I, Tomoya Aki, am not a bootlicker

Therefore, since experience is needed, there must be a need for the opportunity to perform surgery.

If their instructor cannot be arranged at the moment, they will look for other doctors.

The two people who kept their eyes on Aki Tomoya actually saw the effort Yoshida Aoba put into training him.

Aki Tomoya has the opportunity to perform surgery, which means that Yoshida Aoba will arrange one operation for him after another, and he will not need to worry about the basic work that was originally his, and can leave it to the rotating resident trainees.

Talking about status, in fact, if nothing unexpected happens, these three people are more responsible for the basic work in the department. They have to do everything, and they will be called when there is an operation that can be participated.

Similarly, Akitomo knew that there were some things he could not agree to, so he passed the ball to Yoshida Aoba.

If Majima and Nishikino want to rely on their relationship to get more opportunities for surgery, Aki Tomo can also say a few good words to Yoshida Aoba, but it would be a different matter if Aki Tomo also agreed.

The one who can make the decision is actually Yoshida Aoba.

After finding out what was going on from Tomoya Aki, the two of them also understood that if they really wanted to get more surgical opportunities with the help of Tomoya Aki, they had to find a breakthrough from Aoba Yoshida.

After all, Tomoya Aki has not completely secured his position as the lead surgeon.

It is still unknown what kind of surgery Yoshida Aoba will arrange for him later.

"Doctor Nishikino, I will mention something to Doctor Yoshida about your side. You don't have to be afraid of Doctor Yoshida, just go and talk to him directly."

"An Yi, why don't you say something good for me?"

Perhaps sensing that he was being treated differently, Majima asked with some dissatisfaction.

However, Aki Tomoya just gave him a cold look.

After all, they both slept in the same place with Yoshida Aoba for two years. How could their relationship be the same?

If it weren't for the fact that Nishikino really didn't have much contact with Yoshida Aoba, Aki Tomoya would have just let her speak on her own.

"Thank you very much. I will apply to Dr. Yoshida."

When Nishikino Maki heard that Aki Tomoya was willing to speak for her, she nodded happily.

As for Majima, there shouldn't be any problem if he goes and talks to him himself.

But there is one thing that Aki Tomoya is still a little worried about.

"By the way, you're looking for more surgical opportunities from my supervising doctor. Does that count as treason?"

To be honest, Tomoya Aki was still a little worried about the thoughts of the supervising doctors there.

He still knew about Dr. Nakagawa and Dr. Sagara.

One is mainly responsible for adults, and the other is mainly responsible for children. They got along pretty well when they were rotating before.

But what these two people are doing now is equivalent to the behavior of traitors, and I don’t know what they will think.

Don't make them angry, that would be bad.

Aki Tomoya was still a little worried about them.

"Dr. Nakagawa will understand."

"As for me, it was Doctor Sagara who suggested it to me. For his surgeries, the surgical team members are basically arranged by Doctor Sasaki. Who can go in has to get Doctor Sasaki's approval."

The arrangement of the surgical team requires not only technology but also the tacit understanding among the personnel.

The surgical plan needs the director's approval, and who will go is also arranged by the higher-ups based on the situation. It's not that you can just do the surgery with whomever you want. In order to ensure the success rate of the operation, many aspects need to be considered.

The main reason why Tomoya Aki was able to stay in the surgical team with Yoshida Aoba was that Yoshida Aoba was Director Mononobe's favorite disciple.

Moreover, in addition to being an academic, Yoshida Aoba is also an excellent cardiac surgeon. Surgery is not unfamiliar to him, but rather very familiar to him.

So as long as there are no problems in other aspects, it won't affect anything if Aki Tomoya stays by his side and acts as an assistant.

In terms of the right to speak, Yoshida Aoba still has enough say in cardiac surgery.

Director Mononobe is the first in status, but he delegates power to Sasaki Ichiru, so Sasaki Ichiru is nominally second, but in fact he is almost the same as the first.

The third person is Yoshida Aoba, who used to help Director Monobe with basic research in college.

Whether it is Sasaki Ichiru or Yoshida Aoba, even if they did not come to Kanto General Hospital, they could be hired as professors in other university hospitals, and it would not be a problem for them to become the chief professor of a department.

Their qualifications and skills are indeed sufficient.

So from this point of view, it is also important to follow the right people.

As for whether Yoshida Aoba would agree to accept the two of them, it was not something that Akitomo could interfere with.

But he is a good man, and if he feels soft-hearted, he will nod accidentally.

Because of this incident, after they talked about it afterwards, Yoshida Aoba also talked to him alone.

"Doctor An Yi, you are such a good person!"

"You are the good man, Dr. Yoshida!"

Looking at Yoshida Aoba's expression, Akitomo knew how conflicted he was.

Strictly speaking, Tomoya Aki is his disciple, so he can train him without any worries.

But Majima and Nishikino are different, and they still have to consider the feelings of their supervising doctors.

They came to him directly and asked for his help so that they could have the opportunity to join their surgical team in the future, which gave Yoshida Aoba a headache.

Do you think he's some kind of good-for-nothing?

"Dr. Yoshida, what do you think?"

"Let me test the waters first!"

Build a young team?

It’s not that it’s impossible, but we need to see the situation first.

Chapter 482 What do you think?

The requests from Majima and Nishikino were a bit troublesome for Yoshida Aoba.

But he also had some ideas.

It is not impossible to build a young team around Tomoya Aki, and at the same time discuss with Nakagawa and Sagara to jointly train these three good young people.

But if that were the case, he would be under a lot of pressure.

Because if he brought it up, those two people would definitely not have the time to help him.

Big head...

Let’s take a look at the situation first.

……

"This is my VIP patient, Mrs. Omi, the wife of the big boss in Chiba."

Sasaki Ichiru agreed that Akitomo could perform the surgery as the lead surgeon, but he did not immediately arrange for him to perform the first surgery as the lead surgeon.

However, a few days later, Yoshida Aoba took him to meet a VIP.

She was a 65-year-old woman who lived in the best single room in the hospital. She had a special person to take care of her. She was obviously from a wealthy family.

For a VIP like this, everything must be arranged well in advance unless there are any unexpected events.

But Yoshida Aoba was not good at pleasing such noble people.

A patient is a patient, no matter who they are, they are all the same in his eyes.

Therefore, it is not the first time that I have encountered some people with strange tempers and have been involved in medical lawsuits.

He has offended many people.

There is someone who can be used right now, and Tomoya Aki is a young and handsome guy. Yoshida Aoba feels that Mrs. Omi should like a young and handsome guy like Tomoya Aki more than an old man like him.

So even though he is Mrs. Omi's attending physician, all the polite things can be done by just letting Aki Tomoya.

In response, Akitomo could only say: "This is a hospital, not a gigolo parlor."

"I know. I asked you to read the report."

Yoshida Aoba smiled bitterly, touched his nose and pushed the patient's report in front of Aki Tomoya.

A 65-year-old female was hospitalized because of chest tightness, shortness of breath after activity, and inability to lie flat at night for a month.

In the past medical history, he had undergone left-sided closed mitral valvuloplasty due to rheumatic heart disease and mitral stenosis twenty years ago.

A few years ago, it was the same reason, but with a new symptom - aortic stenosis with closure.

Incomplete, I underwent a mitral valve and aortic valve replacement.

I have had two surgeries and was hospitalized again this time. The situation seems a bit complicated.

"Rheumatic heart disease, after mitral valve and aortic valve replacement, mitral stenosis with regurgitation, aortic stenosis, tricuspid regurgitation, pulmonary hypertension, heart function level III to IV, hypertension level II..."

According to the diagnosis report and looking at the past medical history, if there are no accidents this time, he will definitely need surgery again.

"It must be a double valve replacement. Are you interested?"

Yoshida Aoba looked at Aki Tomoya who was reading the report carefully and asked him what he thought about the operation.

Aki Tomoya raised his head, a thought flashing in his eyes.

He looked at Yoshida Aoba with some surprise.

This time the patient is a VIP. Is Yoshida Aoba so confident in handing over the surgery to him?

An Yilun didn't think too much about it, but said with some expectation: "No problem!"

"Don't be so confident. How long have you been in contact with this patient? You say there is no problem. This patient is still a VIP of our cardiac surgery department. If something goes wrong... Do you understand?"

Yoshida Aoba looked at Aki Tomoya helplessly.

That’s why young people are so confident.

But being so confident is not a good thing. If anything unexpected happens, Akitomo will be in big trouble.

"I know, but Dr. Yoshida, if you let me perform the VIP surgery, will Dr. Sasaki agree?"

If it was just an ordinary patient, it would be fine, but this time the patient was a VIP, and...

Aki Tomoya glanced at Mrs. Omi's medical history, about her two operations, the surgical procedures used during the operations, and other details...

The last surgery was five years ago, and five years later he was admitted to the hospital again to prepare for surgery. Replacing the double valves again was not that simple, and there was another problem.

Taking into account the patient's specific situation, he put himself in the surgeon's position and thought about how to perform the operation. At the same time, he didn't know whether Sasaki Kazuru would be willing to let him perform the operation.

Even he could see the problem, and Akitomo didn't believe that Yoshida Aoba didn't know about it. And would Sasaki Ichiru really trust him to perform the surgery?

"Tell me first, what do you think? What do you think?"

Yoshida Aoba did not promise that Aki Tomoya would be the surgeon, but first made sure whether Aki Tomoya had an idea about the operation.

"Mrs. Omi had her first surgery 20 years ago, and the second one five years ago. The first one was a left-sided closed mitral valve dialysis, and the second one was a mitral valve and aortic valve replacement..."

This was her experience of two surgeries, and Akitomo specifically mentioned this.

His focus is on the second surgery which is the closest.

"Due to my age and actual situation, a biological valve was used in the second replacement surgery."

Bioprosthetic valves are suitable for some patients over 60 years old and patients with contraindications to anticoagulation, and their life expectancy is also shorter than that of mechanical valves.

At that time, according to the patient's specific situation, a biological valve was used for replacement.

"But there is a problem. During the operation five years ago, the mitral valve was replaced with a No. 27 bioprosthesis. Because of the small aortic valve ring, only a No. 19 bioprosthesis could be replaced. Then, in the review report four years ago, the average mitral valve pressure difference was 4 mmHg, and the aortic valve peak pressure difference was 38 mmHg..."

"In the follow-up examination two years ago, the average mitral valve pressure gradient was 3.5 mmHg, and the aortic valve peak pressure gradient was 65 mmHg..."

"After this hospitalization, the examination report showed that the average mitral valve pressure gradient was 10.6 mm Hg, moderate to severe mitral valve regurgitation, the aortic valve peak pressure gradient was 71 mm Hg, and moderate tricuspid valve regurgitation..."

"The peak pressure gradient of the aortic valve is increasing year by year. Initially, we think that the aortic valve needs to be replaced with a larger bioprosthesis."

Until this hospitalization examination, Akitomo discovered that the peak pressure difference of the aortic valve had been increasing significantly year by year.

Taking this into consideration, Akitomo Yamada suggested implanting a larger artificial valve.

"But what if there's a mismatch and complications arise?"

Yoshida Aoba asked expressionlessly.

"Aortic curtain reconstruction and expansion!"

Amano Tomoya expressed his thoughts without hesitation.