at this sight.

People living in peaceful environments would never see such infants – mere skeletons.

Poor little guy!

His lips were cyanotic. He kept his eyes half-closed, oblivious to the dangers he was in.

Perhaps humans have an inherent sympathy for their own kind. Facing this unfamiliar little guy, Yang Ping’s eyes grew misty, blurring his vision. A slight pain throbbed in his heart.

He made great efforts to control himself, only then could he steady his emotions. He approached the bedside, constantly rubbing his hands generate heat.

His clavicle, sternum, ribs, pelvis, limbs, every bone was distinctly visible. His limbs were like a delicate, dried-up twig. One worried that even taking a breath would break his bones.

His abdomen; the peristaltic movements of his intestines were clearly visible. They were just under the skin; the spine could be easily felt by touching the abdomen.

Professor Li handed over a stethoscope, designed specifically for auscultation in infants. Yang Ping, being as careful as possible and soft to the extreme so as not to break the bones, placed the stethoscope on the right side of his chest, the location of his heart.

The second heart sound at the pulmonary artery was obviously weakened; there was a systolic ejection murmur at the left edge of the sternum. The blood flow of the left ventricle impacted the tumor making a clicking sound.

While in both lungs, faint moist rales were heard indicating lung infection.

While he was auscultating, suddenly, his eyes opened up and looked at Yang Ping, continuously watching him. He seemed as if he was pleading, saying ’Save me.’

Yang Ping took a deep breath, handing over the stethoscope to Li Zehui, and then finished some physical examination.

After the examination, Yang Ping signaled the man to wrap his child with the towel. The man wrapped silently and smiled to the awakened child. fɾēewebnσveℓ.com

Li Zehui spoke calmly: "After his wife’s death, the child was deprived of breast milk. In the war and the desert, there was no formula milk. He chewed some coarse food into bits, mixed it with cold water and feed the child. When the helicopter of the Red Cross found him at the border, he only had half a bottle of water left, which was mixed with some unknown food dregs and already turned rancid. He had several suppurating gunshot wounds on his body. He handed a piece of paper to the Red Cross staff, asking them to bring his child here for treatment."

It was hard to imagine how he steadfastly made it to this hospital with his child.

"Have you met him in Yemen?" Yang Ping asked.

"Yes, that was in the Red Cross Hospital. He and his wife brought the child to me, and I was helpless as the hospital was not equipped to perform such surgeries. I could only conduct trauma surgeries. I wrote this address and my phone number for him, told him that I would be here every month. Unexpectedly, he really made it here. I have no reason to give up." Li Zehui shared the patient’s experience, deep in emotion.

"Can he go through surgery?" Li Zehui gave a hopeful look.

Yang Ping looked at the child’s father again. He was squatting at the corner again, still looking over here, seeming to await some news.

"I’ll do my best."

Yang Ping responded.