godfather of surgery

Chapter 1353 Fifteen Notebooks
Xia Shu sealed the cardboard boxes and glanced back at the duty room.

His gaze fell on the desk.

Fifteen large, black hard-cover notebooks were neatly stacked there.

Those were his study notes.

Xia Shu walked over, picked up the top book, and opened it.

During his hundreds of days and nights at the research institute, he meticulously recorded every surgery he participated in, every case discussed, and every casual remark Yang Ping made. Initially, he noted down technical details: the angle of the anastomosis, the choice of sutures, the duration of cardiopulmonary bypass, and the handling of intraoperative complications. Later, he began to record seemingly unrelated things: the patient's occupation, dietary habits, sleep patterns, medication history, family medical history, and even living environment.

Xia Shu closed the notebook and stacked it with the others. The edges of the covers were worn, and the spines of several books were cracked, which he carefully repaired with transparent tape. The inside was densely filled with words, some pages had drawings, and some pages had folded corners for markings.

There was a knock on the door.

"Please come in."

The door opened, and three young men in white lab coats walked in. Xia Shu recognized the one in the lead; he was Zhou Zheng, a doctoral student recruited by Li Zehui this year, and Xia Shu had seen him a few times in the department. The two behind him were unfamiliar faces; they were probably junior colleagues in the same group.

"Teacher Xia!" Zhou Zheng greeted her with a smile, "Director Li sent us to help move things."

Xia Shu was taken aback for a moment: "No need to trouble yourself, I can move it myself."

“No trouble at all,” Zhou Zheng said, already rolling up his sleeves and walking to the corner. “Director Li specially sent us over to help. We’re young and strong, so it’s a good opportunity for us to get some exercise.”

The two doctoral students behind him nodded in agreement and began to pick up the cardboard boxes on the ground.

Xia Shu opened her mouth, but didn't know what to say.

Zhou Zheng picked up a cardboard box, looked at the label, and asked, "Teacher Xia, what's in this box? It's quite heavy."

“Books,” Xia Shu said, “and professional materials.”

“Okay, I’ll carry it down first.” Zhou Zheng carried the box out, but turned back at the door. “Teacher Xia, leave your stack of notebooks there, I’ll come back and get them.”

The three young men made several trips back and forth, loading all six cardboard boxes onto the flatbed trailer.

When Zhou Zheng returned, he saw Xia Shu still standing in front of the desk, staring at the pile of notebooks.

"Teacher Xia, please give this to me."

Xia Shu hesitated for a second, then nodded.

Zhou Zheng glanced at them; fifteen notebooks were stacked together, neatly bound with tape. Each cover had a handwritten number: 1 to 15.

"These are your notes, Professor Xia!"

"Ah."

Zhou Zheng didn't ask any more questions. He carried the stack of notebooks out; they were very heavy.

There was a sticky note on the bedside table, which he had put up when he first arrived. It contained a quote from Yang Ping: "A good surgery can only save one person. Passing on the skills can save more people."

The sticky note had turned yellow and the edges were curled up.

He didn't tear it up; he left it for the next person to move in.

He turned around and closed the door.

Downstairs, a hospital van and a car were already waiting. The three doctoral students loaded the cardboard boxes and notebooks into the van, and Zhou Zheng dusted off his hands.

"Teacher Xia, you can take a car there, we can walk."

"Let's go together," Xia Shu said. It was only a few steps, but Li Zehui had arranged for a car to pick them up and a truck to carry their luggage.

Zhou Zheng glanced at his expression and didn't insist any further.

The four of them walked through the institute's courtyard toward the surgical building. Several young doctors in white coats passed by, some of whom recognized Xia Shu and nodded in greeting.

Li Zehui stood at the door of the cardiac surgery ward in the surgical building, waiting.

"You're here?" He saw Xia Shu, then the three doctoral students behind him and the small trailer. "Have you moved all the stuff over?"

Zhou Zheng eagerly replied, "Reporting to Director Li, six cardboard boxes and a stack of notebooks, all in place!"

Li Zehui nodded and looked at Xia Shu.

“Dr. Xia,” he extended his hand, “welcome!”

Xia Shu grasped his hand.

Li Zehui is a world-leading cardiac surgeon, working at the Cleveland Clinic's Department of Cardiac Surgery, and a member of the American College of Cardiothoracic Surgeons. He has practiced medicine in the United States for over twenty years and is an authority in the field of congenital heart disease; wealthy individuals from Europe and the Middle East travel to Cleveland specifically to have him perform surgery.

Such a person has returned to China to participate in the Sanbo tournament.

Xia Shu asked him why he came back.

Li Zehui's answer was simple: "Because Professor Yang is here. Only by being with a great person can one achieve great things."

At this moment, the two stood at the entrance of the cardiac surgery ward, looking at everything before them.

The cardiac surgery ward covers an area of ​​over 2,000 square meters and has 48 beds, including 12 ICU beds. It features a circular nurses' station, a giant intelligent monitoring screen, six image reading workstations, a remote consultation room, two Class 100 laminar flow operating rooms, and one hybrid operating room.

The team consists of six extracorporeal circulation specialists, four anesthesia specialists, twenty-three nurses, three rehabilitation specialists, two nutritionists, and one psychological counselor.

The team includes young PhDs from Fuwai and Anzhen hospitals, as well as returnees from the United States, Germany, and Japan. The extracorporeal circulation specialist was recruited by Li Zehui from Cleveland, a Chinese who had been with him for fifteen years; the anesthesiologist had worked at Sanbo Hospital for eight years; and the nursing team was selected from Sanbo Hospital and underwent rigorous training.

Sanbo is not short of money now. With Yang Ping's support, Xia Changjiang is determined to build Sanbo into a world-class medical center.

Cardiac surgery is of paramount importance. The most advanced equipment is only the foundation; what truly makes this department stand out is its people.

With Li Zehui and Xia Shu, Xia Changjiang has no worries about the development of cardiac surgery.

Li Zehui and Xia Shu arrived at the office, where the doctor next to them handed over a medical record, which Li Zehui took and passed to Xia Shu.

“This is your first surgery in cardiac surgery,” he said. “Take a look.”

Xia Shu took the medical record.

Turn to the first page.

The patient is a 53-year-old male. Diagnosis: complex aortic root aneurysm with severe aortic regurgitation, three-vessel coronary artery disease, and a history of two open-chest surgeries.

He raised his head.

The patient has a history of two open-chest surgeries. This means that the chest cavity is full of adhesions, and the normal anatomical structure has been completely altered. In addition, there is an aortic root aneurysm—a no-go zone for cardiac surgery; once the aneurysm ruptures, there is little hope of saving the patient.

The medical record ends with a line that reads:

"Cleveland Heart Center consultation opinion: Surgery is too risky, conservative treatment is recommended."

Xia Shu looked at Li Zehui.

"They dare not do it?"

Li Zehui nodded: "This is a patient admitted by Professor Yang. He said you'll be fine."

Xia Shu remained silent for a few seconds. Although he had familiarized himself with the case beforehand, he was still under a lot of pressure, after all, it was the first time he had performed such a difficult case in an operating room outside the research institute.

The first surgery was performed at 10 a.m.

When Xia Shu entered the operating room, everything was already prepared. The cardiopulmonary bypass technician was adjusting the machines, the anesthesiologist was checking the medications, and the scrub nurse was counting the instruments. Everyone glanced up at him, then lowered their heads and continued with their work.

Xia Shu walked to the sink and began to scrub her hands.

The water was cool, and the coolness refreshed him as he rinsed his hands. Looking at himself in the mirror, he recalled his first time performing a difficult surgery. Back then, he too had stood before the sink, scrubbing his hands, a little nervous. Yang Ping walked past him and said, "Only those with a steady mind have steady hands."

He remembered it.

After washing his hands, he put on his surgical gown and gloves. He walked to the operating table and stood in the surgeon's position.

Li Zehui has already taken the position of first assistant.

The operating lights came on.

“Let’s begin,” Xia Shu said.

They had discussed the surgical plan three times. They had reviewed the CTA no less than fifty times before the surgery, and the 3D reconstruction model had been run countless times on the computer; every possible contingency had been rehearsed. Li Ze would lay out all the experience he had accumulated in Cleveland over the past twenty years, going over it point by point with Xia Shu.

But what truly allowed Xia Shu to stand firm were those fifteen notebooks. Xia Shu understood that they would be his strongest support for the rest of his life.

The sternum was sawed open, and the chest cavity was opened. The adhesions were more severe than expected; the heart was wrapped in thick scar tissue, like a bird entangled in a spider web.

"Sharp separation, slow down."

Xia Shu picked up the scissors and told himself this. He remembered a sentence he had written in his notebook, something Yang Ping had said when treating a patient who had undergone a second thoracotomy: "Don't use blunt dissection on adherent tissues, it will tear important structures. Be sharp, be slow, be patient. The truly top-notch dissection technique must be sharp dissection."

The scissors tip followed the scar, inching along.

Separate, stop the bleeding, separate again, stop the bleeding again.

Two hours later, the heart was finally revealed. The aneurysm at the root of the aorta was the size of a goose egg, with walls as thin as paper; it could be seen pulsating slightly with each heartbeat.

"Prepare for extracorporeal circulation," Xia Shu said.

Intubation, switching to a ventilator, cooling down. Heart stopped, aneurysm incised, replacement with a valved prosthetic vessel, coronary artery re-implantation.

Three hours, four hours... six hours.

The last stitch was completed in the sixth hour.

After rewarming, the heart started beating again.

On the monitor, blood pressure was 115/70, heart rate was 82, and blood oxygen saturation was 99%.

The anesthesiologist's voice was slightly unsteady: "Stable."

Xia Shu didn't speak immediately. He looked at the heart, watching it beat strongly in the new aortic root, for a long time.

“Close your chest!” he said.

The surgery ended at 5 p.m.

Xia Shu walked out of the operating room and leaned against the wall in the corridor. His surgical gown was soaked with sweat, his legs were a little weak, but his hands were still steady.

Li Zehui came out and handed him a glass of water.

"Is this your first time performing such a complex surgery independently?"

Xia Shu nodded: "This is the first time I've felt psychologically independent. Before, no matter how big the surgery was, Professor Yang always had a backup plan. It's a different feeling."

How do you feel now?

Xia Shu thought for a moment.

"It felt like...flying once."

Li Ze smiled. Professor Yang's apprentices were indeed different; the difficulty of this surgery was already among the world's top.

“In my twenty years in Cleveland, the most difficult surgeries I’ve ever done are of this level,” he said. “You’re doing this kind of surgery for your very first time.”

Xia Shu did not speak.

Li Zehui patted him on the shoulder.

"Yang Ping didn't misjudge him."

That night, Xia Shu stayed in the ICU until 2 a.m. Only after all the patient's vital signs stabilized did she return to her office.

The office is new, the bookshelves are empty, and the desk is completely bare.

He stood there, when suddenly something came to mind.

Where's my laptop? Suddenly, I felt a little panicked.

He turned to go out and look for it when there was a knock on the door.

"Please come in."

The door opened, and Zhou Zheng poked half his head in: "Teacher Xia, I'll put your stack of notebooks on your desk. You weren't here when I moved them in this afternoon, so I took the liberty of doing it myself."

Xia Shu looked back and saw that the desk was indeed neatly stacked with those fifteen notebooks.

"Thank you," he said.

Zhou Zheng smiled and didn't leave.

"Teacher Xia, may I ask you a question?"

"explain."

“Those dozen or so notebooks of yours,” Zhou Zheng pointed to the bookshelf, “could I… borrow one to take a look at? Just one is fine.”

Xia Shu looked at him.

Zhou Zheng was a little embarrassed: "I don't have much clinical experience, and I'm not sure if I can do it well. You've taken so many notes... I'd like to see how you got through it."

Xia Shu remained silent for a few seconds.

Then he walked to the bookshelf, took down the first book: "Sorry, you can take a picture or make a copy, but you can't take the original with you."

The notebook he had just started using had somewhat clumsy handwriting and simple content. He flipped to the first page, glanced at the line of text, and then handed it to Zhou Zheng.

“Look at this one first,” he said. “Give it to me immediately after you take the photos; this set of notes is very important to me.”

Zhou Zheng accepted it with both hands, as if it were a precious treasure.

"Thank you, Teacher Xia!" He held the notebook, started taking pictures, and left only after checking that no pages were missing.

Xia Shu stood in front of the bookshelf, looking at the fifteen notebooks.

Hundreds of days and nights, more than a thousand surgeries, and countless cases.

I wrote all of that down in my notebook.

But there are some things I can't remember.

For example, today, standing by the operating table, at the moment the chest cavity was cut open, Li Ze stood opposite him without saying a word, but he knew that person trusted him.

For example, after the surgery, when I walked out of the operating room and leaned against the wall, I was soaked in sweat, but my heart was full.

For example, the light in Zhou Zheng's eyes when he asked, "Can I borrow it to take a look?"

I can't remember those.

But those are the most important.

Xia Shu walked back to the window and looked outside.

The glass walkway was still lit up in the night. People passed by, perhaps students just off work, or perhaps doctors on night shift.

He watched for a while.

Then he went back to his desk, sat down, and opened a new blank notebook.

Turn to the first page and write down the date.

Then I started writing:

"The first surgery performed by the newly opened Department of Cardiac Surgery: a complex aortic root aneurysm complicated with severe aortic regurgitation and three-vessel coronary artery disease, with a history of two previous open-chest surgeries. Surgery duration: six hours and seventeen minutes. Intraoperative complications: two. Management plan:..."

He wrote very slowly, stroke by stroke.

He closed his notebook and leaned back in his chair.

Outside the window, the lights of Sanbo Hospital gradually came on. People were moving about in the glass corridor, and nurses were still busy in the cardiac surgery corridor. The monitors in the ICU emitted a regular beeping sound.

Everything is just beginning.

He sat for a while longer, then stood up to leave.

As he reached the door, he suddenly remembered something.

He glanced back at the bookshelf.

The notebooks were neatly stacked there.

There's another surgery tomorrow.

There are still many surgeries to be performed.

There are still many notes to take.

He turned off the light and closed the door.

The corridor was quiet. The light at the nurses' station was still on, and the nurse on duty was writing a record with her head down. She saw him and nodded.

He nodded and continued walking forward, feeling at ease.