godfather of surgery

Chapter 1191 Motivators

Training doctors is actually training their knowledge and skills system. For example, in training Li Min, Yang Ping reconstructed his entire knowledge and skills system so that he could develop superb medical skills.

Seeing the discussion about local anesthesia in the group, Yang Ping believes that this type of anesthesia is very useful in grassroots hospitals. Grassroots hospitals cannot compare with large hospitals in big cities in terms of medical personnel and equipment, so some basic medical technologies are particularly important.

Yang Ping decided to teach Li Min this local anesthesia technique so that he could successfully complete the surgery even if he encountered anesthesia difficulties in grassroots hospitals in the future.

With a stethoscope around her neck, Fujiwara Miyuki's tall figure followed behind Tang Fei. They had just returned from rounds, and if Xiao Su hadn't reminded him, he would have forgotten about her existence. Manager Qiu suggested not sending Fujiwara Miyuki back for the time being, because from all indications, she was the one who secretly leaked information. She wasn't actually in danger; if she were, she would have been already. Later, Xiao Su also thought it would be more advantageous to keep her, so they decided to let her stay.

When Fujiwara Miyuki saw Yang Ping, she smiled and greeted him. Yang Ping nodded. This world is too complicated. Compared to interpersonal relationships, Yang Ping felt that scientific research was the simplest and purest thing.

Yang Ping went to the lab and stayed there for several hours before coming out in the afternoon. He checked the time and realized he had to rush to participate in the hospital-wide case discussion.

Yang Ping knew that everyone hoped he could attend the weekly hospital-wide consultation, as it was an opportunity for doctors to discuss and learn from each other. Whenever he had free time, Yang Ping would definitely go.

On his way to the administration building, Yang Ping saw Dean Xia, Director Han, and Dean Sun rushing off somewhere. They were all very busy these days. The site selection for the super laboratory had been completed, and there was still a lot of work to be done. In addition to the super laboratory, a remote surgery center was also to be established within the hospital. The clinical hospital had just been established, and organizational restructuring was also underway. However, Dean Xia was a very energetic person. Yang Ping never saw him tired while lecturing. No matter what, even during the period when he was falsely accused and suspended from his duties for investigation, Dean Xia was always full of passion. Yang Ping even saw him doing push-ups and sit-ups in his office.

After returning home, Johannesson sent Yang Ping a WeChat message to let him know he was safe. He told Yang Ping about Robert's banner incident, and Yang Ping couldn't help but laugh. How could that be? But when it comes to playing tricks, Robert is the only one who can handle things.

On the way, we ran into Director Duan from the HIFU department. His signature bald head was very eye-catching, shiny and glistening in the sunlight.

"Professor Yang!" He spotted Yang Ping from afar, his briefcase tucked under his arm.

With his attire and demeanor, a stranger might mistake him for a construction foreman. He shook Yang Ping's hand and said, "Professor Yang, it's been a long time."

Yang Ping often stayed in the research institute and didn't come out, while Duan Guangtou went out to perform surgery every few days. He was already one of the best in the country when it came to uterine fibroid removal using the HIFU knife. Others always had various complications after uterine fibroid removal, but he was clean and refreshed after the procedure, without any complications. Relying on this unique skill, he performed surgery everywhere and made a fortune.

"Professor Yang, I'm resigning," Director Duan said.

Yang Ping was quite surprised: "You were doing so well, why did you resign?"

“Sanbo Hospital is great, and I really miss it. But my friends and I have started a group of doctors and rented HIFU (High-Intensity Focused Ultrasound) equipment from the manufacturer. I want to go it alone,” Director Duan said. “I also explained to Dean Xia that he is a really good person. He promised that if I want to come back, I can contact him anytime.”

"You're planning to go solo? You should think this through," Yang Ping reminded him. There are quite a few doctors starting medical groups these days, but very few are doing well. Most of them lose money and eventually have to go back to the hospital.

Director Duan said in a low voice, "I've thought about this. I won't hide it from you. I started my own business a long time ago and have been making a profit for a long time, which is why I dared to resign. In the end, I still have to thank you. You taught me how to make a living. I don't know how to thank you enough. Really, thank you."

Director Duan bowed formally and respectfully to Yang Ping, who quickly helped him up, saying, "We're all colleagues, what are you doing?"

"Inviting you to dinner or giving you gifts is not appropriate now. I've thought about it for a long time, and the only thing I can do is bow deeply to you. Without you, I wouldn't be where I am today, Professor Yang. If you ever need my help in the future, just say the word. I'll go through fire and water for you without batting an eye. I heard that little girl Sisi has recovered very well?" Director Duan still remembered Sisi. Back then, Yang Ping often brought Sisi over for HIFU treatment of her tumor.

Director Duan has been through the ups and downs of business and now has a certain江湖气 (a kind of江湖-like, street-smart, and sometimes shrewdness) about him.

“She’s participating in a new treatment in our lab and is recovering well. I’m going to the hospital’s conference room for an in-hospital consultation. You’re busy, we can talk again when you have time.” Yang Ping checked the time; the case discussion was about to begin.

"Okay, I won't take up your time. I'll come back to thank you later after I've completed the formalities." Director Duan said goodbye to Yang Ping, carrying his briefcase.

The hospital's administrative building has now been converted into wards, but several conference rooms have been retained. After all, the hospital holds large meetings from time to time, such as hospital-wide case discussions.

The leaders and administrative staff are still crammed into the prefabricated houses. At first, the administrative staff complained a lot, but after being reprimanded by Dean Xia, no one complained anymore, and they have gotten used to it now.

When Yang Ping arrived, the conference room was already full of people, all waiting to start. Yang Ping originally wanted to sneak to sit in the last row. When he was in school, he liked to sit in the last row the most because of the freedom.

But now that he has this freedom, Director Han saw him coming in from afar and immediately got up and grabbed him. The first row had been reserved for him long ago, how could he let him sit in the last row? Not to mention in this institute, even at any academic conference of any level in the country or the world, Yang Ping would definitely be in the first row, center position.

Director Han is now the head of the expert group, not only the head of the expert group at Sanbo Hospital, but also the head of the expert group at the Clinical Medical College. He is qualified for this position, and everyone respects him.

“I just glanced at them, and there are a few interesting cases today. You should say a few more words about them. Everyone is looking forward to your speech every week,” Director Han said.

Yang Ping checked the time; it would start in a few minutes. Doctors continued to come in, and aside from those on duty and those in the operating room, most would voluntarily come to participate in the case discussion.

Almost all the senior directors of the orthopedics department were present, which shows that the orthopedics department attaches great importance to this hospital-wide case discussion. Director Tan greeted Yang Ping. Director Tan is now the senior director of the orthopedics department, which is developing very well.

The first case we'll discuss is an orthopedic case. This patient was initially admitted to the pediatric ward and then transferred to the orthopedics ward, where they are currently hospitalized.

The case report was given by a chubby graduate student who was in the same group as Director Bai. Director Bai was known in the orthopedics department as the "heavyweight medical team," and no member of the entire medical team weighed less than 90 kilograms.

This patient is a 13-year-old girl who has experienced recurrent pain in multiple parts of her body for 11 years. Yang Ping reviewed the case summary in his hand. The medical history spanned 11 years, starting at the age of two. She had visited quite a few hospitals. The key feature of the pain was bone pain in multiple parts of her body, frequently occurring in the joints, accompanied by local tenderness. The pain worsened at night and was significantly relieved during the day. The painful areas were also swollen and hot. Apart from these characteristics, there were no other obvious positive signs on physical examination. The pain severely affected her ability to walk.

I've had quite a few tests done, including various blood tests, MRI scans, and more, all at Sanbo Hospital.

The blood test results, taken together, indicate a significant inflammatory response. MRI scans of major joints such as both knees and hips show inflammation and damage in these joints.

These symptoms have recurred over the past 11 years, including low-grade fever, weight loss, and a malnourished appearance.

After Yang Ping reviewed the materials, the graduate student Hai Li on stage gave a report. After the medical record report was completed, the attending physician in the same group supplemented the medical history. Then, Director Bai personally went on stage to speak, which showed that they attached great importance to this case.

"Experts, this case was transferred from the pediatrics department. Our Director Tan has also seen it, and we have discussed it within the department. The diagnosis is chronic relapsing multifocal osteomyelitis. We feel that there is no problem with the diagnosis. The key is the treatment. We know what orthopedic surgeons fear most is osteomyelitis, especially chronic osteomyelitis. For orthopedic surgeons, this is a catastrophic disease and the most troublesome. If they could refuse, I think orthopedic surgeons would least want to treat this type of patient."

"However, this is only because we believe the diagnosis is correct. Let's see if the experts have any different opinions on the diagnosis?"

Yang Ping reviewed the medical records in his mind. Indeed, the diagnosis was correct, but the treatment was a major problem. This type of osteomyelitis was aseptic osteomyelitis, which was different from the purulent infections we usually encountered, which were bacterial osteomyelitis.

In other words, from a pathological perspective, this type of osteomyelitis is not caused by bacterial infection, but is an autoimmune inflammatory disease. It is caused by certain factors in the patient, such as gene mutations, which lead to the activation of the immune system in the absence of triggering factors such as infection, resulting in spontaneous inflammation. These activated immune system components damage the body's own tissues and cells, and sometimes even endanger life.

This case is indeed this disease. Yang Ping reviewed the medical record again and confirmed that the diagnosis was correct. The orthopedics department is developing well under the leadership of Director Tan.

This case is quite difficult to diagnose; there are only about 500 documented cases worldwide.

"The diagnosis should be correct. This case has undergone pathological examination, and I reviewed the pathological sections of the bone tissue," Wen Ruzheng stated.

That was a very assertive and stylish statement.

“The pathology report doesn’t have any specificity; diagnosis mainly relies on symptoms,” the spinal surgeon immediately stated.

“There are characteristic features in the pathology. I’ve recently been researching the various histopathological manifestations of autoimmune diseases and am preparing to publish an article. There are indeed characteristic manifestations. It’s a long story, and we can discuss it privately later. In short, I believe there are no problems with the diagnosis, at least I accept the diagnosis from a pathological perspective.”

Wen Ruzheng displayed his distinctive style, knowing that engaging in discussion in this setting would waste everyone's time.

"Yes, I agree with the diagnosis; there are no issues with the clinical symptoms," the text states, indicating agreement.

Dr. Jin, a spinal surgeon, said: "The diagnostic criteria for this disease are not very complete at present. I think it is quite impressive that we were able to make a diagnosis. I just saw her X-ray. There are obvious osteolytic lesions at the sclerotic edge of the distal femur and proximal tibia, accompanied by mild periosteal reaction. I also saw similar reactions in several other areas. Combined with the clinical symptoms, I think the diagnosis is correct."

"Professor Yang, could you please take a look and see if we've made a mistake in our diagnosis?" Director Tan turned to Yang Ping, hoping to get his opinion, since it was a rather difficult case to diagnose.

"No problem. Based on the information from the medical history, physical examination, and auxiliary tests, the diagnosis is completely correct," Yang Ping said confidently.

Director Tan felt relieved, and the next step was to discuss the treatment.

"I've been reading a lot of literature on this topic these past few days. The treatment for this disease is not very effective at present, especially for those with less obvious symptoms and longer durations of symptoms. Half of the cases will have significant sequelae, such as skeletal deformities, limb length discrepancies, lameness, chronic pain, etc., which will seriously affect the patient's appearance and function."

Have you had any genetic testing done?

That's Zhang Lin's voice. He just came in; he probably just finished surgery.

"For these kinds of cases, it's best to do genetic sequencing. That's the only way to find the real cause and solve the problem at its root," Zhang Lin said, sounding like a great professor.

In the past, people would secretly laugh at him for being pretentious, putting on airs like a great professor and speaking so eloquently.

But now no one is laughing at him, because he and Xiao Wu recently worked on a project and successfully cracked a genetic case. The paper is in preparation, and everyone in the hospital knows about it, even the cleaning lady knows. Zhang Lin and Xiao Wu's project is of very high quality and has made a major discovery.

Moreover, people used to joke that they were the institute's golden and silver hooks, and that they were Professor Yang's hook-pulling heroes.

No one laughs at them now because they have actually written a monograph, which has been published, and applied for a large number of patents related to hooks. To be honest, they are indeed world-class experts in hooks, and their book on hooks is the world's first monograph on hooks.

Being number one in the world, regardless of the specific field, is a truly remarkable achievement.

Many doctors now look on with envy, hoping to hear what this inspirational figure has to say. Zhang Lin and Xiao Wu used to be seen as somewhat of a clown, but now they are seen as inspirational role models for ordinary people.

Many doctors wanted to hear Zhang Lin's opinion, especially regarding genetics, as he had recently made some progress in the field.

P.S.: I've been a bit busy lately, so I might not have been revising the draft very carefully. I hope you can all understand. Thank you all for your continued support. I will try my best to keep updating.