A Tale of Two Cities Supporting Xinjiang

"Dr. Zhou Yi! Quick! A child is dying!"

At three o'clock in the morning, Zhou Yi was awakened by urgent knocking on the door.

Nurbahati was standing outside the door, holding an electrocardiogram in his hand.

"A five-year-old boy from the pastoral area, suffering from acute heart failure."

Nurbahati's voice tightened: "The local hospital says it's a complex congenital heart disease, and they can't treat it."

Zhou Yi instantly regained consciousness, grabbed the electrocardiogram, and found that the heart rhythm was irregular, the ventricles were thickened, and there were obvious signs of myocardial ischemia.

"Where are you? What's the situation now?"

"He's still in the county hospital's ICU, holding on with medication, but he won't last much longer."

Nurbahati followed Zhou Yi to the hospital. "The county suggested transferring him to Urumqi, but the transfer would take eight hours, and the child might die on the way."

The emergency room was brightly lit.

The county hospital's ambulance had just arrived, and the medical staff were carefully transferring the child to the hospital bed.

It was a thin Kazakh boy named Yerbol, his face was cyanotic, his breathing was shallow and rapid, and his small chest was heaving violently.

His parents followed beside the stretcher; his mother was crying so hard she could barely stand, while his father held his son's hand tightly.

"When did the illness begin?" Zhou Yi asked the county hospital doctor while quickly examining the patient.

"He suddenly had difficulty breathing at 10 p.m. and was already in shock when he was brought to our place."

The county hospital doctor was sweating profusely. "We did an ultrasound, and it's a ventricular septal defect with pulmonary hypertension, and Eisenmenger syndrome has already appeared."

This is one of the most challenging cases of congenital heart disease—due to long-term defects, the pulmonary artery pressure increases abnormally, causing blood flow to reverse.

Simply put, the "hole" in the heart can no longer be easily repaired.

"What about surgery? Can you perform it?"

"We don't have the resources or the technology."

Urumqi Children's Hospital might be able to help, but...

However, the risks of transshipment are too great.

Given the child's current condition, there is a high possibility that something might happen on the way.

Nurbahati has contacted the hospital in Urumqi.

The voice on the other end of the phone sounded regretful: "If it's just a simple ventricular septal defect, we can do it."

However, it has progressed to Eisenmenger syndrome...and the surgical mortality rate exceeds 50%.

"Furthermore, the risk of you transferring it here is too high; we dare not accept it."

"What should we do then?"

Yerbol's father grabbed Nurbahati's arm, his voice hoarse, "My child... is only five years old..."

Zhou Yi stared at the fluctuating numbers on the monitor, his mind racing.

Transshipment is too risky; not transshipping is tantamount to waiting for death. We can't do it locally, and we dare not accept orders from other regions.

Suddenly, he remembered Dalian.

He dialed Professor Liu's number, disregarding the time difference, "Senior, there's a critically ill child with congenital heart disease who needs help."

There was a rustling sound coming from the phone; Professor Liu had clearly just woken up from his sleep.

But after hearing the description of the patient's condition, his voice immediately became clear: "Send me the information, and I'll contact the cardiac surgeon right away."

Every second of the wait felt incredibly long.

In the ICU, medical staff took turns trying to save Yerbol.

The child's blood oxygen saturation has been hovering around 80%, and heart failure could occur again at any time.

An hour later, Professor Liu called back: "Our experts here have examined it and say it can be done, but the child must come to Dalian."

"The transfer can't be completed; the child won't make it to Dalian."

There was a moment of silence on the other end of the phone. Then Professor Liu said, "What if... we could guide you remotely?"

"What?" Zhou Yi thought he had misheard.

"We provide surgical plans and will guide you through the procedure in real time via video."

Professor Liu spoke faster, "Do you have the equipment?"

"We do have the equipment, but this is heart surgery, not appendicitis."

Professor Liu said on the phone, "I know the risks, but not doing it means certain death, while doing it offers a glimmer of hope. You decide."

After hanging up the phone, the ICU was silent. Everyone looked at Zhou Yi and Nurbahati.

"Old servant, do you dare?" Zhou Yi asked.

Nuerbahati stared at the child on the sickbed, remaining silent for a long time.

He had been a doctor for 25 years and performed thousands of surgeries, but he had never performed such a complex heart operation under such conditions.

He finally spoke: "I need a team, the best of everything—anesthesia, cardiopulmonary bypass, scrub nurses…"

"Send personnel from the entire region!" Zhou Yi immediately took action.

At 5 a.m., the surgical team was assembled.

In addition to Nurbahati as the chief surgeon, there was an anesthesia expert who rushed over from Urumqi overnight, an extracorporeal circulation specialist transferred from Shihezi, and the hospital's best surgical nurse.

Meanwhile, a team of experts was also formed in Dalian—the director of cardiac surgery, the director of anesthesiology, and an extracorporeal circulation specialist—all on standby online.

Zhou Yi looked at the old computer in the operating room: "The problem is communication. We need to ensure that the video doesn't lag and the sound is clear. This is crucial to every second of the surgery."

Aygul stepped forward: "I'll contact the telecommunications company!"

They've been testing 5G networks recently; there might be a way.

Miraculously, after hearing about the situation, the telecommunications company immediately dispatched a 5G signal vehicle, which arrived at the hospital entrance at 6 a.m.

The technicians assured that "the signal is fine, and the delay will not exceed 0.1 seconds."

The surgery is scheduled for 8:00 AM.

During the preoperative discussion, experts from Dalian appeared on a large screen.

Dr. Li, the director of cardiac surgery at Dalian Hospital, looked grave. "The child's condition is very critical. The ventricular septal defect is about 2 centimeters in diameter, and the pulmonary artery pressure has exceeded the systemic circulation pressure."

Traditional repair surgery is no longer feasible; palliative surgery is necessary. First, pulmonary artery banding will be performed to lower pulmonary artery pressure, and then radical surgery will be performed once conditions improve.

"We don't do enough pulmonary artery constriction."

I will guide you step by step.

Director Li said, "The key is the tightness of the bandage. If it's too tight, it will cause right heart failure; if it's too loose, it won't be effective."

We will make adjustments through real-time ultrasound monitoring.

The atmosphere in the operating room was so tense it was almost palpable.

The head of the anesthesiology department in Dalian provided guidance via video: "Note that children with Eisenmenger syndrome are extremely sensitive to anesthetic drugs, so you must proceed slowly..."

Opening his chest. When Nurbol's small chest cavity was opened, revealing his struggling, beating heart, everyone held their breath.

Nurbahati said softly, "It's worse than I imagined. The right ventricle is significantly enlarged, and the pulmonary artery is dilated like a small balloon."