Cen Meng smirked. "Let's give him some fun!"
Chief Surgeon Liu nodded in satisfaction and asked, "What about the other one?"
"Thirty-two-year-old male, 168 centimeters, 112.5 kilograms."
It was a simple introduction, but every surgeon understood the meaning behind it.
A subcutaneous adipose layer approximately ten centimeters thick was enough to be one of the biggest obstacles of an appendectomy. The general surgery department usually called this sort of case 'well drilling'.
Apart from its intense difficulty, the patient would have an increased risk of complications such as fat liquefaction of the post-surgical incision. Thus, no one would willingly accept such a case, and anyone who did would treat the patient as conservatively as possible.
Chief Surgeon Liu was content with the appendicitis cases today and a smile finally appear on his face. "Very good."
The compliment exhilarated Cen Meng, who figured all his hard work had been worth it if he got Chief Surgeon Liu's approval.
"Protect the patients at all costs and prepare to take over the operations at any time. Also, ask Chief Surgeon Su from the obstetrics department to come and consult them. We need to ensure their safety and prevent any intraoperative accidents."
Conspiracies and schemes between doctors were usually simple and ethical. Hardly any doctor would have the heart to exchange a patient's life for their own success.
Even though a medical dispute involving iatrogenic death would send a doctor straight to the pits of hell, few doctors would resort to setting up such an unethical scheme. Perhaps this was why no one had clawed their way to the peak of the medical world after all these years.
"Don't worry, I've made the necessary arrangements. I've sent someone for Chief Surgeon Su and they should both arrive very soon."
Chief Surgeon Liu was grateful to have such a competent chief resident to save him so much trouble.
He tapped Cen Meng's shoulder gently and returned to the surgical demonstration classroom confidently with his hands on the man's back.
…
Zheng Ren and Xie Yiren returned to the hospital as fast as they could. Neither of them cared about their unfinished supper, it was the 'night of the appendix' they were having that had them bouncing off the walls.
The restaurant was not far from the hospital, so as soon as they arrived, the nurse on duty informed Zheng Ren that the patient had been transferred from elsewhere to Sea City General Hospital via ambulance and was currently in the first general surgery department.
Zheng Ren and Xie Yiren rushed to the inpatient building without a second thought.
Incidentally, at the main entrance of the inpatient department, Zheng Ren passed the elderly lady from earlier who had tinnitus and dizziness.
The elderly lady's son's expression darkened instantly upon noticing Zheng Ren.
As he passed by, the man snarked, unintentionally or not. "What a lousy doctor."
"Huh?" Zheng Ren noticed them both, whom he had referred to the oral surgery department for the removal of a denture, only after hearing the man's hostile voice.
"You didn't get a tooth extraction?" asked Zheng Ren.
The middle-aged man lost his composure and started complaining aggressively. "The doctor from the oral surgery department said that wasn't the case at all. Do you even know how to diagnose a patient? Did you think it was fun to mess around with us in the middle of the night?"
Helplessly, Zheng Ren could only smile bitterly and spread his hands in response.
The keening wail of an ambulance siren approached the hospital.
Zheng Ren was not an oral surgeon, nor could he force the patient to extract a tooth. Unable to do anything else, he explained, "Truth be told, this is a rare condition. You can go to Peking University Third Hospital if you've the chance. They've better knowledge of oral medicine and surgery."
Zheng Ren and Xie Yiren then darted to the first general surgery department.
Cen Meng, who was standing by at its corridor, started mocking as soon as he saw them.
"Chief Zheng, you've become more impressive after working in the emergency department."
"Chief Cen, don't make fun of me," replied Zheng Ren; he had no d.e.s.i.r.e to start an argument with the chief resident. The only thing on his mind at the moment was to finish ten perfect appendectomies as soon as possible.
Cen Meng sneered upon seeing Zheng Ren's usual 'cowardice'. He then approached Zheng Ren and patted his shoulder gently, just like Chief Surgeon Liu normally did. "Chief Zheng, I'll give you my full support even when you're in the emergency department. Let me know if you can't perform the surgery later. I'll do it for you."
"Thank you, Chief Cen." Zheng Ren smiled in response, but failed to detect the murderous aura radiating from Cen Meng's soul.
Cen Meng snickered and thought, 'Enjoy your triumph and pride while you still can. The acute appendicitis and pregnancy case will bring you straight to hell later.'
However, he made no attempt to inform Zheng Ren in advance, and looked forward to seeing Zheng Ren's face when the upstart surgeon finally realized the patient was twenty-eight weeks pregnant.
Both men's expressions turned serious as the transport stretcher trolley's wheels rolled across the marble floor.
Spotting them, a rural medical escort running ahead of the stretcher trolley said, "The patient is here."
He let out a sigh of relief.
"What's the situation?" Despite being slow and woozy at the moment, Zheng Ren detected something fishy about this one.
"Acute appendicitis in pregnancy. Twenty-eight weeks of gestation with symptoms of potential miscarriage due to abdominal ache," explained the escort.
Soon, Zheng Ren saw the patient with her distended abdomen being wheeled into the department.
Hiss…
What a tricky case!
Acute appendicitis in pregnancy was uncommon and its current appearance in Sea City General Hospital had taken him aback.
Well, to operate or not to operate… That was the question.
It was a question that would stump even a chief surgeon of any department.
"Doctor, please save my child," pleaded an anxious young man in his twenties, who had followed the stretcher trolley into the first general surgery department.
"Are you the patient's family?" asked Zheng Ren.
"I'm her husband. Doctor, please save my child," replied the young man as he held onto Zheng Ren's arm.
Xie Yiren frowned in disgust at the young man, who clearly cared only for the safety of his unborn child without a word about his pregnant wife; she hid in the office to stop herself from berating the irresponsible husband.
This sort of situation happened in hospitals nearly every day.
Since nothing could be done, it was better to simply escape.
Cen Meng approached Zheng Ren, who did not have that luxury to escape, and said with a wide grin, "Chief Zheng, the case is yours. Don't forget to ask for my help if you need anything."
Chapter 20 - You’ll Pay for the Baby’s Life If You Can’t Save The Him
Zheng Ren ignored the hostility in Cen Meng's words and pushed the transport stretcher trolley into a treatment room.
After reading through the patient's details and various investigative reports in the upper right corner of his vision, Zheng Ren came to a conclusion—it was troublesome!
Even so, he performed a simple physical examination on the patient not to confirm the diagnosis, but to locate the most ideal location for an incision.
The patient was a nineteen-year-old female at twenty-eight weeks of gestation with mild v.a.g.i.n.a.l bleeding and tenderness at the right umbilical region of the abdomen. No rebound tenderness or muscle guarding were noted.
Her acute appendicitis was relatively mild, but she had other, more serious issues that complicated surgical treatment.
He sent someone to invite the chief resident of the obstetrics department to consult this patient while ven
ous catheterization was being done. This was a complicated case and he desperately needed some luck in order to complete the surgery perfectly.
The obstetrics department chief resident was soon at the first general surgery department. This was an emergency that involved two precious lives, so the sense of urgency was felt by all.
Zheng Ren invited the patient's family members to the office for preoperative informed consent as the chief resident examined the patient.
"Clear evidence of the risk of miscarriage. The precipitating factor, an inflamed appendix, needs to be dealt with as soon as possible to save the fetus," said the obstetrics chief resident.
"Will the surgery affect the baby?" asked a middle-aged man anxiously.
Zheng Ren felt helpless. In the family's opinion, the child was of utmost importance, but what about the pregnant woman? Perhaps medical personnel were the only people empathizing with her.
Clearly, none of these people gave a damn if the pregnant woman died during the surgery, as if she was merely a disposable childbearing machine for them.
Zheng Ren tried to comfort the man. "Usually, no."
However, a middle-aged woman slumped against the wall and began to wail after hearing Zheng Ren's answer.
It was a dry wail.
She was also mumbling something incomprehensible.
Zheng Ren, who had no intention of humoring her insincere theatrics, hardened his expression and asked every family member, except for the decision-makers, to leave the office immediately. Those who wanted to cry could do so outside and those who were needed to deal with procedure would proceed as planned.
Irresolution would be unacceptable as it would delay the patient's treatment.
The patient was his primary concern. Her family members had no direct relation to him in any aspect and were ultimately irrelevant.
After the office regained its peace and quiet, Zheng Ren earnestly began explaining everything regarding the surgery to the patient's husband, parents and in-laws.
Whenever Zheng Ren clarified a procedure, the patient's husband and in-laws would inquire about the baby's safety without giving the slightest concern for her. Meanwhile, the patient's parents merely stood in one corner of the room with dark expressions and sealed lips.
Sea City General Hospital had the best medical facilities in the area and the patient required surgery to save the fetus. This was the best chance they had to save the baby.
However, the family members were unwilling to sign the informed consent doc.u.ments and wanted to shirk their responsibility.
Vexed, Zheng Ren rebuked them, "Do you still want to save the baby?!"
Finally, one of the family members reluctantly signed the informed consent doc.u.ments under the threat of the fetus' demise and Zheng Ren's smoldering gaze.
The hospitalization procedure had completed at the same time. Zheng Ren then provided them some medical advice and contacted the operating theater before changing into surgical attire.
Normal people encountering such apathetic family members would feel cold and hopeless, even scrub nurses like Xie Yiren and medical personnel who did not have much contact with the patients' family.
However, Zheng Ren had seen too many cases like this in his career and had adapted to the harshness of reality.
He could not guarantee the safety of the fetus. In fact, the a.d.u.l.t's well-being was the main priority on his list.
The fetus or the a.d.u.l.t… Was it a tough choice?
Their future… Well, that was none of his concern, right?
He pondered the patient's surgical site and the best location for an incision as he walked toward the operating theater.
Every case of acute appendicitis during pregnancy had an inflamed appendix in an ectopic position due to compression by the gravid uterus. It was much more complicated than the misdiagnosed acute appendicitis with an ectopic appendix this afternoon.
Right after Zheng Ren had changed into surgical attire, the anesthesiologist on duty angrily pushed open the door, causing a loud bang as it hit the wall.
He roared at Zheng Ren, "How did you inform the patient's family members just now? They didn't even agree to general anesthesia. Talk to them again."
"..." Zheng Ren was dumbfounded.
They did not even want general anesthesia? What the hell was going on? Were they expecting the patient to go through agonizing pain throughout the entire surgery?
Were they here to cause trouble or seek treatment?
Zheng Ren, wearing his surgical gown, put on a white coat and stormed out of the operating theater.
The patient's husband noticed Zheng Ren's stiff expression and instantly begged, "Doctor, the anesthetic will make my child an idiot even if you save him, so please don't use any anesthetic."
"What the f*ck! I'll cut you up without anesthesia and see how you like it!" reprimanded the exasperated Zheng Ren.
"Who the hell do you think you're raising your voice against?!" howled one of the family members in frustration.
"Do you still want the surgery to proceed? If not, the baby will not survive!" Zheng Ren knew that he had no choice but to firmly reason with the unreasonable.
Besides, the unborn child was clearly at the top of their priorities.
"You'll pay for his life if you can't save him!" roared the patient's father, who had remained quiet all this time at the back of the crowd.
He looked like an honest man with a weather-beaten face, but his current ferocity numbed Zheng Ren's heart, as if he had been electrocuted and his heart had gone into asystole.
Zheng Ren had seen countless people with this attitude in the emergency department, but as a doctor, he had to protect the patient's well-being no matter what.
However, he was powerless against accusations and threats like these. What was he supposed to do when even the patient's biological parents no longer cared for her safety?
Some things would never change even when he had the power of the System.
"Doctor…" Someone grabbed his arm.
Zheng Ren turned around and noticed that the trembling hand and sweaty palm belonged to the quiet, nineteen-year-old pregnant woman, who was powering through her agony on the stretcher trolley.
"Doctor, you don't need to anesthetize me. I can endure the pain."
Her bangs were drenched in sweat and glued to her forehead. There was an unhealthy redness to her features from the pain, but her eyes were bright and alert, which made Zheng Ren wonder if this was terminal lucidity.
"Why don't we just leave and visit another hospital?" asked one of the family members.
"Good idea. The rural hospital can perform the surgery with local anesthesia but the doctors here can't. What a low standard."
"Let's go to another hospital."
A few family members, the closeness of their relation unclear, were causing an uproar.
Zheng Ren was stunned. The patient risked a potential miscarriage and an intrauterine fetal death would be inevitable if there was any further delay in surgical treatment.
Moral coercion was indeed useful at times.
Zheng Ren gritted his teeth, frowned, and finally let out a sigh.
After repeatedly using the System to check the patient's status and confirming that she did not suffer any form of mental disorder, Zheng Ren frowned and said, "Your body will respond to the intense pain with uterine contraction, which will increase the risk of miscarriage."
"I can and will endure it." Tears started rolling down her cheeks. "Please, doctor…"
Local anesthesia. That was the only choice.
"Fine, we'll proceed with local anesthesia."
Zheng Ren wanted to glare at her family members but it seemed pointless.
He also wanted to comfort the patient, but had no idea what to say.
Sighing heavily, he pushed the patient's family members aside and wheeled her into the operating theater.
"Chief Zheng, is everything settled?" asked the anesthesiologist after noticing Zheng
Ren and the patient enter the operating theater.
"Local anesthesia will be used," said Zheng Ren.
"You're crazy!" The anesthesiologist was shocked. "Who'll bear the responsibility if anything happens to her?"
"The surgery will be hindered without anesthesia. Who'll bear the responsibility if she ends up with a miscarriage?" Zheng Ren threw the question back at him.
It was a debate that offered no definitive answers.
The anesthesiologist silently admired Zheng Ren's determination in bearing full responsibility and assisted with the patient transfer to the operating table.
"Why isn't there an assistant with you?" asked the anesthesiologist casually.
"There's a lack of staff in the emergency department. Nothing I can do about that."
"You… Alas…" Everything the anesthesiologist had in mind could only leave him as a sigh.
Cen Meng, who had been with the crowd the entire time, immediately left them after finding out Zheng Ren had decided to perform an appendectomy under local anesthesia, running downstairs and ignoring the elevator.
He pretended as if nothing had happened as he greeted Chief Surgeon Liu upon reaching the surgical demonstration classroom. Before the duo fully entered the room, Cen Meng whispered, "Chief, Zheng Ren wants to do it under local anesthesia."
Chief Surgeon Liu's expression darkened immediately, but as soon as he recalled that Zheng Ren was a chief resident in the emergency department, a hideous smile formed on his face. "He is asking for death."
Chapter 21 - Outrageous Practice
The pregnant woman was lifted onto the operating table, which was then angled downward 15 degrees to the left.
It provided better access to the appendix as the gravid uterus shifted to the left. At the same time, this position was better for reducing agitation to the uterus during the operation and minimizing the risk of miscarriage or complications.
Preoperative preparations were swift and Xie Yiren was already in position.
Zheng Ren scrubbed and gowned up. The sterile surgical dr.a.p.es were in place as he stood before the operating table.
The Surgeon's Studio c1-799 Page 14
