"Boss, what did you do?" Su Yun scanned his surroundings and found nothing odd. If a lobectomy was performed, he would have to present the damaged lobes to the family.
"Suturing. Didn't you just speak of it?" Zheng Ren answered matter-of-factly.
Su Yun was speechless.
"Scrub in," Zheng Ren told Su Yun.
"Do you still need me? Does my presence even make a difference?" Sarcastic Su Yun was back.
Brother Yun's sarcastic remarks came whenever he felt like it.
An unhappy Su Yun would deliver a few lines of sarcasm.
A happy Su Yun would do the same.
The habit would be incredibly unflattering if it was anyone but Su Yun.
Su Yun had the skills and swagger to make derisive but honest comments because no one could fault him.
This was exemplified by the number of buddies he had back in Imperial Capital.
If he ever wanted to go drinking, there was a long list of contacts he could pick from.
Zheng Ren ignored Su Yun's pointless question and continued with the surgery.
As usual, despite his complaints and rants, Su Yun went to wash his hand and put on the surgical scrubs.
He came back to the operating table fully-dressed. He used one hand to feel the right lung.
He could feel the thick double-stranded No. 7 suture in a figure-of-8 suture pattern.
It was the same technique Su Yun had in mind. Did Zheng Ren have some background in cardiothoracic surgery?
From a cardiothoracic standpoint, what Zheng Ren had done was extremely daring.
Su Yun had spent a lot of time thinking about the various methods to seal the two wounds while speaking to the family.
He landed on the same solution as Zheng Ren.
When he returned to the operating room, Zheng Ren was already done.
Su Yun glanced at Zheng Ren as he was fixing the rib fractures.
Zheng Ren's attention was fully on the procedure, unaware of any unwelcoming stares.
The ribs fixation was a tedious process.
The actual procedure was not difficult but the damage to the rib cage extended from the second rib all the way to the ninth rib. They had to maneuver the clips in a restrictive operative field.
30 minutes later, the internal fixation surgery was completed. They checked for any active bleeds before closing up the c.h.e.s.t.
"Su Yun, we'll have to pay attention to the patient's airways," Zheng Ren instructed.
Zheng Ren was referring to whatever fluid that was lodged in the patient's airways. After the surgery, the blood in the patient's airways had to be aspirated.
"Don't worry. The reason why I'm staying in the ICU tonight is to make sure all the blood is removed from his airways. If we followed the standard treatment workflow, the patient could lose up to 40% of his lung capacity."
"Hmm, thank you then."
"Yes, thank me." Su Yun's eyes shifted to Xie Yiren, then back to Zheng Ren. His eyebrows were questioning.
He was asking if Zheng Ren had made any progress.
This man was too nosy for his own good.
Zheng Ren said nothing but nodded before shaking his head.
Su Yun shook his head, his eyes crinkling with a smile.
Once the patient woke from the general anesthesia, he was transported to the ICU.
Cao Guozhen accompanied the entourage to the ICU. He wanted to keep an eye on the patient, ignoring the jabs thrown at him by Su Yun.
If it were not for the two surgeons from the emergency department, Cao Guozhen would have seen his entire career flushed down the drain.
Death or a fate worse than it would take him.
When the patient arrived at the ICU, the vital sign monitor was displaying a steady electrocardiogram. The patient's blood pressure was also in the normal range at 120/72 mmHg while the blood oxygen level was at 94%.
The numbers were satisfactory.
Unless an unforeseen event happens, the patient would survive.
Regardless, Su Yun was stringent with post-surgery monitoring. A set of aspirators was brought to the patient's bed and Su Yun began the process of suctioning the fluids from the patient's airways.
The specialized hard-tube aspirator was only available in the ICU.
As the tube was not flexible, it stimulated the airways and made the respiratory muscles contract, forcing the trapped fluids outward.
The device could not be used mid-surgery but once the rib fractures were stabilized, they would not have to worry about the patient's coughing. There was a lower risk of damaging the lungs once the rib cage was fixed.
Su Yun was relieved at the sight of dark red fluid that crept up the aspirator tube.
The blood in the airways was only starting to coagulate. Su Yun could remove the fluid that was accessible.
As for the blood trapped deeper in the lungs, he would try his best, but the remainder would have to be dealt with through the natural absorption by the body.
"I'm leaving," Zheng Ren announced once the patient was stable. The dark blood being pulled out of the patient's airways was reassuring.
Su Yun did not bother to look at Zheng Ren. He waved his hand as if shooing a fly.
Cao Guozhen followed Zheng Ren and uttered softly behind the surgeon, "Chief Zheng, thank you for today."
Zheng Ren smiled. "It's alright, Chief Cao."
Cao Guozhen was smart enough to know what Zheng Ren and Su Yun had saved him from.
"Let us have lunch together one day," Cao Guozhen said with gratitude.
The two men parted ways outside the ICU department.
Zheng Ren did not communicate with the patient's family. Su Yun would handle all of it.
He texted Xie Yiren as he walked.
It was almost 10:00 pm, too late for a date.
After all, it was improper for a girl to be out late.
Of course, it was unavoidable in this line of work, but work was an exception. Zheng Ren would have to be on standby tonight for any emergency surgery as Su Yun would be busy in the ICU.
He should go home and rest.
Chu Yanran was staying over at Xie Yiren's house tonight so it was unlikely that anything would transpire between Xie Yiren and him.
Xie Yiren, Chu Yanran, and Zheng Ren went back to the neighborhood. Zheng Ren recalled the memory of holding Xie Yiren's hand while they were walking down the streets searching for food. It was a sweet one.
After saying goodbye, Zheng Ren went in and took a shower. Xie Yiren and he texted for a while before he went to bed.
The next day, Zheng Ren made a pit stop to the ICU before taking over the shift in the emergency department.
The patient was in good shape. He only complained about the lack of rest due to the suction procedure.
The charts showed a total of 400 ml of gunk removed from the patient's airways.
Su Yun's presence in the ICU really made a difference. If the surgeon was not available, no nurse would dare to perform a suction in 20-minute intervals.
There was a risk of damaging the trachea.
After seeking the ICU chief's opinion, the patient was transferred to the emergency wards alongside the patient who was stabbed in the heart.
Chapter 405 - Mayo Clinic
Zheng Ren busied himself with the patients that came into Sea City General Hospital, the small hospital that was insignificant in the world of academic medicine.
At the same moment, something was about to transpire in the Mayo Clinic Headquarters in Roc.h.e.s.ter, Minnesota.
The 38-year-old Mu Tao was flipping through articles and writing up his daily surgical journal.
After leaving Imperial Capital and returning to Shenzhen City, he felt incompetent.
To be the best surgeon, he had to go to the best hospital and receive the most advanced medical training the world had to offer.
He still had the fiery passion of youth in him.
Mu Tao had spoken to Old Wu about his aspirations and the old profe
ssor was supportive.
Old Wu had friends in the international medical community. He managed to obtain a six-month international exchange program for Mu Tao in the world-renowned Mayo Clinic.
It was only six months but Mu Tao was very thankful for the opportunity.
When he first arrived at the Mayo Clinic, he began learning enthusiastically despite the jetlag.
Canada's Montreal General Hospital was in the top five hospitals, but Mayo Clinic was ranked first worldwide.
They could compete with Montreal General Hospital in any field, even neurosurgery.
Here, Mu Tao was exposed to all sorts of advanced medical facilities and medical theories. The doctors were knowledgeable and the surgeries they performed were complex and holistic.
In the field of interventional surgery, Mayo Clinic was also ranked first.
They were especially well-known for their TIPS procedure for the treatment of decompensated cirrhosis-induced gastric varices, portal hypertension, and ascites.
One of the best minds in the field of interventional surgery once said the techniques used in Mayo Clinic were five to ten years ahead of time.
After witnessing first-hand, Mu Tao concurred with the assessment.
Sometimes he even believed five to ten years was an understatement.
Mu Tao was regarded as China's best technical interventional surgeon and he carried that reputation with pride.
When he saw the TIPS surgery performed at Mayo Clinic, his pride and ego were shattered.
In Shenzhen City, Mu Tao's TIPS puncture attempts were always limited to a dozen or so and the success rate of the surgery was as high as 85%.
Even Wu Haishi was amazed by his disciple's accomplishment.
With a stellar track record in performing TIPS surgery and his sharp instincts, Wu Haishi had called Mu Tao a prodigy.
Mu Tao was a talented surgeon, no doubt.
Here in Mayo Clinic, the TIPS surgeries that Mu Tao witnessed all had less than ten puncture attempts.
The challenging blind puncture was also an aspect Mayo Clinic was looking into in hopes of a swifter and less damaging TIPS surgery.
The current procedure in all Mayo Clinic branches was to place a specialized guide wire in the portal vein to map out the general area. This reduced the chances of a total miss when performing the puncture.
The method had already been discussed publicly in a journal article.
Reading it in an article was nothing compared to witnessing it live. The additional guide wire significantly improved workflow efficiency.
The TIPS procedure could be completed with five or fewer puncture attempts and the surgery success rate was as high as 95%. The post-surgery hepatic encephalopathy incidence rate was as low as 30% with this method.
These statistics were unbeatable.
Mu Tao believed the crown jewel of interventional surgery had been cleanly plucked by Mayo Clinic.
Learn, research, operate. Mu Tao kept a steady pattern every day while he was in America.
He had even forgone sleep, taking only 4-hour daily naps.
Mu Tao only had six months and found himself running out of time. There were too many things to learn and too many surgeries to perform.
Every day, there were countless dignitaries and rich businessmen who stopped by Mayo Clinic for a consultation or check-up.
A referral letter from a specialist cost USD7,000.
The figure was shocking.
However, Mu Tao truly believed the price tag was worth the service. Even if the price was doubled, it would be worth it because life was precious.
For interventional procedures, the were many patients who were available. Although Mu Tao could not perform the surgeries, he could assist and learn.
Whenever fatigue caught up and threatened to drown him, Mu Tao recalled the situation back in Imperial Capital.
Mu Tao wanted to be the best in the country! Anything less was not acceptable!
For this goal, he would push himself to the brink of exhaustion.
Mu Tao embraced each second he spent in Mayo Clinic.
…
…
Back in Sea City General Hospital's emergency ward, Zheng Ren was performing a physical examination of the patient who was stabbed in the heart.
His recovery was swift. The patient was able to go to the bathroom unassisted while carrying the c.h.e.s.t drainage system.
Cardiac stab wounds and cardiac tamponades required emergency medical attention. Time was the main factor in these rescues as once the window of opportunity had passed, there was a high risk of brain damage.
This patient was incredibly lucky.
During the transport of the patient from the ICU, he and his lover had thanked Zheng Ren profusely.
After the initial shock, his lover's mental state had finally returned to normal. She was no longer wailing and sobbing as she had during the emergency response.
The woman seemed to have forgotten what had happened that day.
Zheng Ren watched his words as he spoke to the couple. He did not want to jog her memory lest she remembered how he kicked her aside that day. Had he not brought her lover back from the dead, the woman would likely sue him for assault.
Zheng Ren checked the patient's temperature and listened to his c.h.e.s.t sounds. No fever, no signs of infection. Everything was going well for him.
One more week of observation would do before discharge.
As for the sutures on his c.h.e.s.t, they could be removed in a few more days.
The other patients were all in stable condition. Under Zheng Ren's management, the emergency wards were orderly and proper.
The key was in the quality of surgical procedures as it dictated the post-surgery care, which was resource-intensive.
Needless to say, the medical staff was essential in maintaining the emergency wards' smooth operation.
Professor Rudolf Wagner had gotten used to the workflow in the emergency department. To end up here in a small general hospital in Northeastern China, the professor believed it was God's will.
He was able to witness Zheng Ren complete a TIPS surgery with a single puncture attempt.
The professor had faith he could practice and master the technique.
On the other hand, the patient with prostatic hyperplasia was on his way to China.
Professor Rudolf Wagner did not forget his initial goal of winning a Nobel Prize. It was his life goal.
With the help of a magnificent East Asian surgeon like Zheng Ren, Professor Rudolf's hopes soared.
This was a sign from God.
After making his rounds, Zheng Ren headed back to his office and picked up on his reading.
He was glad the activity boosted his skills in the System and gave him an edge.
He had no idea why the System had chosen him or when It would desert him but he now had the ability to save lots of people and that was enough.
Zheng Ren treasured every second he had with the System.
Chapter 406 - Boss, You’re Mocking Me
The department phone rang.
Zheng Ren answered the call. A doctor from the emergency internal medicine had called to inform them a young female with acute appendicitis had been admitted. They were on their way to the hospital.
Zheng Ren called Su Yun. "We have an appendicitis case. Take Yang Lei with you to surgery."
"Oh." Su Yun's head was buried in his phone, likely texting or playing a game.
Nowadays, the emergency ward required two appendectomies on average. Yang Lei had much more surgery opportunities after he was transferred to the emergency ward.
Even though he lacked the talent, his skills improved with continuous surgical practice.
The patient arrived shortly.
Zheng Ren performed a physical examination carefully and reached a diagnosis.
The patient was a sixteen-year-old girl.
She had been experiencing right lower abdominal pain for two days, accompanied by a low-gr
ade fever. The emergency lab report showed elevated levels of leukocytes and neutrophils, which were indications of an infection.
The B-scan ultrasonography excluded the possibility of ovarian disease. The symptoms were typical and Zheng Ren's diagnosis was in line with the System.
She was cleared for surgery.
"The patient's diagnosis is very obviously acute appendicitis. When was the last time she ate and drank?" Zheng Ren asked.
The patient's father was a man in his thirties, most likely from the rural village in the outskirts of the city looking at the way he was dressed.
When he heard Zheng Ren's question, he sized up Zheng Ren cautiously and answered, "Around 6 o'clock this morning."
Zheng Ren was puzzled by the man's defensive behavior.
He glanced at the time and it was still before 10 a.m. She had to wait for another two to three hours to fulfill the 6-hour fasting period before surgery.
"Don't let her take any food or liquids from now onward," Zheng Ren said, "We'll be preparing her for surgery at 1 p.m."
"Surgery?" The man replied immediately, "Doctor, we don't want surgery."
"Hmm?" Something clicked in Zheng Ren and he realized that they would be facing some complications.
He had guessed earlier that it might be surgery-related.
As expected, the patient's father continued, "We don't need surgery; just give my daughter some anti-inflammatory medication."
"If we apply conservative treatment for acute appendicitis, there may be a risk of rupture. It will seriously endanger the patient's life." It was not Zheng Ren's intent to threaten the father; he was merely stating the truth.
Fan Tianshui, for example, was a strong man like, yet he had a close encounter with death just because he did not receive the appropriate treatment in time.
Besides that…
A gay p.o.r.n star, Masaki Koh from Tokyo, refused to get an appendectomy because he did not want to scar his body. His appendix ruptured and he developed peritonitis and other complications, which ended up taking his life at the ripe age of twenty.
Some diseases healed over time, but they could also progress into a life-threatening condition.
General surgeons usually preferred a radical approach.
The appendix was not an essential organ. Instead of suffering the pain of conservative treatment, they would advise people to have it surgically removed.
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