The Surgeon's Studio c1-799
Page 344
"Chief Chen, prepare for emergency surgery." Zheng Ren said as he took out the radiographic films and glanced at them.
Chapter 726 - Converting And Reconstructing The Data
"Huh?" Chief Chen was stunned for a moment.
Zheng Ren held the patient's CT radiographic films in his hands as countless thoughts flew through his mind.
In the ruins of Nanchuan Town, the life-and-death surgery had allowed him to touch upon the great fetters of technology. However, he had also unintentionally broken these fetters.
Although it was only reflected in the surgery then, Zheng Ren knew that his ability to read radiographic films would definitely provide a leap in his abilities.
When he was performing surgery at Pengxi Village Hospital, more relevant information would involuntarily appear in his mind every time he saw the patient's radiographic films.
If it were not for the fact that he was at the frontline and countless patients were waiting for treatment, Zheng Ren would have long been unable to suppress his curiosity to ponder about it.
At this moment, facing a patient with abdominal pain, the radiographic films that Zheng Ren saw and the fragments that appeared in his mind were not the same.
The CT radiographic films were simplified and turned into data. Then, they were fused in his mind and turned into what Zheng Ren wanted.
Because Zheng Ren could already see the patient's diagnosis, the burden of merging and completing the data was not big. He immediately found the anomaly in the radiographic films, locating the problem.
Looking at the radiographic films in front of him, there was only a very vague anomaly. If one did not look carefully, this would just seem like any ordinary CT film of a retroperitoneal hematoma. The abnormality could be misdiagnosed as a fatty deposit or a false shadow.
However, it was a different scene when Zheng Ren looked at the radiographic films now.
Su Yun came over, frowned, and asked, "Boss, I think these radiographic films are fine."
Chief Chen also felt like it was strange but did not say anything. His experience in Nanchuan Town made him realize that this young doctor was special. Otherwise, he wouldn't have specially called Zheng Ren to come over.
"Su Yun, look..." As Zheng Ren spoke, he suddenly thought of something and immediately said, "Chief Chen, use a micro-pump to reduce and control the patient's blood pressure. The patient's pain is severe so make sure to administer 5 mg of morphine first."
Zheng Ren spoke very politely, but his expression was full of confidence and his tone was one that could not be rejected. It was the standard posture of a superior doctor.
Although Chief Chen was puzzled, he did not refuse. He immediately called for the nurse and administered 5 mg of morphine according to Zheng Ren's instructions. Then, he installed a micro-pump and injected sodium nitroprusside into the vein to control the blood pressure.
Now that the patient could not be moved, Zheng Ren could not do anything even if he was anxious.
Although the blood pressure on the ECG monitoring was not high, there was still a possibility that the blood pressure would suddenly rise during the moving process and burst through the abdominal aorta.
He had to control the patient's blood pressure first.
This was similar to the first time he went to the Imperial Capital and saw Cui Heming's thoracic aorta dissection on the plane.
However, now that there were micro-pumps and various drugs, so everything was much better than the previous conditions.
Seeing that the other side was busy and would not be performing surgery for a while, Su Yun was unwilling. He grabbed Zheng Ren and asked, "How could you tell? The patient can't be moved for the time being anyway. Let's hurry up and talk about it."
Zheng Ren nodded and walked to the doctor's office with the radiographic films.
The radiographic film viewer was lit up, and there were two radiographic films inserted onto it.
Zheng Ren tidied up the radiographic films inserted on the radiographic film viewer. He found the film bag, checking the time and name on the upper right corner before putting it away. After that, he inserted the patient's abdominal CT scan that was done because of the pain he felt onto the radiographic film viewer.
"Here, look carefully," Zheng Ren said. "It looks very normal, like a normal vascular structure. But do you feel that the density is different from the surrounding blood vessels?"
He pointed at a point on the radiographic films and said with certainty.
Su Yun stared at the position where Zheng Ren's finger was, his expression very strange.
"It's like this, you arrange the pixels according to the digital matrix, and you turn it upside down. Er... It's quite difficult to explain but can you visualize it?"
Su Yun glanced at Zheng Ren and said with disdain, "You mean that the digital matrix passes through a digital converter, and each number is converted from black to white with different gray levels of pixels. After that, it's arranged according to the matrix?"
This was the basic principle of CT imaging and Su Yun naturally understood it. But if it was reversed... What would he see?
"If you know then give it a try. If it's reversed, you'll get the most basic data. After that, follow it up with the 64-slice CT scan with 3D-image reconstruction, converting it again."
Su Yun was stunned.
This conversion meant treating the human brain as a machine, a high-frequency machine at best.
Was this something that a human could do?
The arrogance in his eyes turned into countless doubts. He looked at the radiographic films inserted into the radiographic film viewer and was speechless for a long time.
After Chief Chen finished arranging the nurses' work, he also followed up to see how things were doing on their end.
He was very curious about how Zheng Ren made the diagnosis.
As an old imaging worker, the hospital had imported a machine when Chief Chen was younger. If it was broken, he had to repair it himself.
Therefore, he understood what Zheng Ren said more clearly than Su Yun.
But... Could such a thing really work?
"Doctor Zheng, did you build a 64-slice CT scan with 3D-image reconstruction in your own mind?" Chief Chen asked in puzzlement.
"It's not that exaggerated." Zheng Ren smiled and said, "If all the data were reconstructed, it would be very difficult to do. But if we were limited to this point, the data that needs to be reconstructed would be much less. It would make it relatively easier."
'Is he truly that powerful?' Chief Chen thought to himself. In his opinion, it was definitely impossible to do it, but Doctor Zheng only said that it was very difficult, not that it was completely impossible!
"I understand!" Su Yun slammed the table in front of the radiographic film viewer and said loudly, "Here, it's a vascular intima fault!"
"Yes," Zheng Ren said. "When you're injured, your blood pressure will rise instantly and the blood vessel intima will rupture. "However, because of the massive amount of blood loss, his blood pressure dropped immediately. There was no major problem with the blood vessel intima. After the interventional procedure, the bleeding blood vessels were all embolized. This caused the patient's blood pressure to gradually rise, causing the intima rupture of the abdominal aorta to begin tearing again."
"Boss, you only needed to take a glance to know." Su Yun was a little puzzled. There was no problem with the diagnosis. He even thought that Zheng Ren's words were nonsense.
The key point was that Zheng Ren had restored the CT image to the original data and then reconstructed it. This speed was simply too fast!
Moreover, Su Yun did not ask the biggest question on his mind—how did Zheng Ren determine that there was a problem at that particular point?
Zheng Ren pointed out the location. He had to calculate it in his mind for a long time before he could restore and reconstruct it. Furthermore, when he brought the radiographic films, he casually said to prepare for emergency surgery.
"I've watched too many radiographic films so I had a gut feeling," Zheng Ren said perfunctorily.
Although Chief Chen knew, he was too old. His brainpower could no longer perform such complicated calculations like when he was young.
According to the normal procedure, the patient needed to be brought to the CT room for a vascular CTA examination before he could be diagnosed. After he was diagnosed, he could bring up the surgery form and place a stent in the patient's abdominal aorta. This would solve the problem.
Before interventional surgery, aortic dissection was a serious and fatal disease. With interventional surgery, as long as it could be diagnosed, anything other than type 1 aortic dissection was a small problem.
As long as it was interventional radiography, the position of the aortic dissection could be seen on the image. There was no need to do a 3D reconstruction of the blood vessels.
However, this was only if the diagnosis was 100% accurate.
Chief Chen hesitated.
Chapter 727 - It's Thoraic Surgery, Who's Willing To Lend A Hand
If this were Sea City General Hospital, Zheng Ren would definitely not...try his best to not go beyond the normal medical procedures and just bring the patient directly to the operating theatre. If he went against the medical procedures, he would probably be criticized by others and reported to the Medical Investigation Council, potentially terminating his future career prospects as a doctor.
However, after experiencing the baptism of blood and fire at the frontline, he had unknowingly undergone some changes. Moreover, this was a critical period so he had to follow authority during an emergency.
"Chief Chen, I have confidence in this patient's diagnosis. Please believe in me," Zheng Ren said very seriously to Chief Chen.
His tone was still gentle. Although there were bruises on his face and he looked a little disheveled, there was a sense of trust that rested between his brows.
Chief Chen recalled the scene when he saw Zheng Ren performing interventional surgery in Pengxi Village Hospital.
He looked young but his standard was not low.
Not only was it not low, but it was so high that he could not even see the top even when he raised his head.
Chief Chen might be old but he was not muddle-headed. This was especially true even when he was young. Back then, the procedures for treating patients were not as strict as they were now. Procedural justice? It did not exist at all.
Many years ago, all kinds of auxiliary examination equipment were not available. A good doctor would give a diagnosis and then carry out treatment after taking a look at the patient, conducting a physical examination, and checking the patient's scans. It could be said that everything was very crude and a little rough at times.
However, Chief Chen was used to this type of diagnosis and treatment.
If it were a younger doctor, he would not hesitate as much as Chief Chen. If he did not do a 64-slice CT scan with 3D-image reconstruction for the blood vessels, he would have to undergo surgery. It wasn't a joke.
However, after Chief Chen thought about the possibility of this matter, he waved his hand and said, "I'll contact the operating theater. Once their blood pressure has dropped by about 10 millimeters, we'll head straight in."
Zheng Ren nodded and Su Yun looked at the old man with interest.
They still needed to wait for the news. When Zheng Ren and Su Yun saw that Chief Chen was busy, Su Yun asked, "Since we aren't doing the checkup now, will we just be jumping straight to it later?"
Zheng Ren replied, "If you encounter a patient with cardiac tamponade, won't you just immediately open up his c.h.e.s.t if you're in the emergency department?"
"How can these two things be the same? My finger..." As he said this, Su Yun paused for a moment. The expression on his face was a little strange.
He had already guessed what Zheng Ren was going to say next.
There was a huge difference between touching the cardiac tamponade with his fingers and looking at the radiographic films from his point of view. However, from Zheng Ren's point of view, there was no difference at all.
This guy... Su Yun shook his head and did not scold Zheng Ren.
"If you're tired then take a break. This time, you may need to do a long surgery." Zheng Ren felt exhausted and was about to lie down.
"Boss, is there a need to work so hard? There are other people here to help," Su Yun said.
"It's okay. I heard that the follow-up medical team is coming up soon. We can go down and rest at any time. Before we go down, we should just try to help out a bit more. Moreover, I'm still young. The heart, brain, and blood vessels..." As he spoke, his voice became softer and softer until it disappeared.
At this time, Su Yun was not sleepy at all. He stared at the CT scan and looked at it seriously. His eyes narrowed into slits. The light of the radiographic film viewer was vaguely reflected through his eyes, making them seem as bright as gemstones.
More than ten minutes later, Chief Chen brought more people to bring the patient to the stage.
He repeatedly reminded them that the patient needed to be moved as gently as possible, with no sudden movements.
Once there was a change in aortic dissection patient's position, it would lead to a sudden increase in blood pressure. That would cause the inner and outer membranes of the blood vessels to be torn apart, causing sudden death.
Su Yun had seen at least ten similar cases in Sea City General Hospital. Because he could not perform interventional surgery in Sea City General Hospital, he prepared to transfer the patient to another hospital.
The patients did not think that it was a serious illness. They thought that the doctor was just trying to scare them. They even refused to lie still and be carefully carried into surgery. As soon as they sat up, they changed their positions and died immediately.
A person whose vital signs were quite normal a second ago died in the blink of an eye. His death was very straightforward.
This kind of illness was really very dangerous.
It was rare that Chief Chen actually trusted Zheng Ren so much. This guy was not popular with women but was quite the hit with older people.
In Sea City, he had Old Chief Physician Pan's protection. When he went to the Imperial Capital, Department Chief Kong treated him quite well. When he came to the frontline to provide support, he was favored by Chief Chen.
Although it was useless, Su Yun glanced sideways at Zheng Ren and saw that he was sleeping soundly. His face was bruised and his originally disheveled face was filled with an indescribable sense of trust.
Su Yun let out a long breath and subconsciously blew at the black hair on his forehead. However, they had been doing surgery for far too long. The strand of black hair had been pressed down so hard that it could not fly.
He put the radiographic films into the bag and rushed to the stretcher trolley before Chief Chen brought the patient to the stage.
"Where's Doctor Zheng?" Chief Chen asked.
"He's asleep. I'll go up first and start disinfecting. Just call him from this side," Su Yun said nonchalantly.
Chief Chen knew that he had endured for too long. He could even fall asleep while standing, let alone sitting down.
He did not have any objections and brought the patient up to the stage.
"Chief Chen, is this surgery performed by the vascular department or the interventional department? What brand of membrane stents are you using?" Zheng Ren's voice came from behind.
When did he wake up? Su Yun frowned slightly and turned his head. "Why are you up?"
"I'm fine. I couldn't really sleep well either. When I return to the Imperial Capital, I'll find a place to sleep for a few days and nights." Zheng Ren was very listless, and his footsteps were shaky.
Su Yun did not stop him. After listening to Chief Chen's nagging, he arrived at the entrance of the Class Three Grade-A Hospital's operating theater.
Inside
, there were a few hybrid operating tables.
As the use of interventional surgery in the clinic increased, the doctors in large Class Three Grade-A Hospitals were also used to hybrid surgeries.
However, there were not many operations. The orthopedic doctors were the ones who used such tables the most.
The fracture was cut open and repositioned. After it was fixed, they would take a picture to make people feel at ease. After the joint replacement surgery, they would do another follow-up. It was usually a very easy process.
However, using the hybrid operating room like this was a bit of a waste.
"Doctor Zheng, the doctors from the Vascular Department are performing surgery. They won't be able to come down for the time being. We'll have to trouble you on this side," Chief Chen said.
Zheng Ren nodded. He had long expected that to be the case.
It would be strange if there was a doctor who was free. Chief Chen's hands and eyes were already extraordinary to be able to open up an operating table for himself and for it to be a hybrid operating table too.
Being able to perform surgery in the operating theater was also in line with Zheng Ren's psychological expectations.
Chief Chen brought the doctor to carry the patient while Zheng Ren and Su Yun went to change their clothes.
Just as they put on their isolation suits, a voice came from the corridor. "Who's free? Come over and give us a hand!"
After waiting for a few seconds, no one said anything.
"Chief Shao will be performing the thoracic surgery. Someone, give us a hand!" the circulating nurse shouted at the top of her voice.
Zheng Ren smiled bitterly.
It was likely that all the doctors were exhausted. They could not even find supporting staff. It was already good enough to have a doctor as the chief surgeon. As for the assistant, he could just find a random intern or advanced student to lend a hand.
However, after a few days and nights, he could not even find someone to lend a hand.