The Surgeon's Studio c1-799
Page 93
Was this the big stage that Old Chief Physician Pan talked about?
Feng Xuhui, who was standing aside, overheard Su Yun and Zheng Ren's conversation.
Chief Zheng's capabilities were truly exceptional. A few days in Imperial Capital and he already had the attention of one of the professors.
The man was a golden goose and Feng Xuhui had no intention of letting him go.
A few bites of food later, Zheng Ren was dragged by Su Yun to the outpatient clinic.
It was still early, but there was already a long queue.
There were a few people milling around the area, occasionally striking up conversations with those who were in distress and in an obvious hurry.
"Those people are scalpers. They can profit 5000 yuan from a ticket to meet the specialist," Su Yun said.
Zheng Ren bit his tongue.
"5000 yuan is the friendly price. If the patient seems desperate, they can charge up to 10000 yuan." Su Yun laughed. "Back when I was contemplating leaving Union Medical, I considered being a scalper. But the profiteering was a bit much, I figured I would rather open a vet hospital."
"You keep talking about that vet hospital, yet I don't see you doing anything about it." It was the umpteenth time Zheng Ren had heard Su Yun mention his imaginary veterinary hospital.
"My family is against my dream to open one. My grandmother threatened to off herself." Su Yun brushed the mop of hair that covered his forehead, frustration evident on his face.
They both fell into an awkward silence. Zheng Ren continued studying the CT scan from last night, trying to come up with a solution. On the other hand, Su Yun was scrolling through his phone, his heart heavy with unspoken truths.
Half an hour later, Fang Lin walked into the corridor, a red stethoscope at his neck. A kind-faced old man accompanied him.
"Professor Gu, nice to meet you," Su Yun greeted as he tugged at Zheng Ren's sleeve to get his attention.
Fang Lin opened the consultation room and let them in.
The corridor they were previously in was dimly lit, and a man in sunglasses followed them into the room.
When Professor Gu saw the uninvited guest, he shouted, "Get out! Get out!" The professor shooed the man away like he would a fly.
The man in sunglasses hesitated but Professor Gu's incessant shouts prompted Fang Lin to push him out of the room. His hateful expression was on full display.
Spitting on the ground, he left without turning back.
A confused expression crossed Zheng Ren's face. The man was certainly shady but Professor Gu's treatment of him seemed excessive.
"The guy is a scalper," Su Yun whispered.
Professor Gu grumbled, "Little Fang, do not let these people enter the consultation room next time."
Fang Lin nodded and looked out into the corridor. Once he confirmed that the man was gone, he shut the door.
The incident had broadened Zheng Ren's horizons.
Scalpers were uncommon in Zheng Ren's everyday life, so he had no opinions on the issue.
However, from the long queue they saw outside, Zheng Ren was put off by the scalper's greed. The sunglasses hiding his shifty eyes also raised suspicion. Zheng Ren respected Professor Gu for having to deal with such situations.
"Have a seat." With the door closed, Professor Gu's expression softened.
"Nice to meet you, Professor Gu. I'm Zheng Ren from Sea City General Hospital." Zheng Ren introduced himself and bowed in respect.
"Sit, sit." The anger from before had faded and Professor Gu asked in a cheery tone, "Do you still remember the esophageal tuberculosis case?"
"Yes, I do." Zheng Ren nodded.
"I heard from Little Fang that you managed to give the correct diagnosis. Tell me how you came to that conclusion."
"Esophageal cancer does not have a high fatality rate and during its early stage, the patient will encounter ingestion issues. Very few people would delay treatment." Zheng Ren had prepared his answer on the way to the clinic.
"Yes, carry on." Professor Gu agreed.
"As esophageal cancer spreads, the primary targets are the liver, lungs and brain. It is rare to see metastases in the bones, but if it happens, the long bones would be the focus. There is a low probability of metastasis in the ribs. Dr. Fang showed me the PET-CT scan and I saw multiple spots at the ribcage which pointed to tuberculosis."
Zheng Ren's explanation was sensible. It was a bit forced but no one could refute his logic.
Professor Gu gave him a smile and started to explain the patient's history, even bringing out the PET-CT and NMR scans.
Su Yun's face was expressionless. He was sure the old man was slow on the uptake.
Fang Lin listened attentively to the professor's story.
The woman was his patient. At first glance, he had agreed with the older doctors with whom he consulted that it was a case of metastatic esophageal cancer.
However, Dr. Zheng from Sea City and his own professor had disagreed with the diagnosis. The biopsy had also proven it to be tuberculosis, not cancer. It was an error in diagnosis on Fang Lin's part and he gladly listened to the two men discuss the case.
Doctors had to learn and grow from their own mistakes.
Even the wise Qiu Fazu had botched one of his appendectomies which led to his patient's death. The guilt had motivated him to be a better doctor.
They had to practice carefully with minimal mistakes. Every error had to be examined from all angles to prevent recurrence.
It was a doctor's responsibility.
Half an hour passed quickly.
Within that short period, Zheng Ren gained a significant amount of knowledge.
At the start of their discussion, Zheng Ren had been able to interject and say his piece, but five minutes later, it had become a full blown lecture by Professor Gu.
Chapter 183 - The Attack
Professor Gu went on about the biology and pathology of the case. He detailed his thought process during case assessment and the reflections he made after.
The sight of the old professor's snow-white hair filled Zheng Ren with emotions.
Professor Gu had surpassed Master rank without the help of the System. He had relied on years of experience and hard work to get to where he was now, which was somewhere between Grandmaster and Legend.
The System had given Zheng Ren a boost, but he decided he ought to double down on his efforts.
Fang Lin noticed the time: it was five minutes to 8:00 am. He shuffled closer to Professor Gu and, in a whisper, reminded the old man of the clinic's opening hours.
"Alright, Little Zheng, I think our time is up. Leave me your contact details. Drop by my office whenever you're in town," Professor Gu said in the end.
Birds of a feather flock together. Zheng Ren's correct diagnosis had impressed Professor Gu.
Zheng Ren bowed with humility.
His skills were largely dependent on the System. When would he be able to work independently?
Fang Lin opened the door to lead them out. Zheng Ren and Su Yun said their goodbyes to the professor.
As they were exiting the room, a short man appeared at the door holding a black umbrella.
The black umbrella stood out in Zheng Ren's mind as it was early winter. There was hardly any need for it in this season.
Fang Lin's attention perked up at the unusual character. He blocked the door and asked, "Where is your number?"
There was a flash as the black umbrella fell away.
A knife spanning half a meter was revealed.
The murderous glint of the weapon was unquestionable.
It was shocking.
The knife sliced through the air with ease.
Zheng Ren, who was standing nearest to Fang Lin, pushed the doctor away.
The knife came down on Zheng Ren's shoulder. Blood splattered across the floor.
The blood stunned the attacker for a while. His hateful, beady eyes turned to look at Professor Gu and he retrieved his knife, advancing toward the professor.
At this point, Fang Lin had regained his senses and realized the attacker was heading for Professor Gu. He rushed forward and restrained the attacker's arms.
The attacker was a man of average build. The stool hit his head with an audible thud.
A flash of anger crossed the attacker's face as he realized Fang Lin was hindering his progress.
The man switched targets. The knife plunged into Fang Lin's body.
Zheng Ren's injured shoulder throbbed as blood flowed freely. He could only see the attacker's back but not the weapon.
Adrenaline rushed to his head.
Zheng Ren had nothing that could act as a makeshift weapon and the attacker's body was protected by layers of winter clothing. He decided to headbutt the attacker.
Another loud thud.
Stars danced across Zheng Ren's vision. Between those stars, he caught a glimpse of the attacker falling to the ground. Fang Lin collapsed along with him.
Ding dong! The system chimed the arrival of a mission.
The chime went unnoticed by the hot-blooded Zheng Ren. His vision went red as blood dripped from his forehead; his or the attacker's, he did not know.
[Emergency Mission: Together We Stand.
[Mission Details: Rescue Fang Lin.
[Mission Reward: A Master-rank ancillary skill book, choices available: X-ray radiography, B-scan ultrasonography or magnetic resonance imaging.
[Mission Duration: One day.]
Zheng Ren was nauseous. He felt someone tug his body aside.
Su Yun came up to the attacker and kicked at his neck. It was not hard, but it was accurate.
His target was the carotid sinus.
The carotid sinus was where the aorta branched out into the carotid arteries. Its vascular walls were thinner, making the vessels in the carotid sinus more distended. There were nerve endings deep within that acted as pressure sensors while chemoreceptors there detected changes in blood composition.
Blunt force to the carotid sinus would cause nausea and vomiting.
Su Yun did not place much force into his kick but all that mattered was the target. The attacker passed out immediately.
Everything seemed under control until Professor Gu clutched at his c.h.e.s.t and sank to the ground.
F*ck!
Zheng Ren cursed the whole situation.
They had their reckless hero, Fang Lin, on the ground. On the other hand, Professor Gu was having a heart attack.
They were short on time. Zheng Ren made a quick call.
As Su Yun had previously been stationed in the ICU in Sea City General Hospital, Zheng Ren was sure the man was better at handling a heart attack than he was.
"Su Yun, check on Professor Gu." Zheng Ren pushed Su Yun toward the professor, then knelt beside Fang Lin.
The 50cm-long knife had stabbed into Fang Lin's body and pulled out. Blood was pooling around them and its metallic smell filled the room.
Zheng Ren glanced at the weapon. Based on the bloodstains, the wounds were approximately 20 to 25cm deep.
The display at the top right corner of Zheng Ren's vision listed the diagnosis: ruptured liver, torn diaphragm, ruptured lung, tension pneumothorax, hemorrhagic shock.
Although the stab wounds had been inflicted less than a minute ago, Fang Lin had already fainted from excessive bleeding.
There were multiple wounds that affected vital organs.
"Help! Nurse!" Zheng Ren shouted at the top of his lungs. He shifted Fang Lin's body and started tearing his blood-soaked clothes off.
The earlier commotion had attracted several people's attention, but it was Zheng Ren's shout for help that made doctors rush through the door.
"50ml syringe, iodophor, incision kit. Quick!" Zheng Ren called out for the things he needed.
A young doctor recovered from his shock and quickly left to retrieve the supplies.
The young doctor had received proper training in Imperial General. He returned with the materials and a crash cart.
Zheng Ren took the 50ml syringe and uncapped its large-bore needle, which went into the second intercostal space on Fang Lin's right rib.
The sound of pressure being released immediately wheezed from it.
Realization dawned on the surrounding doctors. It was a tension pneumothorax!
The condition developed when there was damage to the lung or bronchus that allowed air to collect in the pleural space, leading to the formation of a one-way valve.
It would deteriorate when the patient tried to breathe.
Therefore, Zheng Ren had to deal with it even as Fang Lin was bleeding out. Short of an aortic rupture, a tension pneumothorax was first priority in emergency situations.
"Prep the OR1!" Zheng Ren screamed, agitated. His voice was harsh from shouting. Operating room.
Chapter 184 - Critical Damage
Doctors of all ages came to assist.
Zheng Ren paid them no heed and tore open the incision kit, dousing the knife wounds on Fang Lin's body with iodophor.
The dark solution gushed from the bottle and ran out in seconds.
Zheng Ren threw the bottle aside and put on his surgical gloves. He took a scalpel from the kit; without any preamble, he cut into Fang Lin's flesh.
He moved in a flurry. Any comments from bystanders died down after witnessing the first incision.
'Was he going to stop the bleed with his hands?' The old doctors were shocked.
They had not witnessed this outdated method of hemostasis in a long time. How was this civilian outperforming most doctors?
Zheng Ren and Su Yun were, after all, dressed in civilian clothing.
A middle-aged doctor made to stop Zheng Ren, but before the words could leave his mouth, the scalpel drew a 10 cm incision from the stab wound to the right side of Fang Lin's rectus abdominis.
Dark red blood burst out from the incision.
With the aid of his general surgery and interventional surgery Master ranks, combined with the experience of 300 liver dissections, Zheng Ren was able to locate the hepatic artery with his b.a.r.e hands.
"We need blood and a stretcher! Get him to the OR!" Zheng Ren's eyes were bloodshot as he shouted.
A doctor went to grab the stretcher trolley. As they were in the clinic, it took a few minutes. Another doctor was on the phone contacting the relevant departments about getting an operating room.
Zheng Ren's right hand pressed at the hilar area, stopping the leak. He thanked his lucky stars.
They were in Imperial Capital's Class Three Grade A Hospital.
If they had been elsewhere, Fang Lin might already be dead.
The stretcher trolley arrived. Zheng Ren moved awkwardly but carefully as Fang Lin was lifted onto the vehicle with the help of others.
He did not want to tear open Fang Lin's hepatic vein by accident. The consequences could be fatal.
He knelt on the stretcher trolley as a few doctors pushed them toward the operating room.
One of the doctors was an old man who could not keep up physically. He stopped and called the operating room, wheezing as he informed them of the injured doctor's arrival.
Everyone was playing their part in the rescue operation. It was a life on the line, coworker or friend notwithstanding.
The young doctor was at the helm, pulling and steering the stretcher trolley. He also acted as an ambulance siren to get patients and bystanders out of the way.
The sight of a white coat on the stretcher trolley made passing doctors and nurses abandon their current duties.
No one knew the details of the incident but they all wanted to help.
Some assisted with pushing the stretcher trolley while others cleared the road ahead. Some helped summon the elevator to avoid wasting precious time.
Someone asked to take over Zheng Ren's duty but he adamantly refused. He trusted no one but himself to keep Fang Lin's bleed under control.
/> The journey from the clinic to the operating took five long minutes.
The anesthesiologist received a call to be on standby. Several other doctors and nurses arrived at the operating room.
The elevator door opened and the stretcher trolley was pushed out, leaving a trail of fresh blood in its wake.
The anesthesiologist, dressed in a blue isolation suit, took over the stretcher trolley from the doctors and nurses. Without a word, he pushed Zheng Ren and Fang Lin into the operating room.
Thus began the emergency rescue!
The sight of Zheng Ren kneeling on the stretcher trolley with one hand in the patient's abdomen shocked many despite their being medical professionals.
Internal hemostatic control with one's b.a.r.e hands was something read about in books but hardly witnessed in person.
"Which vessel?" the anesthesiologist asked.
Zheng Ren forced out an answer. "Hepatic. I can't let go."
The anesthesiologist understood what Zheng Ren was doing.
An intravenous line and vital signs monitor were set up. Fang Lin's blood pressure was so low that it was undetectable. A blood sample was sent to the hematology lab for blood typing.
A number of emergency drugs were pumped into Fang Lin's veins through the intravenous line.
Zheng Ren was now kneeling on top of the operating table with the surgical light shining down on him. Disinfection was tricky, to say the least.
However, he could not move from his position.
Not even a muscle twitch.
The general surgery department chief rushed over and asked about the situation.
Once he was up to date, he scrubbed in and prepared to operate.
The thoracic chief surgeon was also present. Together, they set up a closed c.h.e.s.t drainage system. Air bubbled in the water seal chamber when the drainage tube was inserted.
At the same time, the anesthesiologist attached a ventilator and started total anesthesia.
In the event of a tension pneumothorax, the ventilator would not be connected until a closed c.h.e.s.t drainage system was set up.
Pumping air into a c.h.e.s.t cavity that was not able to ventilate could cause lung collapse while the increased pressure would prevent oxygen uptake in the lungs.
It would kill the patient.