“Dr. Chang, are you saying that my daughter is being operated on by an outside surgeon?” Mr. Wu asked nervously. He was Little Ni’s father who happened to be Dr. Chang’s older cousin. “I thought you were going to handle the operation?”
Dr. Chang did not know how to respond, he was an internist, not a surgeon. Mr. Wu was a financial account manager who knew very little about the medical world. Mr. Wu believed that it was important to treat his daughter as soon as possible. He didn’t want to travel far and had asked Dr. Chang for a favor. Dr. Chang had only agreed to accept Little Ni after his cousin agreed to waive any liability.
“Dr. Li was the doctor on-site that treated your daughter,” responded Dr. Chang. “He should be treating your daughter’s internal bleeding and clots.” He did not know much about Li Yun as he wasn’t the type to read medical forums or news regarding surgeons. The only thing he knew about Li Yun was that he was a surgeon at Qinbei University Hospital and the director had given him permission to use a spare room. As he was talking to Mr. Wu and Mrs. Wu, a lab technician gave him Little Ni’s CT scans and reports.
“Dr. Chang, what does it say?” Mr. Wu pressed, not giving him even a moment to review the scans.
Dr. Chang ignored him while reviewing the scans. It looked bad, but she will survive. He took out his phone to call the radiologist, “Hey, the report for Wu Ni, how certain are you about surgery?’
“I’m not too certain without a secondary survey,” responded the radiologist. “Dr. Ang seems to think surgery will be better.”
Dr. Chang didn’t care much about the surgery itself, but he didn’t know much about the surgeon from Qinbei. He would rather find a better surgeon to perform than be hassled by his cousin if anything wrong happened. “Do you know anything about this Dr. Li?”
“I am not sure, but I heard he’s some sort the celebrity surgeon at Qinbei,” replied the radiologist. “His surgeries on the medical websites are pretty popular.”
“A celebrity?” Dr. Chang sneered. Most celebrity surgeons on television were hacks. They did more self-promotions than surgeries. It didn’t take him long to decide that it was best to call in a flying surgeon from Panda City University Hospital who specialized in spinal cord surgery.
Mr. and Mrs. Wu also shared the same sentiment. Although it would be interesting to see a celebrity surgeon, it wasn’t like he was a famous actor or streamer. They would rather trust their daughter to a well-known specialist. Within ten minutes after informing Dr. Ang to schedule surgery with a flying surgeon, Li Yun, and Dr. Ang appeared in Dr. Chang’s office.
“Mr. and Mrs. Wu,” Li Yun greeted the parents.
“Ah, Doctor, yes to meet you,” Mr. Wu and Mrs. Wu both returned the greeting. They had some expectations of the so-called celebrity, but Li Yun’s presence was quite strong. He really did look like a celebrity.
“Dr. Li, I hope you respect Mr. and Mrs. Wu’s decision to hire a flying surgeon,” Dr. Chang stated. “You have done an amazing job in stabilizing little Ni, but we need a specialist.”
“I agree that a specialist will be better,” Li Yun replied. “However, we have a very short window. I can’t guarantee that she will be stable by the time the flying surgeon arrives. If we wait too long, her C2 might burst.”
Dr. Chang looked to Dr. Ang, “Is that true?”
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Dr. Ang didn’t know how to respond, he wasn’t sure himself. “Why don’t we wait until she wakes up tomorrow morning? We can perform the secondary survey and physical assessment.”
“What does it mean to have a C2 burst?” asked Mrs. Wu. The word frightened her.
“It would be difficult to achieve hemodynamic stability,” Li Yun replied. “In other words, we will have to stabilize her again before she can undergo surgery. The worst-case scenario would be Little Ni becoming paralyzed.”
Mrs. Wu gasped at the dreadful thought. “If we perform surgery now, it would prevent it? How certain are you?”
“There is no reliable source of data to show whether early operational intervention would benefit spinal cord injuries,” said Dr. Chang. “I am still on the fence about surgery. I would also like to observe Little Ni a little longer.”
“I’m not a specialist in orthopedic or neurosurgery,” Li Yun admitted. He had experienced 125 spinal surgeries via Zuowang. It might not be enough to make him a specialist, but it was enough for him to feel confident. Based on his judgment of Little Ni’s CV system, surgery would reduce complications if the SCI was treated within 24 hours. “But I am certain I can maintain hemodynamic stability during the operation.”
“If we do proceed, how do you plan to stabilize the spinal cord?” asked Dr. Ang. “We don’t have a lot of orthopedic equipment readily available.”
“We will use the broken bone fragments to create an autograft for spinal fusion,” Li Yun replied. “We won’t need to use any screws, rods, or plates.”
“You’re considering vertebroplasty?” Dr. Ang asked. It was a minimally invasive surgery used to alleviate spinal pain by injecting bone cement into the vertebrae. However, most surgeons needed detailed MRIs or local CT scans before they were confident to perform the surgery. Not only that, there was a horizontal translation.
Li Yun nodded, “I should be able to place the bone graft in a way that locks everything in place.”
“That’s an interesting approach,” a voice with a heavy accent said as he entered the room. He was accompanied by the Second Hospital’s director and a foreign woman. Li Yun recognized them as Dr. Redding and Dr. Burton.
As soon as the foreign doctors arrived, Mr. and Mrs. Wu took a backseat to the discussion. Dr. Burton and Dr. Redding were not medical doctors, but they had worked with many medical professionals and were well aware of all the latest innovations in the medical world. Li Yun explained to everyone his surgical plan. From what was discussed, the plan seemed feasible. Dr. Burton translated the plan to Dr. Redding. She was surprised to see that Li Yun would be leading the surgery. As she had diligently investigated all of Li Yun's previous surgeries, she was not aware of his orthopedic and neurosurgery experiences.
After the discussion, everyone agreed to proceed. Both Li Yun and Fan Geng began to scrub in for the surgery.
“Hey, are you sure about me being the first assistant?” Fan Geng asked nervously. He had never performed spinal cord surgery before.
“Better to start somewhere,” said Li Yun. “An Luchang said you did well in the mock surgical test.”
“Well, mock tests are fun,” Fan Geng replied. It was like playing a game to stabilize the spinal cord before it collapse.
At the start of the surgery, Li Yun made a small incision to the front of the neck. Everyone had agreed that an anterior approach would be better for recovery. The first goal was to remove all the loose fragments to create a bone graft. In Li Yun’s mind, he could not see the loose fragments as they have lost their connection to the blood supplies. However, he could see the gaps in his mind. Those gaps were likely to be larger bone fragments. Although he couldn’t see the smaller fragments, the body could naturally heal on its own.
With the fragments taken out, the next step was to realign the vertebra, fill in the cracks, and secure them with bone cement. The cracks in the second vertebra looked small, but they could potentially rupture like an earthquake. Once he corrected the blood flow into the spine, he instructed Fan Geng to suture.
“It’s already over?” The doctors were all amazed.
Vertebroplasty could be considered a simple surgery, but even then it required an hour. Li Yun simply needed ten minutes.