godfather of surgery

Chapter 1166 Am I not qualified?

"Okay, come in."

Yang Ping felt that he should also tell him about the upcoming plan, as this was a major surgery with extremely high risks.

A graduate student helped open the professional electronic screen for reading images and pulled up the full-body CT scan images of the conjoined twins. For this type of patient, a CT scan is essential, and only a CT scan can collect such comprehensive morphological information and reconstruct the three-dimensional shape, which is of great significance for guiding the surgery.

Morris sat beside me like a schoolboy, and the Nobel Prize aura was still dazzling at times.

"Since you're a neurosurgeon, we don't need to use colloquial language; instead, let's use professional terminology that only doctors can understand?" Yang Ping set the tone for the conversation.

Morris nodded. That would be best.

"The principle behind this sisters' surgery is very simple!"

This is Yang Ping's style of speaking. He considers all surgeries to be "simple in principle" because in his mind, all surgical procedures are nothing more than three major areas and three levels: excision, repair, and reconstruction.

"Easy, easy!"

Moros nodded in agreement, but in his heart he thought, "This is not simple at all; it is the most difficult surgery in the world."

"This surgery is actually a separation, a super separation, to safely and accurately separate two connected human bodies."

Yang Ping used the eraser tip of a pencil to draw a line on the screen from a distance.

"During the separation, several points must be ensured: In the completely independent areas, we must be able to find their true boundaries and separate them from those boundaries so that their respective parts are not damaged; in the possible common areas, we must carefully weigh the allocation of these common areas to ensure they receive appropriate functions; during the entire separation process, we must avoid causing collateral damage, such as damage to blood vessels and nerves, while also ensuring that the separated organs can survive independently and perform their original functions, such as not disrupting their blood supply. This is especially important for two organs that share a common blood supply. We must re-plan the common system to achieve a reasonable separation, and after separation, this blood supply system must have room for evolution. If not, we will need to artificially modify the blood supply system."

"Look, this is the liver. Obviously, if we ensure the blood supply to one side, the other side will definitely experience liver failure. We must rebuild the liver's blood circulation in the other side by directly bridging the blood vessels here."

"Therefore, the whole process is not a series of independent modules, but a system engineering project. We must have sophisticated engineering thinking to do all of this."

Yang Ping stopped, and the pencil spinning in his hand also stopped.

While Yang Ping was speaking, the pencil kept dancing on his fingers, which amazed Morris. He wondered why Chinese people's fingers were so flexible, allowing the pencil to dance under the control of just a few fingers.

As a neurosurgeon, understanding these things wasn't too difficult, but this was the first time he had ever understood a surgery from this perspective.

This is like how an ordinary person sees the world differently than a mathematician, physicist, or chemist.

An ordinary person might see a teacup fall to the ground, a mathematician might see probability theory, a physicist might see mechanics and kinematics, and a chemist might delve into the material itself—their perspectives and levels of understanding are different.

Yang Ping's perspective and understanding of this surgery are now at the very top of the pyramid, something Morris himself could never achieve, so it feels like opening up a new world.

"As a neurosurgeon, you should understand that the most difficult part of this surgery is where the true boundaries of the nervous system are, and where I should completely separate them. Even the slightest mistake can have serious consequences. For example, if the neural connections in a common area are severed, both people may lose the neural functions they had when they coexisted. This loss can lead to neurological deficits and even affect their lives."

"For example, this is the medulla oblongata, where the respiratory center is located. What should we do? Even a small mistake can cause permanent respiratory arrest."

"Therefore, we cannot take risks, we cannot go into surgery with trepidation, we cannot go into surgery with uncertainty. We surgeons enjoy challenges, but we absolutely cannot take risks that are gambling-like. Even if we take risks, they must be technical risks."

The master's words enlightened Maurice. He had considered so many things so profoundly, like a philosopher pondering problems. No wonder he was considered the best doctor in the world.

"But how can we find this true boundary? What if this boundary doesn't exist? If it were me, I would probably start with the anatomical boundary."

"Maurice asked."

Yang Ping spoke in a calm and composed tone, exuding a strong sense of confidence that made one feel the powerful support behind every word.

“The anatomical boundary is only superficial. To find the boundary, we need to identify all the nerve nuclei in the area, their connections, and their affiliation. Only then can we make a plan. If the boundary does not exist, we need to assess the optimal distribution of the nerve nuclei and their potential for plasticity after surgery in order to design an artificial boundary line.”

My goodness, this requires so much work, and it might take several years to perform the surgery. But it doesn't matter, in a few years they'll be teenagers, and they'll have plenty of time to wait.

“This will take a relatively long time to complete, so you need to be patient,” Yang Ping said.

Morris nodded in agreement; he was mentally prepared.

"It will probably take about three days," Yang Ping added.

three days?

Was it a slip of the tongue?
Three years would be more reasonable, as this is a very challenging task. It would take their excellent team about three years to complete.

"Three days? or three years?"

"days!"

"Oh!" Morris took a deep breath. "What kind of efficiency is this? Is it even possible?"
"We need to use a powerful artificial intelligence model to accomplish this task, which requires a lot of data, so we will be frequently checking them over the next few days to collect data."

“No problem, we’ll cooperate fully. I’m very curious to know what your AI model is that’s so efficient?” Morris asked curiously. “I’m sorry, this is a black box for the family, because we don’t open this large model to the patient’s family and we have no obligation to explain how it works to them.”

Using a large model to solve the boundary problem of the nervous system is a world first. As a neurosurgeon, Morris was very curious about how this was done. It seems that they have fallen behind in this area. No wonder they were able to find the precise interface of the nervous system in three days.

“This area is the brainstem. I’d like to know how Dr. Yang will handle this area?” Morris is one of the few doctors in the United States who can perform brainstem surgery very well.

Of course, his skill level is still somewhat inferior to that of John Nathan, who is known as the top neurosurgeon in the United States. The main difference between them lies in the number and success rate of brainstem surgeries.

In the field of brainstem surgery, the gap between Morris and Johannesson is not small. A few years ago, their levels were not much different, but in the past year, Johannesson has rapidly widened the gap with Morris.

Therefore, for his two daughters, Maurice had no choice but to seek help from Johannesson. Johannesson studied this extremely special case for a long time and finally said, "I cannot handle this kind of neurosurgery, but I can point you to a path of hope. Go to Sanbo Hospital in China and find my teacher, Professor Yang Ping. He may be able to solve your problem. If even he can't do it, then no one in the world can operate on them."

Johannesson's teacher? And a Chinese one at that?
What kind of remarkable person could be Johannesson's teacher? Today, Morris finally met Yang Ping, who was far too young.

Yang Ping's understanding of this surgery was clearly a level above that of this neurosurgeon. It wasn't a difference in the amount of knowledge or experience, but a difference in the overall level of understanding. This might be what is called a "dimensional reduction attack".

“We need to figure out the location, extent, function, and affiliation of all the neural nuclei in this area. Some are unique to each other, while others are shared. The unique ones do not necessarily correspond to their anatomical location. For example, the neural nuclei on the side closer to the older sister anatomically may actually function as the younger sister's. Shared nuclei are even more complicated. Can they be separated? If separated, will their function be halved or completely lost? This requires extremely in-depth research on the brainstem. Fortunately, I have done relatively in-depth research in this area, but unfortunately, I don't have time to write these papers.” Yang Ping pointed to the brainstem area on the imaging image.

His profound knowledge and research on the brainstem explains why Johannesson mastered so many new and safe approaches to brainstem surgery, significantly improving surgical safety and becoming the leading brainstem surgeon in North America, as well as occupying the very top of the pyramid in the world. The reason is that he had such a remarkable teacher.

Discovering a safe approach for brainstem surgery is something that top neurosurgeons around the world strive for. Even discovering a safer approach than the old ones, or a safe approach that allows access to entirely new areas, is enough to establish a prominent position in the field of neurosurgery.

But the young doctor in front of me didn't care about this at all. He didn't have time to publish papers, which shows that he didn't care about these technologies and had more important things to pay attention to.

The reason why Johannesson, who possessed so many new approaches, never published papers has now been found: the originator of these new approaches was not him, but Dr. Yang. Johannesson could not have plagiarized his teacher's work.

"Professor Yang!"

Morris changed his form of address because he remembered Johannesson referring to the master-level young man before him as "Professor Yang".

"Could you tell me about safe access routes to the brainstem?"

Morris shamelessly brought it up.

As a patient's family member, he has already asked enough questions. In fact, as a patient's family member, all you need to know is why this surgery is necessary, what the risks are, what might happen if you don't have the surgery, and what might happen if you do have the surgery. As for the details of the surgery, that is not within his scope of concern.

"The details of the surgery are the doctor's job, and it's difficult for me to explain them to you clearly." Yang Ping didn't want to talk about the details of the surgery with the patient's family. At most, he would explain the surgical process in simple terms so that the patient's family could have a clear understanding.

The detailed surgical procedures are not only difficult for family members to understand, but they can also easily lead to misunderstandings and waste his time.

“I’m sorry, Professor Yang, I didn’t mean to take up your valuable time. I am also a neurosurgeon, so I am very interested in this topic,” Morrison said frankly.

Yang Ping forgot that he was a neurosurgeon, so he said, "I understand your curiosity, but I want to know what level you have reached in your research on neuroanatomy and function, because these are very important and are some basic knowledge. If you don't have a deep understanding of these, it may be difficult for you to understand what I am saying. Telling you the safe approach directly may mislead you."

“I received full and professional neurosurgical training in the United States. In the US, I am considered a senior neurosurgeon. I perform hundreds of neurosurgical procedures every year, including more than fifty brainstem tumor surgeries annually…” Morris said proudly, feeling that he was fully qualified to communicate with Professor Yang.

Yang frowned. His foundation was not as good as Johannesson's. If Johannesson wanted to learn his brainstem surgery techniques, he would need to study the brainstem anatomy, physiology, pathology, and pathophysiology that Johannesson taught him in advance.

In Yang Ping's view, any new surgical knowledge recommended in existing textbooks, training materials, or even papers is outdated. One must relearn new knowledge and establish new concepts in order to understand everything he says.

Just like how electric vehicles are now being built with an internet-centric mindset, focusing not only on the vehicle's function as a means of transportation but also on intelligent cockpits, human-machine interaction, and intelligent driving, etc., simply possessing knowledge of gasoline-powered vehicles is far from sufficient for building electric cars. This is why some traditional gasoline-powered car companies have always struggled in their transformation efforts. Managers and engineers at traditional car companies lack basic internet thinking, and their knowledge and concepts are not in place, making it difficult for them to understand how to build a good electric vehicle.

"Do you... know much about how the nervous system works?" Yang Ping asked.

Morris nodded: "I'd say I'm an expert."

"Then draw me a diagram of how a neural network works, tell me how the human neural network works, how the low-level functions work, how the high-level functions work, and how they are connected as a whole? From the transmission of biochemical signals and electrical signals, to the conduction, processing, and interaction of various signals, I need a complete diagram, not just some local anatomical or functional knowledge. In other words, tell me all the neurosurgical knowledge you have learned using just one diagram." Yang Ping gave him a question that wasn't too difficult.

"This?... I only possess knowledge relevant to my clinical work..." Morris was speechless. How could he possibly express his neurological knowledge in a single web?

Yang Ping said, "Sir, please go back and rest. If you have any other questions, please communicate with my assistant, Dr. Song Ziming. If necessary, I will reply to you."

Does Professor Yang mean I'm not qualified?

Morris felt a chill in his heart.

A computer repairman can disassemble computers, assemble computers, and repair computers.

However, if you ask him to draw out how the entire computer works, including how the chip is designed, how the chip works, how the motherboard is designed, its working principle, how the chip exchanges information with the motherboard and other components, the underlying logic of the hardware, the system architecture, and how the software and hardware are connected.

Does he know? Clearly, his knowledge is insufficient to answer these questions.

To answer these questions, we would need a team of chip experts, motherboard experts, the programmers who originally wrote the system, and others, and then write a book to answer them.

Does a computer repairman need this much knowledge? Does he really need that much knowledge?