godfather of surgery

Chapter 405 Connecting Steven

International Space Station, American module.

Steven just finished his fitness training. He ran for an hour on a combined weight-bearing and external resistance treadmill, and did some other resistance training.

In a microgravity environment, it is easy to cause muscle atrophy and bone calcium loss. If you can't maintain a certain amount of physical exercise, this phenomenon will be more serious.

After returning to Earth, they will be unable to walk due to muscle atrophy, and will be prone to fractures due to osteoporosis.

Steven wiped off his sweat, swam his light body, and returned to the living cabin, where various appliances were hung on the bulkhead.

He checked the air pressure in the cabin, and there was no abnormality. Not long ago, there was a leak in the Russian cabin, which lost 220g of air every day. It took the magical Russians a month to finally find the leak, a breach of only 1mm. They used Taped it off, then said you can sit back and relax.

If it was Steven, he would definitely do a spacewalk and weld the outside of the vehicle to block it, otherwise it would be difficult to sleep peacefully.

My partner David Hawley is still watching the earth in the observation cabin of the turret. He likes photography, and always likes to take pictures outside the cabin, and then select some high-quality photos to post on Facebook.

David Hawley is in love and he's just trying to woo that girl with these pictures.

From the inside of the cabin, there is no doubt that the dome cabin with seven observation cabins—the turret—is the best choice.

Steven opened his laptop and began to select photos. These were taken by the cameras outside the space station. He promised his daughter that he would accumulate photos of different regions of the earth, and the photos must be taken by the cameras outside, so that there would be no transparent windows .

Every time at this time, Steven is the most relaxed. He has completed a day's scientific research tasks and done some private affairs for his daughter, which he is proud of.

It’s time to make a video call with my wife. With the help of three communication satellites, the International Space Station can connect to the Internet. Not only can I communicate with the ground control center in Houston, but I can also make video calls with my family, browse the web, browse news, and send messages. Tweet, Facebook.

"Honey, I just came back from the supermarket. Look, my daughter is going to fill up the refrigerator with the fruits you like. I told her to wait. There are still 20 days. Don't worry, she won't listen at all." While the wife was busy, she pointed the camera at her.

Steven's wife, an elementary school teacher in Houston, is cooking dinner with steak, salad, and juice on the table.

"My dear, there are still 20 days before we can meet."

"We're waiting for you, my dear. It's like years. I saw the news on NASA's official website. In 20 days, a Dragon spacecraft will be launched at the Kennedy Space Center, and you will complete the rotation."

"Daddy, Daddy!" the voice of the eight-year-old daughter.

"Slow down, baby, what are you doing?" Steven saw the funny daughter, wearing film gloves, with cheese-like things all over her face, hands, and clothes.

"I'm making a salad. When you come back, I'll make a plate of fruit salad for you to eat." The daughter danced with excitement.

"She is learning how to make fruit salad. Look at her face. This is what she has paid for you." The wife carefully dried her daughter's cat face with a wet towel.

"Dad, remember to save a set of photos for me. I promised my classmates, one for each, and your signature is required. I must be a person who keeps my word." My daughter reminds me every time.

"I'm selecting, and it will be sent to your mailbox in a few days." Steven has almost selected.

"She has prepared a speech topic—Looking at the Earth from Space. She speaks to our cat every day. Now I need your photo as the material." The wife touched her daughter's face.

"Thank you, Dad! Let's talk, I'll hide in my room now, and I'll give you 15 minutes." The daughter bid farewell to Steven and hid in her room.

The wife was facing the camera: "Honey, really, I miss you and worry about you. Every day we use the astronomical telescope to look out the window to observe the sky, hoping that you will fly over our heads. Linker wrote a form, using The red pen underlines the time you pass, are you - okay?."

"Thank you dear, I'm fine, how are you?"

"Well, I'm fine too. Linker wants to learn to surf, but I can't. She's waiting for you to come back."

The door was secretly opened a crack, and Linke'er looked at her parents who were video chatting through the crack.
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At the Johnson Aviation Center, the executive offices in Building One, the lights were on.

Members of the medical team and specially-appointed experts from various places are having heated discussions.

The discussion lasted from [-]:[-] pm to [-]:[-] pm, and it was not over yet.

"Our core problem has been clarified. The reason for Steven's heart rate slowing down is unknown. Will this unknown reason affect his return to Earth? Once he can return to the ground, everything will be easy to solve." Collins figured it out.

"That's right, you have found the focal point. I stick to my opinion and do not rule out tumors in the brainstem of the brain, or other lesions."

"Everyone, I was in China not long ago. I saw a patient in his 70s with a brain stem and medullary tumor. The first symptoms were slow heart rate and breathing."

"I mean, if the lesion affects the heart-beating center, it can cause a slowed heart rate, and if the lesion affects the respiratory center, it can lead to slowed breathing."

"I suspect that some kind of lesion is affecting Steven's heartbeat center. The probability is very low, one in a thousand, but we can't gamble. I suggest that we can't return to Earth until we figure it out. If it is a vascular malformation, the spacecraft enters the atmosphere , fell at a high speed, the blood vessel ruptured, and there is no doubt that he would die.”

Johannesson stood up and made his point in an excited tone.

Dr. Eugene also stood up: "From the results of the current color ultrasound examination, there is no problem with the heart, and the blood sample brought back last time did not find any abnormalities, but I want to connect with Steven and personally guide him to do it again Cardiac ultrasound, the state of human health is dynamic, and previous examinations cannot explain everything."

"After the meeting is over, we'll connect with Steven and do a heart ultrasound again."

Collins agrees with Dr. Eugene that the doctors in the medical team are far behind the Johns Hopkins professor of cardiovascular medicine in terms of identification level of color Doppler ultrasound images.

"At the same time, I support Professor Johannesson. I didn't figure out the reason and rushed back to the voyage. I was undoubtedly gambling with Steven's life." Eugene added, with a heavy tone.

Other experts also strongly agree with the two professors, whether it is a heart or intracranial disease, the cause must be clarified and the risk of returning to the voyage must be assessed.

"Our opinions are very unified now, and we must further check to find out the cause and rule out some fatal diseases." Collins concluded.

Johannesson was very straightforward: "Yes, a cerebral angiography must be completed, and it is unrealistic to perform an intracranial CT or MRI examination, but as long as there is a cerebral angiography, I can at least perform a basic risk assessment. Dr. Eugene, I am afraid I will send you Dr. Massimo from the hospital has come to Houston."

Eugene also thought of this: "I'm here to contact, Collins, you contact our hospital in the name of NASA."

Massimo, this talented interventional doctor, since he is going to do a total cerebrovascular DSA, how could he not be present.

"No problem, I will contact Johns Hopkins as soon as possible, but there is no iodine contrast agent in our medicine chest, and the simple X-ray machine on the space station cannot trust digital subtraction angiography." Collins is familiar with the medicine chest of the American module of the International Space Station .

He looked at the Russian doctor in the medical team, and the Russian doctor also expressed his helplessness: "Unfortunately, although we have 18 medicine boxes, we don't have iodine contrast agent either."

The Russians sent an up-to-date drug brochure, and Collins opened it.

As early as 50 years ago, when humans entered space for the first time, astronauts had the habit of carrying a medicine box into space, but what this small medicine box should contain was not mature at that time.

With the increase in the number of spaceflights and the advancement of space medicine knowledge, this drug list is becoming more and more mature.

In order to cope with the health accidents of astronauts, the International Space Station has quite a variety of medicines on reserve. The medical team compiled a list of medicine names based on the list of injuries and diseases that may occur while stationed on the space station.

In addition to medicines, the space station also has some medical equipment: small electrocardiogram measuring machines, pulse measuring machines, blood pressure monitors, amplified stethoscopes, and basic cardiopulmonary resuscitation equipment.

The spacecraft that travels between the space station and the ground only flies once every two or three months.

If the astronauts have urgently needed medicine, the medicine cabinet is not available at this time.

The ground staff should prepare according to the quantity of medicines that may be needed, and send the spacecraft into space.

Due to the limitation of the spacecraft's load, the drugs to be transported must be carefully selected, and broad-spectrum mature drugs should be selected as much as possible.

There are 9 medicine boxes in the American module of the International Space Station, but no iodine contrast agent, because no one would think that the astronauts in the sky will have an angiographic examination.

Collins rubbed his temples: "If this is the case - I have to report it. This requires a spaceship launch arranged in advance to deliver medicines and instruments up. In addition, Susan must be sent up."

Collins decided that it must be reported. This problem is no longer something that the medical team can solve, and it should be decided by the director of the National Aeronautics and Space Administration.

Astronauts receive very limited medical training, all of which are basic treatment and first aid. To complete a cerebral angiography, a more professional person must complete it. This person is Susan.

She is not only an astronaut, but also a surgeon. She has professional medical literacy and can perform some basic operations independently.

Collins looked up, the pain in his cervical spine made his head heavy: "Do you have any comments, the situation is going to escalate now, if it has to be done? We need to arrange a special flight to send Susan and the medicine to the space station."

"One launch, based on the weight of two people, the minimum cost is more than 1 million U.S. dollars."

"This is Musk's price. In the past, the average cost of each launch in the United States was 4.5 million U.S. dollars."

Two engineers who participated in the meeting reminded everyone whether there is another better way.

"This is Mr. Director's math problem. Our problem is how to make a one-thousandth risk become zero."

Johannesson said seriously that considering the cost of money in front of human life is a contempt for life.

The words of the two engineers aroused the hostility of all the doctors, and they shut up immediately. They appeared at the meeting just to answer the doctors' possible questions about the space station engineering.

"That's right, this question is left to Mr. Jim Basa, maybe he can lower the price with Mr. Musk."

"I will draw up a report tonight and report to the Chief Medical Officer and Mr. Director of the Washington headquarters, requesting an additional courier to deliver Susan and the medicine for us. Gentlemen, sorry for the hard work, we will go to the ground immediately In the control center, connect with Steven, and conduct another color ultrasound inspection. Finally, we have to make a detailed plan together, such as the list of medicines and equipment for express delivery, whether Susan will undergo intensive training, and dinner can only be fast food at work. Solved, I'm very sorry." Collins ended the meeting and immediately led everyone to move to another building - the ground control center.

There are eight staff members busy, all staring at the screen.

The ground control center implements a shift system, every nine hours, to ensure that there are seven or eight staff members on duty 24 hours a day.

"Emergency medical line, call Steven, now!" Collins told the shift leader.

"Connect with Steven!" The team leader ordered loudly.

The staff in charge of communications immediately connected to the video system of the space station.

A few calls later, Steven's face appeared on the screen.

"Hello everyone, I'm Steven, I'm fine, what's going on, Collins, your team seems to be there?" Steven greeted.

Collins kept smiling: "Don't worry, we just held a meeting to slow down your heart rate. Now Dr. Eugene needs to guide you to do a color ultrasound again. Do you need David Hawley's assistance?"

"No, no, I can do it by myself. I don't have any discomfort. I finished an hour of running today. I don't think I have a problem. Either you are wrong or the equipment is wrong. In short, it is not my fault."

Steven swam around and began to open a storage box, pulling out the color Doppler ultrasound machine from inside.

"From now on, you have to stop exercising." Dr. Eugene warned Steven.

The reason has not been found. If it is a myocardial problem, exercise will increase the load on the heart, which will cause arrhythmia, and the consequences will be disastrous.

"Johns Hopkins, Dr. Eugene, an expert in cardiovascular medicine." Collins introduced.

Steven straightened the wires and turned on the switch: "Although I am extremely against your words, I will follow your advice, because you are a doctor, can you start?"

"It's ok." The staff in charge of communication adjusted the picture, and the color ultrasound image of the space station was synchronized with the screen in front of them.

"Okay, now you can follow the steps to do the color Doppler ultrasound of the heart." Collins ordered.

Dr. Eugene and everyone gathered together in front of the communication screen to look at the image frame of the color ultrasound.

Left and right ventricle, left and right atrium, valves, aorta, vena cava, pulmonary artery, pulmonary vein—

Dr. Eugene carefully observed the color Doppler ultrasound images of the beating heart, and he asked Steven to repeat it several times.

There is no problem!

"Do you have any discomfort? For example, chest pain, feeling of lack of oxygen, general fatigue, lack of exercise ability? This is related to your return flight." Dr. Eugene is still not at ease.

"No, I don't have any discomfort." Steven was optimistic and didn't think there was anything wrong with him.

"Headache, dizziness, muscle incoordination, what's wrong with Ren and Yi?" Johannesson asked.

"No, if I can, I want to challenge Tyson."

"Okay, take a good rest, and feel free to contact us if you have any questions."

Dr. Eugene can't see anything wrong with the cardiac ultrasound.

Can only wait for the next inspection.

　The two chapters together, more than 4000 words, thank you everyone!
　　
　
(End of this chapter)