godfather of surgery

Chapter 1365 Dean Xia Taking a Walk

Chapter 1365 Dean Xia Taking a Walk

The changes at Sanbo Hospital over the past few years have been evident to everyone in the industry.

But what really made our peers uneasy was this year.

Several top-notch PhDs trained by the Sanbo Institute have taken on leading roles in emergency centers, neurosurgery, cardiac surgery, and spinal surgery, respectively.

Meanwhile, the first batch of doctors sent abroad began to return. This group of twenty-three was handpicked by Sanbo from among the most outstanding young PhDs. Three years ago, they were sent to top medical institutions in Europe and America—the Mayo Clinic, the Cleveland Clinic, Johns Hopkins Hospital, and more—for a three-year targeted training program. When they left, some people privately remarked: "Sending them abroad is easy, but bringing them back is difficult. With such better conditions, higher salaries, and more advanced research platforms abroad, who would want to come back?"

But they all came back.

Not only did they return, but everyone brought back a wealth of knowledge—some brought back the world's most cutting-edge surgical techniques, some brought back advanced departmental management concepts, some brought back a multinational, multi-center collaborative resource network, and some brought back a completely new understanding of medicine. Like twenty-three seeds, they have taken root anew on the land where they started.

Dean Xia saw all of this.

His habit, unwavering for over a decade: every Friday morning, without prior notice or announcement, he walks alone from the inpatient department to the outpatient building, from the emergency department to the operating room. Sometimes he stands in the corridor for a while, observing the details of interactions between doctors and patients; sometimes he listens to the case discussions at the morning meeting outside the doctors' offices; sometimes he simply finds a place to sit and chats with waiting patients. He calls this "managing with his feet."

The weather was nice today. Dean Xia came out of the administration building, walked through the connecting corridor, and his first stop was the neurosurgery department.

Neurosurgery is one of the top departments in the entire Sanbo Hospital. The corridor was as busy as ever: doctors hurried by pushing medical record carts, the hem of their white coats fluttering in the wind; nurses jogged to the wards, clutching freshly prepared IV bags; family members helped post-operative patients move slowly, the drainage bottles swaying gently under the bed.

Everyone nodded in greeting upon seeing Dean Xia. Dean Xia nodded back, occasionally pausing to ask a few questions.

"How is the patient in bed three recovering after surgery for acoustic neuroma?"

"It's great. The drainage tube was removed yesterday, and I can walk a few steps today. The facial nerve has been preserved very well."

"Has the family member in bed five stabilized?"

"Once things stabilized, our Director Xu personally discussed the matter, explaining the surgical plan and potential risks in detail, which put the family at ease."

Dean Xia nodded and continued walking forward.

He stopped in his tracks as he reached the doctor's office door.

A morning meeting was in progress inside. A dozen or so people sat around a long table, with a film review light on, and several film reels were lined up on the lightbox.

Xu Zhiliang was pointing at the film and explaining it to everyone.

“This case involves a craniopharyngioma, located deep within the brain, adjacent to the optic chiasm and hypothalamus.” His tone was calm and resolute as he circled the key location on the image with his finger. “Traditional craniotomy is highly invasive, has many postoperative complications, and offers poor visualization. I plan to use a transnasal endoscopic approach, entering through the sphenoid sinus and utilizing natural cavities to remove the tumor.”

Someone asked, "Director, is the risk high?"

Xu Zhiliang said, "Intracranial tumors, which one isn't risky?" He paused, his gaze sweeping over the young doctors present, "But the patient has already been to three hospitals, all of which are top neurosurgery centers in the country, and none of them dare to admit him. If we don't take him in, he really has no hope. The family said that the patient is only forty-two years old this year, and his child has just started junior high school."

The office was silent for a few seconds.

Xu Zhiliang added, "Although this location is deep, it's nothing compared to a brainstem tumor."

Dean Xia stood at the door, listening to these words, and a slight smile appeared on his lips.

Today, Xu Zhiliang didn't stutter at all; it must be the sun rising in the west. What he didn't know was that Xu Zhiliang's stuttering had changed from being persistent to intermittent.

Last week, Xu Zhiliang successfully performed a highly complex surgery on a meningioma at the base of the skull. The patient was a female teacher in her fifties whose tumor was compressing the optic nerve, causing her left eye vision to drop to light perception. Xu Zhiliang performed the surgery, which lasted three and a half hours. The tumor was completely removed, leaving the optic nerve and important blood vessels undamaged. The day after the surgery, the patient began to regain light perception in her left eye, and on the third day, she could see her fingers moving. When she was discharged, the patient held his hand, crying uncontrollably. He stood beside her, his face flushed, unable to utter a single word.

In fact, for Xu Zhiliang, who often "dances on the edge of a knife" in the brainstem area, this kind of surgery is really nothing.

Dean Xia didn't go in to disturb them, and turned around to continue walking forward.

Next stop: spinal surgery.

The spinal surgery department is located on the sixth floor of the inpatient ward. The director, Dr. Jin, and the deputy director, Wen Zhong, both joined the Sanbo Research Institute later than Xu Zhiliang and his colleagues, but they received personal guidance from Professor Yang Ping. During their time at the institute, their skills improved very rapidly.

Dean Xia walked to the door of the doctor's office and glanced inside.

Dr. Jin was sitting in front of his computer looking at video data, taking notes in his notebook as he went. His desk was messy but organized; on the left was a pile of the latest issue of Spine magazine and several well-worn anatomical atlases, on the right was a stack of medical records awaiting signature, and in the middle was a half-finished cup of coffee.

Two young doctors were standing nearby, waiting for him to explain.

“Look at this,” Dr. Jin circled the image on the 3D reconstruction with the cursor. “Severe scoliosis, Cobb angle 78 degrees. The patient is a 15-year-old girl, in her growth and development period. Without intervention, her chest development will be restricted, her cardiopulmonary function will be affected, and her life expectancy will be shortened.”

A young doctor asked, "Doctor, is it possible to perform this procedure at such a wide angle?"

Dr. Jin looked up at him and said, "Yes, but we can't use the conventional posterior approach for correction. It's too invasive, causes too much blood loss, and carries a high risk of complications. I plan to use Yang's osteotomy correction combined with segmental internal fixation to complete the correction in one surgery."

The young doctor hesitated for a moment: "Yang's osteotomy? Doctor, isn't that too risky? The slightest mistake could damage the spinal cord."

Dr. Jin moved the cursor to the apex of the spine: "It's precisely because the requirements are high that we need to use it. You see, this patient's scoliosis is rigid; conventional methods simply can't straighten it. The essence of Yang's osteotomy technique lies in the fact that it doesn't forcibly 'straighten' the spine, but rather allows the spine to 'follow the natural course' during the correction process through multi-segmental, asymmetrical osteotomies. This technique is most suitable for this kind of severe deformity because it can disperse the tension on the spinal cord during correction, minimizing the risk of nerve damage."

He spoke these words in a calm tone. Because when he was at the research institute, he had performed a large number of such surgeries under the guidance of Professor Yang Ping, from the initial retractor and forceps delivery to later becoming a first assistant and chief surgeon, every step of which was taught to him by Yang Ping step by step.

Dean Xia stood at the door for a long time before finally knocking gently.

Dr. Jin looked up, saw it was him, and quickly stood up: "Dean Xia!"

Dean Xia waved his hand: "Sit down, sit down. I'm just passing by and taking a look around."

He went in, sat down next to Dr. Kim, and glanced at the 3D reconstructed image on the screen.

"How confident are you about this girl?"

Dr. Jin thought for a moment: "About 80%."

Dean Xia was somewhat surprised: "So confident?"

Dr. Jin paused for a moment, realizing the dean had misunderstood, and quickly explained, "Dean, when I said 80%, it was actually a rough estimate. If we were to calculate the probability, based on our follow-up data over the past few years, the neurological function preservation rate of Yang's osteotomy in similar cases is 97.3%, and the corrective satisfaction rate is 92.8%. But these numbers are not very meaningful when applied to specific patients. Each patient's anatomical variations, bone quality, and soft tissue conditions are different, so my estimate of 80% is a conservative clinical judgment."

Dean Xia nodded, patted him on the shoulder, and said, "Good, it's best to be cautious." He then got up and left.

After leaving the spinal surgery department, Dean Xia went to the cardiac surgery department.

Cardiac surgery is one of the departments that has undergone the most significant changes in the entire hospital. These changes are not only reflected in the hardware equipment—the extracorporeal circulation machine is the latest model, the intraoperative transesophageal ultrasound is the best in the hospital, and the hybrid operating room is equipped with the most advanced DSA—but also in the composition of the medical staff.

The department head, Li Zehui, is 46 years old and a Chinese American. He has been at the Cleveland Clinic for 20 years.

What is Cleveland? It's the number one place in the US for cardiovascular medicine for over twenty consecutive years, a mecca for cardiac surgery worldwide. Li Zehui started as a resident there, working his way up to chief surgeon, clinical professor, mentoring over a dozen fellows, publishing more than forty papers in top journals, and receiving the American College of Cardiology's Young Investigator Award. He is a leading expert in cardiac surgery.

Logically, with such a resume, he could have lived a very comfortable life in the United States: a decent income, a respected social status, advanced research platforms, and ample research funding. But not long ago, he made a decision that baffled everyone: to return to China and join Sanbo.

Many of his colleagues advised him against it, saying he was crazy. They argued that China's medical conditions, income, and research environment were all inferior to those in the US; what was he going to gain by going back?

He said that by following Professor Yang Ping, he would have the opportunity to challenge the real "Mount Everest".

So he quit his job, took his wife and children, and flew back to China.

Since Li Zehui arrived, Sanbo's cardiac surgery department has been transformed. He systematically adopted the Cleveland Clinic's approach. From preoperative assessment procedures to seamless operating room workflows, from standardized postoperative monitoring to data-driven discharge follow-up, everything has been restructured according to the standards of top international medical centers. Now, Li Zehui is Sanbo's "golden brand" in cardiac surgery. Patients from all over the country specifically request him for surgery. Last month, an entrepreneur from Northeast China, suffering from aortic root aneurysm complicated by aortic valve insufficiency, visited major hospitals across the country before finally coming to Sanbo Hospital.

When Dean Xia entered the cardiac surgery department, Li Zehui was making his rounds. He was wearing a crisp white coat, holding a medical record folder, standing by the bedside, bending down to listen to the patient's chest with a stethoscope. The family members stood beside him, barely daring to breathe.

After listening, Li Zehui straightened up, a smile appearing on his face, and said to the family, "The recovery is very good. The artificial valve is functioning normally, and the heart function has improved significantly. You can be discharged next week. After discharge, just take your anticoagulant medication on time and come for regular check-ups."

The family members were so moved that their eyes welled up with tears, and they kept bowing, saying, "Director Li, thank you!"

Li Ze waved his hand and said in slightly accented Mandarin, "You're welcome, it's our job."

He turned to leave, and when he saw Dean Xia, he paused, startled: "Dean Xia? What brings you here?"

Dean Xia smiled and said, "Just passing by, thought I'd take a look. Was that person who had just had an aortic valve replacement surgery?"

Li Zehui nodded: "Yes, bioprosthetic valve, minimally invasive approach, five days post-surgery, recovery is going well."

The two walked side by side towards the office. Dean Xia asked, "Have you been performing many surgeries lately?"

Li Zehui said, "There are quite a few. We have more than 50 scheduled this week. Tomorrow we have a neonatal transposition of the great arteries. The patient is only 12 days old and weighs only 3 kilograms. It is quite difficult."

Dean Xia said, "You'll be the one performing the surgery?"

Li Zehui nodded: "I'll do it myself, and I'll guide the younger doctors. They need to see more cases like this and participate more before they can get the hang of it."

Upon reaching the office door, Li Ze opened it and invited Dean Xia to come in and sit down. Dean Xia waved his hand, saying, "No need, I still have a few departments to visit. You go ahead with your work."

Li Zehui didn't press the matter and nodded, "Then please take care."

Dean Xia took a few steps, then suddenly turned around: "By the way, how's that PhD student you recruited doing lately?"

Li Zehui said, "It's great. He learns quickly, has a high comprehension level, and his hands are steady. Last week, under my guidance, he independently performed a coronary artery bypass graft, which went very smoothly, and the patient is recovering well after the surgery."

Dean Xia nodded: "Take good care of them. In a few years, they will be our pillars of strength."

Li Zehui said earnestly, "Please rest assured, we can train world-class cardiac surgeons ourselves."

The last stop was the emergency center.

The emergency center is located on the first floor of Building 1. It is the entrance to the entire Sanbo Hospital and also the busiest and most chaotic place. Every day, 24 hours a day, all kinds of patients flood in like a tide: car accident injuries, falls from heights, sudden heart attacks, cerebral hemorrhages, alcohol poisoning, fights... you name it.

Since Sanbo integrated the Chest Pain Center, Trauma Emergency Center, and Stroke Center into the Emergency Center for unified management last year, things have become even more complicated here. Each of the three centers has its own procedures, its own experts, and its own "temperament." Asking a young person to coordinate these "big shots" has always made Dean Xia a little apprehensive.

When Dean Xia entered the emergency department, Song Ziming was standing in front of the triage desk, talking to a nurse. Upon seeing Dean Xia, he quickly came over to greet him.

"Dean Xia?"

Dean Xia said, "Come and see, are you busy today?"

Song Ziming said, "It's alright. Two people came in from car accidents this morning. One had a ruptured spleen, and the other had a fractured femur. They were both taken to the operating room. There was also someone who suffered cardiac arrest. We performed CPR on him for twenty minutes in the emergency room, and he came back to life. He's now in the ICU for continued monitoring."

Dean Xia nodded and followed him on a tour of the emergency department.

In the emergency room, several doctors and nurses were treating a new patient. The patient was an elderly man in his sixties, pale-faced, sweating profusely, clutching his chest. Beside him stood an anxious old woman, helplessly wiping away tears.

Song Ziming glanced at it and said to the nurse next to him, "Signs of a heart attack. Notify the catheterization lab immediately and start the chest pain procedure."

He walked in and stood there watching for a while. Several doctors and nurses worked together seamlessly. Some pushed the electrocardiograph machine, some established an intravenous line, some drew blood for testing, some gave the patient oxygen, and some comforted the family. The whole process was smooth and efficient; in less than three minutes, the patient was safely wheeled to the catheterization lab.

Song Ziming came out and said to Dean Xia, "These young people are getting more and more skilled."

Dean Xia smiled: "That's because you've done a good job."

Song Ziming waved his hand modestly and said, "I didn't lead them well; it's because they were willing to learn. Plus, the process is smooth now, and everyone knows what to do and when, so it's naturally faster."

The two stood in the corridor, watching the crowds come and go. Dean Xia suddenly asked, "Zimo, are the Chest Pain Center, Trauma Emergency Center, and Stroke Center all operating smoothly now that they've been transferred to the Emergency Center?"

Dean Xia's unspoken message was: The heads of those centers are all senior experts, and they all have quite a temper. How well do they cooperate with you? You're a young man who's not even forty years old. Can you keep them in check?

Song Ziming understood, smiled, and said, "It's running quite well. There's bound to be an adjustment period at the beginning, with everyone having their own ideas and habits. But after that adjustment period, it's actually going even smoother than before. Now everyone's goal is the same: to shorten the D-to-B time and improve the success rate of rescues. As long as the goal is the same, the methods can be discussed. Besides," he paused, "with Dean and Professor Yang backing me up, I feel confident."

Dean Xia nodded and patted him on the shoulder: "Okay! If you have any difficulties, feel free to come to me."

Song Ziming said, "Okay, thank you, Dean."

It was almost 11 o'clock when I came out of the emergency room.

Dean Xia stood in the outpatient hall, watching the crowds come and go. He looked for a long time, and then suddenly smiled unconsciously.

A nurse at the information desk nearby saw this and asked curiously, "Dean Xia, what are you laughing at?"

He said, "It's nothing, I just think it's pretty good."

More than ten years have passed.

More than a decade ago, this was still a wasteland. He and several founders stood here, pointing to the land beneath their feet, and said, "We are going to build a different kind of hospital here."

At that time, no one believed in them. How could a new hospital starting from scratch compare with those century-old "old establishments"? They had no talent, no brand, and no patients.

They didn't argue; they just focused on their work.

Build hospitals, buy equipment, recruit and train people, send them out for training, and bring them in. Year after year, step by step, like farmers planting crops, sowing in spring and harvesting in autumn, without worrying about the future.

More than ten years have passed since then.

Last month, a professor from Harvard Medical School visited and observed our work. He watched live broadcasts of neurosurgery and cardiac surgery, and finally wrote a message in the guestbook:

This is world-class.

The translation is: This is world-class.

When these words reached Dean Xia's ears, he secretly smiled happily to himself.

He is getting closer and closer to his dream.

This is the "three breadths" he envisioned: breadth in medicine, breadth in education, and breadth in research. Medicine, education, and research—a trinity.

He recalled that more than ten years ago, he and several founders sat together, naming the hospital. Someone suggested "Sanbo" (Three Doctors), because it happened to be the name of three key members: Dean Xia, Director Han, and Director Zhou, who were the first batch of doctors to be established at the hospital.

But later, they gave these two words a deeper meaning: extensive medical knowledge, extensive teaching, and extensive research.