Chapter 124: Chapter 124 - 0121: Five Hundred and Four

Soon, the patient came back after getting their medical examination card.

Little Five accessed the computer outpatient system and filled out the examination sheet for the patient: lateral and frontal X-rays (in standing position) of the left knee joint, and an MRI scan of the left knee joint.

The computer showed that the queue for an MRI scan was backed up for a week. Seeing the patient’s anxiety, Little Five cancelled the form and recommended them to go to a private imaging center called “Quantum Imaging”, where they could expedite the examination and get the results on the same day.

Quantum Imaging’s owner is a radiography Ph.D. who spent years studying in the United States. A bright entrepreneur with a solid family background, he chose to run a business rather than practice medicine after returning home.

He invested in setting up an imaging examination center in G City called “Quantum Medical Imaging Center”. All the CT and MRI machines, including PET-CT machines, are top-of-the-line and the business has been booming since it opened.

In big hospitals, it takes a week to get an examination done, and another week to get the report. At Quantum Imaging, it can take as little or as much time as the patient wants.

For expedited services, one needs to pay extra, but the report will be available in two hours. For regular services, results will be available within 24 hours. As for delayed services, Quantum offers discounted rates and results within 24 hours, which is still faster than large public hospitals.

As long as you’re willing to pay, results can be produced immediately upon completion of the examination, for a quite high fee, with a dedicated person accompanying the whole process.

Yang Ping had visited this imaging center and had been impressed. The waiting experience was also pleasant, with a network television, a wide range of newspapers and magazines, and free coffee and beverages. They even had toy rewards to encourage children’s cooperation during examinations.

Hearing that they could be discharged a day or two after the examination, the patient was eager to get everything done right away, including moving into the hospital for surgery. Without further ado, the family members pushed the patient to Quantum for examination.

Meanwhile, Song Zimo, Zhang Lin, and Little Five went to the lab to practice arthroscopic operations along with a few standardized training students and interns, as there were no new patients at the moment.

Once again, Yang Ping began studying the case of Mr. Ning. All the potential puncture angles he imagined were not feasible. Neither could he complete the route of the intervertebral foramen surgery, as it was either blocked by the tumor or by the bone tissue.

The target was like an enemy hiding in a dead spot from a sniper’s bullet path, leaving him completely at a loss.

If none of the routes were feasible when he tried to puncture through soft tissues, what about puncturing through the bone tissue? Yang Ping allowed his imagination to run wild.

If the enemy was hiding in a thick corner of the wall and couldn’t be shot, then the solution would be to open a hole in the wall first, allowing the bullet to pass through the hole and hit the enemy.

This was an interesting idea that Yang Ping believed could work. It would also be the safest as the puncture needle would stay within the bone until it reached its target, which means there was no need to worry about damaging the tumor’s blood vessels.

Yang Ping mentally tried to simulate the puncture process. The nerve root comes out of the intervertebral foramen formed by the first and second thoracic vertebrae. Puncturing through the pedicle of the first thoracic vertebra would be ideal since it points downwards and inwards. After piercing through the bone tissue of the pedicle, breaking through the endpoint bone tissue, and entering the nerve sheath, the rest of the operation would be significantly easier.

Once Yang Ping had refined this plan, he went to Director Han’s office and shared his thoughts.

Upon hearing this, Director Han was amazed and highly commended Yang Ping’s plan. It was in line with his own thoughts. Although the puncture was extremely difficult, it was considered safe, and even if a failure occurred, there wouldn’t be much collateral damage.

Just as Director Han had conceived this idea, Yang Ping had already pieced together a mature plan including the angle, location, and depth of the needle insertion, precautions, and puncture techniques.

Impressed by Yang Ping’s imagination, a delighted Director Han said: “You will come with me to the grand rounds this afternoon. But Director Kong just called. The patient’s family has requested Professor Su Qingyun to attend. They estimate that he will bring his team. If the plan for selective nerve block is confirmed, his team may be performing the operations. Your idea is very good and mature, and although the puncture is difficult, it is much safer as the entire puncture pathway is inside the bone. Even a failure will not have a significant impact, unlike having to perform puncture through soft tissues. A mishap in that could damage blood vessels resulting in bleeding, which would complicate matters. You should also give your opinion at the grand rounds to get some practice and experience.”

“I’d rather not give an opinion, I’ll just go and observe,” Yang Ping felt that at such meetings which were usually attended by high-ranking officials, it wasn’t proper for him to speak.

Director Han shut him down: “When I tell you to give an opinion, you must give one. Don’t keep on mumbling and hesitating. Just present the idea you shared earlier. Don’t be afraid, you’ll be sitting next to me and you are representing me.”

Yang Ping spent the entire morning contemplating the treatment plan for that patient. By the time lunch arrived, Su Yixuan had to call him, otherwise, he would have forgotten to eat.

She had already got his meal ready and was waiting for him in the cafeteria. Yang Ping quickly finished his work and went to the cafeteria.

In the quiet corner, Xiao Su passed the chopsticks to Yang Ping, “I heard that there’s a grand rounds for a patient from Overseas Chinese Building this afternoon?”

“Yes, a patient in the late stages of liver cancer has metastases throughout their body. The tumor has infiltrated the second thoracic nerve root causing severe chest pain. They need a multidisciplinary consultation to find a solution for pain management. I’ve been contemplating the patient’s case all morning and forgot to check your WeChat message.” Yang Ping spoke as he ate his lunch.

Xiao Su didn’t seem to mind Yang Ping’s indifference, “That’s okay. I knew you would be busy. I came first to get us some food and waited for you.”

“A few outside experts have been invited as well. I will also be attending the consultation this afternoon.” Yang Ping reported his day’s plan.

Xiao Su laughed, “Are they all directors? Are you the only young doctor?”

“I don’t know. Director Han has called me over. There’s a professor from a top hospital, he’s the chairman of our province’s Orthopedics Department. I’ll go to experience the demeanor of a big shot professor.” Yang Ping devoured his food.

“Slow down, don’t choke. Do you have enough? Shall I get you more?” Xiao Su said, with concern.

Yang Ping accepted Xiao Su’s napkin, wiped his mouth and said, “I’ve had enough. I’ll eat quickly and go back to study the patient’s surgical plan. It is indeed quite a challenge.”

“If it was not challenging, they wouldn’t be asking for experts from external hospitals. Director Han is nationally renowned. If he needs to ask for external experts, it means that not only is it difficult, but the risk level must be high,” Xiao Su offered his analysis.

“Haven’t forgotten about our weekend plans, have you?” Xiao Su’s dimples looked quite charming when she smiled.

Yang Ping blushed, realizing he had actually forgotten about it.

“What are you nervous for? It’s not a big deal if you forget, as long as I remember it.” Xiao Su’s observations of his expressions suggested to her that he might have completely forgotten.

Xiao Su packed up the two metal meal trays, tidied up the trash on the table, giving it a few wipes with a napkin, making it seem as though no one had ever eaten there.

“Let me do it!” Yang Ping picked up the meal tray, with Xiao Su following him.

“I need to take a call.” Xiao Su’s phone vibrated.

“Hmm, I’m busy this afternoon and won’t have any free time. Hmm, hmm, hmm, understood–” After a few words, Xiao Su hung up the phone.

While returning the meal trays, they bumped into Dr. Jin, who excitedly asked, “Do you remember our last case of metallic ion-reactive synovitis?”

Yang Ping said, “I remember.”

“The patient returned for a follow-up and has recovered. Now, his limbs are no longer swollen or painful, and he can play soccer. The patients’ family was so happy that they brought a banner to express their gratitude. This banner should be given to you.” said Dr. Jin.

“It’s not meant for me. It’s meant for our department, for everyone!” Yang Ping corrected.n/o/vel/b//in dot c//om

After chatting with Dr. Jin for a bit, Yang Ping and Xiao Su returned to their department.

Unable to fall asleep during his lunch break, Yang Ping entered system space to conduct dozens of dissections, reinforcing his anatomical knowledge training. His current ability to construct mental images was still basic. He capable of forming images, but forming complex ones was quite challenging.

Yang Ping tried to recreate the images he constructed in the morning, if he could reproduce them, it meant his memory was improving rapidly, especially his memory for images.

In the afternoon, the patient came back from the full body scan. This patient was followed up by Little Five.

Little Five put up the X-ray, and everyone became anxious upon seeing it.

The X-ray film was filled with varying sizes of particles, round and oval-shaped, with at least hundreds of them visible. There were even some invisible ones on the X-ray film, because cartilage is invisible on X-rays.

Little Five put up the MRI images and everyone felt their entire bodies tense up. The patient’s son nearly threw up, he rushed to the side of the trash can, gagging several times.

Not every doctor can intuitively understand MRI images. The film was filled with hundreds of particles spread across the entire knee joint cavity.

Synovial Chondromatosis! Extremely severe Synovial Chondromatosis! Those with a fear of clusters should stand aside.

Little Five took out his mobile phone to photograph and collect data. He took photos of the patient and the imaging pictures.

“Schedule the surgery for tomorrow, Synovial Chondromatosis, big and small, a total of 504 nodules!” said Yang Ping.

The patient himself ended up covering his eyes.