I run a clinic in the United States

Chapter 230 The Blue Enchantress
The northwest wind blows, and the cork oak tree in front of the Iris Clinic is still lush and lush.This is an evergreen tree, already densely covered with acorns.

A fluffy little squirrel looks for the juiciest fruits among the branches and leaves, and then carries them to its hole.In fact, squirrels don't like to eat acorns. They prefer high-calorie fruits such as pine nuts, hazelnuts, chestnuts, walnuts and spruce nuts. However, because there are too many acorns here, they still become its main food.

San Francisco has a typical Mediterranean climate, with warm winters and cool summers. Although it is already November, the daytime temperature is still more than ten degrees Celsius.

A thin young woman with long straight black hair, brown skin, and a white cardigan on her upper body and a skirt on her lower body walked into the clinic.

"Good morning, how can I help you?" Ava, blond and pretty with youthful eyes, greeted the other party enthusiastically.

The woman couldn't help but look at Ava one more time and thought to herself, she's so beautiful!
Ava beheads men and women.

"You are so beautiful." The other person couldn't help but say.

Ava smiled and said: "You are also very beautiful, um, especially your blue lipstick!"

This should be the Blue Enchantress. Elena showed her this kind of lipstick, but she didn't like it. She thought it looked weird when applied on it, but it didn't stop her from praising others.Although, it doesn't fit her aesthetic.

Zhou Qiao said that all guests come to your door, so you should praise them a lot!
Unexpectedly, the woman's expression darkened, her mouth tightened, and she stopped talking.

A sudden thought occurred in Ava's mind, and she thought to herself, "Did I praise you wrongly?"
The woman thought for a moment, then smiled bitterly and said, "I don't use lipstick or lipstick. My blue lips are due to disease."

"Ah~, I'm sorry, I'm sorry, I didn't mean it. I'm sorry." Ava looked at her in surprise again. Sure enough, she had made a mistake just now. The other person's lips were a bit dry. She really had not used lipstick or lipstick. Woolen cloth.

Is this cyanosis?However, this was the first time she had seen such intense cyanosis.

"It's okay, I'm used to it. My name is Pamela Wendy. I have made an appointment before. Is Dr. Zhou available now?" Pamela Wendy said.

"He has a patient there right now. How about you wait in the rest area for a while? What would you like to drink?" Ava said, leading the other person to the sofa in the rest area.

"I came a little early. A glass of lemonade, thank you." Pamela Wendy sat down and looked at the environment of the clinic. She felt that it was so cozy and made her feel great.

However, when she thought of her chronic illness for many years, she couldn't help frowning and pursed her blue lips.

Her strong blue lips have caused people to misunderstand her more than once, thinking she has blue enchantress lipstick.However, she is not such a seductive woman.

"It would be nice if she was really coquettish, but it's a pity that this is just an external manifestation of the disease." Pamela Wendy sighed in her heart.

"Lemonade is here, don't worry, Dr. Zhou should be here soon."

"Thank you."

At this time, Elena came over with a patient information form and said with a smile: "Good morning, dear Pamela, this is your first time coming to see a doctor. I have a form here that can save you a few minutes. Fill it out?"

Pamela Wendy looked at Ava and then at Elena. For a moment, she couldn't tell the difference, and she exclaimed in surprise: "It turns out you are twins, so beautiful!"

"Thank you."

"By the way, where do you feel uncomfortable?" Elena asked.

"I have a heart problem, and it's a little serious..." Pamela Wendy smiled softly.

After briefly chatting for a few words, Elena and Ava stopped bothering her because they found that Pamela was very weak and would start to breathe heavily if she talked too much.

Pamela Wendy did not wait too long. About 10 minutes later, she entered Zhou Qiao's general clinic and handed over her medical records.

"Eisenmenger Syndrome?" Zhou Qiao read through it carefully and then quickly frowned.

"Yes. This is how other clinics and hospitals diagnose it. The operation is very difficult and almost impossible." Pamela Wendy said emotionally.

She is from Guatemala and had heart disease when she was a child. However, because her family was poor and the medical conditions in her area were poor, she kept putting it off. Later, she tried every means to immigrate to the United States, found a job, and her economic conditions improved, so she started to see a doctor.

In addition, it is also because my condition has worsened significantly recently, which has seriously affected my work and life, and I really can't put it off any longer.

However, after many examinations and visits to several clinics or hospitals, the diagnosis given was Eisenmenger syndrome.There are also congenital heart disease, atrial septal defect, triatrial heart disease, severe pulmonary hypertension... Anyway, there are quite a lot of them, and it makes people's scalp numb just listening to them.

The doctor said that there is no surgery for this disease.

If there is no operation, she will have to wait for death. She may not live to be 30 years old, let alone fall in love, get married and have children!

With her disease, she couldn't have close contact with the opposite sex, and it would really kill someone.I once dated a man for a short period of time, and we had a crush on each other, but because we couldn't do it, we broke up soon.

"Elena, help check if Murphy and Stephanie are free. If so, ask them to come over." Seeing Elena passing by the door, Zhou Qiao stopped her and said.

Now after a long time, Zhou Qiao can easily distinguish Elena and Ava.

Another reason is that they don't wear the same clothes now.Maybe you want to have more of your own characteristics.

"OK!" Elena made a gesture and jumped away.

Soon, Murphy and Stephanie came in together, and Zhou Qiao handed them the information brought by the patient for circulation.

This is a good case, and Zhou Qiao feels that it should be shared with Murphy and Stephanie so that they can participate.This is how medical experience is accumulated bit by bit.

He has a system and does not need to accumulate, but Murphy and Stephanie do.

Pamela Wendy looked at Murphy and Stephanie carefully and said to herself, there are so many beautiful beauties in this clinic.This Dr. Zhou is such a blessing.

Then...are these No. 2 and No. 3 in this surgery competition?
The first three people consulted me together. Oh my God, I was so happy.How could such an opportunity have existed in Guatemala before?I heard that medical treatment at Iris Clinic is slightly cheaper than other clinics.I should have been here earlier.

After Murphy read it, he was silent and handed the information to Stephanie.

Stephanie looked at it carefully and couldn't help but frown.

Generally, the lips and fingers turn blue, a condition medically called cyanosis.

There are many causes of cyanosis, the most common of which is congenital heart disease.

If the heart is not strong enough, the human body will be deprived of oxygen for a long time, and then the joints of the fingers and toes will swell and become like small drumsticks. This is called "clubbing" in medicine.

"How's it going? What's your opinion?" Zhou Qiao asked.

Murphy was the first to speak and said: "Generally, there are two types of congenital heart disease that cause hypoxia. One is congenital cyanotic heart disease. It is characterized by cyanosis at birth, including many kinds of malformations. This condition is relatively simple. .”

"The second is another type of congenital heart disease, which is usually a relatively simple heart disease, such as ventricular septum, atrial septum, and patent ductus arteriosus. It is not purple when you are born, but due to various reasons, treatment is delayed. After a few years, It was complicated by severe pulmonary hypertension and cyanosis.”

Stephanie nodded and said: "Previous doctors have diagnosed Eisenmenger syndrome. If this is the case, it is a restricted area for surgery and the risk of death is extremely high. What we need to figure out now is, what exactly is cyanosis? When did it appear?"

So, the three of them looked at Pamela Wendy.

Pamela Wendy stammered: "...I, I forgot. How can I remember what happened when I was a child?"

Zhou Qiao asked: "What about your family members? Don't they have any impression?"

Murphy also said: "This is very important."

Pamela Wendy sighed: "They don't know either."

She grew up in a poor family, and her parents tried their best and worked from morning to night every day, but they could only barely feed their brothers and sisters. How could they have the energy to pay attention to such small details.

"Let's go to the testing center together and do another echocardiogram." Zhou Qiao said.

Pamela said in surprise: "Dr. Zhou, are you going too?"

Zhou Qiao said: "Yes, your condition is quite complicated. Let's go to the scene to have a look together before we can rest assured." Pamela felt warm in her heart and was very touched, because she had done all the examinations herself before.The doctor did not accompany her, let alone see the situation on site.They all read the image reports on the computer.

Ava then drove and the group headed to the testing center.

If Pamela came alone, she might have to queue up, which she might not be able to do today, but Ava was familiar with people here, so she went to find a good sister inside, chatted for a while, and gave her a small gift. Soon, the inspection was scheduled.

Ava purchased many exquisite little gifts and hid them in the clinic. Every time she brought someone over, she almost always brought something.

Since these things are not of high value and they are friends that we often deal with, it doesn't matter.

Zhou Qiao, Murphy, and Stephanie watched carefully at the side of the echocardiogram.

There were colorful patterns on the display screen of the cardiac color ultrasound, but in the eyes of Zhou Qiao and the others, they could restore Pamela's current heart structure.

Especially for Murphy, the 3D modeling in his brain started at the same time and could be adjusted at any time based on the data detected by the echocardiography machine.A living heart holographic projection is slowly constructed above the display screen, perfected bit by bit, and is still beating slowly, close to reality.

There are also many annotation boxes around it. If others could see it, their jaws would drop. This is nothing more than a science fiction movie.

But it was just a condensation of her imagination, visible only to her.

The image report generated after the examination is static and issued by the imaging doctor, but now when viewed on site, it is a dynamic real-time image.

The difference between the two is naturally huge.Some situations, limited by the level of imaging doctors, may not be able to be truly shown.

Stephanie analyzed from the side: "Here, there is a relatively large defect between the left and right atria, and a large amount of blood flows from the right atrium into the left atrium. Her pulmonary artery pressure should be very high, causing a large amount of tricuspid regurgitation, It flows very fast.”

"There is a septum-like thing in her left atrium." Stephanie fell silent as she spoke, because, judging from the current situation, isn't this "Eisenmenger syndrome"?

That basically blocks the possibility of surgery.

Zhou Qiao looked at Murphy's profile and asked, "Murphy, what do you think?"

Stephanie curled her lips slightly and thought to herself, could she have a better view than me?Although this cool girl's ranking in the competition is slightly higher than mine, there is actually not much difference between one second and one third.

At this time, Stephanie felt sour in her heart when she saw that Zhou Qiao valued Murphy very much.

Murphy pondered for a moment and said to the examining doctor: "There is something wrong with the septum in the left atrium. Please scan it carefully a few more times!"

The doctor who performed the operation returned to the previous place and scanned slowly back and forth.

"Stop! It's right here," Murphy pointed to a place in the left atrium and said, "There should have been four pulmonary veins here, but all the blood was diverted to the right atrium by the septum of the left atrium."

Stephanie exclaimed and shouted: "This is not a triatrial heart, but an extremely dilated coronary sinus!"

Zhou Qiao nodded and gave Murphy a thumbs up.

Murphy pursed his lips slightly and smiled modestly, feeling very charming for a moment.

Stephanie: "..." I really feel bad. The evil consciousness of the Slutty Witch is ready to move again, and she needs Zhou Qiao's dream diagnosis and treatment.

How did Murphy discover such a tiny detail?Is the gap between me and her really that big?Stephanie was upset. Will she be suppressed by Murphy for the rest of her life?

As everyone knows, 3D modeling in the brain is a skill that Murphy was born with and cannot be learned by others.Sometimes clues can lead to extraordinary discoveries.

What's more, Murphy has already performed thousands of heart surgeries, including thoracotomy, in the "Medical Dimension Training Ground".Her attainments in the field of cardiac surgery far exceed those of Stephanie.

Stephanie has not been improved by Zhou Qiao, so she is naturally not as good as Murphy now.

"Let's go back. Once we find the real root cause, the rest will be much easier." Zhou Qiao stood up, thanked the doctor who operated the instrument, and then the group left.

Although the subsequent surgery is still very risky, it is no longer considered a restricted area for surgery.

"Dr. Zhou, how is my condition? Is it not that serious?" Pamela Wendy asked curiously in the car.

Zhou Qiao explained to her and said: "Your cyanosis is not actually due to Eisenmenger syndrome, but complete intracardiac ectopic pulmonary vein drainage."

"..." Pamela Wendy hesitated for a moment and asked, "What kind of disease is this?"

The convoluted and unfamiliar professional vocabulary made it difficult for her to repeat it.

Zhou Qiao explained patiently: "Complete ectopic pulmonary venous drainage is a relatively rare congenital heart disease. Generally speaking, the normal heart is divided into left heart and right heart. The left heart is responsible for transferring the rich blood after the lung exchange. The oxygen-containing 'red blood' is transported to all parts of the body, while the right heart is responsible for recycling the 'black blood' that has absorbed oxygen into various organs to the heart, and then transports it to the lungs for exchange of air and blood."

"The two have no fellowship with each other."

"Anomalous pulmonary vein drainage means that during fetal development, the blood vessel connection is distorted or wrong. The pulmonary vein that should be connected to the left atrium opens in the right atrium for various reasons.

Then for this reason, your body made its own remedy, which is to form a small hole between the left and right atrium. Without this hole, blood could not enter the left atrium, and you would not have been born alive.

But the price of this small hole is that you will be cyanotic after birth.That is, red blood and black blood mix in the atrium, and then your blood oxygen is always in a low state. "

Murphy and Stephanie thought to themselves that Zhou Qiao explained it very well and explained it in simple terms.

However, even though it was so easy to understand, Pamela Wendy still looked confused, but she soon became happy.

Because, although she didn't quite understand it, she could tell from Zhou Qiao's tone that her previous disease was misdiagnosed, and Dr. Zhou and the others now discovered a new situation.The good thing about this situation is that surgery is possible.

"Dr. Zhou, my operation should go smoothly, right? If I have the operation, will I be able to... get married and have children, just like normal people?" Pamela Wendy asked with hope.

Zhou Qiao smiled slightly and said, "Of course. How about letting Dr. Murphy perform the surgery on you this time?"

Pamela Wendy said: "What an honor!" She glanced at the tall and cool girl and said to herself, this Dr. Murphy is indeed very good. If it weren't for her, I would probably still have this disease. torture.

Stephanie curled her lips slightly, and the towering peaks couldn't help but undulate, but she had nothing to say. After all, this time, Murphy's performance was indeed better than hers.

……

Pamela Wendy settled in the Iris Clinic with peace of mind. Ava helped her complete the preoperative examination and at the same time, made an appointment in the operating room of the University of California Medical Center.Fortunately, I once again made an appointment with the Prometheus-3000 surgical robot.

In fact, Zhou Qiao itself has priority to use it, and if there are no special circumstances, he can make an appointment.

Generally speaking, most children with complete anomalous pulmonary venous drainage are cyanotic just after birth, so most of them undergo surgery early after birth. However, everyone's growth environment is different, and not every child can Enjoy such good medical conditions.

It is not easy for Pamela Wendy to grow up smoothly, and later sneak into the United States by chance, and still survive here smoothly.

When everything was ready, Zhou Qiao led a group of people to the medical center.

Murphy is the surgeon, with Zhou Qiao and Stephanie as assistants. In fact, because it is a surgical robot, there is no need for assistants.Most of them are observational in nature.

This Prometheus-3000 surgical robot has three heads and five arms, and a 20 times field of view. There are no "dead spots" during surgery.Compared with the three heads and six arms of Nezha in Chinese myths and legends, it is still one arm short.

But with three heads and five arms, he is already very powerful.

The previous models of Prometheus -1000 and -2000 were said to have a two-person model, which means two people can control and cooperate at the same time. However, this improved model of -3000 has completely abandoned the two-person model.

It is said that the "Yagemohui" Group has proposed a concept surgical robot that uses nerve connections. The surgeon does not need to do it himself. He only needs to connect and control the robot with his mind to perfectly operate the robot for surgery.

Of course, it is still in the dreaming stage.If this kind of technology really exists, it will probably be used not only in medicine, but also in the military field.

Stephanie was very envious and wondered when I could use this high-performance robot to perform an operation.

(End of this chapter)