godfather of surgery

Chapter 1181 Children can be taught
Less than half an hour later, the conjoined twins were wheeled out of the operating room. They had recovered from the anesthesia very well and were even chatting again.

"Oh, doctor, please don't put our carts together, please keep them a little distance apart."

"Yes, that would make us mistakenly think they are still connected."

"It's being pulled open."

"Okay, oh my god, we've really broken up."

The operating room doors opened, and the Morris couple rushed forward to help him out, shaking hands with the doctors repeatedly, but he didn't see Professor Yang.

"The surgery went smoothly. He's now in the ICU for 24-72 hours of monitoring. It's just routine post-operative monitoring, so don't be nervous," Song Ziming told Morris.

Morris looked at his separated daughters and was so moved he almost cried. Just a few hours ago, they were still connected, but now they were separated into individual bodies, lying in different strollers.

"Oh, Mom and Dad, thank you! We're still alive, that's wonderful! You should thank Dr. Yang properly, he's amazing."

"We didn't feel any pain during the surgery. I could even hear them talking. There really wasn't a trace of pain."

"We've really broken up."

Maurice and his wife kissed their daughters' foreheads.

Yes, you two broke up.

The conjoined twins were transferred to the ICU for monitoring.
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Johannesson had arrived at the operating room and caught up with Yang Ping's immediate post-operative lecture. Because of the special nature of this surgery, Yang Ping used it to show everyone how to handle complex, high-risk surgeries without reference cases.

For routine surgeries, there are certain case studies for reference, or surgical procedures in textbooks. There were already ready-made plans in the past. However, the plans are personalized according to the specific circumstances of different conditions.

However, for surgeries like those involving conjoined twins, there are no precedents to follow. The surgery must be designed independently, especially the separation of the brainstem. There is no way to find the boundaries, and consulting literature is useless. You can only rely on yourself and use your own knowledge to create a method to find the boundaries.

When Johannesson arrived, Yang Ping was standing in front of the slideshow, explaining the lesson. It seemed that the lecture had just begun and he hadn't missed any important information.

Johannesson stood in the crowd, listening attentively.

"Our basic knowledge must be solid. Whether it is clinical medicine or basic medicine, the basic knowledge must be particularly solid. Only in this way can we face complex cases and clarify our thinking. Basic knowledge is the module of our thinking. Using these modules, we combine them into different ideas. If there are blind spots in basic knowledge, it is like a module is missing. Once the idea of ​​solving a specific problem requires this module, then this idea will undoubtedly be formed."

Yang Ping explained things step by step from the very basics. In his view, any complex problem is a simple problem constructed in a certain way. Therefore, only by solving the most basic knowledge can one have the ability to solve complex problems.

The doctors around them, including Song Ziming, Xu Zhiliang, Johannesson, as well as many graduate students and visiting doctors, listened attentively, and some even took out small notebooks to take notes.

Things are different now than before. Yang Ping is now like the founder of a school of thought. He not only imparts knowledge to his students, but also teaches them some ideas, how to think, and how to face medicine.

"For example, in this case, the brainstem is connected over such a large area from the head to the cervical spine, and then to the chest and abdomen. There is only one case in the world where surgery was chosen. In fact, the American doctors' judgment was correct. Why do I say that? Because the existing anatomy of the head does not have the anatomical knowledge of conjoined brainstems. In the current medical knowledge, we don't even understand the brainstem of ordinary people. How could we understand conjoined brainstems? With these conjoined brainstem nuclei mixed together, it is impossible to determine which one is the elder sister and which one is the younger sister. There is no instrument that can detect it. If surgery is performed under such circumstances, it will inevitably cause brainstem separation error. The consequence of this error is the patient's death."

"So their judgment is that surgery is impossible, and within the scope of current medical knowledge, this conclusion is correct."

"But we cannot be content to solve problems only within the scope of our existing knowledge. We need to promote medical progress, break through the scope of existing knowledge, and expand the scope of existing knowledge. If every doctor is confined to the existing circle, then that circle will never expand, and medicine will never progress."

"So, how do we solve this problem when we encounter this case?"

"First, we need to understand the mechanism by which these conjoined twins are formed. We clinicians often lack basic medical knowledge. As a research-oriented doctor, you must have sufficient basic medical knowledge. Otherwise, you will be at a loss when faced with complex and unknown problems."

"So how do conjoined twins form? Many people may know, or have looked up the literature, that this is a rare pregnancy phenomenon caused by a single fertilized egg failing to completely separate. Since it is a single fertilized egg that has not separated, let's continue to learn about it along this line of thought."

"Twins can be identical twins or fraternal twins. Identical twins are formed when a fertilized egg, resulting from the union of one sperm and one egg, splits into two embryos during the early stages of development."

"The exact reason why the embryo splits into two is still unclear, but it may be related to the embryo's own development or the uterine environment. Because these twins have the same genetic origin, the genetic information of the two embryos is completely identical."

"Another type is fraternal twins, in which the mother releases two eggs at the same time, which are then fertilized by different sperm to form two embryos. These two embryos develop independently in the uterus and have only about 50% similarity in genetic information."

"Now everyone should understand something."

Yang Ping stopped. He didn't want to talk on and on by himself. Instead, he tried to use an inquiry-based teaching method to guide everyone to think and form their own ideas.

"I understand now. Conjoined twins are actually identical twins. It's just that their fertilized eggs didn't completely separate when they split into two embryos, which is why they became conjoined twins."

Johannesson answered quickly; he was now very active, just like a student.

“Yes, that’s what I think too,” another graduate student immediately said. He had indeed wanted to say that, but Johannesson beat him to it. Yang Ping continued, “It seems that everyone knows about this issue and is thinking about it. Everyone has been wondering why I can find the boundary of their brainstem, why the artificial intelligence model can also find it, but you can’t, and other doctors can’t find it either. They even think it’s impossible to find the boundary, so surgery is impossible.”

"By the way, the reason why Professor He's artificial intelligence model was able to be found is because when he was modeling, from the bottom up, the data he used was provided by me, and the underlying model already had this capability."

"We just talked about identical twins. Now the question is how do we find the boundary? This requires extensive knowledge of genetics and embryology. Otherwise, the problem is unsolvable and we've reached a dead end."

"Now I ask everyone here, who has in-depth knowledge of embryology?"

Everyone was stumped. Who has time to study genetics and embryology? They may have taken basic courses, but those were very basic knowledge, and they haven't reviewed them since the exam. I guess even obstetricians and gynecologists have forgotten most of it.

Johannesson was stumped. As a clinician, his knowledge of genetics and embryology was very limited, and to be honest, he didn't have much to spare.

“Don’t even mention us, do obstetricians and gynecologists not have much knowledge in this area these days?” one of the doctors said, a statement that was immediately met with agreement from everyone.

"That's right. Not only do you lack it, but neurosurgeons, spinal surgeons, and so on all over the world don't have much knowledge of genetics and embryology. This problem requires excellent doctoral-level knowledge of genetics and embryology to have the ability to continue thinking about it."

"So you see, it's understandable that neurosurgeons around the world can't solve this problem; they lack an indispensable module for forming a line of thought."

Johannesson was very ashamed. Yes, at that time, not only him, but many neurosurgeons only tried to solve the problem of boundaries by starting from neurosurgical anatomy and function. But no matter how hard they tried, and with all the cutting-edge equipment they used, they could not find where the boundaries were. They only knew that these neural nuclei were chaotic.

Yang Ping continued explaining.

"But these doctors were able to determine that the brainstem nuclei were disordered and could not be operated on, which is already very good. This is already world-class level. They know where the difficulty lies in that they cannot separate them."

It seems my skills are not bad; at least I know where the difficulties lie. Although I didn't come up with a solution, Johannesson felt even more proud.

"I just talked about genetics and embryology."

Yang Ping's lectures are actually very clear in their thinking. As long as you follow his line of thought and have the relevant knowledge, it is easy to understand. His teaching style is to use simple language to express complex knowledge.

"If you have a deep understanding of genetics and embryology, you will then be able to think about the whole process of how identical twins develop from one fertilized egg into two fetuses, why one fertilized egg can separate into two embryos, when they separate, what conditions are needed, why they do not separate completely, what interference they are affected by, or what conditions are lacking."

"Okay, some people might say that even a PhD in this field might not know, because the mechanism may be unclear. There are too many unclear mechanisms in medicine."

"That's right, that's true. There are also unclear mechanisms that everyone is worried about. But don't forget, even if the mechanism is unclear, it doesn't affect our morphological research. There aren't many unclear mechanisms in morphological research."

“I didn’t quite understand this part,” Johannesson said immediately.

"Yes, since the mechanism is unclear, why doesn't it affect the research? How can we continue the research?" Someone had the same question, and then one by one, people said they didn't understand either.

Yang Ping knew that this was indeed a bit difficult to understand.

"With so much basic knowledge, we can now avoid areas where the mechanisms are unclear. For example, we can understand the problem we just encountered from a morphological perspective, clarify the entire process of identical twins developing from one fertilized egg into two fetuses, and then compare the morphology of these conjoined twins to know exactly where the problem occurred."

"By tracing the development of normal twins from the fertilized egg all the way to this point, we can understand how various neural nuclei are distributed. Artificial intelligence models also use this method. They simulate the development of identical twins and then compare it with the overall morphology of conjoined twins to determine the distribution of neural nuclei. With the help of other methods for verification, the problem is easily solved."

The professor is an expert in genetics and embryology; he's a true polymath. If he were to award doctoral degrees to every specialty, he'd probably have dozens of doctoral degrees.

Johannesson couldn't help but marvel at him. No wonder he was so amazing. He knew everything. How could he have so much time to read so many books and learn so much knowledge? It must take time to learn so much.

Does he read books like someone in a science fiction movie, quickly scanning them with his eyes and then all that knowledge is stored in his brain? That must be it.

The most puzzled person was Song Ziming. He spent almost every day with Yang Ping, but he never saw Yang Ping reading or studying. Although he was occasionally seen holding a book, most of the time he was leaning back in his chair with his eyes closed, resting.

Did he read these books while he was studying? Did he go for years without eating or drinking? Maybe.

Because whenever the topic turns to a particular book or paper, the professor always knows it; he never misses a single book or paper. His knowledge is absolutely profound; he is omniscient and knows everything.

"It doesn't seem difficult at first glance, does it? Anything becomes easy once you grasp the underlying principles. Is flying a plane difficult? It's very difficult for you, but not for pilots who fly every day. It's just that you lack the knowledge in this area, and you don't even think about it. Even if you did, it wouldn't be useful; you lack the knowledge to delve deeper."

"Because I am familiar with this knowledge, I can still study it by drawing by hand even without the help of artificial intelligence, it's just a little less efficient."

Johannesson seemed to understand: "Professor, is it like this? During the process of a fertilized egg evolving into a fetus, when the brainstem separates, the positions of the neural nuclei are constantly changing and appear disordered. But for us, for an embryologist who has done extensive research, we might know what the neural nuclei look like at that moment. Then we just need to figure out when the conjoined twins stop dividing, and the problem is solved?"

"You're a promising young man!" Yang Ping blurted out.