"Sure. Just send me the patient's scans and let me know if there's any contraindications. If the condition is very severe, there's no need for a fee. The Secondary Hospital is not too far away," Zheng Ren replied casually.
Director Zhang was astounded.
Was he for real?
These days, no professor would agree to perform surgery for free. What nonsense was this?
Yet, Zheng Ren was before him with a sincere smile. His kind eyes suggested he meant what he said.
"Don't worry, the patient's family might not have money, but I have some resources set aside. The hospital can offer some assistance to cover the 5,000 yuan fee. Your contribution is vital to this," Director Zhang said. He wanted to cement their deal.
Department Chief Xia smirked.
Zheng Ren chuckled and said, "Arrange as you see fit, as long as safety measures are taken care of. All the preoperative checks have to be done properly. It bears repeating that TIPS surgery is a very risky procedure; this has to be communicated to the patient's family."
Risky? Zheng Ren did not have to remind him. Director Zhang's worry and Zheng Ren's worry clearly did not overlap.
"Chief Zheng, will you be performing the surgery solo or bringing an assistant to the Secondary Hospital?" Director Zhang asked softly.
"I'll bring my assistant." Zheng Ren did not mind making use of Professor Rudolf's expertise when it came at no cost.
Director Zhang's heart skipped a beat.
With a Heidelberg University professor in tow… How much would that cost?
Zheng Ren noticed the change in expression on Director Zhang's face and quickly clarified, "It's alright. The professor's assistance won't cost anything extra."
Director Zhang was speechless.
Things were going much smoother than planned, but Director Zhang still felt uneasy about the agreement.
"Oh, can your hospital perform a diffusion-weighted MRI?" Zheng Ren asked.
"Yes, yes," Director Zhang replied, nodding.
"I will need some diffusion-weighted MRI scans of the liver. Once it's done, courier them to me so I can have a look. Apologies in advance for the trouble," Zheng Ren said. He turned to say goodbye to Department Chief Xia before leaving for the control room.
"See, Old Zhang. Matters: simplified. You've been spending too much time in administration, too much overthinking," Department Chief Xia commented.
Director Zhang gave her a bitter smile, but perhaps the old woman was right. This young doctor was quite the innocent.
Hold on, a preoperative diffusion-weighted MRI?
Why? The liver would have been viewed under a contrast-enhanced MRI or 64-slice CT scan. Why did Zheng Ren require a diffusion-weighted MRI scan? This was not a brain surgery.
By the time the question registered in Director Zhang's mind, Zheng Ren was long gone.
He decided to go in and ask Zheng Ren.
He asked Department Chief Xia for a pen and some scrap paper before hurrying into the control room. "Chief Zheng, about what you said earlier, the patient needs a diffusion-weighted MRI. What else was there?"
Director Zhang did not doubt Zheng Ren's expertise, but he wanted to understand the method.
Zheng Ren listed the preoperative procedures, "The routine blood work, ensuring brain and heart function are optimal for surgery. Then, inform the family about the risk associated with TIPS surgery; they have to be able to accept the high risk before proceeding."
Everything was as per a routine surgery except for the diffusion-weighted MRI.
Director Zhang nodded as he wrote down the instructions on the paper. Once he had everything, he folded the paper neatly and pocketed it.
The attentiveness to detail was a sign of respect for Zheng Ren.
It was improper to have a specialist repeat themselves.
Mutual respect could bridge a relationship between two parties. There was no shame in respecting someone who was of lower status than oneself.
At this point, the bleeding from the puncture wound was staunched and Professor Rudolf and the team were moving the patient onto the gurney. Once that was done, the professor removed his surgical gown and came into the control room.
"Lil Fugui, there are a few more TIPS patients in the coming days," Zheng Ren said.
"Sure. The more the better, but make sure the pre-surgery check is stringent. Let's not have any unwanted incidents in the operating room," Professor Rudolf replied in a Northeastern accent.
Director Zhang's heart swelled when he heard the familiar lilt of Northeastern Mandarin from the professor's mouth.
"Do you have any objections about the fee? It's 5,000 yuan per surgery," Zheng Ren asked.
Professor Rudolf Wagner did some calculations and converted the fee. "650 euros?"
"Around there."
"I don't need it."
"You deserve part of it," Zheng Ren said.
"Boss, I earn 15,000 to 20,000 euros per elective surgery back in Heidelberg. A referral letter cost 5000 euros. I don't need to split 650 euros with you," the professor said matter-of-factly. "This is -- how do you guys say it -- pro bono?1" The chinese word is but I can't think of a more apt word than pro bono.
Chapter 368 - Root Cause Investigation
Director Zhang left with his head lowered.
If he stayed to listen to the ongoing conversation between Zheng Ren and Professor Rudolf, he would be too ashamed to invite them to the Secondary Hospital for the TIPS surgery.
Department Chief Xia found nothing amiss and bid Zheng Ren goodbye before bringing the patient back to the gastroenterology department.
The patient did not have any complications after this round of surgeries. The portal hypertension had subsided. All that was left was the ascites, which required a simple abdominal tap.
In the silence, Zheng Ren watched the mission counter on the System display change from zero to one. His heart beat expectantly.
Initially, accomplishing ten TIPS surgeries in a month had seemed difficult due to the lack of patients.
However, with the help of Director Zhang from the Secondary Hospital, the limiting factor was addressed.
Zheng Ren thought of the hefty mission reward awaiting him and one-month mission duration, then smiled.
"Boss, we're going to the other place to perform how many procedures?" Professor Rudolf Wagner asked.
"I don't know, but it sounds like we'll get however many we want."
"That's great. Research requires supporting evidence—" The professor's words were cut off by another voice.
"Lil Fugui, I'm responsible for the boss's research," Su Yun said darkly, his jet-black hair ruffled with his sudden movement.
Professor Rudolf stared at Su Yun, his excitement dampened.
'The research can't be monopolized by one doctor!' the professor thought.
In the future, other surgeons would be using the Zheng-Rudolf method to perform TIPS surgery. It was what Professor Rudolf had envisioned.
"Quit fighting. We're making the rounds," Zheng Ren said.
Su Yun smiled at Zheng Ren, who had little concern about the proprietary rights of his research.
Trailing behind Zheng Ren, Su Yun and Professor Rudolf discussed under their breaths, occasionally looking up to check on Zheng Ren.
After the surgery, the first thought that came to Zheng Ren's mind was the octogenarian whom he saw in his morning rounds.
Physically, nothing was amiss, but the old man complained of pains and discomfort in different parts of his body.
Why would the old man be faking illness? His children were a filial bunch who came and stayed by his side. He was not faking it for attention.
There was no clinical indication of a disorder. Even the System did not provide a diagnosis.
Odd.
As they reached the emergency department observation unit, an idea struck Zheng Ren.
He would need Chang Yue's help. She was familiar with every patient's family and was better at unearthing infor
mation.
The flurry of thoughts in Zheng Ren's head abated as they entered the observation unit.
The old man's son was peeling an apple by the bed while he laid in bed, whistling a tune as his foot tapped to the music. The old man looked to be in peace.
Was he even sick?
Zheng Ren was sure the old man was faking sick.
He walked up to the hospital bed and said gently, "Sir, I am the chief resident in the emergency department. I'm here to check up on you. Can you tell me where you feel discomfort?"
The old man's eyes popped open and saw Zheng Ren standing before his bed. A frown appeared on his forehead, then he held an arm over his stomach and said, "Doctor, my stomach hurts."
Zheng Ren adjusted the old man's legs so that he was in a supine position. He rubbed his hands to warm them before proceeding with the physical check up.
The old man's acting was not a match for Zheng Ren's expert palpation assessment.
After a round of examination, Zheng Ren found nothing concerning.
Although his mind arrived at that conclusion, Zheng Ren hesitated to order a hospital discharge for the old man.
Arguments about the elderly taking up public resources were often seen online, made by keyboard warriors who hid behind a screen of anonymity. A man in his eighties could theoretically pass on at any moment and thus, could be said to deserve the medical care and attention.
A forceful removal could elicit an emotional outburst that would cause an unpredictable outcome… Zheng Ren would ideally want to sidestep this potential landmine.
They would move the old man to the emergency wards, just to be sure.
Leaving him in the observation unit was a risk, as patients that were wheeled in at night were usually from brawls or car accidents. The old man might experience a heart attack from all the commotion.
Zheng Ren explained their plan to the family members. There was no need to proceed with admissions just yet, but they would arrange for the old man to be under observation in the emergency wards.
Once the old man was transferred upstairs, he was infinitely grateful for the peace and quiet of the emergency wards.
Chang Yue approached Zheng Ren without prompting. "Chief Zheng, who's the patient?"
"I believe he's faking ill, but I've yet to find out why. I'm leaving the case to you; identify the root cause," Zheng Ren said.
Chang Yue stared at him. Her eyes narrowed as she said, "Root cause? And how do I do that? Why don't you teach me some techniques, O wise one?"
Zheng Ren tolerated Chang Yue's impudence. It was expected that she was not too happy about an additional task.
He patiently explained his theory to Chang Yue.
Zheng Ren's calm demeanor was a contrast to her attitude and she quickly quelled her temper. His explanation also made her curious as to why the old man was faking ill.
Was the hospital more comfortable than his own home?
Impossible.
From the records of post-surgery patients, it was clear that many would rather spend the night home than in the hospital. Patients would leave the hospital as soon as they were mobile.
Regardless of the doctors' advice or the medical insurers' warning, patients would up and leave their hospital beds as soon as they could.
However, this patient was the total opposite.
Zheng Ren only relaxed after the briefing was done.
The morning surgery was complete and Yang Lili's breathing tube was removed. In the coming few days, Zheng Ren planned to remove the inferior vena cava filter from the pulmonary embolism patient. Once that was done, there would be no time-s.e.n.s.i.t.i.v.e surgeries on his schedule.
All that would be left were emergency surgeries that came in, the Secondary Hospital TIPS surgeries, and the surgeries arranged by Department Chief Kong in Imperial Capital.
Zheng Ren sat at his table and contemplated the upcoming surgeries.
Minutes later, he retrieved The Fundamentals of General Surgery and continued reading. Reading had become an integral part of Zheng Ren's daily life.
He had his phone next to the open book. His ongoing chat with Xie Yiren slowed his reading to a snail's pace.
The next thing he knew, it was lunchtime.
As Zheng Ren and Xie Yiren discussed lunch options, an unknown call came in.
"Hello?"
"Office Director Ding, hi."
"Yes, I'm at the wards."
"Alright, I'll wait for you here."
Zheng Ren hung up the call.
What did Ding Zhongtai want with him? And to call him through a private line instead of the hospital landline?
As someone who had infrequent contact with Ding Zhongtai, the phone call made Zheng Ren uneasy.
Soon, Ding Zhongtai appeared at the doorway to the office in the emergency wards. He looked around the office, spotted Zheng Ren, and waved.
Zheng Ren walked out and asked, "Office Director Ding, what happened?"
Ding Zhongtai pulled Zheng Ren to a corner. With a low and stern voice, he said, "Little Zheng, did you go ahead and find someone to settle that rear-end collision?"
Collision? Rear-end? What was that?
Zheng Ren looked confused.
"The ambulance," Ding Zhongtai clarified.
'Huh. Rear-end collision was a whole new take on the accident,' Zheng Ren thought.
Chapter 369 - The Satisfaction of The System
"Huh? I don't know." Zheng Ren kept a straight face as he spoke. His innocent eyes bore into Ding Zhongtai's, betraying nothing.
"Little Zheng!" Ding Zhongtai barked sternly.
Zheng Ren's expression remained stoic. Ding Zhongtai's loudness and disapproving tone had no effect on the young doctor.
The futility of his approach made Ding Zhongtai change tack. He put on a concerned expression and sighed. "Little Zheng, I'm trying to protect you."
"Yes, yes. I know. Thank you very much, Office Director Ding," Zheng Ren said.
This conversation with Ding Zhongtai was going nowhere and Zheng Ren wanted to continue his chat with Xie Yiren. He would rather perform a surgery than be engaged in this hushed conversation with Ding Zhongtai.
"Your attitude clearly shows you do not comprehend the severity of the matter. Let me ask you again, were you responsible for calling in the Provincial Department?" Ding Zhongtai questioned.
"No. I'm sure you know I do not have the background to pull such a stunt," Zheng Ren answered truthfully.
Ding Zhongtai knew that was true.
If Zheng Ren was someone important, he would not have been threatened with termination from the Professor Moriyu incident.
However, this time around, someone had informed Ding Zhongtai that Zheng Ren was making it hard for the case to progress. They wanted Zheng Ren to step back so this Porsche case could be deflated and buried.
An immediate sentencing was undesirable and they would only accept a suspended sentencing at worst.
Ding Zhongtai had wanted to avoid treading into treacherous waters if he could.
The suspect in this case had committed a crime, and the case was under scrutiny by the province leaders. All Ding Zhongtai could say was that the driver of the Porsche was terribly unlucky.
In another time, this incident would be a trivial matter.
Zheng Ren would have been charged for driving the ambulance into the Porsche.
Ding Zhongtai studied Zheng Ren, hoping to find some clue as to what the young doctor was thinking.
He was disappointed.
Zheng Ren's eyes remained steady and unwavering.
"Little Zheng, I'm only trying to protect you. Trust me." Ding Zhongtai pondered on how he should inform the people about this as he tried to convince Zheng Ren. "Yang Lili's awake now and this horrible incident can soon come to a close. When the leaders' attention is no longer on the case, who knows what would happen."
Zheng Ren nodded absentmindedly.
Ding Zhongtai was annoyed at the flippant attitude Zheng Ren
was displaying.
There really was nothing he could say to this man.
He cared little about Zheng Ren's career or life.
After Ding Zhongtai left, Zheng Ren remembered he ought to treat Chu Yanran and Chu Yanzhi to a meal.
The sisters had done him a huge favor that day.
To think he had forgotten about it… He only had himself to blame.
Zheng Ren texted in the groupchat, asking if everyone wanted to have dinner together.
Zheng Ren only cared about the money spent, and so did not participate in the restaurant selection.
Today was Chang Yue's shift and, after some discussion, everyone decided to move the dinner to tomorrow.
Having one less person meant less fun, especially since Chang Yue was Su Yun's rival when it came to drinking. Often they would be embroiled in running arguments and drinking matches.
As the texts went on, the clock struck 12.
Just as Zheng Ren was planning to leave for lunch, the emergency department called. There was a patient with acute appendicitis.
'Oh well, I guess lunch may be forfeited.'
He texted in the group chat to inform the others. If the diagnosis was confirmed, they would have to prepare for surgery.
The group chat was bombarded by lamentations and cries of injustice.
Zheng Ren ignored the bunch of drama queens and pocketed his phone. Although everyone complained about having a case during lunchtime, when push came to shove, each of them did their duty.
The patient, a middle-aged female, was wheeled into the emergency ward. The routine examinations and tests were ordered while Zheng Ren confirmed her diagnosis through the System.
The patient had to fast for a few hours before they could begin.
In the group chat, the few ladies were discussing what to order for delivery. Su Yun walked over to Zheng Ren.
There was a sly smile on Su Yun's face, which made Zheng Ren cautious. "What's up?"
Su Yun laughed and said, "The professor is quite an impressive man. We talked about research and he said we can apply for funding for the new TIPS method."
"Funding?" Zheng Ren had little knowledge about such things.
"On the outside, it's like a charity fund contributed by big companies like Boston Technologies and Medtronic. This fund aims to help develop methods and techniques relating to interventional surgery. These companies want to keep tabs on what's happening in the field and through these funds, they can curry favor with the doctors. Boss, congratulations, you're worthy of their attention!" Su Yun explained.
The Surgeon's Studio c1-799 Page 174
