The Godfather of Surgery

International Space Station, US module.

Steven had just finished his fitness workout. He had been running for an hour on a combined weight-bearing external resistance treadmill and did some other resistance training.

In a microgravity environment, it is easy to cause muscle atrophy and bone calcium loss. If you can't maintain a certain amount of physical exercise, this phenomenon will be more serious.

After returning to Earth, they will be unable to walk due to muscle atrophy, and will be prone to fractures due to osteoporosis.

Steven wiped off his sweat, swam his light body, and returned to the living cabin, where various utensils were hung on the bulkhead.

He checked the air pressure in the cabin, and there was no abnormality. Not long ago, there was a leak in the Russian cabin, which lost 220g of air every day. It took the magical Russians a month to finally find the leak, a breach of only 1 mm. They used Taped to seal off, then said to sit back and relax.

If it was Steven, he would definitely go on a spacewalk and weld and seal it outside the vehicle, otherwise it would be difficult to sleep peacefully.

Partner David Hawley is still watching the Earth in the turret observation module. He likes photography. He always likes to take pictures inside and outside the capsule, and then select some high-quality photos to post on Facebook.

David Hawley is in love, he just wants to use these pictures to attract the girl.

Looking from the inside of the cabin, there is no doubt that the dome cabin with seven observation cabins - the turret, is the best choice.

Steven opened his laptop and began to select photos. These were taken by the camera outside the space station. He promised his daughter to accumulate photos of different areas of the earth, and the photos must be taken by the outside camera, so as not to be separated by a layer of transparent windows. .

Every time this time, Steven is the most relaxed. He has completed a day's scientific research tasks and done some personal things for his daughter. He is proud of it.

Time for a video call with his wife, the International Space Station, with the help of three communication satellites, can connect to the Internet, not only to communicate with the ground control center in Houston, but also to make video calls with family members, check the web, browse the news, send Tweet, Facebook.

Darling, I just came back from the supermarket, you see, my daughter is going to fill the refrigerator with all the fruits you like. I told her to wait, there are 20 days left, don't worry, she doesn't listen at all. My wife was busy, and she had the camera pointed at her.

Steven's wife, a teacher at an elementary school in Houston, was cooking dinner with steaks, salads, and juices on the table.

My dear, we can meet in twenty days.

We're waiting for you, my dear. It's been like a year. I saw the news on NASA's official website. Twenty days later, a Dragon spacecraft will be launched at the Kennedy Space Center, and you will complete the rotation.

Dad, Daddy! the voice of the eight-year-old daughter.

Slow down, baby, what are you doing? Steven saw the funny daughter, wearing film gloves, covered with cheese-like things on her face, hands, and clothes.

I'm making a salad. When you come back, I'll make a plate of fruit salad for you. The daughter danced with excitement.

She's learning to make fruit salad, look at her face, that's what she paid for you. The wife carefully wiped her daughter's cat face with a wet towel.

Dad, remember to help me save a set of photos. I promised my classmates, one for each, and your signature. I must be a person who keeps my word. The daughter reminds me every time.

I'm picking, and it will be sent to your mailbox in a few days. Steven has picked almost the same.

She has prepared a speech topic - looking at the earth from space, she speaks to our cat every day, and now I need your photo as a material. The wife touched her daughter's face.

Thank you Dad! Let's talk, I'll go to my room to hide now, and give you fifteen minutes. The daughter said goodbye to Steven and hid in her room.

The wife is facing the camera: Dear, really, I miss you and worry about you very much. Every day we use the astronomical telescope to observe the sky out of the window, hoping that you will fly over our heads. Red pen marks your elapsed time, are you—how are you?

It's hard work, dear, I'm fine, how are you?

Well, I'm fine too. Linker wants to learn to surf, but I can't. She's waiting for you to come back.

The door secretly opened a crack, and Linker looked at the parents who were video chatting through the crack of the door.

——

The Johnson Aviation Center, the administrative offices in Building 1, has its lights on.

Members of the medical team and specially-appointed experts from all over the world are having heated discussions.

The discussion ran from 3pm to 7pm, and it wasn't over yet.

Our core problem has been clarified. The reason for Steven's heart rate slowing is unknown. Will this unknown reason affect his return to Earth? Once he can return to the ground, everything will be solved. Collins came up with a clue.

Yes, you have found the focus. I stand by my opinion and do not rule out tumors in the brain stem or other lesions.

Everyone, I was in China not long ago and saw a patient in his 70s with a brain stem medulla tumor. The first symptoms were slowed heart rate and breathing.

I mean, if the lesion affects the heartbeat center, it can cause the heart rate to slow down, and if the lesion affects the respiratory center, it can cause the breathing to slow down.

I suspect that some kind of disease is affecting Steven's heartbeat center, the probability is very low, one in a thousand, but we can't gamble, I suggest that we can't return to Earth until it is clear. If it is a vascular malformation, the spacecraft enters the atmosphere. , falling at a high speed, the blood vessel ruptures, and there is no doubt of death.

Johanneson stood up and made his point in an agitated tone.

Dr. Eugene also stood up: Judging from the current color Doppler ultrasound results, there is no problem with the heart, and the blood sample I brought back last time did not find any abnormality, but I want to contact Steven and personally instruct him to do it again. Heart ultrasound, the state of human health is dynamic, and previous examinations cannot explain everything.”

When the meeting is over, we will contact Steven to do a heart ultrasound again.

Collins agreed with Dr. Eugene that the doctors on the medical team were not far behind the Johns Hopkins professor of cardiovascular medicine in their ability to discriminate the ultrasound images.

At the same time, I support Professor Johanneson. Without figuring out the reason, rushing back to the voyage is undoubtedly gambling on Steven's life. Eugene added in a serious tone.

Other experts also agreed with the two professors that whether it is a heart or intracranial disease, the cause must be figured out and the risk of returning home must be assessed.

Our opinion is now very unified, and we must further examine to find out the cause and rule out some fatal diseases. Collins concluded.

Johanneson was straightforward: Yes, a cerebral angiogram must be done, it's not realistic to do an intracranial CT or MRI, but as long as a cerebral angiogram is available, I can at least do a basic risk assessment. Dr. Eugene, I'm afraid I'll take you Dr. Massimo from the hospital brought in Houston.

Eugene also thought of this: I'll contact, Collins, you contact our hospital in the name of NASA.

Massimo, the genius interventional doctor, since he was going to do whole cerebral vascular DSA, how could he not be there.

No problem, I'll contact Johns Hopkins as soon as possible, but we don't have iodine contrast in our medicine cabinet, and the simple X-ray machine on the space station can't trust digital subtraction angiography. Collins knows the medicine box in the US cabin of the International Space Station well .

He looked at the Russian doctor in the medical team, and the Russian doctor also said that he could not help: Unfortunately, although we have 18 medicine cabinets, we do not have iodine contrast agent.

The Russians sent over an up-to-date medicine booklet, and Collins opened it.

As early as 50 years ago, when human beings first entered space, astronauts had the habit of carrying a medicine box into space, but what should be contained in this small medicine box was immature at that time.

As the number of spaceflights increased and the knowledge of space medicine advanced, this list of medicines became more and more mature.

In order to cope with the health accidents of astronauts, the International Space Station has a large variety of medicines. The medical team has compiled a list of medicine names based on the list of injuries and diseases that may occur during the stay on the space station.

In addition to medicines, the space station has some medical equipment: a small electrocardiograph, a pulse meter, a blood pressure monitor, a stethoscope, and basic CPR equipment.

The spacecraft that travel between the space station and the ground only fly once every two or three months.

If the astronaut has urgently needed medicine, the medicine chest is not available at this time.

The ground staff should prepare the amount of medicines that may be needed to send the spacecraft into space.

Due to the limitation of the spacecraft's load, the delivery of drugs should be carefully selected, and the broad-spectrum mature drugs should be selected as much as possible.

The American module of the International Space Station has nine medicine cabinets, but no iodine contrast agent, because no one would have thought that astronauts in the sky would have to undergo angiography.

Collins rubbed his temples: If this is the case - I have to report, which requires a spaceship launch in advance to deliver medicines and instruments, and Susan to be sent up.

Collins decided that it had to be reported, that this issue was not something that could be resolved by the medical team and should be decided by the Director of NASA.

The medical training received by the astronauts is very limited, all of which are basic treatment and first aid. Completing a cerebral angiography must be done by a more professional person. This person is Susan.

She is not only an astronaut, but also a surgeon, with professional medical literacy, and can perform some basic operations independently.

Collins looked up, and the pain in his cervical spine made him feel heavy: Do you have any other opinions? Now that the situation is going to escalate, if it must be done? Arrange a special flight to send Susan and medicine to the space station.

For one launch, the minimum cost is more than $100 million based on the load of two people.

That's Musk's price. In the past, the average cost per launch in the U.S. was $450 million.

The two engineers who attended the meeting reminded everyone if there are other better ways.

This is Mr. Secretary's math problem. Our problem is how to make the risk of one thousandth to zero.

Johanneson said seriously, considering the monetary cost in the face of human life, it is contempt for life.

The words of the two engineers aroused the hostility of all the doctors, they immediately shut up, and they appeared at the venue just to answer the doctor's possible questions about space station engineering.

Yes, this question is left to Mr. Jim Bassa, maybe he can lower the price with Mr. Musk.

I will prepare a report tonight to report to the chief medical officer and the director of the Washington headquarters, requesting an additional courier to deliver Susan and medicine for us, gentlemen, sorry, hard work everyone, we will go to the ground immediately The control center, connect with Steven, do another color Doppler ultrasound examination, and finally, we have to make a detailed plan together, such as the list of medicines and equipment for express delivery, whether Susan needs to undergo intensive training, and only work fast food for dinner Solved, I'm very sorry. Collins ended the meeting and immediately took everyone to another building - the ground control center.

There are eight staff members at work, all staring at the screen.

The ground control center implements a shift system, every nine hours, to ensure that there are seven or eight staff members on duty 24 hours a day.

Emergency medical call, call Steven, now! Collins told the shift leader.

Connect Steven! the team leader commanded loudly.

The communications staff immediately connected to the space station's video system.

After several calls, Steven's face appeared on the screen.

Hello everyone, I'm Steven, I'm fine, what happened, Collins, your team seems to be here? Steven greeted.

Collins kept smiling: Don't worry, we just had a meeting about your heart rate slowing down, and now Dr. Eugene needs to instruct you to re-do an ultrasound. Do you need help from David Hawley?

No, no, I can do it myself, I don't feel any discomfort, I finished an hour-long run today, I don't think I have a problem, either you guys are wrong, or the instrument is wrong, in short, it's not my fault.

Steven moved his body and started to open a storage box, and pulled out the color ultrasound machine from it.

From now on, you have to stop exercising. Dr. Eugene admonished Steven.

The reason has not been found. In case of myocardial problems, exercise increases the load on the heart, which will cause arrhythmia, with disastrous consequences.

Johns Hopkins, Dr. Eugene, cardiovascular medicine specialist. Collins introduced.

Steven straightened out the wires and turned on the switch: Although I am extremely opposed to your words, I will listen to your opinion, because you are a doctor, can you start?

Okay. The staff in charge of communication adjusted the screen, and the color Doppler image of the space station was synchronized with the screen in front of him.

Okay, you can do the heart ultrasound again according to the steps. Collins ordered.

Dr. Eugene and everyone gathered in front of the communication screen, looking at the image frame of the color Doppler ultrasound.

Left and right ventricle, left and right atrium, various valves, aorta, vena cava, pulmonary artery, pulmonary vein——

Dr. Eugene looked closely at the ultrasound image of the beating heart, and he asked Steven to repeat it a few times.

There is no problem!

Do you have any discomfort? For example, chest discomfort, lack of oxygen, general weakness, lack of exercise ability? This is related to your return flight. Dr. Eugene was still worried.

No, I don't have any discomfort. Steven was optimistic and didn't think he had a problem.

Headache, dizziness, muscle incoordination, what's wrong with Renheyi? Johanneson asked.

No, if I can, I want to challenge Tyson.

Okay, have a good rest, and feel free to contact us if you have any questions.

Dr. Eugene couldn't see anything wrong with the echocardiogram.

Can only wait for the next inspection.

Two chapters together, more than 4,000 words, thank you!