Chapter 60: 60 – Coronary Angioplasty

The setup for the surgery was slightly different from what most interventionists were used to. They were used to seeing the patient covered with surgical drape, commonly used to protect the body against blood. 

However, the patient's left hand was completely uncovered. Everyone wondered if this was for the so-called pulse reading.

Li Yun sat on a stool next to Mr. Jiang and lowered part of his glove to expose a small portion of his right wrist. He rested his wrist on Mr. Jiang's bare hand and concentrated. Using Qivi, he saw the anesthesia numbing the area and put Mr. Jiang to sleep. Most interventional operations recommended local anesthesia for quicker recovery time, but Mr. Jiang hated the idea of being awake and had chosen general anesthesia. 

"Catheter," Li Yun called out to the nurse.

He didn't have the luxury of a nurse at the rail station, but with all the facilities available, everything was easier. He also had Professor Shao Shan and Doctor Meng,  who were officially assigned as chief surgeon and 2nd assistants. However, they were simply front row spectators.

After receiving the catheter, Li Yun inserted the needle into the radial artery. Some of the doctors nodded. They were impressed. Although it was possible, a lot of doctors preferred to use ultrasound, which removed the guesswork of locating the artery. Anyone who had their blood drawn by an intern nurse knew how painfully difficult it was to find a vein or artery.

The next part will be the tricky part.  Interventional surgery needed greater precision to avoid puncturing the artery and causing further damage. The doctors all wondered how he would manage to navigate the guide wire into the blockage without encountering those problems.

"What is he doing next?" asked old Yi Bao.

"He has to insert the guide wire to the site of the blockage," Yi Ansha explained using a short animation video. "After that, a catheter with a balloon will inflate the blockage. And finally a balloon with a stent will be used to prevent future blockage."

Everyone watched the procedure, but they were not aware of what was going on.  From their perspectives, he was blindly pushing the guide wire into the body.

From Li Yun's perspective, the surgery was easy. Only he could visualize the path of the wire into the bloodstream.  Unlike the emergency atherectomy at the train station, the guide wire he used was the correct gauge, whereas, the one he had used before was an all purpose guide wire that was thick and inflexible.

Once Li Yun arrived at the site with partial plague blockage, he inserted the catheter with a balloon and inflated the area.

"I can't believe he's not going to check the x-rays," the doctors were both amazed and pissed. To some of them, this was not an ethical thing to do.

Li Yun placed two stents around the heart. With Mr. Jiang's lifestyle, two stents may not be enough. There were slight blockages everywhere, but two was the extent of what Li Yun could do. He couldn't put stents in every location that was problematic. Mr. Jiang will need to follow his dietician's regimen, or else he'll need another surgery within five years.

Li Yun inserted a small amount of dye, and instructed the nurse to take an x-ray. Despite him knowing that everything was fine, they still needed formal documentation that the procedure was performed correctly.

After taking the x-ray, it was revealed on everyone's screen. Everyone was amazed that the x-ray looked normal, and that two stents were inserted. 

Some people could not believe it. "There must be another separate imaging screen in there," the doctor tried to explain to themselves.

"There's a camera showing the entire suite," a hospital technician explained as their reputation was at stake. "There is only one screen inside the suite, and it was turned off most of the time."

Yi Ansha looked at her grandfather's face. It was very rare for her to see him without a smile on his face.

"Grandfather, what do you think?" asked Yi Ansha.

"Do you think I can meet him?" Old Yi Bao had a feeling that Li Yun's ability was real.

Outside of the angioplasty suite, Li Yun was surrounded by other doctors, hoping to get a better understanding of the procedure. Li Yun explained to them that it was important to have a baseline pulse reading and to know what type of pulse pattern was considered healthy and normal. Like face reading and micro-expressions, the baseline will be different depending on the person. However, once a baseline was developed, any anomaly meant that something was off.

"It's not so much different from an EKG," Li Yun explained. "There are many different types of patterns, and once you have enough practice, you can tell where there are blockages."

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Li Yun wasn't sure if this was even possible for other people, but if a Chinese medicine master like Sun Simiao and Bian Que studied surgery, would they be able to perform such a feat? Surely it was possible for Bian Que, who was purported to have x-ray vision.

Li Yun collected everyone's business cards and then looked at the time. It was still early, but he still messaged Rouxi to pick him up later.

He heard people approaching, and looked up to see Yi Ansha and an elderly man who appeared to be her grandfather.

"Doctor Li, this is my grandfather, Yi Bao," she introduced.

Li Yun shook hands with the old master.

"Ah, a young man with a lot of shen," said the old man. "I couldn't see it on the screen, but your eyes are sparkling."

Yi Ansha looked at Li Yun's eyes, it was sparkling a bit more than usual.

"Did you have a good time with your girlfriend?" Yi Ansha asked.

Li Yun almost choked. "Uh, yeah. Mr. Yi also has a lot of good shen."

Mr. Yi laughed. "Oh ho, it's all the accumulated good deeds. Were you able to notice anything when we shook hands?"

Li Yun felt a little awkward. Was he infringing on people's privacy when he checked their pulse? Maybe, but it wasn't like he could see them naked. It was mainly blood and miscellaneous junk in a person's body. It wasn't very exciting to see, and more gruesome than the cartoon images.

"Mr. Yi has lived a fairly simple life, I don't see a lot of major complications," Li Yun stated. "But there are some odd blood flow going in and out of all your organs. It doesn't look to be recent damage, more like a slow sort of poison over time. It's not the same type of poison. I can only imagine this is something you have caused on your own?"

Old Yi Bao's eyes twinkled.

"Ah, in all my years, I have never seen anyone who reminded me of my own teacher," Old Yi Bao almost looked like he was about to cry.

"Ah, grandpa, are you all right?"

"I'm all right," Old Yi Bao nodded and then looked pointedly at Li Yun. "I have used my body to experiment with a lot of different formulas. Although most aren't harmful, there are definitely some that I shouldn't have tried."

Li Yun nodded. He understood that unlike Western medicine, clinical studies of formulas were limited due to the personalized nature of prescriptions. The only way to test the effectiveness was either through experience, or by testing them on oneself.

"To have this much knowledge without a master, I can not imagine how far you can go as a TCM doctor. Have you considered it?" He stopped and shook his head. "Ah, why am I even asking? You are the type of person who would do well even in western medicine."

"Although this may be selfish of me, I would like to learn more. I have read a lot, but there are concepts I still am not able to grasp on my own. If Master Yi isn't opposed, can I seek your guidance in the future?"

"Considering you're well versed in diagnosis. Is there something you want to learn?"

"I would like to learn acupuncture and to make prescriptions."

"Ah, I see. Learning acupuncture is a must, but to create proper prescriptions will take a lot of time. If you have questions, this old man will assist you on your path."

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