The Surgeon's Studio c1-799

by Black Ursa Prime

  Chief Xia from gastroenterology was a middle-aged woman in her fifties. She was a little over five feet, with a tiny stature, short hair, and a thin, long face. She gave off the air of a capable, experienced woman.

  "Chiefs, my mother felt a pain in her abdomen after this morning's breakfast…" Zhou Wenxiang repeated the whole situation to them.

  As they spoke, they passed by Zheng Ren. Chief Xia ignored his presence and went straight to check on the patient.

  Chu Yanran felt embarrassed. This was the second time she had asked Zheng Ren for help, only for the patient to seek out other directors and department chiefs, ignoring Zheng Ren outright.

  It was happening again!

  Between the Chu sisters, Chu Yanran was more reserved than Chu Yanzhi, but it was when the good-natured lost their temper that things were truly serious.

  Zheng Ren felt something off upon seeing Chu Yanran's expression and dragged her away by her lab coat like a baby chick.

  "What are you doing?" She glared at him.

  Zheng Ren released his grip and chuckled, saying softly, "It's fine."

  Chu Yanran frowned and stomped her feet. "I'm not going to bother anymore."

  He laughed.

  "Oh, you're flirting with Chu Yanran behind Xie Yiren's back. I'll be keeping tabs on you," Su Yun said coldly, standing behind them.

  Zheng Ren was startled, breaking into a cold sweat even though he knew that Su Yun was joking.

  "Cut it out!" Chu Yanran kicked Su Yun in the shin. "Chief Zheng, I trust your diagnosis."

  Su Yun nodded, his fringe swaying as he spoke. "I'm not sure why, but I also believe him even though the diagnosis seems a little far-fetched."

  After being kicked by Chu Yanran, he turned serious. "The patient has pain in her upper right abdomen. It's understandable to assume acute cholecystitis, but what made you diagnose a gallbladder torsion, Boss Zheng?"

  "The abdominal ultrasound shows a gallbladder distension but no gallstones. You can see thickening of the segmental gallbladder wall by 8 mm, indicating the possibility of segmental adenomyomatosis." Zheng Ren pointed at the B-scan and said, "This was a routine checkup, but when we arrived earlier, it was at the oblique scanning plane and I saw that the compartments within the gallbladder had no visible thickening of its walls."

  "Wow, what great eyesight you have." Su Yun was staring at the B-scan, but being untrained in the field, there was little point to it.

  He was mentally exhausted after following Zheng Ren for so long.

  While he had yet to brush up on interventional and general surgeries, this guy had already moved on to f*cking B-scan oblique ultrasound scanning… Clinicians could possibly read CT and MRI scans, but few knew the operating principles of the diagnostic examination of B-scan ultrasonography.

  Most physicians only looked at the reports attached to B-scans.

  Since B-scan ultrasonography required further specialization, doctors capable of sonography were very popular. There were always long queues for ultrasounds every single day.

  As they were talking, Chief Xia had already started to examine the patient.

  She was professional in her physical examinations and also very experienced in making diagnoses off interviewing patients. At a glance, she was clearly a seasoned doctor with plenty of clinical experience.

  Following the physical examination, she looked at the B-scan report.

  "Obviously acute cholecystitis. You can choose the conservative treatment or opt for surgery. It all depends on what you want," Chief Xia said confidently. "What do you think, Chief Sun?"

  "Me?" Chief Sun laughed and waved it off. "Little Zheng, what's your opinion on this?"

  This… Zheng Ren did not know what Chief Sun was doing.

  The man had probably gotten used to slacking, and was thus unwilling to take a firm stance in front of others.

  "I think the patient might have acute gangrenous cholecystitis, which requires immediate surgery," Zheng Ren explained honestly.

  "How did you see that?" There was a hint of reprimand in Chief Xia's tone; she was not discussing the condition with him, but rather questioning him condescendingly.

  Department chiefs had their own stature during clinical examinations, like grassland wolf pack alphas, and no one was allowed to challenge their authority.

  The pups from their own pack notwithstanding, everyone else's was forbidden to as well!

  As Zheng Ren was the chief resident of the emergency department, Chief Xia was going soft on him. A chief resident or young doctor who dared to defy their own department chief would be asking for trouble.

  Old Chief Physician Pan's treatment of Zheng Ren was the exception, not the rule.

  That was in itself partly due to Zheng Ren's proficiency in the Whipple procedure during the livestream.

  Would Old Pan have clashed so violently with his peers to poach Zheng Ren otherwise? He had even acquiesced to Zheng Ren's requests and retreated to a more supporting role since.

  "I saw something similar during the B-scan oblique ultrasound scanning," Zheng Ren explained, his tone free of frustration.

  Chief Xia's face dropped. She stared at Zheng Ren sternly but did not argue.

  Over ten seconds of silent rumination later, she said, "Go and get the test results."

  The clinical doctor beside her obeyed and obtained the patient's details before turning around and running to the emergency department laboratory.

  Chief Xia had both hands in the pockets of her lab coat and a red stethoscope hanging around her shoulders. The color of the stethoscope reminded Zheng Ren of Fang Lin.

  He wondered if Fang Lin had recovered. When Zheng Ren was about to leave Imperial Capital, Fang Lin had not expressed his gratitude, promising only to visit Sea City once discharged.

  Those words had been troubling.

  Zheng Ren had no idea where to show a visitor around. Despite being born and raised in Sea City, he had been busy fighting to survive his entire life, spending all his time working to earn a living and sparing none for leisure.

  When he had been studying Chengdu University, he had had no chance to visit the Wuhou Shrine, only going to the Wide and Narrow Alley when he was forced to by his classmates. Even standard tourist spots were not his cup of tea, let alone other attractions such as Dujiangyan City and Mount Emei.

  If Fang Lin really did come all the way from Imperial Capital, Zheng Ren would be in trouble. He could not just spend all that time eating and drinking in Sea City, and even if he did, Zheng Ren had no idea what to introduce him to. Would he end up offering Fang Lin a shift in the emergency department?

  Zheng Ren was willing to do so, but it was simply not hospitable.

  Chu Yanran and Su Yun were surprised by Zheng Ren's silence and rare troubled expression.

  What had happened to Chief Zheng? Had he crumbled under Chief Xia's authority? Impossible; Zheng Ren was very straightforward and unafraid of anyone in general.

  Was he doubting his own diagnosis?

  Soon, Chief Xia's clinical doctor returned, test report in hand.

  Chief Xia took it and glanced at it briefly before saying coldly, "C-reactive protein levels in the blood are normal, white blood cell count is 7.5, neutrophil levels within range. Clinical laboratory testing does not support acute gangrenous cholecystitis."

  Chapter 274 - Injuries Sustained by Fall (Part 3 of 5)

  Su Yun scowled but regained his composure almost immediately. He blew at the fringe in front of his forehead and sneered, "I'll wait for you to come and beg me to do the surgery."

  However, Chu Yanran felt Chief Xia's explanation was reasonable. The routine blood test and C-reactive protein levels indicated no inflammation. Why had Zheng Ren concluded that it was acute gangrenous cholecystitis caused by gallbladder torsion?

  Weird.

  Zheng Ren was not one to be that careless, but he had truly slipped up this time.

  However, deep down inside, she still felt Zheng Ren was right, which was even weirder
.

  As he watched Zhou Wenxiang direct the caretaker in moving the old lady onto the stretcher trolley, Zheng Ren sighed and said, "You really don't want to have surgery? I strongly suggest that you do it."

  Zhou Renxiang stopped all pretenses and ignored Zheng Ren out of scorn, saying to Chu Yanran, "Yanran, you're wasting your life in Sea City with your qualifications. You should find the opportunity to go to Provincial Capital. It's nearer to your home, and you can also take care of your mother."

  Although he was not speaking to Zheng Ren directly, it was obvious that he was telling her not to waste her time around this useless chief resident.

  Chu Yanran glowered furiously, but she had no idea how to argue. Internally, she added a mental note not to take on similar cases anymore.

  There was no reason to embarrass Chief Zheng like that.

  Zheng Ren sighed and shook his head before saying dejectedly, "Let's head back, then."

  "Chief Zheng, please don't be mad," Chu Yanran said timidly, feeling ashamed.

  "It's fine." Zheng Ren waved.

  Chu Yanran did not know that Zheng Ren was more fixated on how to receive Fang Lin in Sea City than the attitudes of Chief Xia and the patient's stubborn family member.

  "Be patient," Su Yun said, "Soon they'll be begging you to do it. You can decide whether or not to then, depending on your mood."

  "Stop talking nonsense. I don't hold grudges, why wouldn't I agree to it?" Zheng Ren said.

  The three of them returned to the emergency ward. Chu Yanran did not follow them in and went to the operating theater instead, most likely to brood.

  Zheng Ren had intended to ask her if Xie Yiren had reappeared, but did not have a chance to after the whole commotion.

  Back in his office, Zheng Ren started reading the General Surgery magazine while Su Yun sat behind him on a chair, bored and tapping away at his phone.

  Chang Yue seemed to overlook their presence. She was busy going from ward to ward to chat with patients, inquire about their condition and strengthen their fortitude.

  How nice if every day were this peaceful, Zheng Ren thought as he read.

  Even if it meant that he would be unable to showcase his skill, it was still better than adrenaline-fueled, high-stakes emergency rescues.

  The sun was very bright in the afternoon, its warm rays shining through the office windows and onto the pages. Zheng Ren was surrounded by warm sunlight and the pleasant scents of paper and ink.

  It was as if he was back in his student days, free from the stress of emergencies.

  "Do you get your surgical skill from reading books?" After observing Zheng Ren reading for an hour, Su Yun could not stifle his curiosity any further.

  "Reading, performing surgery, and reflection," Zheng Ren said, brushing Su Yun off while keeping his eyes on the magazine.

  Su Yun kept quiet and returned to his phone.

  He pretended not to have asked anything.

  The freedom to read leisurely on a sunny afternoon was not the fate of an emergency department physician.

  Less than ten minutes after their conversation, Zheng Ren's phone rang uncontrollably.

  His heartbeat shot up to 110 beats per minute.

  It had been ages since he had last experienced such a rush. Although he had only just returned, he adapted to it instantly.

  Zheng Ren picked up and heard the nurse from the emergency department saying, "Chief Zheng, fall injuries!"

  "Noted." Zheng Ren hung up immediately and closed the book before hurrying out of the emergency ward.

  "Why can't people live normally? Jumping off buildings and all," Su Yun grumbled behind him.

  The peak of property development was over. All construction would have stopped by now as it was already winter in northeast China.

  Patients with fall injuries were usually those who attempted suicide by jumping off buildings.

  "Do you think everyone's like you, with natural talent, a good family background, opportunities, luck and health?"

  "I have troubles too. There are too many girls chasing me and it's really bothersome."

  "..."

  Both of them jogged towards the emergency department.

  A young woman was lying on the stretcher trolley, her exposed skin pale as if completely drained of blood.

  The nurse had already inserted an IV catheter and was connecting it to a bag of saline.

  An ECG monitor showed a blood pressure of 60/30 mm Hg and a heartbeat of 160 bpm.

  From the upper right corner of his vision, Zheng Ren saw the System's diagnosis: ruptured liver, ruptured spleen, multiple fractures in the pelvis, femoral shaft fractures on both sides, multiple fractures on the tibia, fibula, and calcaneus, retroperitoneal hematoma…

  Fortunately, her c.h.e.s.t area was safe. If she had ruptured lungs and multiple fractured ribs, Zheng Ren would have had to consider leveling his cardiothoracic surgery up to Master rank.

  "Get the emergency B-scan ultrasonography; take her blood and send it to the blood bank," Zheng Ren yelled.

  Everyone worked according to standard protocol. Emergency department nurses were efficient; when the doctor from the emergency department arrived with the B-scan ultrasound on a trolley, they had already prepped the patient for gastric and urinary tube insertions.

  Knowing the patient was going for surgery, they set everything up in case Chief Zheng began yelling again.

  The doctor performed a B-scan ultrasound and reported the results accurately to Zheng Ren.

  "Where is her family?" Zheng Ren asked loudly.

  "I'm here," a young man in his late twenties answered from behind Zheng Ren.

  "What's your relationship with the patient?"

  "She's my fiancée."

  "She needs emergency surgery, can you sign off on it?"

  "Yes." The young man seemed rather responsible, unlike some cowards who ran off the instant they heard that their signature was required.

  "Su Yun, take him to sign the pre-surgery consent form and pass it to Chang Yue," Zheng Ren ordered.

  "Doctor, my fiancée won't die, right?" the young man asked gravely.

  "I can't guarantee anything. Her condition is very serious, but we'll try our best to save her." Once the B-scan ultrasonography was complete, Zheng Ren called another physician and a nurse along to rush the patient towards the operating theater.

  As he ran, Zheng Ren pulled out his phone and called the operating theater to prepare for surgery.

  The journey to the operating theater was not far, but it could still save them a few extra minutes.

  In an emergency rescue, every one of those minutes could decide if the patient lived or died.

  They reached the operating theater at record speed. "Enter the hybrid operating room and prepare for laparotomy to stop the bleeding," Zheng Ren said.

  Another hybrid surgery? He truly had had no chance to rest after returning to the emergency department.

  It was not that Zheng Ren's duties were extra arduous. When he was not around, the patients would be referred to their respective departments for surgery since no one else was capable of doing it all at once.

  After the emergency department doctor and nurse assisted the Chu sisters and Xie Yiren in transferring the patient onto the operating table, they left the room.

  Zheng Ren slipped into the isolation suit as fast he could and entered the operating room.

  "How long until the packed red blood cells arrive?" he asked.

  "20 minutes. I've asked the emergency department to send for it." Chu Yanran was reliable.

  Zheng Ren said nothing further as he began sterilizing and putting on the sheets.

  Under the surgical lamp, the patient's skin was so pale that the light reflecting off it was eye-watering; it only regained a sense of vitality when iodophor was applied.

  Chapter 275 - Unintentional Reveal (Part 4 of 5)

  In the live surgery broadcasting room of Xinglin Garden, another surgery broadcast began.

  [What
kind of advanced surgery will the surgeon perform? Is the hater from yesterday still alive?]

  [I wanted to ask the same question.]

  [I kept saying that this surgeon has great skill, but the doubting Thomas could not be persuaded. Such people would not survive three episodes in a drama series. By the way, after yesterday's observation, I noticed that the surgeon's interventional and general surgical skills have improved. Is this another genius professor starting a livestream?]

  [The more I watch, the more I believe that there's a team behind this live surgery broadcast. It's impossible for all of these surgeries to be done by one person. Has anyone here gone on an exchange to Montreal Medical Center, Canada? Can you share your experience?]

  After some idle chatter, everyone went through the patient's medical records to understand the situation.

  The doc.u.mentation was not that complicated. There was no need to crack one's brain and provide a differential diagnosis. The details shared in the livestream room had always been simple and to-the-point, and were always proven right no matter how bizarre they seemed.

  After completing sterilization, Zheng Ren raised his hand and a scalpel handle appeared in it.

  At that point, most viewers had glanced through the records and returned to the live surgery broadcasting room.

  [Such serious injuries were most likely sustained from a high fall.]

  [It's a young woman, did she attempt suicide because of relationship problems?]

  [Please focus on the surgery, your bullet-screen gossip is blocking my view.]

  The surgery was straightforward; a laparotomy would be done to repair the liver and remove the spleen. As for the rest… After the patient's condition stabilized, they would send her to orthopedics to fix her secondary fractures.

  The situation was as critical as that from yesterday's live broadcast, but to any surgeon, it was significantly less complicated.

  Most doctors watching the broadcast had encountered patients with fall injuries.

  Zheng Ren made a 15 cm long median incision.

  It was larger than usual as this was an emergency surgery; an unobstructed view of the trauma was more important than appearances.

  Ths skin and subcutaneous tissue were an eerie pale color due to blood loss, and under the stark light of the surgical lamp, resembled a mourning shroud.