Surgery Godfather-Chapter 628 - 571: The Pregnant Young Man

Yang Ping and Song Zimo could only drink apple cider vinegar, but they drank it with the fervor as though it was alcohol.

"Cheers!"

"Cheers"

Gulping down another glass.

Those who didn’t know the truth would surely believe they were witnessing the real spirit of a drinking party.

Xu Zhiliang was a lightweight drinker, but his enthusiasm was impressive.

Zhang Lin always claimed, "No more, this is my last glass!", yet he never reached his limit, it always seemed like he was one drink away.

Little Five wasn’t flushed, his heart kept its rhythm, as if they had just started drinking.

Liang Fatty was unpredictable, sometimes he performed well, today was one of those days.

The new anesthesiologist, Doctor Wei, seemed somewhat out of place. He sat aside, nodding quietly and maintaining a very restrained posture.

Doctor Wei was a hard worker who preferred actions over words.

Two dozen beers were polished off by them.

Zhang Lin reclined in his chair resting when his phone rang. A check-in call from his wife roused him immediately.

"I only had a couple. Just meaningfully having some drinks with Professor Yang. Don’t worry, I didn’t finish the two glasses, still have half of it left. Yes, yes, yes." Teacher Zhang was extremely tender, bending over as if he was about to touch the ground, but he couldn’t help burping.

At the same time, Fatty called the waitress and insensitively blurted out: another dozen.

Zhang Lin immediately covered his phone.

Fatty squinted at him, "Look at you. Scared of your wife to such an extent. If I get married, I’m going to make sure my wife is obedient."

Fatty reached for his glass, "Fill it up."

But soon realized that his glass had disappeared. Where was the glass?

They don’t usually let loose and drink heartily, normally they stop at a reasonable point during meals.

But today was different, the spinal external fixation clinical experiment was successful, and it was a significant achievement in their department.

Except for Doctor Wei, who was new, everyone else had significantly contributed. Song Zimo and Xu Zhiliang were the backbone of the project, Zhang Lin was responsible for collecting patient data after admission, and Little Five communicated with the patients and followed up after discharge.

Everyone contributed to this success, and that made them very happy.

Another reason was that Fatty was heartbroken. He had been brooding all day, so his brothers decided to join him to blow off some negative emotions.

After dinner, they all dispersed.

Little Five and Zhang Lin accompanied Fatty for a walk around the hospital. They planned not to go home but sleep in the department and casually play some games.

Yang Ping and Xiao Su took a stroll around the hospital. Their families were both pushing them to get married, so they needed to discuss their wedding plans.

Parents were always like that: first, they would urge you to find a date, then they would push you to get married, and then they would encourage you to have children.

However, Yang Ping and Xiao Su were not in a hurry. Xiao Su knew that Yang Ping was busy with his new project. The wedding could be postponed.

But as people say, man proposes but God disposes.

——

The following morning, the weather was excellent.

Yang Ping crossed the overpass, rushing to the hospital for work. Today was Saturday, and he had a live-streamed lecture scheduled at nine.

The "Iron Triangle" had drunk pretty heavily the night before and were still freshening up in the on-duty room. Each had panda eyes, looking like they had played games late into the night.

Song Zimo and Xu Zhiliang had arrived early. They were preparing for the nine o’clock lecture.

The venue was the Teaching Room, which was equipped with a camera facing the podium for live streaming.

Graduates, standardized training students, and interns started arriving at the doctor’s office. They had all come to attend the lecture.

Usually, the teaching schedule included rounds, surgeries, and end-of-shift transitions.

But today was a Saturday, and there was no major shift change, only personal shift changes between the medical staff who were on duty.

No surgeries were scheduled, and each doctor individually checked on their patients.

Yang Ping asked the on-duty doctor if there were any patients with special cases. The doctor said that Gynecology and Obstetrics had admitted a patient in the afternoon.

Li Jun, male, 26 years old, abdominal distension for three months.

Physical examination revealed a mass in the lower abdomen, solid, clear boundaries, slightly tender to touching, moderate ascites, perineal and anal skin sensory disturbance, loss of anal reflex.

Supplementary examinations done were a surface ultrasound and MRI.

"A patient admitted from the Gynecology department?" Yang Ping found it strange.

It was common for patients to be referred to the wrong department, but it was rare for a man to be sent to Gynecology. Even if a man had abdominal distension, he would most likely think of a tumor than being pregnant.

Not that Yang Ping was curious; physicians need to be clear about the diagnosis process.

This is called medical history. Only by understanding the medical history can a real diagnosis be made, especially in complicated cases.

"I also don’t know." The doctor responsible for the patient was also a bit puzzled; he’d been considering why a man would see a gynecologist.

"See the image!"

Yang Ping casually mentioned, without dwelling on the matter.

The outpatient department had conducted an MRI and a surface ultrasound. Usually, pictures were first displayed on the screen for everyone to analyze. This was both a way to get familiar with new patient information and to cultivate independent thinking among the doctors.

After a brief analysis, the results of the imaging examination were displayed.

Experienced clinicians often have a higher interpretation ability of X-ray, CT, and MRI images than radiologists, as they can combine these images with what they see during surgery.

But less experienced doctors rely heavily on the diagnoses of radiologists.

However, the surface ultrasound was an exception. Most surgeons lack the ability to interpret it and have to rely on its report. The images on the surface ultrasound report only appear symbolic and, unlike X-rays, cannot be directly interpreted.

"An abdominal mass? Is it a mass? Clearly, teeth and the spine, as well as other bones, are visible."

"Is the medical record wrong? Is it a female?"

"A fetus?"

Their first reaction was that, apart from a fetus, how could there be a spine?

Someone questioned if he had made a mistake with the gender, which irritated the on-duty doctor who defended his reputation: "I did a detailed physical examination; the patient has male genitalia."

"To those voices of doubt, suspecting I’ve written the case wrongly, shut up and stop adding fuel to the fire."

At this time, the crowd was growing, with people gathering around the digital viewing screen. Song Zimo, Xu Zhiliang, and Zhang Lin, together with Little Five and Fatty, had also finished washing up and had breakfast.

Drinking isn’t great, and even after a night, after washing up, Yang Ping could still smell the alcohol on them.

Fortunately, it was Saturday, everyone was off, which mitigated the issue.

"Zoom in, is that a spine?"

"It does look a bit like a spinal cord."

"Do we have the CT scan?"

"No, I asked the head of the Ob/Gyn department who said they were afraid of misdiagnosing, so they didn’t dare to perform a CT scan." The doctor on duty was quite serious, commendable indeed.

That being said, the Ob/Gyn doctors at the time were afraid this was the infant, and therefore didn’t dare to do a CT scan, opting for an MRI instead.

MRIs lack ionizing radiation, CT scans, on the other hand, expose patients to significant amounts of it.

Everyone discussed at length, but the doctor held back on releasing the diagnosis like an enigma, mainly due to the spine which left everyone stumped. Among all known tumors, none seemed to have a growing spine.

Even in the cases of teratomas, it’s mostly teeth, hair, nerves, bone fragments, and fat, etc.

A distinct spine like this, none has seen or heard before.

Everyone was getting anxious, fearing Professor Yang would start inquiring, cursing the duty doctor for withholding the diagnosis.

The duty doctor leisurely presented the patient’s diagnosis: Pelvic teratoma with sacral nerve damage.

Yang Ping furrowed his brows, gazing at the image on the screen.

Teeth, hair, and irregular bone fragments are commonly found in teratomas, but a full spine is indeed rare.

Perhaps it’s best to meet the patient then. For a clinician, this is a principle that needs to be followed.

It was just past seven, so Yang Ping decided to visit the patient.

The patient had a fair and clean complexion, with delicate features and extraordinarily good looks, portraying a sort of gentle beauty that’s in line with the popular image of a young male celebrity.

By his bedside was a sunny-faced boy - tall and sizable, wearing a trendy T-shirt, with some strange tattoos on his arms.

After asking about the patient’s medical history, Yang Ping found nothing notably different from what was recorded in the medical record.

The patient continuously felt bloated in the lower abdomen, but didn’t pay much attention to it. The belly started to bulge slightly three months ago. At that point, he thought it was because of lack of exercise that had resulted in a small belly.

It was only until his belly continued to grow larger when they performed a surface ultrasound in a local hospital. Both of them didn’t think the local hospital’s expertise was up to par, so they came to Nandu’s Sanbo Hospital from out of province for medical treatment.

"What is your relationship with him?"

Yang Ping asked the sunny-faced boy.

Li Jun, the patient, turned his head to look at the sunny-faced boy, seemingly indecisive.

"I’m his cousin. Is it serious?"

The sunny-faced boy seemed somewhat tense.

"I’ll speak to you in detail about it later."

Yang Ping felt he should talk to them properly about it. The tumor was compressing the sacral nerve, even growing into the sacral canal via the sacral opening. It would be quite challenging to completely remove it.

Moreover, physical examination revealed sensory impairment in the anal area, and the patient was having some difficulty controlling bowel movements.

"Did the outpatient doctor explain any treatment options to you then?"

Patient Li Jun hadn’t spoken for the entire time. The sunny-faced boy helped answer: "They didn’t explain anything, only that it might be a teratoma and that surgery would need to be conducted in your department. They did mention that this teratoma was a bit strange, asking why there was a fully developed spine in there, as they’ve never seen such a teratoma before."

"Indeed, it’s a bit complex. Close the door, I need to examine you." Yang Ping took over the gloves handed to him by Song Zimo.

Although the door was closed, there was still a large circle of residents and interns surrounding them, all with eager, yearning gazes.

Even for a male patient, it was a bit embarrassing.

"It’s okay, we are a teaching hospital, this is a normal situation."

Indeed, while enjoying the advanced medical treatment at a teaching hospital, it should be remembered that it is still a teaching hospital. One needs to be prepared psychologically for the scrutiny that comes along. Without access to actual cases for these interns to observe, they would never truly grow.

"It’s okay, it’s okay!"

The sunny-faced boy was comforting the patient by stroking his forehead.

The patient was first lying down, then turned over to lie on his stomach, his trousers were completely taken off, and the diaper he was wearing was also untied.

The medical record didn’t get the patient’s gender wrong, everyone can confirm now, there will be no more doubts.

Yang Ping examined the skin sensation, following the dermatomes one by one, discovering that the duty doctor’s physical examination was quite accurate. The perineal and anal skin had sensory disorders, and the rectal reflex couldn’t be induced.

"Do you usually have any problems with bowel movements?"

"I often don’t realize it, but excrement and urine just slip out."

That’s why he was wearing a diaper.

Which also meant the sacral nerve roots had been seriously compressed.

These interns were eager to get a clearer look, vying to examine the rectal reflex because of the crowded room.

"Everyone can examine dermatome muscle strength, and sensation, especially rectal reflex. All should experience this."

No choice, in the face of a classic case, the interns had to get hands-on and experience it themselves.

Everyone was excited, already brandishing the sharp-end reflex hammers, getting ready to stimulate the patient’s anal mucosa with the spikes, observing whether the anus has any contractions.

Sometimes, in their pursuit of accuracy, they even extended their index fingers, applying paraffin oil as a lubricant, their index fingers would then be inserted into the patient’s anus to feel whether there was any contraction.

"Everyone line up, don’t squeeze! One at a time!"

Zhang Lin maintained the order and then demonstrated himself how to examine the rectal reflex.

The sunny-faced boy was unhappy but kept his discontent to himself.

"I will talk to you separately about his condition later!"

Yes, the situation was a bit complex. Even if the tumor was removed, there was still a possibility that the nerves would not recover post-surgery. The skin in the perineal and the anal area would be numb, just like a piece of dead skin, and worse, the patient could be incontinent unknowingly losing feces and urine.

The sunny-faced boy’s face turned gloomy, accepting the truth.