Surgery Godfather

Chapter 446: Chapter 407: The Highest Emergency

Chapter 446: Chapter 407: The Highest Emergency

Merritt Island, Florida, Kennedy Space Center, Falcon 9 rocket takes off.

This rocket is going to send the Dragon Spaceship to the International Space Station. Originally, it was designed to carry four astronauts; now, it only carries Susan with the remaining payload all given to medical instruments and medicine.

Eight hours later, the Dragon Spaceship is captured by the Canadian Robotic Arm of the International Space Station, successfully completing its docking with the space station.

Susan, the doctor astronaut, is traveling to space for the second time. The first time, she stayed for six months and completed a medical experiment, successfully developing a drug to cure lung cancer.

This time, she is not up there for an experiment; she is there for further examination of Steven.

Of all the astronauts who can travel to space anytime, only she can independently complete the DSA of the whole brain blood vessels, which requires certain interventional treatment techniques.

There’s not a moment to spare. With the help of David Hollis, Susan secures the instrument equipment.

On the space station, in a microgravity environment, anything to be used steadily needs proper fixing, otherwise, it fluctuates.

Many generic interfaces are on the cabin wall to fix these devices. The manufacturers of the digital subtraction X-ray machine have modified the machine overnight according to NASA’s requirements. Not only can it be sent to space by the rocket, but it can also be fixed.

Steven wanted to participate in these tasks as well, but Susan refused. Before his condition is clear, he is not fit to engage in any physical labor or sports.

Once everything is prepared, Steven is secured on a flatbed. The restraints on his limbs prevent him from losing control, especially his head must be fixed securely.

Having grown accustomed to such microgravity environment, Susan can perform skills freely that even the best-interventional doctors are unable to in this kind of surrounding.

Having performed an iodine contrast agent allergy test and confirmed its negativity, Susan begins her formal operation.

Susan and David Hollis put on protective lead clothes. David Hollis assists as Susan puts on sterile gloves. The right groin area is disinfected, up-to-the-navel and down to the middle of the thigh, including the perineum.

Adhesive film sheet is used to spread the sterile sheet to prevent it from floating up.

After local anesthesia, she begins to puncture the right femoral artery. The puncture is successful, and the blood that sprays out is compressed in time by Susan, otherwise, those red blood droplets will scatter everywhere. Even actions that are considered simple on Earth are very difficult in space.

If it was not for Susan, this plan would not be feasible.

The puncture is pulled out, the sheath was left inside, then the guidewire was inserted until it reached the suitable location. The catheter was inserted along the guidewire, pulled out, and Susan connected the syringe to begin pushing the contrast agent.

Even after ten hours of training, her movements are proficient, and she doesn’t create scattered blood droplets in the cabin.

The special syringe that carries iodixanol, the contrast agent, is injected into the artery from the end of the catheter.

The machine starts the X-ray scan, and the ink-like vascular image begins to spread gradually. The image is transmitted to Houston’s ground control center on Earth.

The long-awaited group of experts immediately focuses their attention. Each of them has a computer, with the graphics on the screen slightly delayed due to network latency uncertainty.

The automatic screenshot function of the computer captures the images one-by-one and saves them for meticulous study later on.

The common carotid artery, internal and external carotid arteries, vertebral artery, angiography of the blood vessels of the whole brain, step-by-step, the angiography of the whole brain, coarse and fine branches, winding, and juxtaposed, gradually perfect the image.

“Susan! Do not use heparin! There may be a risk of bleeding!” Professor Massimo from the Intervention Department of Johns Hopkins directs Susan to conduct DSA of the whole brain blood vessels.

The first meeting did not include this professor. When John Ansen suspected a cranial disease, this top-notch Intervention professor was invited. The continuation of the intervention relied heavily on him.

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This Intervention doctor is extraordinarily gifted. His numerous contributions to the Intervention Department, for instance, familiarizing TIPS surgery, and designing many cardiac and cranial intervention methods.

TIPS surgery, transjugular intrahepatic portosystemic shunt.

In 1986, Doctor Palmaz established the drainage channel using balloon dilation stent technology based on the work of his predecessor, hence modern TIPS surgery was established. In 1988, Frerburg first applied this technology in clinical practice.

And Professor Massimo, when he was younger, devised an entirely new set of intervention instruments and operating methods to lower the threshold of the top-notch technology in intervention, enabling it to be widely used.

Massimo is highly creative; his contribution to Intervention is countless, which has also accumulated a huge amount of wealth for him.

He has invented many interventional instruments and consumables. Medtronic, Abbott, Cook, and Boston Science technical all have cooperations with him. Currently, half of the new products come directly or indirectly from him.

In the field of neurosurgery, John Ansen is top-tier in the United States, but in terms of intervention, he must admit defeat to this gentleman.

“You’ve wasted a hundred million US Dollars. If half were given as gambling money, I would certainly dare to return to Earth this way.” Steven said.

“Quiet, Steven!” Susan stopped him.

“How’s the image quality, professors? I dare not go any further with my catheter. I can only inject the contrast agent from here. I request guidance.” Indeed, Susan did not dare to go any farther. If she was a bit bolder and placed the catheter deeper, by doing a step-by-step super selection, the image quality would be better.

“No need to go forward, it’s enough.”

Massimo’s hair is a mix of white and black. He is charming with a handsome face, tall and robust body, a pair of fascinating blue eyes, which have once infatuated countless girls in Johns Hopkins University.

The quality of this complex and diffuse whole brain blood vessel angiography image is not very good, but, it can be considered as a failed angiography.

Susan did her best. If on Earth, her performance would have been better, able to produce high-quality images.

John Ansen frowned; it might be necessary for GG Corporation’s AI to read the images. It was hard to tell by eye if there was a problem and if so, where.

Professor Massimo untied and took off his tie, tossing it onto the workbench: “Damn! Medulla oblongata’s life center internal small artery aneurysm, a life-threatening aneurysm!”

Before all the doctors could react, Professor Massimo had made a diagnosis. John Ansen and Eugene studied the pictures one by one, asking with some doubt, “Are you sure?”

“100% certain. In imaging and intervention, as long as I’m alive, no one can surpass me. John Ansen, Eugene, believe me, this medulla oblongata’s life center artery aneurysm is like a ticking bomb that could go off and kill this guy at any time.” Massimo unbuttoned another shirt button.

“Is your air conditioning broken?” Massimo asked.

Collins shook his head. How could that be? Wasn’t the temperature quite appropriate?

“See, here is the aneurysm!” Massimo pointed out the location of the lesion.

It was a black mass, in which details were indistinguishable, vaguely appearing. DSA was also of limited accuracy, not all anomalies could be detected.

But if Massimo said it was there, then it was definitely there. This genius, currently, the most classic interventional works in the world, more than half were edited by him, the most advanced interventional techniques, more than half came from his innovation.

He wasn’t bragging, nor was he arrogant. In terms of intervention, he was truly the peak of the world, an unsurpassable existence.

“You can stop now, Susan. Thank you for your hard work,” Massimo commanded.

John Ansen finally noticed the not so obvious anomaly. Massimo’s judgment was correct.

The computer connected to GG Corporation’s medical brain, the image was enlarged, processed for comparison, then slowly contrasted. Indeed, a small artery aneurysm had penetrated the inner part of the medulla oblongata.

John Ansen felt a shiver run down his spine- this artery was the nameless artery, the artery that crossed the heart’s central hub.

This symptom usually occurred in one in a thousand cases, yet Steven was the unlucky one.

“Medulla oblongata unnamed small artery aneurysm. This artery is the devil’s curse. It traverses the heartbeat core.” John Ansen turned pale.

Collins’ dry lips quivered a few times, “What should we do next?”

Everyone in the control center froze, staring at Massimo who was now their greatest hope.

“If he returns to Earth, high-speed plummeting would cause the aneurysm to rupture, undoubtedly leading to death. You can simulate this using computers if you don’t believe me.” Massimo asked Collins to have a doctor use the GG Corporation platform to build a model for a return simulation.

“I believe you. I want to know, what should we do?” Collins asked.

“If we were on Earth, I’d have a 20% chance of completing this intervention. The target vessels are too complex. No one in the world has ever achieved intervention on such an aneurysm. The current available catheters, guidewires, and coil springs are not capable of completing it. But, in my lab, I have thinner and better products. Unfortunately, they lack FDA certification. If I could use these instruments, I could have a 20% success rate on Earth. I’ve completed 200 monkey animal experiments. Damn it, the air conditioner is broken.” Massimo was sweating profusely.

Collins immediately said: “The situation must continue to escalate. I’m reporting to Washington now.”

“He is on the space station now. Even if I risk going up, I wouldn’t be able to adapt to the microgravity environment there without sufficient training. I wouldn’t be able to perform the surgery.” Massimo shook his head.

“He’s just an aneurysm, and you’re the best interventionist in America!” Collins got a little excited.

“Don’t shout at me. I don’t like the way you’re acting now. Put away your arrogance. I’m not a member of your expert group. You asked me to come here. Believe it or not, I can go back to Baltimore right now. This is your NASA issue. It has nothing to do with me.” Massimo yelled.

“I’m sorry, I was too impulsive. Please forgive me.” Collins realized he was too impulsive.

Massimo nodded: “Be a gentleman. Talk to me nicely. I don’t like it when people speak loudly. The situation must escalate. He can’t last more than 3 days, that is 72 hours at most. Or it could be that the blood vessels burst in the next second. The vessels have already exceeded the limit and can explode at any time.”

“This is not an ordinary intracranial aneurysm. It passes through the life core. No one in the world has ever done this kind of intervention. Even on the ground, I only have a 20% success rate. This is already the highest level in the world today. But unfortunately, he is now in the sky, 400 kilometers above. I can’t do anything.” Massimo put away his usual confidence.

“And it is still expanding, just measured precisely a few times from the imaging, it is expanding.” John Ansen reminded.

“But Steven is not uncomfortable?” Collins’ dry throat made his pronunciation unclear.

“A slow heartbeat is the symptom. The next symptom is death. Once it bursts, the heartbeat instantly stops.” Massimo emphatically informed Collins.

“I’m reporting now!” Collins looked at Massimo and John Ansen.

“Yes, report it. This is not a problem you can solve. Let your director roll over from Washington. Don’t let him sleep.

“I’m reporting right now!” Collins repeated.

He immediately reported to NASA’s Chief Medical Officer: “Sir, we need to initiate the highest level emergency plan. Steven has an aneurysm in the brainstem heartbeat center, which can burst and cause death at any time. He won’t last more than 72 hours. If he’s not lucky, he could die at any moment.”

“Susan, lower Steven’s blood pressure and have him rest quietly, talk less.” Massimo commanded.

Susan was also very nervous inside. On the space station, she was the only doctor, and with her limited simple equipment, what can she do?

She felt helpless, extreme helplessness.