“You’re as irritating as my second aunt,” Professor Rudolf Wagner said disdainfully. “Is it so difficult to treat primary liver cancer?”
Cheng Lixue was at a loss for words.
How could he not know?
Also, what was this about his second aunt?
After being an interventional doctor for a few decades, Cheng Lixue had done more than a thousand interventional surgeries on liver cancer. He also had a few dozens of patients who recovered from primary liver cancer.
Even though there were not many, Cheng Lixue was rather experienced in this area.
However, the size of this patient’s tumor was enormous… His thought was that it was far too late for the patient to stand a chance of recovering. He could only try his best to prolong the patient’s survival.
“Chief Zheng, what do you plan to do after this?” Cheng Lixue was not bothered by the professor’s criticism. To him, it was normal to be lectured by one of the top professors in the world.
“We’ll use radiofrequency ablation to burn it off,” Zheng Ren replied.
“You will need to insert 3 to 4 needles then,” Cheng Lixue estimated.
“Uhm, 3 should suffice. Lil Fugui, note down the points of insertion,” Zheng Ren said. “The 10th intercostal space on the right, 4 o’clock. 1.5 cm to the right on the midclavicular line in the upper right quadrant of the abdomen. 15 degrees clockwise for the angle of insertion.”
“What about the third one?” Professor Rudolf Wagner paid full attention to Zheng Ren and wrote down the points of entry in German.
The professor was considered a linguistical genius considering that he was able to converse in Mandarin within such a short time frame, but he still needed more time to master the written language.
“I still need to calculate the last position,” Zheng Ren said.
The truth was that Zheng Ren thought of going to the Secondary Hospital to perform more TIPS surgery to complete the second stage of The Crown Jewel so that he could get the 3000 cases of radiofrequency ablation experience and the Interventional Surgery Success Rate +2 passive skill.
This would only delay Zheng Yunxia’s surgery for a few days but if Zheng Ren could complete the mission, she would gain much more from the surgery.
He decided to wait.
“Chief Cheng, what are those scans you’re holding?” Zheng Ren asked after seeing Cheng Lixue was still in a daze after he finished examining Zheng Yunxia’s scans. Zheng Ren had to remind him that he was carrying a bag full of scans.
“Uhm…” Cheng Lixue regained his senses and remembered the reason he came here.
“These are the scans and information of patients that meet the requirements for TIPS surgery. Please have a look, Chief Zheng.” Cheng Lixue placed them on the table.
Cheng Lixue felt a soreness in his arm as he had carried the bag for a little over half an hour.
Before he had the chance to stretch his sore arms, Zheng Ren already took out the first envelope to view the patient’s information.
The professor took the envelope from Zheng Ren and extracted the DW-MRI of the patient’s liver and inserted them onto the radiographic film viewer.
Finally, it was his turn. Cheng Lixue quickly gathered himself together and adjusted his position to have a clear view of the scan.
“The patient’s condition looks fine,” Zheng Ren said in a relaxed manner as he browsed through the diagnosis.
“Boss, this is a typical tumor. We can insert the needle at a 25-degree angle of depression,” Professor Rudolf Wagner said.
“Between 24 to 28 degrees should be fine. This way, we can increase the fault tolerance. One thing to note down, align the needle to the left posterior wall of the liver during insertion. Do you have anything else to add on, Lil Fugui?”
Professor Rudolf Wagner quickly wrote down what Zheng Ren mentioned.
When he heard Zheng Ren’s question, he answered without lifting his head. “No, boss. This patient has a typical tumor, I think that I can succeed in the first attempt with my eyes closed.”
“Uhm, it’s quite simple but you shouldn’t be too careless,” Zheng Ren said. “Let’s move on to the next patient.”
Hmm? That was all? Cheng Lixue was stunned when he saw the professor start to collect the scans, the patient’s information, and his notes before keeping them in the envelope.
What did they say?
It all happened so fast as if they had not mentioned anything at all.
No!
They said…that the needle insertion could be done in the first attempt.
A week ago, if someone told Cheng Lixue that they could succeed in the insertion for TIPS surgery on their first attempt, he would have given them a tough slap to wake him up.
However, Zheng Ren managed to accomplish all that in the TIPS surgery he performed in Secondary Hospital.
Cheng Lixue had no choice but to believe what he saw.
However… What did he learn from this? Nothing!
What should he do?
Cheng Lixue reached out to hold Professor Rudolf Wagner’s arm in a panic and said, “Professor, wait.”
“What the hell do you think you’re doing?” The professor glared at him angrily, causing him to shudder in fear.
Zheng Ren laughed and said, “Lil Fugui, take the scans out.”
Professor Rudolf Wagner scowled at Cheng Lixue again before saying, “Boss, this is just a waste of time.”
“You didn’t say that three days ago,” Zheng Ren said smilingly.
“Okay, you’re right, Boss.” The professor shook his head and continued, “Soon you’ll know that you’re wrong.”
“You’re referring to his inexperience on the fundamentals and that he won’t be able to learn quickly?” Zheng Ren said.
“Of course, I think there are probably 3 people at most in this world who could master the imageries of MRI scans in one sitting, excluding myself.” Professor Rudolf Wagner announced proudly.
Cheng Lixue broke out in a cold sweat.
Why would he start learning TIPS surgery with imaging? This was entirely different from what he had expected.
Should he not start with the basic surgery operation instead of imaging? Furthermore, DW-MRI was never used in interventional surgeries…
Cheng Lixue was completely dumbfounded.
“Chief Cheng, how much do you know about DW-MRI? Zheng Ren asked while he stared into Cheng Lixue’s eyes.
“Diffusion-weighted imaging utilizes the Brownian movement of water molecules…” Cheng Lixue stuttered for a bit and failed to elaborate further.
Interventional doctors were more specialized in X-rays.
For instance, interventional embolization surgery was performed under X-rays. After radiofrequency ablation gained popularity in the recent decade, many doctors started to dabble into CT scans but MRI, more specifically DW-MRI, was still…
Cheng Lixue had no clue about it.
“Let’s see, what can you infer from this position?” Zheng Ren put up the DW-MRI scan of the first patient on the film viewer and pointed at a specific position while asking his question.
Cheng Lixue was lost.
“The gradient pulse with the same length, amplitude, and position is applied to both sides of the 180b pulse in the spin-echo (SE) sequence. Try subtracting one of the sequence pulses and think along that direction.” Zheng Ren tried his best to explain in layman terms.
Nonetheless, Cheng Lixue’s expression sold him out.
The Secondary Hospital’s interventional department chief was completely lost.
“What about…” Zheng Ren thought for a while before saying regretfully, “Chief Cheng, why not you spend a few days in the CT room to learn?”
“…”
Zheng Ren sighed.
Professor Rudolf Wagner was able to grasp the idea and keep up and even Su Yun did as well, but they were both exceptionally gifted. Cheng Lixue was no match for them.
“You’re as irritating as my second aunt,” Professor Rudolf Wagner said disdainfully. “Is it so difficult to treat primary liver cancer?”
Cheng Lixue was at a loss for words.
How could he not know?
Also, what was this about his second aunt?
After being an interventional doctor for a few decades, Cheng Lixue had done more than a thousand interventional surgeries on liver cancer. He also had a few dozens of patients who recovered from primary liver cancer.
Even though there were not many, Cheng Lixue was rather experienced in this area.
However, the size of this patient’s tumor was enormous… His thought was that it was far too late for the patient to stand a chance of recovering. He could only try his best to prolong the patient’s survival.
“Chief Zheng, what do you plan to do after this?” Cheng Lixue was not bothered by the professor’s criticism. To him, it was normal to be lectured by one of the top professors in the world.
“We’ll use radiofrequency ablation to burn it off,” Zheng Ren replied.
“You will need to insert 3 to 4 needles then,” Cheng Lixue estimated.
“Uhm, 3 should suffice. Lil Fugui, note down the points of insertion,” Zheng Ren said. “The 10th intercostal space on the right, 4 o’clock. 1.5 cm to the right on the midclavicular line in the upper right quadrant of the abdomen. 15 degrees clockwise for the angle of insertion.”
“What about the third one?” Professor Rudolf Wagner paid full attention to Zheng Ren and wrote down the points of entry in German.
The professor was considered a linguistical genius considering that he was able to converse in Mandarin within such a short time frame, but he still needed more time to master the written language.
“I still need to calculate the last position,” Zheng Ren said.
The truth was that Zheng Ren thought of going to the Secondary Hospital to perform more TIPS surgery to complete the second stage of The Crown Jewel so that he could get the 3000 cases of radiofrequency ablation experience and the Interventional Surgery Success Rate +2 passive skill.
This would only delay Zheng Yunxia’s surgery for a few days but if Zheng Ren could complete the mission, she would gain much more from the surgery.
He decided to wait.
“Chief Cheng, what are those scans you’re holding?” Zheng Ren asked after seeing Cheng Lixue was still in a daze after he finished examining Zheng Yunxia’s scans. Zheng Ren had to remind him that he was carrying a bag full of scans.
“Uhm…” Cheng Lixue regained his senses and remembered the reason he came here.
“These are the scans and information of patients that meet the requirements for TIPS surgery. Please have a look, Chief Zheng.” Cheng Lixue placed them on the table.
Cheng Lixue felt a soreness in his arm as he had carried the bag for a little over half an hour.
Before he had the chance to stretch his sore arms, Zheng Ren already took out the first envelope to view the patient’s information.
The professor took the envelope from Zheng Ren and extracted the DW-MRI of the patient’s liver and inserted them onto the radiographic film viewer.
Finally, it was his turn. Cheng Lixue quickly gathered himself together and adjusted his position to have a clear view of the scan.
“The patient’s condition looks fine,” Zheng Ren said in a relaxed manner as he browsed through the diagnosis.
“Boss, this is a typical tumor. We can insert the needle at a 25-degree angle of depression,” Professor Rudolf Wagner said.
“Between 24 to 28 degrees should be fine. This way, we can increase the fault tolerance. One thing to note down, align the needle to the left posterior wall of the liver during insertion. Do you have anything else to add on, Lil Fugui?”
Professor Rudolf Wagner quickly wrote down what Zheng Ren mentioned.
When he heard Zheng Ren’s question, he answered without lifting his head. “No, boss. This patient has a typical tumor, I think that I can succeed in the first attempt with my eyes closed.”
“Uhm, it’s quite simple but you shouldn’t be too careless,” Zheng Ren said. “Let’s move on to the next patient.”
Hmm? That was all? Cheng Lixue was stunned when he saw the professor start to collect the scans, the patient’s information, and his notes before keeping them in the envelope.
What did they say?
It all happened so fast as if they had not mentioned anything at all.
No!
They said…that the needle insertion could be done in the first attempt.
A week ago, if someone told Cheng Lixue that they could succeed in the insertion for TIPS surgery on their first attempt, he would have given them a tough slap to wake him up.
However, Zheng Ren managed to accomplish all that in the TIPS surgery he performed in Secondary Hospital.
Cheng Lixue had no choice but to believe what he saw.
However… What did he learn from this? Nothing!
What should he do?
Cheng Lixue reached out to hold Professor Rudolf Wagner’s arm in a panic and said, “Professor, wait.”
“What the hell do you think you’re doing?” The professor glared at him angrily, causing him to shudder in fear.
Zheng Ren laughed and said, “Lil Fugui, take the scans out.”
Professor Rudolf Wagner scowled at Cheng Lixue again before saying, “Boss, this is just a waste of time.”
“You didn’t say that three days ago,” Zheng Ren said smilingly.
“Okay, you’re right, Boss.” The professor shook his head and continued, “Soon you’ll know that you’re wrong.”
“You’re referring to his inexperience on the fundamentals and that he won’t be able to learn quickly?” Zheng Ren said.
“Of course, I think there are probably 3 people at most in this world who could master the imageries of MRI scans in one sitting, excluding myself.” Professor Rudolf Wagner announced proudly.
Cheng Lixue broke out in a cold sweat.
Why would he start learning TIPS surgery with imaging? This was entirely different from what he had expected.
Should he not start with the basic surgery operation instead of imaging? Furthermore, DW-MRI was never used in interventional surgeries…
Cheng Lixue was completely dumbfounded.
“Chief Cheng, how much do you know about DW-MRI? Zheng Ren asked while he stared into Cheng Lixue’s eyes.
“Diffusion-weighted imaging utilizes the Brownian movement of water molecules…” Cheng Lixue stuttered for a bit and failed to elaborate further.
Interventional doctors were more specialized in X-rays.
For instance, interventional embolization surgery was performed under X-rays. After radiofrequency ablation gained popularity in the recent decade, many doctors started to dabble into CT scans but MRI, more specifically DW-MRI, was still…
Cheng Lixue had no clue about it.
“Let’s see, what can you infer from this position?” Zheng Ren put up the DW-MRI scan of the first patient on the film viewer and pointed at a specific position while asking his question.
Cheng Lixue was lost.
“The gradient pulse with the same length, amplitude, and position is applied to both sides of the 180b pulse in the spin-echo (SE) sequence. Try subtracting one of the sequence pulses and think along that direction.” Zheng Ren tried his best to explain in layman terms.
Nonetheless, Cheng Lixue’s expression sold him out.
The Secondary Hospital’s interventional department chief was completely lost.
“What about…” Zheng Ren thought for a while before saying regretfully, “Chief Cheng, why not you spend a few days in the CT room to learn?”
“…”
Zheng Ren sighed.
Professor Rudolf Wagner was able to grasp the idea and keep up and even Su Yun did as well, but they were both exceptionally gifted. Cheng Lixue was no match for them.
