Surgery Godfather
Chapter 1130 - 906: Just Short of a Thread

Chapter 1130: Chapter 906: Just Short of a Thread

For this case of cobalt toxicity, everyone, whether director-level or standardized training students, was very interested.

They were even more intrigued by the diagnostic process of this case because it offered everyone some insights.

Why had the patient visited many hospitals, seen numerous doctors, and, judging from his medical experiences, these hospitals were major ones within the province, some having heavyweight experts in rheumatology, immunology, and tumor, but unfortunately, none could establish a definitive diagnosis? After receiving symptomatic treatment in the Cardiovascular Department of Sanbo Hospital for two solid weeks, there was still no diagnosis.

At that time, he was admitted to the CCU due to severe heart failure, stabilized after rescue treatments, and later transferred out of the CCU. At this point, the cardiovascular doctors were at their wits’ end and had no choice but to use their last resort—a hospital-wide consultation.

Orthopedics received the consultation request and was the most eager; the attending physician decided to get a sense of the situation in advance, and this visit directly solved the complex problem.

Why did everyone rack their brains without arriving at a diagnosis, yet an orthopedic doctor easily resolved it?

As Director Tan said, the problem lay in the blind spot. Whether they were experts in rheumatology and immunology or tumor specialists, they were limited to their own fields, endlessly circling within their expertise.

They had performed nearly all relevant tests concerning infections, tumors, and rheumatology immunology, except for testing heavy metal ion concentrations in the blood.

This was because it simply hadn’t occurred to them, lacking knowledge in this area.

Yang Ping sat in the front row, quietly listening to the discussion. Director Zhao had noticed Yang Ping’s presence early on.

Yang Ping could no longer keep a low profile as he now had an almost god-like stature at Sanbo Hospital. Director Zhao, regardless of his own intentions, would ask Yang to say a few words. Even if Director Zhao let him be, so many young doctors wouldn’t possibly let him off.

"Our Professor Yang also started in orthopedics. Regarding this case, could Professor Yang share a few words with everyone?"

Director Zhao walked up to Yang Ping with a microphone.

The young doctors in the audience all eagerly watched Yang Ping, waiting for him to speak, because he always managed to say something akin to mathematical axioms and theorems that were very useful.

If it meant saying a few words, so be it; Yang Ping walked up to the podium and Director Zhao handed him the microphone.

He thought for a moment—what to say? The case had been solved, and the diagnosis and treatment were clear. Consider speaking about how to think through complicated cases.

The young doctors in the audience, especially the graduate students and standardized training students, began jotting down notes; they were keen on seizing this opportunity. Most of them would leave Sanbo Hospital after completing their studies and might not have many chances to attend Professor Yang’s lectures in the future.

"Let me talk to the young doctors for a moment. In fact, the complex cases we encounter can generally be categorized into a few types: first, atypical symptoms; second, beyond the scope of knowledge; third, currently unrecognized by medicine. No matter which category it falls under, it’s most crucial to capture the key clues of the disease. Thus, one must have comprehensive knowledge. As Director Zhao said earlier, one should read and study regularly. Once there is a knowledge gap, some clues will be missed. And these crucial clues are extremely important in diagnostics; they’re like the loose thread on a garment. Once you grab this thread, the whole seam comes apart effortlessly."

"Traditional Chinese medicine greatly values the role of clues in diagnostics. Experienced traditional Chinese medicine doctors, when faced with complicated cases, would chat with the patient about anything concerning their condition after observing and inquiring. Although it seems like small talk, this is actually them waiting for that thread to emerge. As they talk, clues naturally arise, and the experienced doctor would have an epiphany, immediately grab the clue and follow it through to achieve a final differentiated diagnosis."

"This is the secret of traditional Chinese medicine doctors in treating diseases. I wouldn’t tell this to just anyone. We, in Western medicine, should learn from this secret. When facing complex cases, we continuously review the medical records, improve them, look through the patients’ past medical data, interact more with the patients, and ask about their medical history. You never know, a clue might just appear while asking. The diagnosis of complex cases hangs by such a thread."

"Also, when diagnosing diseases, start with common diseases but don’t overlook rare diseases. Each time you diagnose an illness, consider all possible diseases in your mind. How do you do that? Review them based on the classification of etiologies in our pathophysiology. This forms a rigorous and comprehensive thinking habit, less likely to miss important clues. Especially when a diagnosis has not been attained, every anomaly could be a clue. Anyway, facing so many threads, which one is the right clue? Just pull on each one to test."

Indeed, Professor Yang’s casual remarks were solid gold rules. This thread theory was indeed full of philosophical logic, and the young doctors earnestly noted down this thread theory.

Subsequently, Yang Ping lectured everyone on issues related to metal implants.

Metal is widely used in medicine, especially in orthopedics where most spinal and joint implants are primarily metallic, such as spinal internal fixation, artificial intervertebral discs, artificial joints, and so forth.

After being implanted in the human body, metal wear leads to metal particles and ions. These microscopic metal particles spread into the surrounding soft tissues, causing local reactions and activating macrophages and inflammatory responses.

Metal ions enter the blood circulation and then travel throughout the body, depositing in terminal organs. Some metal ions are inherently toxic, such as heavy metals typified by cobalt; some metal ions cause damage to organs upon deposition; and some have the potential to be carcinogenic in the human body, such as high levels of titanium, which may pose a high cancer risk.

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