Surgery Godfather-Chapter 1998 - 1353: Fifteen Notebooks (2)

Li Zehui and Xia Shu came to the office, and the doctor next to them handed over a case, which Li Zehui passed to Xia Shu.

"This is your first surgery in the Cardiac Surgery Department," he said, "take a look."

Xia Shu took the case.

He opened to the first page.

Patient, male, fifty-three years old. Diagnosis: complex aortic root aneurysm with severe aortic valve regurgitation and coronary artery triple vessel disease, history of two previous open-heart surgeries.

He lifted his head.

History of two open-heart surgeries. This means the chest cavity is full of adhesions, and the normal anatomical structure has been completely altered. Plus the aortic root aneurysm - that’s the forbidden zone in cardiac surgery; once the aneurysm ruptures, not even a miracle can save the patient.

At the end of the case, there was a line:

"Cleveland Heart Center’s consultation opinion: Surgical risk too high, conservative treatment recommended."

Xia Shu looked at Li Zehui.

"They don’t dare to operate?"

Li Zehui nodded, "This is Professor Yang’s patient; he said you can handle it."

Xia Shu was silent for a few seconds. Although he was already familiar with the case beforehand, there was still significant pressure, as this was his first time operating as chief surgeon on such a high-difficulty case outside the institute.

Ten o’clock in the morning, the first surgery.

When Xia Shu walked into the operating room, everything was ready. The extracorporeal circulation technician was calibrating the machine, the anesthesiologist was verifying the medication, and the instrumental nurse was counting the instruments. Everyone looked up at him for a brief moment and then bowed their heads to continue their work.

Xia Shu walked to the sink and started scrubbing his hands.

The water was cold, refreshing his mind. He looked at himself in the mirror, recalling the first time he operated as chief surgeon on a high-difficulty surgery. Back then, he also stood by the sink, scrubbing his hands, feeling a bit nervous. Yang Ping walked past him from behind and said a sentence: "A steady heart leads to steady hands."

He remembered it.

After scrubbing his hands, he donned his surgical gown and gloves. He walked to the operating table and stood at the chief surgeon’s position.

Li Zehui was already standing at the assistant’s position.

The shadowless lamp lit up.

"Let’s begin," Xia Shu said.

They had already discussed the surgical plan three times. They had reviewed the pre-operative CTA at least fifty times, rotated the 3D reconstruction model on the computer countless times, and rehearsed every possible complication. Li Zehui had laid out all his twenty years of accumulated experience at Cleveland for Xia Shu, reviewing it bit by bit.

But what truly anchored Xia Shu was those fifteen notebooks. Xia Shu understood that they would be his strongest support for the rest of his life.

The sternum was sawed open, revealing the chest cavity. The adhesions were more severe than anticipated, with the heart wrapped in thick scar tissue like a bird caught in a spider’s web.

"Sharp separation, a bit slower."

Xia Shu picked up the scissors, telling himself in his mind.

He recalled a sentence noted in his notebook, which Yang Ping mentioned when handling a case of a second open-heart surgery: "Don’t use blunt separation for adhesions; it might tear vital structures. You need sharp separation, go slow, and be patient. The true top-tier separation technique is sharp separation."

The tip of the scissors clung to the scar, moving bit by bit.

Separate, stop bleeding, separate again, stop bleeding again.

Two hours passed, and the heart finally became visible. The aneurysm at the aortic root was the size of a goose egg, with a paper-thin wall, pulsating slightly with each heartbeat.

"Prepare the extracorporeal circulation," Xia Shu said.

Intubation, switching, cooling. Cardiac arrest, opening the aneurysm, replacing the artificial blood vessel with a valve, and re-implanting the coronary arteries.

Three hours, four hours...six hours.

By the sixth hour, the final stitch was completed.

Rewarming, the heart resumed beating.

The monitor displayed, blood pressure 115/70, heart rate 82, blood oxygen saturation 99%.

The anesthesiologist’s voice was slightly whimsical: "Stable."

Xia Shu did not speak immediately. He watched the heart, observed it powerfully beating within the new aortic root, and watched for a long time.

"Close the chest," he said.

The surgery concluded at five o’clock in the afternoon.

Xia Shu exited the operating room and leaned against the hallway wall. His surgical gown was soaked through, his legs felt weak, but his hands remained steady.

Li Zehui came out and handed him a cup of water.

"First time doing such a difficult surgery independently?"

Xia Shu nodded, "First time psychologically independent; no matter how big the surgery was before, Professor Yang was there for reassurance. The feeling is different."

"How do you feel now?"

Xia Shu thought about it.

"Like I’ve...flown once."

Li Zehui laughed, a student brought up by Professor Yang is truly different. The difficulty of this surgery was already world-class.

"In my twenty years at Cleveland, the most challenging surgeries I’ve performed were at this level," he said, "And your first time as chief surgeon, you did this."

Xia Shu said nothing.

Li Zehui patted his shoulder.

"Yang Ping didn’t choose the wrong person."

That evening, Xia Shu stayed in the ICU until two in the morning. Only when all the patient’s indicators were stable did he return to the office.

The office was new, the bookshelf was empty, and the desk was barren.

He stood there, suddenly recalling something.

Where is the notebook? An unexpected panic hit his heart.

He turned to leave to search for it, but then there was a knock on the door.

"Come in."

The door opened, and Zhou Zheng poked his head in: "Mr. Xia, I placed your pile of notebooks on your desk. You weren’t around this afternoon when I moved them, so I took the liberty."

Xia Shu turned around and saw that the desk indeed had those fifteen notebooks neatly stacked.

"Thank you," he said.

Zhou Zheng smiled and didn’t leave.

"Mr. Xia, may I ask you a question?"

"Go ahead."

"Those notebooks," Zhou Zheng pointed to the bookshelf, "Can I...borrow one to look at? Just one will do."

Xia Shu looked at him.

Zhou Zheng seemed a bit embarrassed: "I don’t have much clinical experience, and I’m unsure if I can do well. You’ve recorded so much in your notes... I want to see how you got through it."

Xia Shu was silent for a few seconds.

Then he walked to the bookshelf, took down the first book: "I’m sorry, you can take photos or make copies, but the original can’t be taken away."

This was the first one he started recording in, and the handwriting was somewhat raw with simple content. He turned to the first page, glanced at the line, and then handed it to Zhou Zheng.

"Start with this one," he said, "Take the photos and return it immediately; these notes are very important to me."

Zhou Zheng accepted it with both hands, as if he was receiving a treasure.

"Thank you, Mr. Xia!" He embraced the notebook, started taking photos, and only left after verifying there were no missing pages.

Xia Shu stood in front of the bookshelf, looking at the fifteen notebooks.

Hundreds of days and nights, over a thousand surgeries, countless cases.

They were all recorded in the notebooks.

But some things couldn’t be recorded.

For example, standing by the operating table today, cutting open the chest cavity, Li Zehui stood across from him without saying a word, yet he knew that person trusted him.

For example, after the surgery, exiting the operating room, leaning against the wall, drenched, but feeling fulfilled inside.

For instance, just moments ago when Zhou Zheng asked "Can I borrow it to look?", the light in his eyes.

Those couldn’t be recorded.

But those were the most important.

Xia Shu walked back to the window, gazing outside.

In the night, the glass corridor lights were still on. Someone was passing by, possibly a student just finishing their shift, or a doctor on the night shift.

He watched for a while.

Then he walked back to the desk, sat down, and opened a new blank notebook.

Opening the first page, he wrote down the date.

Then he began to write:

"First chief surgeon surgery in the Cardiac Surgery Department: complex aortic root aneurysm with severe aortic valve regurgitation and coronary artery triple vessel disease, history of two previous open-heart surgeries. Duration of surgery: six hours and seventeen minutes. Intra-operative surprises: two. Handling plans:..."

He wrote slowly, stroke by stroke.

After closing the notebook, he leaned back in his chair.

Outside, the lights of Sanbo Hospital gradually lit up. In the glass corridor, people were walking, and in the cardiac surgery corridor, nurses were busy. The ICU monitor emitted a rhythmic beeping sound.

Everything had just begun.

He sat for a while longer, then stood to leave.

At the door, he suddenly recalled something.

He glanced at the bookshelf.

The notebooks were neatly arranged there.

There are more surgeries tomorrow.

Many surgeries still to be performed.

Many more notes to be recorded.

He turned off the lights and closed the door.

The corridor was quiet. The nurse station light was still on, and the nurse on duty was jotting down notes. Seeing him, she nodded.

He nodded back and continued forward, feeling very grounded.