70

Chapter 70

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Chapter 70: I Don't Remember

It was an uneventful afternoon and the patients' conditions were stable. Zheng Ren was reading a book while Chang Yue walked around the wards, chatting with patients and family members after she finished documenting cases.

The Chu sisters and Xie Yiren were in the operating theater, missing the crazy night of forty-nine appendectomies. Chu Yanzhi wanted to burn calories, but there was no point in doing it right now. She could not possibly give Zheng Ren a whack and throw him onto the operating table, right?

Zheng Ren had already forgotten about his massive stash of experience points and was quietly reading his book in his office, waiting for the emergency department to call him to confirm the diagnosis of random patients.

Around three o'clock in the afternoon, footsteps were heard in the emergency ward corridor.

Zheng Ren was unconcerned as they could belong to visiting family members or friends.

The emergency wards could not possibly implement closed-off management as it took at least 1.4 nurses to take care of a patient.

Not only that, Old Chief Physician Pan had only managed to allocate the bare minimum of nurses required of the emergency wards after plundering the entire hospital.

Thus, any visitor could come to and leave the wards at will. After all, upper management usually provided ideas or suggestions and subordinates would be those handling tiresome issues. Whoever took these seriously would just attract trouble to themselves.

"Hello, Doctor Zheng."

There was a knock on the office door. Several men stood at the doorstep headed by a woman who resembled a celebrity, especially in a black sweater and big sunglasses.

Who was she? Zheng Ren was stunned.

From her appearance… Zheng Ren's mind remained blank as he had no memory of her at all.

"I'm Zhou Jinxi. Doctor Zheng, do you still remember me?" The lady took off her sunglasses and wore a sweet smile on her face.

'Zhou Jinxi… Was she the patient who underwent an endoscopic transrectal appendectomy last time?' Zheng Ren was able to recall the patient's name and case details, but he failed to relate them to the lady smiling warmly before him.

Zheng Ren shook his head in response.

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There was a moment of awkward silence.

"Hello, Doctor Zheng." A person standing behind Zhou Jinxi walked forward, gave Zheng Ren a professional, calm and elegant smile, and added, "I gave you a business card last time. Do you remember?"

"Not really." Zheng Ren scratched his head, completely forgetting the agent who had given him a business card in the corridor outside the endoscopic unit. She had also said that she would entertain Zheng Ren whenever he visited Sorcery Capital in the future.

"Great wits have short memories, Doctor Zheng." The smile on the agent's face froze a little, but she continued without losing her composure. "Miss Zhou won the championship in the modelling competition. Before we return to Sorcery Capital by flight tonight, we would like to thank Doctor Zheng for making this possible."

"Oh, please have a seat," Zheng Ren said, finally managing something sensible.

The pair of jeans Zhou Jinxi wore accentuated her slim thighs and curvy body, and clearly showed her amazing elasticity with every move.

Zheng Ren's heart remained calm as a millpond as Zhou Jinxi, a beautiful angel, walked into the room. Then, he asked casually, "How goes your recovery?"

"Very good," answered Zhou Jinxi with a grin. "Ambulation on the first day, liquid diet consumption on the second and straight to the competition on the third. Sister Wu was worried about the risk of surgical wound breakdown, but everything seemed fine. Doctor Zheng, your surgery skills are incredible!"

Zhou Jinxi gave Zheng Ren a thumbs up and clicked the "like" button.

There was a warm luster on her hand as if she was carved out of a pure, white jade.

Zheng Ren confirmed that Zhou Jinxi had indeed recovered completely without any risk of complications after reading her details in the System panel.

"Chief Zheng, the little girl wants to know when can her father get discharged from the hospital," asked Chang Yue, interrupting the conversation after squeezing through the crowd.

The girl in question was shy and dared not to follow Chang Yue after seeing the crowd in the office.

"Eh?" Zhou Jinxi's agent, who seemed to have noticed something interesting, stood up abruptly, walked toward the young girl and eyed her up in a domineering manner.

The agent was shorter than the girl, but her presence alone more than made up for it.

The young girl lacked self-confidence and asked weakly, "Why are you looking at me?"

"How old are you?" the agent ignored her question and asked.

"Seventeen."

"Studying or working?"

"I initially planned on working, but my father was sick and I had to take care of him. I'll start finding a job once we return home," answered the girl, gradually lowering her head, embarrassed and self-abased.

Chang Yue, who noticed the agent's overbearing attitude, turned around and stood between the girl and the agent. Then, she grabbed the girl's hand and took her into the office.

"Chief Zheng, the little girl wants to know: when can her father get discharged from the hospital?"

"In three days. If you're not in a hurry, I suggest you wait for a week and return home only after removing the suture. Otherwise, you can simply go to any rural health center for suture removal," answered Zheng Ren confidently.

If Zheng Ren had used an absorbable catgut suture to close the surgical wound, there was a possibility that a wound dehiscence could occur post-activity. However, a reverse cutting needle with a size seven suture thread had been used instead. It was strong enough to hold the wound edges together and Zheng Ren was certain about it.

"Little girl, did you hear him clearly?" Chang Yue said, "Don't worry too much. Even though Chief Zheng looks a little ugly, he is an expert in surgery. If he says everything is fine, your father will be alright."

There was nothing Zheng Ren could do about Chang Yue's description.

"Okay!" The young girl bowed deeply to Zheng Ren and quickly ran away.

There was a slight gleam in the agent's eyes. After the girl left the office, she asked, "Doctor Zheng, is she a family member of your patient?"

"Yes."

"What are you going to do?" Chang Yue's high emotional quotient was limited only to the patients and family members. Every other time, it was about on par with Zheng Ren's.

However, she was slightly wary of the agent's attitude and was thus ruthless with her question.

"The company is going to assemble a group consisting entirely of women. That girl's body and appearance meet our requirements, and that was the reason for my questioning," The agent understood everything after noticing the vigilance in Chang Yue's expression and mocked, "Are you seriously thinking that I'll be trafficking her?"

"Yes," Chang Yue admitted. Damn, she was indeed a frank lady.

"Many people begged for my attention, but I couldn't be bothered with them," the agent said proudly, "There aren't many opportunities that can completely change one's life. Doctor, are you sure you can speak for her?"

Chang Yue hesitated immediately.

She was fully aware of that young girl's family condition, so…

Zheng Ren's phone suddenly rang and interrupted their confrontation.

"Chief Physician Pan, understood.

"Why?

"Alright, I'm on my way."

Zheng Ren hung up after a few words, and with a regretful tone despite his relaxed appearance, he said, "ICU, urgent consultation. Please excuse me."

"Don't worry about it, Doctor Zheng." The agent took out a business card from her handbag and handed it to Zheng Ren once more. "Please give me a call if you visit Sorcery Capital in the future. Doctor Zheng has given Zhou Jinxi and me great help this time, so don't bother with formalities when the time comes."

Smiling politely, Zheng Ren accepted the card and casually tucked it into his pocket.

"Chang Yue, help me see the visitors out. I'm going to the ICU now."

"Multidisciplinary consultation shouldn't include the emergency department, right?" asked Chang Yue doubtfully.

"Chief Physician Pan said that the emergency department is involved as long as it's an emergency case. I'll come back soon, so wait for my return before you get off work," Zheng Ren instructed Chang Yue and left the office without bidding farewell, even with a 180-centimeter tall supermodel in the room.

IndexChapter 71 - Hysterectomy or No?

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Chapter 71: Hysterectomy or No?

Zheng Ren rushed to the first floor of the emergency department building and found Old Chief Physician Pan waiting for him.

The two men ran toward the ICU. At the changing room before the ICU entrance, they put on surgical caps and masks, changing into dark green sterile scrubs and even swapping their shoes for slippers before entering.

The ICU was like treasure vaults in movies, where one had to change their clothes and go through two rounds of scrubbing before being allowed in.

This was to prevent the risk of contamination as most ICU patients had tracheostomy tubes connecting them to ventilators. They had very poor immunity and microorganisms that were usually commensals could become lethal pathogens.

Inside the ICU, many department chiefs were already there on the case.

The System display at the upper right corner of his vision told him that it was a placental abruption of the hemorrhagic sort.

The patient was a young female, 20 months into pregnancy. Due to pregnancy-induced hypertension, the placenta had detached from the uterine wall. The distance between the placenta and the uterus was half the length of the placenta.

The patient was bleeding excessively, resulting in a pallid complexion. She was sweating profusely and her heart rate was rising while her blood pressure was plummeting. She was exhibiting symptoms of hemorrhagic shock.

Fetal asphyxia had set in and the fetal heartbeat was undetectable. The baby was already dead.

This was a tricky case…

As this was the patient's first pregnancy, a hysterectomy would close the door on any future pregnancies. It was a cruel thing to do to an expecting mother.

However, if an emergency hysterectomy was not performed, the bleeding would not stop. The obstetric and gynecology department had tried to manage the bleed but antihemorrhagic drugs had helped little.

They were stuck between a rock and a hard place.

A few of the department chiefs that came to consult had the same opinion. The case was a tricky one. They frowned at the worrying numbers on the vitals monitor, deep in thought.

The diagnosis was simple, but the biggest problem was the decision to remove the uterus.

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Su Yun stood by the patient's bed with a blue clipboard in his hand. His coat was white as snow and a stethoscope hung over his neck. He stared at the department chiefs with an impassive look.

"I suggest that we discuss this in the office. Time… There should be only ten minutes left. Xiao Su, start prepping for surgery," the ICU chief spoke.

The various department chiefs filed out of the ICU. Su Yun saw an unobtrusive Zheng Ren at the end of the crowd. Anyone would have missed his presence had they not been paying attention.

Su Yun gave the usual orders and the nurses got to work.

He left the observation room and went into the second room in the corridor. The room had clear windows and a large, makeshift table made up of a few office desks. There were a dozen or so chairs around it.

The ICU chief glanced at the clock and said, "We have nine more minutes."

"I don't think there's much more to debate," the obstetric and gynecology department chief, Su Yun, spoke firmly as he adjusted his horn-rimmed glasses, "We have tried many ways to stop the bleed but none were effective. Any more delays and the patient could go into hemorrhagic shock. By then, surgery won't be a viable option."

"Haih." The anesthesiology department chief sighed audibly. He started to speak but paused at the last second.

"Old Wang, what do you have to say? Don't sigh and just say it." The ICU chief was in an agitated mood and did not welcome dithering.

"If we only had an interventional surgery expert," Anesthesiology Department Chief Wang said. It was what everyone was thinking.

"Ask if the endovascular team can help us out."

The ICU chief's expression was dismissive. "The endovascular team has 18 myocardial infarction patients today among the three wards, all lined up for surgery."

If a myocardial infarction acted up without surgical intervention, death was guaranteed for the patient.

It was unlike the pregnant patient in the ICU who had the alternative of a hysterectomy to save her life.

These razor-sharp contradictions were a daily occurence in the hospital. Which lives were more virtuous? None. In the face of death, every person was equal and the only inequality lied in society.

Even if the endovascular surgeon was free to assist in the surgery, if something were to happen, who would be blamed? According to the law, surgeons were only licensed to practice within their expertise. Among all the specialties, only trauma surgeons were allowed some leeway.

The crowd was silent.

Zheng Ren stood at a corner. He had no authority to speak in this sort of large-scale emergency rescue meeting that involved the whole hospital.

If it were not for Old Chief Physician Pan's insistence, Zheng Ren would not have even been allowed to attend this meeting. The other department chiefs respected his seniority.

Zheng Ren understood the point they were making. If they wanted to preserve the uterus and stop the bleed, it had to be through interventional methods.

Surgeons involved in interventional radiology were exposed to large amounts of radiation. After one of the specialized surgeons had been diagnosed with diffuse large B-cell lymphoma, such surgeries became less popular. Doctors preferred placements in the endovascular team for coronary angioplasty and as time passed, there had been no one in the interventional radiology-assisted surgery department.

For this, Anesthesiology Department Chief Wang lamented.

The mention of interventional radiology reminded Zheng Ren of the System. It had once tempted him to choose interventional surgery.

Maybe he could try it out? Zheng Ren considered.

There was only a few minutes left. He had to decide.

Zheng Ren entered the System and opened up the Shop. He stared at the interventional surgery training option and hesitated.

He was not debating whether he wanted to purchase the training. Experience points were nothing if he could save one life or let the patient retain her reproductive ability.

His hesitation was self-doubt. He was unsure if he was eligible for the training.

Ever since attaining the System, Zheng Ren's memory had improved significantly. His knowledge of anatomical positions had gotten better alongside his general surgery skill.

Based on his memory, interventional surgery for a placenta abruption called for the embolization of the uterine artery. It was the easiest interventional surgical procedure.

Then… that was it.

Once the decision was made, Zheng Ren confidently selected the training.

In a flash, the operating theater rose from the ground. Zheng Ren felt a tug as a lead apron was affixed to his body. With a simulation mannequin before him, Zheng Ren gripped the catheterization kit in his hand.

How should he do this?

Zheng Ren was in a stupor.

[Please add skill points into interventional surgery to proceed with training.]

The robotic female voice of the System reminded Zheng Ren of his own thoughts. You idiot, you should have prepared your skill tree before trying a new surgery. Did you think you could just waltz in with zero preparation and pick up interventional surgery?

Sweat rolled down Zheng Ren's back. He used a skill book to raise his interventional surgery skills to Graduate rank, at 1000 skill points. Then he added 1 more point to achieve Expert rank.

The jump in skill level felt like a thunderbolt striking him from the sky. His whole body was paralyzed.

In an instant, his mind was clear as unfamiliar memories started to file in.

During his climb up the general surgery skill tree, Zheng Ren did not feel any noteworthy changes. That was because he was a general surgeon and was routinely exposed to pertinent cases. Even when he got 2000 skill points in general surgery, he only felt pride for his achievement.

This was a different case. Zheng Ren went from zero to Expert and it made him regard the System with wonder.

He had a total of 189920 experience points, worth around 52 hours. Equipped with the Expert rank, Zheng Ren bought 50 hours of surgical training time. The remaining points would be kept as a backup.

Interventional surgery training had begun!

IndexChapter 72 - Alone Without Assistance (Part I)

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Chapter 72: Alone Without Assistance (Part I)

In the meeting room, Obstetrics and Gynecology Department Chief Su let out a sigh. He stood up and said, "Then that's settled. I'll speak to the family about the operation."

"It's the only way." Many of the department chiefs knew it would come to this, but had held out hope for an alternative plan.

"If I could have a second." Zheng Ren took a step to block the doorway.

"Eh? Xiao Zheng from general surgery?" Chief Su's familiarity with Zheng Ren started and ended with the first general surgery department.

"He's the chief resident of the emergency department now." Old Chief Physician Pan immediately corrected Chief Su, his tone protective.

"What is it?" Chief Su asked with a frown.

"I can perform interventional surgery. And emergency embolization surgery falls under emergency rescue protocols, making it legal," Zheng Ren stated.

"You?" A dozen pairs of eyes stared at Zheng Ren.

"I had done it during my housemanship." Zheng Ren knew it was a paper-thin reason. There was no way Chief Su would believe him.

Nevertheless, Zheng Ren could not think of a better lie to convince Chief Su.

"Step aside. I need to prepare for surgery." As predicted, Chief Su had no interest in Zheng Ren's nonsense.

Old Chief Physician Pan watched Zheng Ren. "Are you sure?"

"The emergency operating room has the hybrid operating table and we can borrow some consumables from the endovascular team. Compatibility is not perfect but it shouldn't be a problem. The only thing we lack for the uterine artery embolization is absorbable gelatin sponge."

The main procedure done by the endovascular team was angioplasty, so why would they have absorbable gelatin sponges?

"Old Chief Physician Pan…" Chief Su's frustration was palpable but he still respected the old chief's stature in the hospital.

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"Give Zheng Ren ten minutes on the hybrid operating table…"

"I only need five!" Zheng Ren said cheerily.

"Alright, five minutes. If it fails, the hysterectomy can proceed immediately. The emergency operating theater has the necessary machines, nurses, and anesthesiologist. The attempt will not compromise the hysterectomy in any way," Old Chief Physician Pan spoke.

Chief Su did some mental calculations. This attempt could reassure the family that the hospital had tried their very best and the hysterectomy was the last resort. They would be more accepting of the news.

"Will there be any complications?" Chief Wang from the anesthesiology department asked.

"It's possible but the chances are low and there's no time to explain," Zheng Ren replied.

"Then get to the emergency operating room now!" Chief Su slammed his hand on the wall and strode out of the room. He was going to inform the family about the procedures.

They would exhaust their arsenal to save the patient with hysterectomy being the last resort. The family would feel better hearing that.

As Chief Su agreed to operate in the emergency department's hybrid operating theater, Zheng Ren heard a System mission arrive.

[Emergency Room Mission: Save A Mother-To-Be

[Mission Details: Perform a uterine artery embolization surgery.

[Mission Reward: 100 skill points, 1000 experience points, one silver chest.

[Mission Duration: 3 hours.]

Zheng Ren had no time to go through the specifics. A life was on the line.

Su Yun wore a surprised expression when he looked at Zheng Ren… or dumbfounded was more accurate. A few seconds later, a sliver of a smile appeared on Su Yun's face.

A few surgeries during his housemanship and the guy thought he could complete an emergency uterine artery embolization within five minutes!

This was utter nonsense. He was just a general surgeon punching above his weight.

However, Su Yun's smile was not one of mockery but of genuine curiosity.

During a life-threatening emergency, speed was essential.

Zheng Ren and Old Chief Physician Pan hurried to the vascular imaging room for the necessary consumables.

The consumables used in angioplasty were of different make from those used in embolization, but in light of the emergency, practicality was all that mattered.

As they walked, Old Chief Physician Pan asked Zheng Ren about the type of absorbable gelatin sponge he needed, then proceeded to make a call.

A brief conversation on the phone later, he told Zheng Ren the absorbable gelatin sponges would be arriving soon. The old chief was a well-connected man indeed.

With Old Chief Physician Pan's guarantee, Zheng Ren felt his confidence rise.

Upon arrival at the vascular imaging room, Zheng Ren started to look for suitable consumables.

The materials used by the endovascular team were mostly soft and fine, characteristics that were not required in embolization surgery. After all, the uterine artery lumen was much wider than even a coronary artery with 90% blockage.

Zheng Ren's Expert rank allowed him to skillfully sieve through the many available materials and gather what he needed. A few minutes later, he was bounding toward the emergency operating theater, a bunch of guide wires and guide catheters in hand.

He was a bit winded when he reached the operating room. He let out a breath and started preparations.

Suddenly, the System spoke into Zheng Ren's ear and a new mission flashed at the top right corner of his vision.

Two missions? Zheng Ren was shocked.

[Special Mission: Alone Without Assistance

[Mission Details: No one can assist you. You can only rely on yourself. Surgery is not a one-man show but under special circumstances, it necessitates a solo operation.

[Please complete one surgery alone.

[Mission Reward: Unknown.

[Mission Duration: 3 hours.]

Alone without assistance… This phrase was like a bullet to Zheng Ren's heart.

Although Zheng Ren had the well-maintained hybrid operating theater, the lack of an assistant, a technician, and compatible equipment was paramount.

If this was a standard surgery, forgoing any one of the above would have led to failure.

Unfortunately, he had no time.

No time to practise.

No time to wait.

No time to waste.

His success or failure would determine a woman's future of becoming a mother.

Zheng Ren ignored the mission. The reward was inconsequential compared to the patient's life.

He switched on the slumbering machine. The noise reduction feature meant only a low humming could be heard.

The Siemens Artis zee Biplane Interventional Angiography System was released two years ago. The state-of-the-art facility had been untouched for more than a year.

Without an operator, the sleek machine was just a heap of metal.

Initiation, optimization. There was no technician, so Zheng Ren assigned the system access and control from within the operating theater. Similar to surgical lighting controls, a sterile film would be fixed over the Siemens' controls which would allow him to manipulate the system from within the sterile environment.

Earlier on, Xie Yiren and the Chu sisters had been called in.

The current procedure only required local anesthesia. Therefore, the Chu sisters were on standby. If Zheng Ren's attempt failed, the hysterectomy would call for the sisters' expertise in total anesthesia. However, the appearance of Anesthesiology Department Chief Wang diminished their chances of getting involved with the surgery.

Xie Yiren was facing a similar situation. Once the surgical instruments were prepared, she was left with nothing to do.

The patient was transported in. Her blood pressure was at 70/50 mmHg, her breathing rate was 25 breaths per minute and her blood oxygen saturation was at 92%. Her face was pale and she was sweating profusely, the classic symptoms of hemorrhagic shock.

Her intravenous tube was connected to a fresh bag of blood. The dark red flow was symbolic of the patient's lifeline.

Those present knew that the blood transfusion was short-term treatment. Excessive bleeding would lead to severe complications such as disseminated intravascular coagulation.

Stopping the bleed was imperative and Zheng Ren would decide whether it would be by a drastic hysterectomy or a minimally-invasive interventional surgery.

IndexChapter 73 - Alone Without Assistance (Part II)

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Chapter 73: Alone Without Assistance (Part II)

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Preoperative preparations were completed with commendable efficiency. The general hospital doctors and nurses did quality work, as expected.

No one wanted the young lady to lose her reproductive ability, especially when she had no children yet.

Obstetric and Gynecology Department Chief Su was informing the family about the surgery. He had little faith in Zheng Ren's abilities but respected Old Chief Physician Pan's judgment. The preparation and the blood transfusion for the patient took some time but the most time-consuming process was informing the family.

It took skill to deliver bad news to family members calmly and persuade them to make the right decision.

Chief Su decided to have a go at it.

It would not impact preparation for his surgery, so why not?

Shielded by lead glass windows, the other department chiefs stood in the control room and watched Zheng Ren's lonely operation.

Anesthesiology Department Chief Wang raised a question, "I heard the guy did 49 appendectomies a few days ago."

"Yes. The young man has great qualities. He has high quality work, good work ethic and is reliable." Old Chief Physician Pan gave a positive review of Zheng Ren.

Quality work, strong work ethic and the willingness to work. It was the ultimate praise for a doctor.

Su Yun stood at the back of the room with his back against the wall. His jet-black hair was tousled and the way they fell across his face was indescribably pretty. He silently observed Zheng Ren's movements in the operating theater. The way Zheng Ren opened the catheterization kit indicated proficiency, and even local anesthesia was accomplished swiftly.

The Seldinger technique was used to access the femoral artery and a vascular sheath was inserted. Each step was done expertly. This surgery was getting interesting.

Su Yun's eyes gleamed.

He turned heads whenever he walked around the hospital. The bold would come up to him and take their chances. However, inside the control room, no one paid him any attention. All eyes were fixed on Zheng Ren even if they could not decipher his actions.

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On Xinglin Garden, a livestream started.

Hundreds of doctors flocked to the stream within a minute of going live. The livestream was akin to an observation class. Many who joined did not even read the case study but typed away regardless. Doctors who did not know what was going on flirted with the pretty robot nurse. The livestream was brimming with excitement and activity.

[Salute to the surgeon! He's starting another surgery.]

[I rewatched the worm removal surgery at least ten times, my balls are on fire!]

[High temperature can reduce sperm motility. Are you trying to save on condoms? Even condoms are not a guarantee, though.]

[Agreed. A few days back, our hospital delivered a newborn who had a condom clutched in his hand.]

[That's one fortunate baby. Bless me with some of his luck.]

Most of the doctors in the livestream were general surgeons of various ranks. Their typing speed could match that of an esports gamer and the screen was filled with comments. One could say that there was a camaraderie among the viewers.

A moment later, the bullet comments vanished.

The viewers noticed the surgeon was performing local infiltration anesthesia over a large surface area.

The injector was used to administer the anesthetic. It did not remain in the subcutaneous layer and was pulled out after injection.

[Can't tell what the god is doing.]

[Judging from the position, could it be a femoral artery ablation?]

[What are you going to do with a femoral artery ablation? A bypass surgery wouldn't require you to touch that artery. Perhaps a thrombectomy? Congrats to the endovascular comrades, you guys will have something new to learn today.]

A few messages shot across the screen. They were surprised to see the livestream change to the view of the catheter needle and vascular sheath.

Then they saw the guide wire snake out.

Once a predefined length of the guide wire was inserted, another view appeared below the initial livestream. The second screen showed the guide wire travelling along the artery.

[It's an interventional radiology-assisted surgery? Is this a different surgeon?]

[Maybe this anon is a marketer from some private hospital who selected some surgeries as advertisement?]

[I feel the same way but logically speaking, a private hospital wouldn't advertise something simple like an inguinal hernia repair. It costs a few hundred yuan per surgery, there's no profit for them.]

[Also, a private hospital wouldn't do 49 appendectomies overnight.]

As the viewers debated the surgeon's origin, the guide wire had moved along the femoral artery and entered the bilateral internal iliac artery.

The contrast agent was administered. A pall of black smoke appeared on the image of the uterus.

Although the general surgeons had little experience in interventional surgery, they knew that the black smoke was due to the radiation from the contrast agent.

The agent covered a large area of the screen with the dark, intense smoke, indicating major bleeding in the patient's uterus.

[I'm an endovascular surgeon. The surgeon's guide wire doesn't look like a standard Cobra guide wire. It seems to be extremely soft and flexible.]

[And yet the surgeon has managed to guide the wire from the femoral artery into the internal iliac artery in a single attempt. Even with the Cobra wire, I couldn't guarantee a success on the first try.]

In the operating control room, there were two 40-inch LCD screens displaying the ongoing surgery.

Those in the room were all chiefs of their respective departments. None of them practised intervention surgery, but that did not stop them from lobbing criticism and unnecessary commentaries.

Not everyone could perform surgery but anyone could make disparaging remarks.

The ICU chief did not even give Zheng Ren the benefit of the doubt. He was waiting expectantly for the whole drama to end so that Chief Su could start the hysterectomy after obtaining the family's consent.

However… This surgery was progressing without a hitch…

The femoral artery puncture saw blood at the first attempt.

Not everyone had such skill, and it was doubly difficult when the patient had low blood volume due to hemorrhaging. 'This could be attributed to the nitrite poisoning cases a few days back', the ICU chief reminded himself.

When the guide wire was inserted, Zheng Ren switched on the imaging system. The image was broadcasted to the control room screens and the ICU chief saw the guide wire was at the branching of the internal iliac artery.

Now, the level of expertise required to achieve this was astounding.

The contrast medium showed that there was a massive bleed in the uterus, more severe than previously estimated.

The ICU chief was slightly panicked. If too much blood was lost, by the time the family members agreed to a hysterectomy, the patient might not survive.

Through the Xinglin Garden livestream, the doctors could see the severity of the bleed. A nervousness ran through the viewers.

Even though they did not know the identity or location of the patient, the doctors online went into emergency rescue mode.

[My god, that's a lot of blood! Looks like an aortic rupture.]

[Must be a placental abruption that tore open the uterine artery. What else can it be?]

[The blood pressure is dropping. The patient might go into cardiac arrest due to hypovolemia.]

[The god is in the middle of an emergency rescue, not some… Damn, he's livestreaming this. He can't be that confident?]

The numbers on the vital signs monitor were evident to all who witnessed. The patient had lost too much blood and was on death's door.

IndexChapter 74 - Alone Without Assistance (Part III)

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Chapter 74: Alone Without Assistance (Part III)

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

"Bang!" The emergency operating theater door flung open and one of the Chu sisters rushed in with a sterile package in her hands.

"Chief Physician Pan, the absorbable gelatin sponge!"

Sure enough, the medical supply Old Chief Physician Pan demanded had been delivered within ten minutes. It was also fortunate that Sea City General Hospital was located in the city center, surrounded by the headquarters of many medical device companies. If the hospital was in a suburb, the delivery would not have been as quick even if a helicopter was involved.

Two units of fresh frozen red blood cells were quickly consumed. Xie Yiren, who had been attentively watching the infusion, put a lead apron without hesitation.

The lead apron was heavy, but she was determined despite the strenuous effort.

"Put it away," a voice said lazily, "This is a man's job."

Stunned, Xie Yiren saw Su Yun, who had been standing beside her all along, picking up a lead apron and putting it on. After that, he walked toward the console and pressed the intercom button.

"Zheng Ren, stop the procedure temporarily, we ran out of blood."

Then, he brushed the black hair falling on his forehead aside.

"Do you know how to do it?" asked Xie Yiren.

"I'm the smartest man in the world. I know everything," answered Su Yun.

Even in the presence of so many senior consultants, he could still casually utter all manner of childish statements with no hint of shame.

Su Yun was definitely a weirdo.

After Zheng Ren made a gesture, Su Yun opened the thick lead door and entered the room.

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The surgery continued as soon as the lead door was closed.

In Xinglin Garden, after a short pause of the livestream, the host surgeon started performing superselective catheterization using a micro-guidewire.

The so-called superselective catheterization referred to the usage of a micro-guidewire for the superselection of small arteries branching at an acute angle from a large parent artery.

The concept was similar to a mainstream forking off to several branches. Any expert helmsman would know that it was extremely difficult to maneuver the boat into a particular branch smoothly when facing turbulent flow and inertia from the trunk. It required lots of experience.

The same rules applied to this surgery as well.

The guidewire in the left internal iliac artery was directly superselected into the left uterine artery without any trouble.

[What a smooth entrance. Sure looks like it isn't difficult at all.]

[This surgery is awesome!]

[Uh… This vascular surgeon is in shock. The manipulation is simply fascinating.]

Even if they were professional doctors, the differences in subspecialties made them feel worlds apart.

After the smooth entry of guidewire into the left uterine artery from the left internal iliac artery, the comments in Xinglin Garden were immediately divided into two groups—the ignorant merely assuming that it was an easy task, and those who understood the procedure sending their reverence without a second thought.

After the guidewire entered the desired artery, microcatheterization began.

The microcatheter waltzed through all the tough spots and acute corners without brute force, and the whole process was smooth-sailing.

Following the injection of the absorbable gelatin sponge, embolization of the left uterine artery was complete.

Since the first embolization had been successful, what were the odds of failure for the next one?

Two minutes later, the right uterine artery was embolized as well.

Zheng Ren waited one minute before performing the angiography again. Fortunately, the deadly "smoke" sign in the uterine arteries did not appear again.

He withdrew the guidewire and microcatheter before applying pressure on the wound. The surgery was officially complete.

Su Yun had nothing else to do after changing one pack of fresh frozen red blood cells. He initially thought that the procedure would take at least fifteen minutes, but he did not expect Zheng Ren to complete it in just a few minutes.

After staring at Zheng Ren for a few seconds, he brushed the black hair on his forehead to the side and smiled.

Pretty as a picture.

"Chief Zheng, is there a shortage of staff in the emergency department?"

That was unexpected. Confused, Zheng Ren asked subconsciously while maintaining pressure on the wound, "What?"

"I heard that you've been performing surgeries independently these past few days. Poor bachelor, you even have to perform operations alone." The pretty Su Yun was indeed a sharp-tongued man. It was clearly a compliment, but somehow it became foul as soon as it left his mouth. "Do you need a competent assistant who is ten thousand times more beautiful than you?"

"…" Were it not for the fact that Zheng Ren was compressing the wound to achieve hemostasis, he would have surely slapped the bastard to death.

In the operator console room, many senior consultants were flabbergasted.

The bewildered Chief Wang of the anesthesiology department looked at the clock hanging on the wall. The surgery time… was more than six minutes, which seemed to be longer than what Zheng Ren initially promised, but was that a problem?

Not at all.

Old Chief Physician Pan looked proud with a smile hanging on his face and arms crossed over his chest. The fact that Zheng Ren finished the surgery successfully gave him more satisfaction than if he had completed the operation himself.

The ICU chief's mind was in chaos after receiving a critical hit as he had been the one insisting on a hysterectomy from the beginning. After all, the patient's life was far more important than her reproductive ability. In his opinion, anyone who hesitated on this simple multiple-choice question was undoubtedly idiotic.

Thus, he had great prejudice against both Old Chief Physician Pan and Zheng Ren.

However… he had not foreseen that Zheng Ren had completed the uterine arteries' embolization in just a few minutes.

What the f*ck!

He was dazed and confused despite his happiness.

All of these went against his knowledge of medicine. Since when were general surgeons so skillful, even knowing how to perform a catheter embolization?

"Bang!" The operator console room door was flung open again.

Poor door. It was always the target of critical damage during an emergency.

"The patient's family agreed to a hysterectomy. The anesthesiologist will begin administering anesthesia and the nurses will prepare the instruments. Let's get ready for surgery!" Chief Su of the obstetrics department quickly instructed with a dark expression. Obviously, her attempt to communicate with the family members had not gone well and led to a choice between life and death for the patient.

However, no one in the operator console room moved a muscle, as if they had not heard her commands at all. Her suppressed emotions burst forth instantly.

"What the f*ck are you guys waiting for?!"

Every senior consultant possessed an awe-inspiring aura and that aura intensified especially in an emergency.

There was no superior-subordinate relationship or deception at that point. Everyone had to go all out in the rescue operation and try their very best to pull the patient back from the brink of death.

Blurting out swear words did not mean that the doctor was without manners.

"Chief Su, the surgery is complete and the uterine arteries have been embolized. The hemorrhage… The huge hemorrhage has stopped." Old Chief Physician Pan, who had a cruel sense of humor, paused for a brief moment and savored the anxious look on Chief Su's face before continuing, "Use vaginal packing for hemostasis and labor induction can be commenced in one to two days."

"…" Chief Su's eyes widened and her pupils dilated immediately as if there was a complete absence of pupillary light reflex.

"What?!" Her voice was sharp like a shattered glass piercing everyone's eardrums. She simply refused to believe such an outrageous claim.

"The surgery is complete, and the patient's uterus and life have been saved." Old Chief Physician Pan slowly added, "Whether the patient will have DIC or unsuccessful labor induction in the future is none of my concern."

His current expression was full of pride. "How can you not let the emergency department handle emergency cases?"

"Uh…" Chief Su finally noticed the imaging video that was running in a loop in the console.

From the initial pall of black smoke in the angiogram, to smooth embolizations, until the smoke sign completely disappeared in the second imaging. What did that mean? Naturally, Chief Su understood it perfectly.

Was it a success?

Her previous perturbation instantly vanished into thin air. The moment she left her distressed state, energy drained from her body and she slumped down on a chair. "That's good. That's very good."

IndexChapter 75 - Reward—Master Rank In Interventional Radiology

Index

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Chapter 75: Reward—Master Rank In Interventional Radiology

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

[His general surgery skill should be one of the best in this country. I don't know anything about interventional radiology, but I've consulted my colleagues in the cardiovascular department. Any surgeon who can embolize a uterine artery within five to six minutes is unrivaled in the province. However, it was impossible for the same surgeon to achieve such a high standard in different surgery subspecialties. Therefore, I suspect that this is actually an official account. Evaluation complete.]

[The feeling is mutual, but that surgery was done beautifully.]

[What the hell is interventional radiology? Can I have a show of hands of those who didn't understand the whole operative process?]

Countless comments flew across the screen. Even as doctors, they were bewildered by the cross-disciplinary surgery broadcast.

However, none of them could criticize this surgery after witnessing the effect of treatment.

Preoperative diagnosis was definitive: placental abruption and hemorrhagic shock; two terms that were more than enough to induce hypertension in any experienced doctor.

Those terms were equivalent to aggressive resuscitation and a life on the brink of death.

[Will the embolization of uterine arteries cause the uterus to necrose? I would appreciate it if anyone can enlighten me.]

[I've the same question in mind too.]

[…]

[Thank you for the A2A. Instead of using embolization coils or other embolic agents, the host surgeon chose to use an absorbable gelatin sponge due to its expandable properties after absorbing blood to form an embolism for hemostasis. Since the gelatin sponge dissolves in one week, the bleeding points in the uterine arteries have already clotted and restoring blood supply to the uterus won't cause a hemorrhage again.]

Xinglin Garden was indeed a professional website. Someone would definitely show off their knowledge and respond to questions almost instantaneously.

[One week? The uterus will necrose by then, right?]

[Go back and read the anatomy atlas. Here is a hint, pay attention to the source of uterine arteries and the branches that supply the uterus.]

[The uterine functions won't be affected. Rest assured, questioner.]

The uterine arteries embolization was complete within a few minutes.

The smoke dissipation signified that the surgery was successful.

The next few steps would be blood transfusion, vaginal packing and induction of labor.

However, subsequent procedures were simple and there was ample time to study and change the treatment plan if the need arose.

The most difficult part actually lay in those few minutes of uterine artery embolization.

When the surgery objectives—saving the patient's life and reproductive ability—had been fully achieved, the atmosphere in Xinglin Garden live broadcast room became lively again.

[I've an urge to further my studies, but I'm scared after hearing that it's a private hospital that had registered an official account for advertisement.]

[It looks like the hospital isn't led by Putian Medical Group1, so don't worry and feel free to further your studies there.]

[Yes. If the host surgeon works in Putian Hospital and chose not to use a synthetic mesh for hernia repair, they would have been forced to resign after the surgery was complete.]

The live broadcast room soon became quiet following the exit of thousands of viewers who failed to understand the surgery.

Even though viewers were leaving one after another, a few people kept entering the room to watch the replay of the surgery.

Most of these doctors were interventional radiologists who just registered new accounts in Xinglin Garden.

This group of doctors was a minority in the nationwide medical field but were indispensable. It was why Sea City General Hospital had no choice but to perform a hysterectomy; it did not attach enough importance to interventional radiology.

There were only a few doctors working in interventional radiology and their skills varied tremendously. Therefore, they had reached a consensus that highly skilled interventional radiologists were scarce in the medical world.

For example, a tertiary hospital in Sorcery Capital specializing in hepatobiliary surgery could finish an interventional radiological treatment for hepatocellular carcinoma within ten minutes. That was absolutely shocking.

…

Zheng Ren ignored Su Yun, who seemed to be provoking him with ill-intended criticism. Transferring to the emergency department just to assist him in surgery? What a ridiculous joke.

Ten to fifteen minutes of wound compression was needed to achieve hemostasis.

Xie Yiren was busy discarding all disposables and cleaning various surgical instruments post-surgery in the operating theater.

Moreover, at least two nurses' signatures were required to confirm the usage of blood bags.

Xie Yiren carried out these tedious tasks in an organized manner. The bored Chu sisters also assisted her and performed any tasks that were within their powers.

These young staffers had slowly developed a harmonious relationship after getting along well with each other in the past few days.

The patient's blood pressure, based on the readings on the monitor, had begun to stabilize and gradually increased a minute later. Staring at the 100-percent surgery completion rate in the System panel, Zheng Ren knew that her uterus had been saved.

Ding-dong!

The System's mission completion notification sound was music to his ears especially after a successful emergency rescue operation. The feeling was comparable to that of a senior consultant approaching him with a thick red packet after completing a surgery while saying, "This is a bonus from the hospital management."

It was a beautiful dream, but a distant one as nobody actually gave a bonus for such a reason.

Except for the System, of course.

[Emergency Room Mission: Save A Mother-To-Be accomplished. The surgery completion rate is 100 percent. 100 skill points, 1000 experience points and a silver chest obtained. Time spent: 23 minutes and 15 seconds. The remaining time is converted to 9405 experience points.]

Ding-dong!

[Special Mission: Alone Without Assistance accomplished. The surgery completion rate is 100 percent. Mission Reward: A set of lead apron with radioactive energy conversion properties awarded and the host's interventional radiology skill is upgraded to the Master rank. The remaining time is converted to 9405 experience points.]

Zheng Ren was again surprised by the System's unconstrained creativity.

He knew that the System had been prompting him into learning interventional radiology ever since it started giving him various tempting offers.

However, he was born in the general surgery department and simply could not comprehend the purpose of interventional radiology, which was why he had given up every time.

This time, upon encountering this emergency case, the System had seized this opportunity and gave Zheng Ren a special mission with an irresistible reward—an interventional radiology skill upgrade to the Master rank.

Was the System trying to lead him down a path of no return in interventional radiology?

What could Zheng Ren possibly do about it? However, he would not mind at all since it could improve his overall skill as well. As the older generations said, knowledge was no burden, and he firmly believed in that wisdom.

'If I had put more effort into interventional radiology in the beginning, perhaps I could have saved fifty hours of surgery intensive training time. Damn, what a pity.'

The fact that Zheng Ren had poured a massive amount of experience points into the Shop shattered his heart to pieces.

There were still a few minutes left until complete clot formation, so without wasting any time, Zheng Ren started calculating the skill points and experience points in his inventory.

Despite completing two missions, his general surgery skill tree remained the same at 2044 points, but there were 1529 skill points, 2 skill books and a silver chest in his inventory. Adding the experience points from the mission rewards to the remaining 9920 points, he currently had 28730 experience points in his savings.

These experience points were more than enough to purchase a set of surgical equipment, but they would be insufficient if he wanted to master a surgical technique.

'I need to work harder," Zheng Ren thought.

Regarding the random lead apron with some magical transformation power, Zheng Ren failed to locate it and presumed that it was stored somewhere in the System.

Zheng Ren decided to leave the silver chest, which could contain special rewards, aside for the time being. He was afraid that opening the chest would release mystical rays that could attract the attention of the nancy boy—Su Yun, who was currently standing beside him.

Yes, for ordinary people like Zheng Ren, the handsome Su Yun was a typical nancy boy.

In this era where appearance ruled the world, Su Yun would attract an incredible amount of attention no matter where he was. Plain-looking bachelors had no choice but to weep alone in a corner.

At least, that was what he had convinced himself of in order to comfort his fragile heart.

Ten minutes later, Zheng Ren stopped compressing and dressed the femoral artery puncture point. Then, he transferred the patient to the stretcher trolley and let Chief Su of the obstetrics department to send her back to the ward.

Zheng Ren believed that Chief Su would not encounter any issues explaining the patient's condition to her family members.

They would likely be exhilarated after knowing that both the patient's life and uterus had been saved.

Regarding the fetus… Its death was fated and there was nothing they could do about it. Gestational hypertension was extremely difficult to treat and its pathophysiology remained poorly understood even until now.

Zheng Ren gazed after the slowly vanishing stretcher trolley before taking his lead apron off.

His surgical gown was completely drenched in sweat.

A stressful event such as an emergency rescue operation would cause the body to secrete a large amount of catecholamines, hence the diaphoresis. In addition, an airtight lead apron weighing more than ten kilograms had to be worn throughout the interventional radiological treatment process. That alone was more than enough to induce perspiration in its wearer.

'An interventional radiologist's life is really difficult,' Zheng Ren thought.

Why did the System insist on guiding him to interventional radiology? It was a good question, but Zheng Ren had no answer for it.

IndexChapter 76 - New Guy Reporting In

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Chapter 76: New Guy Reporting In

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

After the surgery, Zheng Ren jotted down the emergency meeting minutes and the details of the surgery. Then, he went for his usual ward rounds.

Chang Yue was in one room, chatting with the family members. Zheng Ren did not consider it slacking off as communication was part of a doctor's responsibility.

If Zheng Ren and Chang Yue were to fuse into one person, they would be the perfect doctor.

Hmm, the thought was slightly disturbing. Zheng Ren shook his head and crushed the idea.

The patients in the ward were doing well, and some were even being discharged.

Most of the patients were locals who opted to leave once they regained mobility. Even a single room in the hospital could not compare to the comfort of one's own home.

Those who stayed in triple-bedroom wards had to deal with overcrowding as visitors flitted in and out. Sometimes, it felt hard to breathe in such rooms, and patients were thus often eager to be discharged from the hospital.

The hospital did not have many foreign patients as Sea City was neither the blessed city nor the vice city of the nation1. Regardless of medical insurers' pleas to remain in the hospital, patients were still discharged accordingly.

The last room had Cen Meng's uncle.

Cen Meng was in the room reading as his uncle rested with closed eyes.

It was an open surgery, so recovery was much slower.

There had been patients who left the hospital just one day after laparoscopic surgeries.

Zheng Ren had even heard of escaped patients gorging themselves and developing pancreatitis as a result.

Zheng Ren entered the room and gave Cen Meng a faint smile. There was nothing to say between the two of them. Now, it was strictly a relationship between doctor and patient's family.

He meant Cen Meng no harm but was not about to forgive the man. Even though Cen Meng had knelt before him in sincere apology, Zheng Ren held onto his grudges.

The awkwardness between the two was palpable to Chang Yue.

She ignored the two chief residents and headed straight to the patient's bed to start chatting with the patient.

The conversation captured Zheng Ren's attention and he found out Cen Meng's uncle was a fan of Japanese cuisine. Generally speaking, Japanese cuisine was mostly based on ocean fish which had relatively fewer parasitic worms.

There were unscrupulous businesses in the country that intentionally served freshwater fish as ocean fish. Freshwater fish had a higher incidence of parasitic worms. Ingestion of these infected fish could lead to a case like that of Cen Meng's uncle.

Of course, luck and consumption volume were at play here.

Zheng Ren had once met a septuagenarian who loved essential oil massages. He had the habit of getting said massages twice a day. Three months later, he developed acute kidney failure due to overexposure to some unknown substances in the essential oil.

At the end of his ward round, Zheng Ren was very impressed with Chang Yue.

She was impassive toward him but incredibly sincere when dealing with patients. She knew about Cen Meng's uncle's love for fresh seafood and proposed a recovery plan with that in mind. The hospital was lucky to get a resident like her.

Zheng Ren had no doubts that Chang Yue would never treat him with such warmth. Without much fanfare, he went back to his office to do some reading.

He was a single dog for a reason.

Zheng Ren was a homebody, his home being the office and the operating theater.

As the days passed, the weather got colder, and yet the emergency department was heating up.

In two days, Zheng Ren treated eight acute appendicitis patients and four with acute cholecystitis.

The long-term main mission was to become the best general surgeon. He still had six unused skill points from surgery completions. Among the eight appendectomies, two had perforation at the appendix while one was gangrenous. Based on their classification, the three procedures were second-grade surgeries which warranted double points. From the appendectomies alone, Zheng Ren was awarded 11 completion points.

The four cholecystectomies were done through laparoscopy and thus considered a third-grade surgery. He gained 16 points for them.

A total of 27 points were added to his store. He also completed three main missions related to the vascular system, giving him another three points.

From all this, Zheng Ren was rewarded with 30 skill points and 3000 experience points, reaching a total of 1549 experience points1. After all those surgeries, his general surgery skill tree was up to 2065 points.

He was one step closer to the Master rank. His heart was filled with glee.

Zheng Ren just needed to focus on completing surgeries. He never thought this day would come. When he was with the first general surgery department, the surgeries were all done by the chief resident and he had no chance to learn.

This was hands-on experience. As older doctors would say, even the dumbest person would be able to perform an appendectomy after practicing a hundred times.

It was all about practice.

Going home was unnecessary to Zheng Ren. He figured that he should simply take a day off and move his belongings to the hospital.

At the house, he ran into Xiao Zhao and they talked for a while.

The livestream had initially been a huge success but reports of it being a breach of privacy soon emerged.

Hence, Xiao Zhao's livestream was suspended.

Xiao Zhao was not saddened by the fact. Instead, he believed this was a blessing in disguise. He was in the midst of testing a few public websites, as he planned to edit the surgery videos and upload them to an open access site.

Zheng Ren was amused by Xiao Zhao's eagerness.

Zheng Ren had no brains for business and marketing. He knew nothing about Weibo or other public websites and thus left such matters to Xiao Zhao. He only urged Xiao Zhao to keep it on the down-low.

Packing a suitcase with some clean clothes, Zheng Ren went back to the emergency room.

As he stepped into the corridor, he saw a detestable figure.

Su Yun had an unmistakable profile. Zheng Ren had a severe, irrevocable case of face blindness but Su Yun's face still stood out.

There was only one figure standing in the hallway and Zheng Ren recognized Su Yun immediately.

"Chief Zheng, I'm reporting in." Su Yun noted the suitcase behind Zheng Ren but made no moves to help. He leaned against the wall, striking a pose that seemed juvenile to Zheng Ren.

For a moment, Zheng Ren felt that Chu Yanzhi and Su Yun would make a good couple. Chu Yanzhi also had that childish habit of cheering for herself before an anesthesia procedure.

However, Chu Yanzhi was much more tolerable since she was a young and pretty lady.

Su Yun, on the other hand, was inexcusable.

Zheng Ren tamped down his disgust and forced a smile. "Why are you here?"

"I'm reporting in, didn't you hear? Did the radiation exposure damage your auditory nerve? Or maybe the nephrotoxicity caused a loss of hearing? That's a bit over-the-top from just one procedure," Su Yun answered.

This man deserved a beating.

Zheng Ren cursed internally. He lost out in looks and wit when it came to Su Yun. He walked away with his suitcase, ignoring the man.

"What's wrong? Am I not welcome?" Su Yun doggedly followed Zheng Ren all the way to the on-call room. He leaned against the doorframe like a boneless person with a mysterious smile on his face.

"Not really," Zheng Ren said, "You should report to Old Chief Physician Pan. I doubt he would want someone like you."

"He already agreed." Su Yun showed a charming smile.

"Oh? How did you convince him? Are there insufficient personnel in the emergency department?" Zheng Ren asked as he sorted his things. He avoided looking at Su Yun, fearing that his self-control would fail to prevent him from kicking the man.

"I'm here to partner with you. That's not the main reason of course. After all, you can perform solo surgeries," Su Yun continued, "I'm here to solve the shortage of nurses in the department."

Su Yun? Nurses? Shortage?

Zheng Ren identified the three keywords in Su Yun's explanation.

IndexChapter 77 - Sharp-Tongued Nancy Boy

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Chapter 77: Sharp-Tongued Nancy Boy

Zheng Ren thought for a moment. The situation was understandable.

While he was stationed in the emergency room, there were no signs of women swarming to the department. That would not be the case for Su Yun. His arrival would bring a much-welcomed boost in manpower, especially when it came to nurses.

This was the stark difference between the beauty and the beast[1].

"Aren't you related to Director Fu? How did you end up here in the emergency room?" Zheng Ren asked.

Su Yun's crinkled eyes assessed Zheng Ren. He spoke contemptuously, "Perhaps I should reconsider the necessity of my transfer to the emergency department."

Zheng Ren tidied his belongings and refused to respond to Su Yun's theatrics.

"Director Fu being my relative and my transfer to the emergency department are mutually exclusive. Is the logic confounding for your addled brain? I didn't notice your slowness during the surgery." Su Yun's tone was filled with sarcasm.

Zheng Ren let out a sigh.

A pumped-up Su Yun was like Chu Yanzhi but his sarcasm resembled Chang Yue. He was good-looking…like a combination of the few ladies Zheng Ren knew. The f*cker was a sharp-tongued nancy boy[2].

"I look forward to your guidance," Su Yu chuckled, totally unruffled by Zheng Ren's demeanor.

Guidance… Haha…

Su Yun stopped the awkward conversation and pulled out his phone. There was a small smile on his face. Zheng Ren figured he was either playing a game or flirting with one of the ladies.

Around ten minutes later, a young nurse came into the room. "Su… Chief Zheng, here are some of the fruits I bought today. Both of you should have some," she said to Zheng Ren while her eyes were seduced by Su Yun.

The basket of fruits for 'them' was then placed in front of Su Yun.

Red-faced, the young nurse turned to leave.

Before she did, Su Yun looked up and ran a hand through his dark hair. "Thank you."

The hand appeared to have stroked the lady's heart as well. Zheng Ren thought she would start squealing in delight.

Really… Since becoming the emergency department chief resident, he was in the hospital almost 24/7. None of the nurses had ever given him anything, let alone a basket of pre-washed fruits.

Each fruit gleamed as water droplets on them reflected the light. The fruit basket had been prepared with love.

Zheng Ren could imagine the excitement and joy of the nurse or nurses washing the fruits.

Was he not deserving of such treatment?

The single dog was incredibly frustrated. He stood and left the on-call room.

"Where are you going?" Su Yun's voice followed Zheng Ren like a spirit.

"Wards. Checking up on the patients under observation," Zheng Ren replied moodily.

"Is that how you spend your free time?" Su Yun laughed as he fell in step with Zheng Ren, unaware that his presence was stoking Zheng Ren's anger.

"As a chief resident, making rounds is a duty, not a pastime," Zheng Ren answered coolly.

There was an oncoming nurse who was preoccupied with her phone. A presence made her look up and a surprised expression came over her face.

"Ah!" The enthusiasm manifested in the slight skip in her step. "Dr. Su, why are you in the emergency department? Are you visiting a patient? I can take you there. Who are you looking for?"

Su Yun gave her a smile and said, "I've been placed in the emergency department. Making the rounds with Chief Zheng here."

Hearing those words, the nurse almost lost her grip on her phone—a full-blown blush colored her face crimson.

Zheng Ren picked up his footsteps. An ugly, single dog like him could not bear any more injury to his ego.

However, the perpetrator was still on his heels, strolling in a lackadaisical manner. Su Yun had a friendly disposition and smiled at everyone who greeted him.

One of the patients in the emergency room even walked over, a hand over her abdomen, to ask for Su Yun's WeChat details. He turned her down politely.

The fact that even sick patients were approaching Su Yun made Zheng Ren's blood boil.

As they walked past Old Chief Physician Pan's office, Zheng Ren heard voices in disagreement.

He made a move to enter but Su Yun spoke up suddenly, "ICU Chief Qian and Chief Pan are arguing. You sure you want to interrupt them?"

"Yes? Why are they fighting?" Zheng Ren asked and instantly regretted it.

This bastard was going to belittle him again.

"If your IQ was at least half your surgery skills, you wouldn't need to ask such a question." Su Yun shot him a mocking smile.

Zheng Ren was speechless.

Su Yun's departure from the ICU must have made some nurses request for a transfer.

The ICU was tough and hard work. Many of the ICU nurses suffered lumbar disc prolapse by the age of 30.

Su Yun was a blessing to the ICU. Never before had the department seen transfer requests favouring the ins instead of the outs, the hectic environment and heavy workload notwithstanding .

Hence, Su Yun's departure was a whirlwind to the ICU.

No wonder ICU Chief Qian came all the way to the emergency department. While Old Chief Physician Pan was revered, Chief Qian was not about to roll over and take it.

Tsk, what a scene.

Zheng Ren gave up.

He continued making his rounds and was welcomed with newfound fondness.

Fondness that was directed to the man behind him, Zheng Ren had no doubt.

The patients were all in stable condition. Many of them gave reasons to remain in the emergency observation ward. Once their insurance claims were maxed out, their illness would be cured immediately.

Zheng Ren left the observation ward. Su Yun was like an annoying fly that would not leave him alone no matter how hard he swatted.

Something made him stop when he walked past the emergency room.

There was a female patient in her mid-twenties talking to the on-call doctor.

Zheng Ren read the details on the System's interface and thought for a moment.

"What's up?" Su Yun asked curiously. He peeked into the room and saw a pleasing silhouette. His lips curled into a smile.

"You can't be that thirsty," Su Yun teased.

Zheng Ren eyed Su Yun, a gleam in his eyes.

"What are you thinking?" Su Yun warned.

"Do you know what she has?" Zheng Ren asked.

Su Yun answered in a condescending tone, "Why don't you go and ask yourself?"

"Look at her fingers. There's abnormal swelling, isn't there?" Zheng Ren said.

Su Yun peered into the room again. The young lady's hands were set in front of her. On the middle finger of her right hand, there was a red bump. It did not look like an abrasion or burn. He also ruled out the common folliculitis.

"Yeah. What's your diagnosis?" Su Yun was curious.

"Endometriosis," Zheng Ren concluded.

The answer left Su Yun speechless.

Endometriosis occured when live cells of the endometrium attached themselves to surfaces outside the uterus. It was a common women's condition.

Endometrial cells were localized in the uterus but could develop ectopically due to various reasons, one of them being backward menstrual flow through the Fallopian tube.

The young female patient… Middle finger… Endometriosis…

Su Yun was in a daze for a good ten seconds. Then, he shook his head and his mop of black hair followed suit. He was very attractive.

"Logically, it could happen but the chances are slim to none. I've never heard of an endometriosis case like this," Su Yun said honestly.

"If you don't believe me, go ahead and ask. The treatment is simple; just get the hand surgeon to remove the excess flesh. As to how she got it, it's none of our business." Zheng Ren threw the responsibility to Su Yun.

After all, this case required some tricky personal questions.

Zheng Ren was a simple-minded man who valued honesty in conversations. If he went to speak to the patient about endometriosis and how it could possibly have ended up on her finger, he could get sued for sexual harassment.

On the other hand, Su Yun should not have any obstacles.

This was a man who could turn other men gay. This lady would be a walk in the park.

[1] 帅逼和丑逼: can also be translated as the handsome and the ugly.

[2] 娘炮: derogatory term for an effeminate or homosexual man.

IndexChapter 78 - Finger Endometriosis

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Chapter 78: Finger Endometriosis

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Zheng Ren gestured to the doctor on duty in the emergency department to come out and let Su Yun handle the consultation session.

He noticed the gleam in the female patient's eyes as soon as her gaze rested on Su Yun as if the small universe in her heart just exploded.

'Appearance does rule the world.' Zheng Ren sighed heavily and called the doctor on duty to the corridor for the discussion of recent emergency admissions.

"Bang!" Old Chief Physician Pan's office door flung open and ICU Chief Qian stormed out of the room.

It was necessary to maintain a certain degree of grace since there were many patients outside the office, so the door had to be the one receiving collateral damage in the end.

Following ICU Chief Qian's departure, Old Chief Physician Pan slowly walked out of his office with a smile on his face. Judging by their expressions, it was obvious who had had the upper hand in the argument just now.

Old Chief Physician Pan, whose mood had lightened up after witnessing ICU Chief Qian's exasperation, noticed Zheng Ren and summoned him to the office.

"Little Zheng, sit." Old Chief Physician Pan picked up a teacup with steam rising from it.

"What kind of support do you still need in your work?" he asked.

"I've listed out the medical supplies required for interventional radiology. I hope we can get it as soon as possible." Instead of sitting down, Zheng Ren stood like a recruit reporting to his squad leader and said seriously, "Interventional radiology is useful for diagnosing and treating emergency cases, just like—"

Old Chief Physician Pan waved his hand, interrupting Zheng Ren.

"Don't worry about it. I've submitted a temporary purchase order and the supplies should be delivered in two days. Since it's just a temporary list, we still need to make more orders in the future. It'll be fine as long as you communicate with the matron." Old Chief Physician Pan was indeed a soldier who carried out his tasks swiftly. He had already solved the most problematic issue in the hospital—the purchase of new medical supplies—in just two days.

"As for the rest… What is Su Yun doing here?" asked Zheng Ren.

"He requested the transfer himself. I heard that he had a quarrel with Director Fu too," Old Chief Physician Pan added with a smile, "He is a man with extraordinary ability."

"…"

Well, it was true, especially with the nurses.

"I checked his files and called my comrades in Union Medical College Hospital. Everyone was sorry to see him leave at that time."

"Alright then." Zheng Ren would not push the point if there was nothing wrong with the working principles involved.

After all, many hands make light work, even though Su Yun's words were mean and harsh.

Even if he was good for nothing, the emergency department could still enshrine him as a mascot since he could help to skyrocket its development into overdrive.

Coincidentally, Su Yun and the young female patient were leaving the consultation room together when Zheng Ren left Old Chief Physician Pan's office.

Blush seared through the female patient's cheeks and her big, sparkling eyes were full of joy.

On the other hand, Su Yun, who seemed to have given necessary advice to the patient, wore a stony expression and quietly stood beside Zheng Ren like a ghost.

'It looks like he has solved this patient's problem perfectly,' Zheng Ren thought with a smile.

"Doctor Su, do I consult you on my next appointment?" asked the young female patient whose gaze drifted past Zheng Ren as if he was invisible and rested on Su Yun.

"My job is in the emergency wards upstairs, not consultations," answered Su Yun impatiently.

Ignoring the hostility in Su Yun's tone, the seemingly smart and playful girl made a cute face and said happily, "I'll visit you in the emergency ward on my next appointment."

After that, she turned around and trotted away without waiting for Su Yun's response.

She was akin to a shy girl of the past with a crush on someone.

Whether it was due to anxiety or the pair of five-centimeter high heels she had on, the girl sprained her ankle around the corner.

'She is panicking…' Zheng Ren stared at the back of the girl leaving the hallway and sighed.

"Looks like the consultation went on smoothly," Zheng Ren said to Su Yun on their way toward the emergency ward.

"It's alright," Su Yun habitually brushed the black hair on his forehead to the side and added, "She has become straight, thanks to me."

"Huh?" Zheng Ren was confused. 'Become straight? What the hell does that mean?'

It was impossible for Zheng Ren, who had been immersed in learning, performing surgeries and taking care of the patients, to know much about this issue.

"Your diagnosis is correct. I told her to get a minor hand surgery in the outpatient department and she'll know the result once the resected tissue is sent for pathology." Su Yun then added with a zombie-like face, "She asked me out for a meal and wanted me to change her wound dressing. Please don't look for me when you encounter female patients during your consultations next time. They're annoying."

"Oh," Zheng Ren replied perfunctorily, but deep down, he was exhilarated. It was satisfying to see Su Yun, who had a nasty attitude, admitting defeat once in a while.

"There won't be so many troublesome issues if you're the doctor in charge. No female patients will ask you out for a meal, unless they're blind."

Su Yun's critical hit followed soon after.

Zheng Ren's inexperience in arguments put him at a serious disadvantage, so he chose to endure ten thousand critical damage and return to the emergency ward in silence.

Chang Yue was wandering around the ward, as usual. Zheng Ren then returned to his office and started reading his anatomy book so that he could accumulate some skill points.

Su Yun sat on a chair behind Zheng Ren and quietly played on his phone.

Occasionally, some nurses would pretentiously walk past without looking into the office, but Zheng Ren was aware of the truth. Had they ever passed by his office this frequently in the past?

After reading the book for a while, one of the Chu sisters, with surgical attire underneath her white coat, came looking for him.

"Chief Zheng, my father's old friend is sick. I heard that he has severe signs of peritonitis," the twin said, "Should I ask him to visit the emergency department straight away?"

"Have you asked for his medical history?" asked Zheng Ren without raising his head, utilizing this time to read the last few sentences.

"Yes, I've taken a simple history. My provisional diagnosis is peritonitis, but I am unsure as to what is the cause," answered the twin.

"Send the patient here first. How old is he?"

"Seventy-six years old male with a history of cerebral infarction three years ago. A caregiver has been taking care of him due to difficulty in ambulation. The old man has a bad temper and every time when he is sick, he refuses to go to the hospital and will self-medicate for a few days instead. He took the same measures this time but was complicated with fever, so he had no choice but to agree to a hospital visit."

"When will he arrive?" asked Zheng Ren, closing the thick book after finishing the last few lines.

"In ten minutes, give or take."

Soon, he heard the sound of stretcher trolley wheels rolling across the marble floor in the corridor.

A well-mannered and dignified man in a casual outfit, aged around fifty years old, quickly walked in along with the stretcher trolley.

"Uncle Lin, you're finally here. This is Chief Zheng. Let's take a look at grandpa first." The Chu sisters pushed the stretcher trolley into the resuscitation room. Zheng Ren, who was following closely behind them, failed to notice the man's extended hand.

Zheng Ren had his mind fixed only on the patients, and as for their family members… Who were they?

The middle-aged man looked slightly awkward.

"That's how he is, a medical expert with poor interpersonal skills," Su Yun explained to the man before entering the room, which made it sound like he was very sociable himself.

The patient's condition and final diagnosis were shown in the upper right corner of his vision.

Acute on chronic suppurative cholecystitis.

"Order a bedside B-scan ultrasonography and check for vital signs. Chang Yue, take his history and ask if he has any contraindications for surgery," Zheng Ren examined the patient and made the necessary arrangements. "If the family agrees to surgery and the patient has fasted long enough, you two will prepare general anesthesia and inform Xie Yiren to arrange instruments for laparotomy."

Chang Yue, who was standing half a step behind Zheng Ren, documented his instructions with a pen and notebook in her hands.

Regarding a few minor details that Zheng Ren had missed, Chang Yue merely confirmed them and closed her book.

"He needs surgery?" asked the middle-aged gentleman, somewhat puzzled.

"The patient has chronic cholecystitis and this is an acute manifestation, which means his gallbladder should be edematous and has severe adhesions. If he is treated conservatively, it'll take a long time for antibiotic infusion to take effect, and dysbiosis will most likely happen. That's why I suggest surgical removal of the gallbladder."

IndexChapter 79 - Let The Senior Consultant Do It

Index

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Chapter 79: Let The Senior Consultant Do It

The middle-aged man remained silent. An emergency doctor in charge of ultrasonography dashed over with a portable ultrasound machine cart and examined the elderly man. The diagnosis of cholecystitis was confirmed.

When Chang Yue keyed in the patient's personal information into the inpatient admission form, only then did Zheng Ren realize that the middle-aged man was Lin Yuanshan, who worked in the province.

The admission process was soon complete, but before Chang Yue could explain the patient's condition and everything about the surgical treatment to Lin Yuanshan, the directors of Sea City General Hospital, Chief Surgeon Sun of the second general surgery department and a few clerks rushed into the emergency department.

"Mr. Lin, why didn't you inform me about your arrival in Sea City General Hospital?" Xiao Keming greeted enthusiastically from afar, even extending his right hand from more than ten steps away from Lin Yuanshan.

"The girls from the Chu family said that Doctor Zheng of the emergency department is very professional, so here we are," answered Lin Yuanshan indifferently, appearing unapproachable and arrogant.

However, Director Xiao and the rest acted as if this was perfectly normal.

"This is Old Chief Physician Pan of the emergency department, and he is Chief Surgeon Sun of the second general surgery department. They're here to ensure everything is up to par," Director Xiao introduced them one by one.

Lin Yuanshan nodded, annoyance clearly visible in his slightly furrowed brows.

After chatting casually for a while, Chief Surgeon Sun hurried to the resuscitation room and performed a detailed examination on the patient.

Zheng Ren was also experienced in examining patients, but since he had the System, the clinical examinations were merely for show and mostly performed out of habit. In all honesty, skipping the examination was completely acceptable as the System always provided him with comprehensive information and definitive diagnoses of the patients.

Chief Surgeon Sun's professionalism and thorough examination eased the irritation in Lin Yuanshan's eyebrows to a certain degree.

"He has acute cholecystitis. According to the B-scan ultrasonography report, there is a lot of gas near the gallbladder, presumably due to the inflammatory stimulation on the bowel. Surgery is the better option in this case." Chief Surgeon Sun gave his judgment.

"The patient is old, so we've to check if there are any comorbidities," Director Xiao instructed.

"Sinus bradycardia noted on the patient's electrocardiogram. Bilateral lung fields are clear without any signs of hypostatic pneumonia. Preoperative blood investigations have been ordered and the laboratory will send the results within thirty minutes," Chang Yue reported all relevant information.

The nurses had already started preoperative preparations such as urinary catheterization, nasogastric tube insertion, and surgical skin prep.

"How big is the surgical wound?" asked Lin Yuanshan out of worry.

After all, the elderly man was in his seventies and had a previous history of cerebral infarction. His physical condition had deteriorated and slow recovery was inevitable.

Lin Yuanshan's concerns were not without basis.

"Quick recovery can be expected if we perform laparoscopic cholecystectomy on the patient." Chief Surgeon Sun comforted him.

"Laparoscopy? Doctor Zheng strongly suggested an open surgery." Lin Yuanshan expressed his disagreement.

A senior surgeon in his fifties and a young brat in his thirties, who would the family member believe? The answer was pretty obvious.

When Director Xiao heard that Zheng Ren had diagnosed the patient, he asked nervously, "Zheng Ren, you're highly skilled in laparoscopic surgery, so why did you suggest an open cholecystectomy?"

"This is a case of acute on chronic cholecystitis. I'm worried about the severe adhesions in the peritoneal cavity," answered Zheng Ren frankly while ignoring the pressure Lin Yuanshan exerted on him.

A medical nerd like him could not possibly perceive that sort of aura.

Lin Yuanshan frowned.

Sorcerers who predicted upcoming misfortunes would be tied to a stake and immolated. Everyone—from westerners in the Medieval period or the modern world, or even easterners—had the same thought on their minds.

It was unconvincing, especially when it was a young man stating that the patient's condition could be complicated.

Thus, Lin Yuanshan elected to ignore Zheng Ren and asked Chief Surgeon Sun of the second general surgery department directly, "Chief Surgeon Sun, do you think he can undergo minimally invasive laparoscopic surgery?"

The Chu sisters had already left to prepare for general anesthesia, but their presence would likely not have changed his mind anyway.

"It'll be difficult," replied Chief Surgeon Sun truthfully. After answering the question, he quickly turned around and blinked innocently as a form of apology to Old Chief Physician Pan.

"If surgery is necessary, I would like Chief Surgeon Sun to perform the laparoscopic surgery. Open surgery can be attempted when laparoscopy fails," said Lin Yuanshan decisively.

"Is the emergency operating theater fully equipped?" asked Director Xiao.

If he were honest, Director Xiao would have preferred to let Chief Surgeon Sun handle the operation as well. After all, he was a senior consultant with impeccable skill at surgery, so the chances of success would be much higher.

As for Zheng Ren… It was better for him to stay out of a case that involved a very important patient.

"Yes, I've done some laparoscopic cholecystectomies recently," Zheng Ren remained unconcerned and added, "Chief Surgeon Sun, please check the equipment later and make sure everything is well prepared. You can get a replacement from the general surgery department if there are any missing or incompatible instruments."

"It should be fine." Chief Surgeon Sun had a feeling that he had fallen into a trap. He preferred not to provoke these two troublesome emergency doctors, which was why he always backed out of any conflict with them.

However, his involvement in this special case was something he could not have foreseen.

"Once the blood test results come back and there aren't any contraindications for surgery, let's proceed to save the patient." Director Xiao tried to create a relaxing atmosphere and said with a smile, "Sea City General Hospital usually performs around a thousand laparoscopic cholecystectomies each year. We even surgically treated a 108-year-old man last year and he could already ambulate on post-op day one. Don't worry, Mr. Lin."

"Hum!" Lin Yuanshan mumbled through his nose and coupled with his worried expression, the atmosphere remained slightly gloomy.

During the wait for preoperative examinations, Chang Yue began documenting pre-admission and preoperative counseling and broke the dead silence in the office with the continuous tapping of her keyboard.

On the other hand, Zheng Ren went to the resuscitation room as he disliked the current office environment.

"You're an insidious man," said Su Yun, who followed Zheng Ren everywhere like a shadow.

"What do you mean?" asked the puzzled Zheng Ren.

"You suspected that the patient has severe abdominal adhesions. If whatever you said is true, there is no way he can be treated with laparoscopy," Su Yun said, "Why didn't you stop him?"

"Will they listen to my opinion?" Zheng Ren was an honest man, but he was no fool.

He had learned to judge situations more effectively after working in the medical field for so many years. Most importantly, if he insisted on his point after the family members made their own decisions, an argument would be unavoidable.

"Good, you don't have the heart of Saint Mary. I feel more at ease after knowing this." Su Yun's smile stunned a junior nurse, who was preparing the patient for surgery in the resuscitation room.

Zheng Ren felt that this brat was simply causing too much interference in the resuscitation room.

"Let Old Sun perform the surgery first. By the way, I'm curious. How can you tell that the patient has severe abdominal adhesions?"

"In the B-scan ultrasonography image, a band of free air can be seen in the gallbladder area. You can consider that sign as a simple gas disruption in normal patients, but if you look carefully, there isn't any obvious motility noted in the gas band. That's why I suspect that some inflammatory organic matter has enveloped the transverse colon and displaced it superiorly to the liver edge."

Zheng Ren immediately turned on his invincible mode when explaining medical issues.

It was one thing to make conjectures, but it was a different and much easier thing altogether to explain the condition through deduction after acknowledging the final diagnosis of the System.

Su Yun had a pair of delicate eyebrows. The delicacy remained even when he frowned without any trace of solemnity, which made him look calm and steady. His glamor intensified and blinded everyone who peeked in on him.

He desperately tried to recall the B-scan ultrasonography image during the bedside examination.

Was it possible that whatever Zheng Ren mentioned was true? How did he even acquire such an in-depth knowledge of ultrasonography?

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