General Conference Room, Department of Surgery, University of Tokyo Hospital.
Around the rectangular conference table, experts are discussing cases. There are not only professors from the University of Tokyo Hospital, but also professors from Juntendo Hospital. It can be said that the top surgical professors in Japan have gathered here.
Several of them are leading professors in Japan, such as Professor Ito, a consultant professor of spine surgery and neurosurgery at Juntendo Hospital, and the current director of spine surgery and neurosurgery.
He has always advocated that neurosurgeons should be familiar with the brain and spine, and only after they are familiar with the brain and spine can they divide into subspecialties.
In Japan, which has an academic system, these professors have absolute say. They have taken a back seat, and the case discussions they are invited to participate in are either members of the royal family, conglomerate bosses, or political figures.
Their rich experience can be an important basis for decision-making, and more importantly, their prominent status can be a solid backing for the surgeon.
Juntendo Hospital’s status in Japan is equivalent to China’s Xiehe Hospital.
In Japan, in terms of medicine, Juntendo University has a higher status than the University of Tokyo School of Medicine, and Juntendo Hospital has a higher status than the University of Tokyo Hospital. It is no exaggeration to say that Juntendo is the father of the Tokyo University School of Medicine.
The case under discussion is none other than the head of the Fujiwara family—Fujiwara Tanio, the current president of the Fujiwara Foundation and the uncle of Masao Fujiwara.
After the tumor was discovered during a physical examination, the Fujiwara Foundation donated US$3 billion to Tokyo University to conduct research on his case.
"The risks of Mr. Fujiwara's surgery are too high. Currently, even with the help of the most advanced navigation equipment, there is no success rate, less than 5%."
"Yes, we have conducted a lot of animal experiments, and the success rate of surgery cannot exceed 5%."
"Would you consider inviting Europe and the United States to participate in the treatment?"
"No, the success rate in the United States is not higher than ours. I am very familiar with Johnathan at Mayo. Their surgical operations may lag behind ours in terms of details."
"Mr. Fujiwara's condition is confidential. If it is not necessary, try not to invite others to participate."
"I agree, I personally think that we are already at the forefront of surgery for this type of tumor."
"Everyone, have you ever thought about it? If the operation is not performed, Mr. Fujiwara Tanio has no chance! Professor Fujiwara Masao, what do you think? You are both a core member of the patient treatment team and a patient's family member." Professor Ito has gray hair, but
He is energetic, especially his waist is straight and his voice is loud.
Fujiwara Masao took notes while listening. Although he had a secretary dedicated to taking notes, he still took some necessary notes himself.
"According to my student Fumiya Takahashi who went to China for further study and reported back, Dr. Yang Ping in China had a successful case." Masao Fujiwara felt that something fresh should be injected into the discussion.
"This case doesn't mean anything. What's different about his surgical method?" asked Professor Daisuke Komori, Director of the Department of Neurosurgery at Tokyo University Affiliated Hospital.
"He has done a lot of in-depth research on the anatomy of the upper cervical spinal cord and brainstem, especially on the anatomy and function of nerve nuclei. Based on this, he designed a unique surgical approach. In his cases, the patient even
The heartbeat and respiratory arrest occurred several times, and the operation was continued after resuscitation. The most incredible thing is that once, the operation was performed during the period of cardiac and respiratory arrest." Fujiwara Masao did not see it with his own eyes, so he can only describe it based on Takahashi's report.<
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"This is so crazy! You can perform surgery after the heart has stopped because of the extracorporeal circulation support. Once the brain's vital center stops working, who can provide replacement protection? Who can guarantee that it can be revived?" Professor Komori felt unbelievable and said in a tone of voice
Frivolous.
"Are you sure Takahashi saw it with his own eyes? Based on your description, the credibility of this case is extremely low. If we use it as a reference, we will go astray." The director of neurosurgery at Suntang Hospital also couldn't believe it.
"We also have a success rate of 5%. It's not surprising that there are successful cases. I'm afraid it's more of a matter of luck. Besides, if he has a mature surgical plan, why hasn't he published a paper?" responded the deputy director of Shuntang Spine Surgery. The director of the spinal surgery department of Soontang Hospital was away for a meeting, and the deputy director attended the meeting on his behalf.
"It takes time for a paper to be published and published. This is not a reason to deny it. Everything should not be based on emotion, but should be supported by evidence. There is no evidence to show that its credibility is low, so this information cannot be ruled out for the time being." A white-haired man said.
The professor’s tone was calm.
He is Fujiwara Masao’s teacher, consultant professor of the Department of Orthopedics at the University of Tokyo Hospital, Professor Ikeda.
"Everyone, we must be cautious about anything that is beyond common sense. We must not be gullible or rashly judge it as low credibility. In this way, we will miss some valuable information. Some people have a mocking tone. I
I think such an attitude is very dangerous and blindly arrogant, which is a sign of falling behind soon!" Professor Ikeda further reminded everyone in a stern tone.
Professor Ito immediately said: "I very much agree with Ikeda-kun, you are only one step away from falling behind!"
In response to the old professor's reminder, everyone blushed and no longer dared to make fun of you frivolously.
"Continue---" Professor Ito asked Masao Fujiwara to continue.
"I asked Takahashi to copy his surgical method, and then simulated the operation on experimental monkeys. Unfortunately, I could not copy his surgical effect. This doctor, I was fortunate enough to have crossed paths with him. He once successfully completed an abdominal surgery.
I have failed in this kind of surgery for complex hemangioma damage, but he succeeded. For this reason, I sent Takahashi to China to study with him. After Takahashi came back, he reported to me that this person's surgery was like a ghost.
Takahashi used to be arrogant, but after returning from China, he became humble and cautious, so I think this person is by no means simple, but he is an orthopedic surgeon. As far as I know, in China, upper cervical spinal cord tumors are orthopedic
It is in the scope of the spine, but brainstem tumors are in the scope of neurosurgery. It is difficult to understand why he can perform cross-disciplinary surgery, and it is the most dangerous cross-disciplinary surgery. In China, this is almost impossible." Fujiwara Masao did not deny it lightly, but at the same time
There are doubts again.
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"Let it go in advance, but don't ignore it!" Professor Ito felt that it would be meaningless to discuss this issue further and it would be difficult to discuss it clearly.
"I heard that your inpatient department admitted a case very similar to Mr. Fujiwara?" Professor Ito asked.
"Yes, our neurosurgery ICU is currently treating a patient whose condition is very similar to Mr. Fujiwara's. I think we can perform an operation on this patient, and then accumulate experience from it, and then apply the experience to Mr. Fujiwara's operation. The success rate of the operation
It will definitely improve a lot." Professor Komori suggested.
The professors were stunned for a moment, and then Professor Ito said: "This is a good opportunity. The success rate of surgery requires accumulation of volume. Ape animal experiments are very close to humans, but there is still a gap, and tumor models are very different. If there is a close
No matter whether this person's operation is successful or not, it is definitely a good opportunity for President Fujiwara, and we must cherish it."
"Wouldn't it be better to do this?" Someone raised an objection.
"For the advancement of medicine, there will always be people who make sacrifices. This is not surprising and does not violate ethics." Professor Ikeda said in a serious tone.
"There is no ethical rule that dictates the order of our surgeries." Professor Ito supports Professor Ikeda.
Masao Fujiwara breathed a sigh of relief, because as a family member of the patient, he could not bring up the idea of using this patient as a research case to accumulate experience for his uncle's surgery.
Now Professor Komori has helped to propose it, and Professors Ito and Ikeda agree. Of course Fujiwara Masao is happy, but he is most worried about the two professors rejecting it.
"But --- the patient's family has informed us that we are undergoing conservative treatment for the time being. They will invite a doctor to perform the surgery. The doctor's information will be submitted to our hospital soon." Professor Komori was quite disappointed again.
There was anger in Ito's tone: "In the field of neurological and spinal surgery, is there anyone more advanced than us? Even Johnson from Mayo does not dare to say that he has surpassed us in surgery. Who will he invite? The United States and Europe
For the purpose of exchange and learning, we will invite top professors to come and perform surgeries. In addition, do we need to invite others to perform surgeries? We can refuse this request. For such cases, Juntendo, Tokyo University Hospital,
They are all top-notch beings. You should explain clearly to them that this case is the most dangerous tumor in the world. The danger is due to the location of the growth, not our technology. The number of people in the world who can operate on him should be in the single digits.
We are one of them."
"I have explained patiently, but the other party is very determined. This patient cannot be transferred. If surgery is needed, it can only be done at our place. But if the other party proposes to ask a doctor outside the hospital to perform the surgery, as long as the doctor's qualifications meet the requirements, regardless of law or ethics, we will
It seems impossible to refuse!" Professor Komori was helpless.
Professor Ito became even more angry: "It's ridiculous. This is contempt for us. How can there be patients who don't believe in us?"
"He may not be clear about the medical profession. If you continue to communicate with them, we must perform the surgery. As for inviting a doctor to perform the operation, I can't think of anyone they want to invite. It's just Johnathan, the neurosurgeon at Mayo.
Doctor, he is no better than us." Professor Ikeda and Professor Ito completely agree.
"Understood, I will do my best." Professor Komori promised.
Masao Fujiwara also said: "I will work with Komori to change the minds of the patients' families."
"Our first-generation hall master, Mr. Sato Tairan, founded Juntendo University, and the third-generation hall master, Sato Naonaka, founded the Tokyo University School of Medicine. When the Tokyo University School of Medicine was officially established, 20 of the 22 professors came from Juntendo, Juntendo and Tokyo University Hospital.
The best hospital in Japan. Now, Mr. Fujiwara is lying in our ward, but we seem helpless. My heart is in pain, so you must do your best, unite and cooperate, and strive for the greatest success rate of surgery. Operations under the microscope,
I’m already old, so please leave it to you two, Fujiwara Masao and Komori Daisuke!”
Professor Ito stood up and bowed, and Fujiwara Masao and Komori Daisuke immediately stood up and returned the bow.
"Please take me to see President Fujiwara again?" Professor Ito requested.
The meeting was temporarily adjourned. Fujiwara Masao and Komori Daisuke led Professor Ito to visit the special ICU ward again to visit Fujiwara Tanio.