[English subtitles are available] [Dr. Tang] [Episode 1] [In Operation] How is the patient? There is venous engorgement of her jugular vein and her face is black. Her blood pressure dropped very fast. The dissection has ruptured. Build emergent extracorporeal circulation. Hepatitis. The extracorporeal circulation must be built within five minutes. [Operating Room Control Panel Time] Cannulate the femoral artery. Dermatome. Otherwise, it will cause irreversible damage to the brain of the patient. Electric saw. Chest retractor. Two minutes and 50 seconds. [Operating Room Control Panel Time] Hemorrhoea. Suction apparatus. Autotransfusion. Blood pressure is dropping. Find the bleeding point. [Operating Room Control Panel Time] 3 minutes and 40 seconds. Open the extracorporeal circulation. Blood pressure dropped to the critical point. Four minutes and one second. [Operating Room Control Panel Time] [Yesterday] I shouldn't have eaten mango last night. I was on night shift and I stood all night. My feet are so swollen. What does it have to do with mango? Mango. Mango. It sounds like busy(mang sounds like busy in Chinese). She offended the god of night shift. According to you, we can only eat salted fish on night shifts(salted sounds like idle in Chinese). Head nurse, salted fish is too expensive. As long as there's no hemorrhoea or heartbeat stop, I'm satisfied with eating pickles every day. You are superstitious. Head nurse. How long do you think she can hold on? In Cardiac Surgery Department of A. H. J. S Hospital dominated by male doctors, Tang Jiayu is the first female director ever. [Tang Jiayu, Senior Doctor, 38, Director of Cardiac Surgery Department, Leader of Severe Cases Team] Since she came here all of a sudden, there have been much discussion. [Qin Dazhong, Associate Senior Doctor, 52, Member of Severe Cases Team] There is all kinds of gossip. [Zhou Da, Attending Doctor, 34, Member of Severe Cases Team] Not only that, [Long Xiangdong, Attending Doctor, 32, Member of Severe Cases Team] the four subordinates assigned for her are all troublesome figures in Cardiac Surgery Department. [Jiang Bailie, Resident Doctor, 27, Member of Severe Cases Team] Xinran. Here. Time for breakfast. Look. I bought you your favorite shepherd's purse wonton. Eat it while it's hot. Are you scalded? I'm fine. I'm always clumsy. Xinran. Director Liao. How do you feel today? Does your chest still hurt? No. When is the surgery? It's a waste of money to live here. This kid. Director Liao, we are kind of anxious waiting here. When can Director Song do the surgery for Xinran? We're here for his reputation. Director Song is really busy recently. But she's not in an acute seizure. Don't worry. If we can arrange a surgery, we'll arrange it as soon as possible. Okay. I don't know if they told you or not. The surgery will be divided into two times. The cost is not low. I've sold my house. As long as I can save my daughter, money is not a problem. Xinran. Have a good rest. By the way, Director Liao, there are two more examination sheets. Can you take a look to see if we need to do it today? I didn't prescribe it. You did it? No. I did. Dissection of aorta. The condition will change at any time. We need the latest examination result to make the best judgment. Who are you? This is Tang Jiayu, Director Tang, the new charge of our Heart Center. Director Tang. My surname is Tang. I'll be Luo Xinran's doctor from now on. Director Liao, do the handover with my men. What do you mean? Excuse me. How do you feel? He just asked. Qin, what's going on? Can't you tell? The higher-ups have reassigned patients. Wait. What's going on? The patient came for Director Song. Is this appropriate? Director Liao. This is the ward. Let's talk in the office. Here, Xinran. Let's go. Hold my hands at the same time. Bye, Director Liao. Hold it hard. Xinran. Harder. Your left hand is weaker than your right hand. How long has this been? I sprained my ankle in the shower yesterday. I'm fine. Raise both hands at the same time. Be cooperative, Xinran. Cooperate. Raise your hands. Liao Xiaobo is my capable man. Scolding him is like a slap in my face. This is a warning to others. It won't work to have an outsider be the director of the center. Liu Feng, let me remind you. It has aroused public anger. It's not too late to replace her. Who? You? You tried it before. The three months when you were deputy director, there were three postoperative complications. Song Baode, the three complaint letters are still on my desk. Do you want to read them? Postoperative complications of heart surgery can't be completely avoided. It's a matter of probability. I worked hard in Anhe for 20 years whole-heartedly. She came back from abroad and took my place without doing anything. Where is my face? You... You think too much. Tang Jiayu is a surgery star of Kermede Medical Center. The Cardiac Surgery Department of Anhe needs such a strong surgeon. You are good at scientific research and thesis. Everyone knows that. Also, I reassigned the patients today for your own good. Luo Xinran's father suddenly died of Marfan syndrome three years ago. It is a genetic disease. Now it's his daughter and reporters want to report this. For such a case that easily arouses public opinion, if you fail, won't it hurt you more? Besides, you've done a lot. Look at the four subordinates you found for her. Which one is easy? How dare you make up stories that she's my ex-girlfriend? Enough. Stop quibbling. I've reported our relationship to the president. It is put on record in Medical Affairs Department, too. So, let me make this clear beforehand. I won't stand by and do nothing if anyone does anything unnecessary. In that case, take a look at this and decide if you'll stand by. Who is it? Wait. Come in. Director Tang, the results of Luo Xinran's examination can be checked on the computer now. This office used to belong to Director Song, right? How did you know? His style. [Great Doctors Are Pure And Sincere] I took a look just now. It's not much different from how she was when she was admitted to the hospital. We don't need to arrange the surgery in a hurry, right? It's the opposite. Make an appointment with the operating room tomorrow morning. David Operation and total aorta replacement. Total aorta? Any problem? No. I'm leaving if there's nothing else. Director Song, let me report to you. Luo Xinran will be operated tomorrow. David Operation and total aorta replacement. Why does Anhe Hospital end up like this? What do you mean? The ex-girlfriend of vice president just became the head of Heart Center in an imposing manner. Well, the president and the Medical Affairs Department don't even care. Is there no law? Exactly. But Longlong, that ex-girlfriend... is a past. Maybe Director Tang and President Liu are innocent now. Which side are you on? Longlong, it's not about the side. I'm just expressing my personal opinion. In the end, I'm still standing with you. OK. Sit down. Come on. This woman's background is not simple. She's less than 40 years old and has already been in this position. I don't really believe there is nothing behind it. If only we had a female president. I wouldn't still be an associate senior doctor at this age. Qin, don't think too much. Even a female president won't promote you. That's right. It'd be good that you are not demoted. Why? I'm very popular with women. Ask my ex-wife if you don't believe me. Which ex-wife? You... Don't be mean. What does Longlong mean? The one who asked you to leave without a trace? Or the one who fought you to the police station? Or the one who sold the car? -Yes, the one who sold the car. -You... Qin. After all, you have a lot of ex-wives. Teachers, Director Tang asked me to inform you of the surgery tomorrow. David Operation plus total aorta replacement. Is she insane? In China, not many can do such surgery. That's right. I was stunned. I only watched this legendary technique in the videos on the Internet. She... I think she's trying to show off. Just wait and see. The operation may not be successful. Don't forget Song Baode still has a trump card. [A. H. J. S Hospital] Director Ye. Director Cui of Neurosurgery Department called our operating room saying that at 3 p.m., a patient needs barbiturate coma and asked if you have time to go there. Okay. Tell him I'll be there on time. OK. Hello, Liu Feng. You want to see me? I'm sure there's nothing good when you want to see me. Yiming, come here. Vice President Liu, what can I do for you? Here. Hey. You've been busy lately, so I'm giving you extra food. If you bring me the fried dishes from the canteen, I would believe you. But this is the sea cucumber with scallion of the restaurant near the entrance of the hospital. There must be something. Tell me. What is it? If you were a girl, I would marry you. The new Director Tang of the Heart Center... Your ex-girlfriend. Everyone in the hospital knows. What's wrong? Look at this. The four male doctors under her have written transfer reports together. They all don't want to team up with her. Cardiac Surgery Department attaches most importance to teamwork. They're trying to take a drastic measure. She's a general without soldiers in Cardiac Surgery Department. I want her to have at least one reliable ally in the operating room. Me? Liu Feng, you know I don't want to get involved in the complex affairs of the hospital. What complex affair? It's a timely assistance. Surgeons cure disease. Anesthetists save life. Surgeons and anesthetists are compatriots. To support her in the operating room, who is more suitable than you? I can't. I can't. What did Liu Feng say about the transfer? It's enough for him for a while. But I have to do Luo Xinran's surgery. The three postoperative complications last time made our team in a mess. This time, we'll use the reporters and promote it. We need to make a comeback. But Liu Feng is supporting her. I hate women who rely on men to get promoted. I'm the disciple of the former director. The legitimate heir. Who doesn't respect the former director in this hospital? But will he give a hand in this with his characters? Whether he will do something depends on me. When I was studying abroad, it was 10 years ago. I met her for the first time at Kermede Medical Center. She was a chief resident at that time. But many people in the hospital already knew her. It's the first time I met such a shining girl. On the operating table, she just conquered me. After I came back, I thought about it calmly. She's more gifted than me and devoted herself to surgery whole-heartedly. A girl like her is not suitable to be a wife. But over the years, I've been watching her progress abroad. I watched her become the surgery star of Kermede Medical Center step by step. That proves I'm right. And I believe if Anhe Heart Center wants to be better, she must be here. So, for the development of the hospital, please help her. You've been talking to me for so long, and it's still for this. Look. I've listened to your story. I didn't eat anything. I have to go to the Neurosurgery Department later. I'm leaving. You owe me a big favor for your father's deed three years ago, right? Have you made up your mind? Are you sure you want to play this card? I have nothing else to play. I have no choice. I'm just an ordinary anesthesiologist. There's nothing I can do. Don’t pretend to be modest. There are people in Anhe who don't like me, but everybody likes you, Ye Yiming. Well, don't reject me in a hurry. Can you think about it? Just think about it. I'm not saying yes. You're the best. Director. What's up? I heard that our Heart Center is going to have a total aorta replacement surgery. Luo Xinran's surgery has been cancelled. What did I say? Don’t underestimate Song Baode’s ability. Jiang Bailie. Have you asked bed 23 to sign the Consent for Operation? It's time to tell the patient to stop eating and drinking before the surgery. Head nurse. I just got the information that the surgery has been cancelled. Cancelled? You all know about the surgery tomorrow morning, right? Yes. It's a big surgery tomorrow. It takes time and energy. Don't stay up late tonight. Rest early, Director Tang. See you in the operating room tomorrow. See you tomorrow. We really don't need to tell her? Why should we? Someone will inform her since she has that background. Director Tang. Head nurse. Do you have time? I have something to tell you. What is it? [A. H. J. S Hospital] It's you. Liu Feng. Do you have anything to tell me? About cancelling the surgery, and the transfer application You knew it all already? If Wu Minmin hadn't told me, I would have been kept in the dark by you like a fool. What did you say to persuade me to come to Anhe Hospital? You said no one would question my qualifications. Why is everything happening now completely different from what you promised? I didn't expect it to be so serious. Even the former director came. How about you don't do the surgery for now? And return the patient to Song Baode's team and make peace. There's a long way to go. Liu Feng, I know that for your career, you have to settle it. But the safety of the patient is also more of a doctor's duty. I don't allow anyone to ruin it. This time, I won't give in. What can I do? I've tried everything I could. Don't forget. I gave up my job of Kermede Medical Center and came back. I can't lose this battle. I need your help. Go ahead. As long as I have the power to do it. To have a public case discussion. Song Baode and I present how to treat this case separately and let the patient choose. Director Tang. Morning. Morning, Director Song. Make the rounds of the wards? I heard you requested a case discussion and let the patient choose between the two? We are colleagues. There is no need to be so furious. There will be more furious things in the future. Get ready. Director, I heard the surgery was cancelled. Look, you didn't tell us in advance. We didn't rest well all night. I've received your transfer applications. Unfortunately, the hospital has its own rules and regulations. It's not up to you. Don't even think about it. Let me make it clear today. As long as I'm still in Anhe, no one can leave this team. You don't accept me now just because I'm new here. And I'm a woman. Also, Song Baode doesn't like me. But I can promise that after I begin working officially, you will have more reasons to hate me. Don't be late for the case discussion. What... What does she mean? Why do you keep provoking her? Can't you just work and go home? While the priest climbs a foot, the devil climbs 10 feet. [Chief Complaint and Present History] Bed 23 has been diagnosed Marfan syndrome for six years. Dissection of aorta type A, total aorta dilation. It needs to do preventive surgery. There are two surgeries. First, we'll replace the main aortic root and replace the aortic valve. At the same time, replace the arch of aorta. In the second stage, we'll replace thoraco-abdominal aorta. This way, the time of each surgery is shorter, and it is safer for the patient. The patient has no pain now. So I suggest the patient to stay in hospital for a few days and get the best condition. That's all. [Patient's Condition] I choose David Operation plus total aorta replacement. Although Luo Xinran has aortic valve lesion, it has not reached the stage of changing it. If the valve of her gets changed, she will need to take anticoagulation pills for the rest of her life, which will affect the patient's future life. David Operation means the doctor repairs the the patient's aortic valve manually to restore it to its original form. How should I put it for the difference of changing and repairing valve? It's like giving someone a screw knife. He can change the old door to a new door. But only skilled craftsmen can repair an old door like a new door. And change the whole aorta at once because there's no need for two surgeries. The patient is young and healthy. She can endure the total aortic replacement surgery. Besides, one operation suits her better. Most importantly, it can save money for the surgery. I've sold my house. As long as I can save my daughter, money is not a problem. Considering the patient's condition has developed rapidly within a year. Around two days, her hands couldn't reach the same height, and her hands cannot have the same strength. I think [Chief Complaint and Present History] she needs surgery as soon as possible. Total aorta replacement is the most difficult surgery in cardiac surgery field. There aren't many doctors who can do such a surgery in China. Dr. Tang, it's not bad to think for the patient and let her recuperate for a few more days. Besides, the patient doesn't have chest pain. Why are you in such a hurry? The dissection of aorta is a time bomb. It may rupture at any time. Once it ruptures, the patient will be in danger. Director Song, you cannot guarantee it won't break, right? Absolutely not 100%. -But... -I'm willing to do total aorta replacement. Xinran. Mom. I want Dr. Tang to be the surgeon. Let's discuss it. -Let's listen to... -The doctor said if I don't get the operation now, it might rupture and have a danger of life. I don't want to be like dad. Then... it's a deal. Vice President Liu, I suggest we do an open surgery and let everyone to learn from Director Tang. Is that okay? I can do a public surgery. No problem. Head nurse, get ready for the surgery for the patient. Okay. Xinran. I'm fine. [Informed Consent] About the risk of the surgery and postoperative complications, I've made myself clear. If you have no objections, please sign over there. Director Tang, my daughter is my only family now. So after she goes into the operating room, you will have more than one life in your hand, but two. I don't know if I can ask... ask... you to make sure she'll be fine. No doctor can guarantee that. It's risky as long as it's surgery. Let alone a heart surgery. I can only say I'll try my best. Director Tang. Director Ye. Is there a problem? Patient's family is worried about the patient. Can you tell them in detail? This operation takes more than 10 hours. It's too torturous for them to be outside. To make her understand this fully, she needs to go to medical school for eight years and be a cardiac surgeon for over 10 years. So, do I have to say that? That's not what I meant. I know what you mean. You're thinking for the patient's family. But I'm not the kind of doctor who is kind and considerate. I'm another kind who keeps the patient alive, and shows my professionalism fully on the operating table. Saving the patient is responsible for them. As for the rest, I don't care. If there's nothing else, I'll get ready for the surgery. Head nurse. Director Ye asked me to come over to call the patient. But the patient of bed 23 is not in the ward. Not in the ward? Yes. Luo Xinran. Why are you here? Sit down. Shouldn't you be in the OR? I chose you to be the surgeon. In return, promise me something. What is it? If my treatment doesn't work, and there is postoperative complication, don't save me. I know you're competing with that old man doctor. So if you don't agree, I won't do the surgery. What old man doctor? Dr. Song. I really hope what you said here can be heard by him. So, can you promise me? Luo Xinran, I believe you know clearly even if I promise you now, when I'm in the OR, I will still do whatever I should do. You will already have anesthesia then. You won't know anything. My dad died of Marfan syndrome due to hemorrhoea caused by rupture of dissection of aorta. He was talking last minute and he was gone in the next minute. I know this disease. Some are paralyzed, and some get amputation and become a vegetable. It is worse than death. But you know what? My mom sold her house to save me. My dad loved her so much. But now, she has to worry about everything. I really don't want to burden her anymore. It's not bad to die on the operating table. Luo Xinran, you're only 16 now. Sixteen. When other kids are 16, they are pretty. And I'm this tall. I can only play volleyball. But I can’t even run now. It's better to die with dignity. Am I right? Don't take what I said not seriously. I'm serious. Please. Don't be afraid. How old are you? Sixteen. Okay. You'll be fine after some sleep. Give the medicine now. Ten mg of muscle relaxant. Ten mg of diazepam. How is the patient? There is venous engorgement of her jugular vein and her face is black. Her blood pressure is dropping very fast. The dissection has ruptured. Build emergent extracorporeal circulation. Circulation, countdown. Hepatitis. Cannulate the femoral artery. Dermatome. The extracorporeal circulation must be built within five minutes. Otherwise, it will cause irreversible damage to the brain of the patient. Hemorrhoea. Suction apparatus. Autotranfusion. [OR Centralized Control System Timer] Two minutes and 40 seconds. Found the bleeding point. Clear it. [OR Centralized Control System Timer] Three minutes and 50 seconds. Open the extracorporeal circulation. Turn it on. The building of extracorporeal circulation is complete. [OR Centralized Control System Timer] Four minutes and 10 seconds. Four minutes. I don't want to burden her anymore. It's not bad to die on the operating table. Let's start the surgery. Anesthetist. Pay attention to brain protection today. Pay attention to postoperative complications. Got it. Allis. Therapeutic icecap. Give me 26 four branches aortic graft. Sew it up. Anesthetist. Check the ultrasound. One point eight of back flow. One point eight? No problem. Such a small back flow can lead a normal life. It's an ideal result. I'm this tall. I can only play volleyball. But now, I can't even run. She can't run if there's back flow? Director Tang, what did you say? She can't play volleyball anymore. I have to keep the running for her. I want to repair the valve the second time and try to reduce the back flow. No, when we were repairing the valve, her lesion area was found to be much bigger than the CT scan before the surgery. And there's no place to inject the needle now. Besides, the patient can't endure extracorporeal circulation now. Yes, for such a big surgery, it's not bad now. Can... Can we not make it more exquisite? Yes, I agree with Qin. Don't talk. The main surgeon is trying to find a way. Don't stop the pounding of the heart. I will try to repair its shape from outside the aorta. How? The intravascular space of aorta is round. If the perimeter is the same, circle has the largest area. As long as the needle replenishes it from outside, and change the intravascular space to non-circle shape, and reduce the intravascular space, there is possibility the aortic valves can combine. Double-ended needle, four zero thread. Now？ It fits together almost perfectly. Back flow, 0.2. There is a saying in surgical field. A top surgeon has a brain on his fingers. Before stitching, the brain has pictured what the organs may look like after the restoration and can find the exact location. Director, the patient is awake and her condition is good. They say what surgeons fear most is hunger. It's actually dehydration. It's so hard to bear. Here. Thank you, Director. Director, can I ask you a question? Go ahead. Luo Xinran only has symptoms of arms. How did you know it's acute? Have a seat. Any abnormality found in the patient it's a distress signal from the body. I read all the cases after Luo Xinran. Her condition is very special. She's not getting worse gradually, but suddenly in some points. She's so young and has developed total aortic dilation. I guess her hand symptom should be the start of another round of deterioration. And few patients will experience painless acute period like her. Is that why you insist on getting the surgery as soon as possible? There are no minor things in aorta. Although I'm not 100% sure, I dare not take the risk. Director, I want to apologize to you. Yesterday, I told Director Song, so the surgery was suspended. I almost killed the patient. Because you didn't know she had an acute seizure. I thought you just came to the hospital. You just want to prove yourself in a short time. But today in the operating room, I realized that you're really amazing. I can teach you in the future. Thank you, Director. [Long Xiangdong: Go to Science brewery for some beer.] Director. every time after our big operation, we'll go to Science. SCI can be used for discounts there. Why don't you come with us today? I'm not going. I have something to do later. Hello, Director Tang. Director Tang. I'll be alone with the patient for a while. The surgery went well. But there are some difficulties in the recovery after surgery. They are all very difficult. Without tenacious desire to survive, you might not be able to get through it. My surgery will be in vain. So I'm here to tell you a secret. When I was eight, my father died of heart disease. I was the only one by his side when he died. So at that time, I knew no one can leave with dignity. Later, I became a doctor and I saved one after another. Many people also died on my operating table. But none of them is worthless. Whether he's ugly or pretty, smart or stupid, rich or poor, everyone who exists in this world has a meaning. You are the only daughter of your mother. Your life is even more important than her own life. So, Luo Xinran, I want to tell you everyone only has one life. So no matter what difficulties you face, you shouldn't give up easily. Understand? Thank you. [Ye Yiming] [OK] Yes! [Severe Cases Team Office] This height is just right. Pin it. Head nurse. Director. Are you changing the plate? Yes. According to Vice President Liu, your medical team has been named Severe Cases Team. By the way, Vice President Liu is waiting for you in the office. Got it. Come in. Song Baode finally moved his looking-good books away. I hope he can stop from now on. What do you want? [Great Doctors Are Pure And Sincere] There's a technology which has been developing abroad for many years. But it's completely blank in clinical trials in China. I asked you to come back to let you lead the R&D and make clinical trials for the full intellectual property. CH-VAD. What do you think? [Dr. Tang-Bonus Scene] [Marfan syndrome] [Wei Daxun as Ye Yiming] Marfan syndrome is a genetic disease. People with this disease are very tall and tend to have longer arms and legs than normal people. Archeologists used to find the fingers of a pharaoh abnormally long on the painting of ancient Egypt. They presumed that he might have Marfan syndrome. Marfan syndrome's most fatal lesion can happen in cardiovascular system, and aortic aneurysm and dissection of aorta are the most common. For example, the famous US volleyball athlete Hyman died suddenly on the sports field due to the rupture of dissection of aorta resulted from Marfan syndrome.
