"Leave the things here. I'll go to the operating room first." Xie Yiren finished her food and rushed out of the on-call room.
Chapter 149 - Fan Tianshui, The Security Guard
The patient suffered from an acute but simple case of cholecystitis.
During the transfer of the patient to the emergency department, Zheng Ren noticed that Su Yun and Xie Yiren had gone to prepare for the surgery.
Under normal circ.u.mstances, informed consent procedures were handled by a junior surgeon. The junior surgeon would transport the patient to the operating room and begin anesthesia and disinfection. Once surgical dr.a.p.es were in place, the junior surgeon would notify the senior surgeon.
Zheng Ren's "junior" had declared himself flawless but had left Zheng Ren here to handle the informed consent procedure. In Zheng Ren's eyes, such disrespect was a major failing.
It was not a simple blemish on Su Yun's character, but a crater.
Fortunately, it was still daytime. The emergency ward was relatively quiet, so Yang Lei and Chang Yue came upstairs to assist with the patient, relieving Zheng Ren of his task.
Half an hour later, the patient was ready and the family was informed of the ins and outs of the procedure. Yang Lei wheeled the patient into the operating room.
Zheng Ren was appreciative of the advantages granted by his status as chief resident.
The downside of such a position, though, was that he was responsible for anything that went wrong with the surgery as the most senior staff member. If complaints and accusations came up, the chief resident or department chief would not be long for the hospital.
Zheng Ren had once heard of an obstetrics and gynaecology department chief in another hospital who pushed the blame onto their subordinates whenever a problem arose.
In the end, their subordinates resorted to calling the chief whenever something happened to a patient. They recorded the chief's instructions on the patient's charts. If the chief did not pick up their calls, the subordinates would note that down as well.
It did not take long before lack of sleep caught up to the department chief. They were demoted as a result of their deteriorating health.
It was an extreme example of the responsibility of a senior surgeon. Zheng Ren was only a chief resident. Moreover, with the aid of the System, his diagnoses and treatment selections were infallible.
He changed his clothes and entered the operating room.
The Chu sisters had completed anesthesia and Su Yun was arranging the surgical dr.a.p.es over the patient's body.
Zheng Ren had arrived just in time. He washed his hands, put on the surgical scrubs and stood at the lead surgeon's position.
The patient had a mild case of cholecystitis that necessitated only a laparoscopy. Su Yun got the necessary instruments ready while Yang Lei scrubbed in. The surgery commenced.
It was a simple cholecystectomy. Zheng Ren took less than 20 minutes to remove the gallbladder. He took the specimen out of the operating room to show the family.
Su Yun and Yang Lei performed the rinsing and closing of the wound.
The whole team functioned like a well-oiled machine.
Yang Lei made the last stitch. Soon, the patient stirred from anesthesia.
Yang Lei admired the Chu sisters' ability to time their anesthesia accurately. They had to be extremely familiar with the patient's rate of drug metabolism and the surgeon's speed in practice.
It would be disastrous if the patient were to wake up mid-suture.
The surgery had taken less than an hour. Yang Lei waited for the patient to be fully awake before moving them. Once they were gone, the operating room was quiet again.
The three ladies snuck off to the on-call room with snacks in hand. They whispered conspiratorially like schoolgirls as they munched on their junk food.
Once the patient had left the operating table, Chang Yue got to work. The surgery journal was the only paperwork Zheng Ren had to do. Everything else fell under Chang Yue's job scope.
She was happy to do it.
Zheng Ren's surgeries were always neat, which made paperwork a breeze. Furthermore, she did not have to work night shifts.
Hence, Chang Yue never grumbled about her job. She happily tended to patients in the ward and the paperwork.
On the other hand, Yang Lei's existence was immaterial in the emergency department wards. The same had happened when he was stationed at the first general surgery ward. Most patients did not even know he existed.
He made rounds three to five times a day to record case progression, and yet patients could never remember his name.
There had been only one emergency case in the day shift so far, which made Zheng Ren uneasy. He had a superstition: a day without at least three surgeries meant a large-scale emergency was looming around the corner.
Seven in the evening was peak hour in the emergency department.
Zheng Ren went to check on the patients in the observation ward. He felt reassured when he found no cases of severe or rare illnesses.
As he walked to the treatment room, he passed security and noticed a familiar man.
He stopped and took a closer look.
It was Fan Tianshui, the man who saved him a few days ago.
"Brother Fan, what are you doing here?" Zheng Ren said in surprise.
"Good day, Dr. Zheng." Fan Tianshui stood, tense like a wound-up javelin. His movement was swift and steady, a stark difference from when he first arrived in the hospital.
"Manager Lian assigned me here to the hospital."
"Little Six?"
"Yes." Fan Tianshui smiled and said, "The guards stationed here were from another security company, but the manager said they were not up to par. So, rather than making me oversee their work, I might as well take up the job."
Zheng Ren knew that the hospital's housekeeping staff were supplied by a certain agency but was not aware that the same applied to security.
He was enlightened by Fan Tianshui's explanation.
"Thank you for your work," Zheng Ren said sincerely.
"This is a good place, so I should thank you instead," Fan Tianshui replied with a sheepish look. "They're paying me 3000 yuan a month, with food and accommodation. And the job isn't even physically tiring."
'A man of simple p.l.e.a.s.u.r.es,' Zheng Ren thought.
"Brother Fan, if someone makes a ruckus here, don't hesitate with your course of action," Zheng Ren reminded Fan Tianshui.
"Don't worry. We're all civilians here. If anything happens, adjudication is up to the public security bureau. My responsibility is just the safety of the emergency department," Fan Tianshui said with a smile.
"Good." Better to leave it to government agencies to bicker over the law. Zheng Ren did not want any major incidents in the hospital. "Want a light?"
"Sure." They went to the smoking room outside the emergency department. Fan Tianshui opened a pack of Reishi and offered a stick to Zheng Ren.
The brand of cigarette was too strong for Zheng Ren's taste, so he declined.
"Busy these days?," Zheng Ren asked.
The two men lit their smokes. Fan Tianshui took a deep drag and said, "The manager informed certain people around Sea City General Hospital to keep a lookout and take care of any organized attempts at trouble, so it has been pretty peaceful these days. Anyone who wants to pick a bone with medical professionals is directed to other hospitals."
Zheng Ren was taken aback by the revelation. He had not expected himself to have a hand in contributing to the hospital's safety.
Although Zheng Ren felt a moment of sadness, he was the one reaping the rewards of Fan Tianshui's employment.
Moreover, anyone could appreciate a safe working environment.
Even with his top-notch surgical skills, Zheng Ren appreciated security guards who kept the situation under control.
"How's life with the company?" Zheng Ren asked casually.
The clear difference between the Fan Tianshui now and the Fan Tianshui on the hospi
tal bed previously more or less hinted at the answer.
"Dr. Chang and Manager Lian said you were the one who found this job for me. I will never forget this favor. The company is good. I can save up around 1000 yuan a month after giving some assistance to the families of my fallen comrades."
"That's good." Zheng Ren nodded.
They exchanged a few more words before their cigarettes went out. The conversation came to an end.
Chapter 150 - Measured Steps
Most surgeries were assigned to the general surgery department except for those that were urgent, which were directed to the emergency department. Therefore, the emergency department was usually idle.
Moreover, with Little Six's influence over the department's security, there were fewer unruly patients and families making a scene. The days passed by peacefully.
Zheng Ren did three to five emergency surgeries a day. Occasionally, a few doctors from the obstetric and gynecology department, knowing the wonders of interventional surgery, would ask for his assistance in cases with severe hemorrhaging.
Days passed without a new mission from the System. For a brief moment, Zheng Ren nearly forgot about its existence.
Zheng Ren only entered the System when he received notifications for the main mission. He would sit and daydream in the thatched cottage or by the lake for a while.
Half a month had passed when Zheng Yunxia came for her checkup.
The frequency of checkups after a transarterial embolization procedure varied between each doctor. Zheng Ren's post-surgery management followed northern culture. Zheng Yunxia had a more aggressive form of cancer, so 35 days was the maximum interval between visits.
She was not required to board. Instead, they took a few blood samples and did a contrast-enhanced 64-slice CT scan with image reconstruction.
The CT scan reminded Zheng Ren of the master skill reward he had.
He decided to test it out. It was a waste to have the skill and not know how to use it.
On the next day, Zheng Yunxia's test results were out. Her liver function had recovered with only a mild elevation in glutamic pyruvic transaminase and glutamic oxaloacetic transaminase. Her bilirubin levels were back to normal.
The alpha-fetoprotein in her blood had fallen from 2000 to 132.
The outcome of the surgery was good all around.
Studying the numbers on the test results, Zheng Yunxia's hands began trembling involuntarily.
Her medical knowledge was mostly derived from Baidu, but after countless disappointments, she had told herself to never pin her hopes on any treatment.
Hope only made disappointment worse.
She had not expected to find this group of people when she was at her lowest. They had lent her a helping hand and pulled her out of despair.
She took the test results and went to the emergency department to find Chang Yue, who took a photo of them and sent it to the group chat.
Everyone celebrated the uplifting news and started to discuss the next course of action.
A blood test provided only one part of the picture when it came to assessing the malignant behavior of the liver tumor. The most important part was still the CT scan.
Su Yun was the one who contacted Sister Zhao and requested her to work overtime. They wanted to get all the tests done in one shot.
A thought nagged at Zheng Ren's mind. The transarterial embolization required a surgeon with the right qualifications.
Changfeng Microinvasive Surgery had only agreed to assist because Professor Pei from Sorcery Capital had been invited to perform the surgery.
However, it was not feasible to invite the professor each time Zheng Yunxia required treatment.
Even though the previous surgery was technically performed by Zheng Ren and Su Yun, there were strict laws to be followed. They could dance around the line but any step too far would spell disaster.
It would be like triggering a landmine.
Zheng Yunxia's results were satisfactory, so Zheng Ren considered recurring treatments for her.
However, he would need three to five years to obtain the necessary qualifications. It was not a viable option.
Zheng Ren went to Old Chief Physician Pan's office.
Only the old and the wise could find a solution to their problem. After all, Old Chief Physician Pan handled all the hospital's requests, be they human resources, financial support or policy changes. Perhaps this could be regarded as a change in policy.
Zheng Ren knocked on the door but Old Chief Physician Pan was not in.
He took out his phone and dialed for Old Chief Physician Pan.
It turned out that Old Chief Physician Pan was in one of his administrative meetings. He excused himself when Zheng Ren called him about a problem.
Once they were seated in the office, Chief Physician Pan said, "Another email came about the new procedure Professor Pei wants you to try. You should start making preparations for your flight to Imperial Capital. It should be in a few days."
"Oh?" Zheng Ren was surprised.
"This is a good opportunity for you. There'll be a lot of well-established people in the audience. Are you excited?" Old Chief Physician Pan said as he smiled at Zheng Ren.
"So-so," Zheng Ren replied honestly. Research into new procedures was usually undertaken by daring doctors in prefecture-level hospitals. In truth, Zheng Ren had little interest in research.
"Young man, you should be optimistic. This is a great chance to learn and improve your skills," Old Chief Physician Pan advised. "Right, so what did you need help with?"
"It has something to do with Professor Pei. The patient who underwent his guided surgery is back for her checkup. I've gone through her results and believe multiple rounds of treatment may be required."
"Okay, I'm with you so far," Old Chief Physician Pan said.
"My professional qualification is limited to emergency rescue procedures. The last surgery could be justified as an emergency interventional surgery. But that justification would not work this time."
"Ah, I see." Old Chief Physician Pan gave him a whimsical smile. This issue was a small matter to the old man.
After a moment of thought, Old Chief Physician Pan announced, "The hospital's interventional surgery department will close down and all related surgeries will be delegated to the emergency department's catheterization team. We can't stand by and watch as patients suffer."
That last line was a guilt trip. Zheng Ren pretended not to hear it.
The most salient point was that all interventional radiology-related surgeries were under the emergency department's jurisdiction.
Zheng Ren asked prudently, "Will it work?"
Old Chief Physician Pan replied with a chuckle, "Of course. All this can be settled from my end. What you should worry about is yourself."
"Me?" A look of surprise graced Zheng Ren's face.
Old Chief Physician Pan shook his head. Young people nowadays did not consider situations from all angles.
"I'm worried about your health. Long-term treatment will require a lot of sessions and chronic exposure to radiation. If tomorrow you get a girlfriend and plan to have children, we will have to stop such treatment for the sake of your health."
It was a point that did not occur to Zheng Ren.
Marriage and children were things of the distant future. Zheng Ren, who had been single all his life, was unlikely to break the habit. However, Old Chief Physician Pan's words made him think. What would they do if there was a queue of liver cancer patients needing treatment and he required recovery time from radiation exposure?
"Of course, that is an extreme scenario. We could reduce patient capacity in favor of better time and resource management. Zheng Yunxia would be our first patient." Old Chief Physician Pan evidently already had a plan in mind.
"We are, after all, the emergency department. Emergency surgeries come first," the old man said with a tone of finality.
Zheng Ren agreed with him. Management was where experience counted.
"Oh, and please send me a copy of your identity card. Manager Feng from Changfeng Microinvasive Surgery will book the plane ticket for you," Old Chief Physician Pan said.
Chapter 151 - Custom Configuration Part I
"Chief Resident Zheng!" an on-call doctor yelled.
"Yes?" Zheng Ren answered.
"There's a patient requesting admission but… I think you should have a look."
Zheng Ren was a surgeon born and bred, and was thus not familiar with this on-call doctor from the medical wing of the emergency department. Zheng Ren was rarely called to weigh in on their cases. If the patient's condition was severe, they were naturally admitted to the hospital.
Zheng Ren nodded and headed for the emergency rescue room.
In the room, a wheezing, elderly man of seventy-odd years lay on a stretcher.
Standing by the bed was an old woman of similar age.
"Chief Resident Zheng, this old lady wants to admit her husband but doesn't want us to treat him," the on-call doctor told Zheng Ren.
In some cultures, the custom was for terminal patients to pass at home. Some preferred to do so at their holy places but a good number of people chose the hospital.
It was the early winter season now. The hospital saw an increase in patients in every medical department. Many wanted to leave the hospital as soon as they were allowed to.
"You must be Dr. Zheng," the old woman said. She had a kind, serene expression, as peaceful as the lake in the System. Her brows were slightly furrowed by hints of sadness.
"Madam, good day. Yes, I am Dr. Zheng," Zheng Ren replied.
"I would like to send my husband on his last trip. It's a bit inconvenient at home, so I hope it's not a problem." The old woman bowed slightly. Her movements were subtle and she carried an air of class that implied a certain pedigree.
"It's not a problem but we currently don't have any vacancies in the related department, so there's nothing I can do."
A flash of disappointment crossed her face, but it was gone in a second.
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