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Chapter 90 - A Snowy Rescue Operation

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Chapter 90: A Snowy Rescue Operation

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

As it was still early winter, the temperature had not yet dropped drastically. Thus, the falling white confetti caked every surface it touched and instantly melted, forming a huge blanket of black ice when a cold breeze blew across it.

This was a very dangerous situation as drivers would not realize that the road surface had changed dramatically.

Snowfall in the middle of the night could reduce the risk of road traffic collisions to a certain degree.

However, it was the morning rush hour right now. Thirty to forty kilometers per hour was considered slow, but it was an entirely different story on an icy road.

Just as Old Chief Physician Pan finished his sentence, Zheng Ren watched a rear-end pile-up on the opposite main road through the office window.

Despite both emergency and regular brakes locking, the cars still slowly skidded across the black ice. It was a rare sort of despair to experience firsthand.

This would be one of those times, however.

As traffic was slow on the main road opposite the hospital, the collision merely resulted in small scratches on the cars, which was not a big deal.

Even so, a few meddlesome car owners would insist on a hospital checkup and admission for observation. It was unnecessary but a reasonable request.

Therefore, the emergency department could expect to be swarmed by patients today.

"Ding-ling-ling!" A classical ringtone came from Old Chief Physician Pan's phone.

"Hello. Yes, I am.

"Okay. Rest assured, preparations have been made.

"Yes, and about the blood bank, I'll send someone to collect all types of blood from the bank in the city center."

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Zheng Ren knew that something was definitely wrong from those words alone. His epinephrine level skyrocketed, endorphin pumped into his system, and the high-energy phosphate bonds within his cells hydrolyzed and released energy reserves for his body's consumption.

"Witnesses claim that there were several injured in a large-scale traffic collision on Benteng Bridge. Ambulances are currently on their way to the scene, so it's time for us to get ready as well," said Old Chief Physician Pan.

When melted snow refroze, it formed a thin ice layer on the road surface, which made it extremely slippery. Although uncommon, it would still happen in Sea City once every few years.

Vehicles traveling on flat ground in urban areas were not hugely affected due to limited speeds, but the same did not apply to vehicles on the overpass.

The vehicles' inertia combined with reduced friction between the tires and ice, one after another…

The picture in Zheng Ren's mind was tragic, but he knew reality was usually more catastrophic.

He picked up the phone and gave Xie Yiren two tasks. The first was to inform the matron to count the surgical instruments and restock them in case they did not have enough. Secondly, he wanted the Chu sisters to check on anesthesia and other medication to minimize chaos during the upcoming rescue operation.

"Can you work?" Zheng Ren asked Chang Yue.

"No problem at all." She stood and made herself a cup of Nescafe instant coffee.

Truly, Zheng Ren thought, Chang Yue behaved more like a man in drinking and at work…

"Come, let us wait in the emergency department," Old Chief Physician Pan said, "We've to mobilize every department in this rescue operation too."

These were, without a doubt, standard procedures.

The slippery road surface forced all vehicles to slow down. Even though it only took ten minutes to get to Sea City General Hospital from Benteng Bridge, the situation was completely different now and the ambulances would require at least half an hour to complete the journey.

…

Medical emergency protocol required the nearest hospital to mobilize ambulances to the crash site within three minutes of a distress call.

A few minutes ago, as soon as a siren blared, the doctor in charge of emergency rescue stood up abruptly, retrieved a first aid kit and, with a nurse, rushed to the ambulance outside the triage center.

The ambulance driver slammed on the accelerator and the anti-lock braking system instantly activated, causing the ambulance to drift ten meters across the pavement before he slowly regained control of the steering wheel.

"The road today is so slippery," said the driver, terrified.

Normally, the siren on the ambulance was off when delivering patients with minor traumatic injuries or non-urgent illnesses, but in this sort of situation, the siren wailed like a baby in distress, emitting a sickening shriek.

Other vehicles carefully gave way to the ambulance when they heard the caterwauling.

However, even though most people knew the importance of giving way to an ambulance, it had to be done slowly due to the icy road surface.

It was normally five minutes away, but at such a snail's pace, the ambulance finally reached the crash site more than ten minutes late.

Scanning the scene… They saw a long metal dragon of approximately thirty to forty cars crushed together with different degrees of damage; most of the vehicles made of thin sheet metal had been deformed.

The inertia of the vehicles sliding off the bridge had caused this huge accident.

The doctor quickly jumped off the ambulance, but he accidentally slipped and fell to the ground. The first aid kit in his hand flew out, gliding along the icy pavement before coming to a halt nearly twenty meters away.

"Little Song, are you alright?" asked a nurse out of concern as she carefully stepped out of the ambulance.

"Yes, I'm fine," replied Doctor Song with a grin, enduring the pain that burned his hands and cheek.

It was obvious that the large abrasion on his face was equivalent to disfiguration, but fortunately, he was a man. If a female doctor had suffered from such an injury, she might have committed suicide after sending patients from the crash site back to the hospital.

Slowly and cautiously, he moved to the first aid kit, picked it up and started making his way toward the crash site.

"Doctor, here! I'm here!" someone shouted at the top of his lungs.

"I'm dying, please save me!" Doctor Song ignored the man after stealing a peek at him.

He followed his judgment and walked straight towards a heavily deformed car.

Eighty to ninety percent of those who could scream for help were fine due to their ability for articulation, but of course, "fine" only meant they were not on the brink of death. Doctor Song had even encountered a tough guy who had driven hundreds of kilometers on his motorcycle with a fractured tibia.

He noticed bloodstains on the door of the contorted car as he neared. Silence reigned inside the car and not a single wounded person could be seen around it. Moreover, he could vaguely outline a man lying in the passenger seat even from afar.

Something must be wrong!

"Doctor, help!" Lots of people cried for help along the way.

A choice had to be made at this moment. Doctor Song could always randomly send a victim back to the hospital as it was the most convenient and acceptable way to do so. In addition, he would not even need to risk fall-related injuries by climbing on the icy pavement.

Even so, he insisted on doing the right thing as a critically wounded victim would not survive until the next ambulance's arrival. In that case, he had to send the victim with the most severe condition back to the hospital first.

After tumbling a few times, Doctor Song, whose face had become swollen and bruised, finally reached the deformed car.

The car door had fallen to one side. The driver, who had blood all over his face, was lying with his thoracoabdominal area resting on the steering wheel; it was impossible to tell if he was alive or dead.

Without hesitating any further, Doctor Song quickly grabbed the car door to stabilize himself so that he could pull the patient out of the car.

To his surprise, the door was so heavily deformed that a sharp metal edge sliced open his hand.

Crimson fluid oozed out instantly.

There was no time to deal with such a "minor injury". Doctor Song firmly planted his feet on the pavement, grabbed the patient, unfastened his seatbelt, and yanked him out of the car with all his might.

Going down the slippery pavement was much more difficult than climbing up.

Doctor Song glanced at the ashen-faced patient and felt his thready pulse, which suggested internal hemorrhage. Staring desperately at the medical personnel—the nurse and paramedics carrying an empty stretcher trolley—still struggling to climb up the bridge, he instructed them to return and wait for him. Then, he lay down and stabilized himself with his feet before pulling the patient with him.

Just like that, Doctor Song slid down the black ice along with the patient.

IndexChapter 91 - An Unconventional Rescue Operation

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Chapter 91: An Unconventional Rescue Operation

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Doctor Song hugged the patient tightly while his feet continuously searched for support in an attempt to increase friction.

However, he was at the mercy of the icy pavement.

This sort of rescue was definitely illegal, but special circumstances required special solutions. Were he to follow the standard procedure, the patient would be long gone by then.

Two paramedics used their bodies as a barrier and finally stopped the downward momentum of the duo, but it came at a price. The impact at that speed was almost the same as a full-force kick on the body.

Doctor Song was covered in red, a mixture of both his and his patient's blood. Ignoring the pain, he carried the victim, who had not suffered any secondary injury, onto the stretcher trolley and slowly pushed him into the ambulance.

Blood pressure readings came back at 80/40mmHg, which meant that the patient was in hemorrhagic shock. He was given supplemental oxygen and medications to induce hypertension after establishment of venous access. The siren sounded even more dreary as the ambulance rushed back to the hospital.

Every vehicle tried to give way to the ambulance as it was the only green channel between life and death.

In the ambulance, aggressive fluid resuscitation and drug administration were performed to maintain the patient's vital signs. Doctor Song ignored the wounds on his body and thoroughly examined the patient for signs of trauma while constantly reporting his condition to the emergency department so that early preparations could be made.

Twelve minutes later, the ambulance finally arrived at Sea City General Hospital emergency department.

Zheng Ren had been waiting for a long time at the main entrance.

The nurse in the ambulance handed over a few vacutainer tubes of freshly drawn blood for laboratory tests, mainly blood group and screening tests for HIV and syphilis. This was a necessary procedure as severely wounded patients desperately required blood transfusions.

The stretcher trolley was speedily pushed into the resuscitation room. Zheng Ren then inserted a central venous catheter into the subclavian vein while another doctor performed a B-scan ultrasonography on the patient.

At the same time, a nurse performed nasogastric tube insertion, urinary catheterization and preoperative skin preparation.

The senior consultants, highly experienced doctors from various departments—general surgery, orthopedic surgery, neurosurgery and urology surgery—had been waiting for the patient on high alert, so they knew what to expect after seeing the patient's condition.

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The provisional diagnosis was traumatic hepatosplenic rupture complicated with hemorrhagic shock.

Fortunately, the tall patient had owned a small car, so there was no impact on the chest.

Chief Surgeon Sun said seriously, "Little Zheng, you're young and fast, so go ahead."

Zheng Ren nodded in response as this was not a good time for modesty. The emergency operating theater had long been prepared and they could save at least five to ten minutes of precious time by performing the emergency surgery here.

Whether the patient lived or died could depend on these few minutes.

"Get him to the emergency operating theater and prepare for surgery," instructed Zheng Ren.

"Old Chief Physician Pan, I'm going to perform the emergency surgery. Please take it from here," he said to Old Chief Physician Pan before he departed.

"I'm guessing there'll be lots of casualties." Old Chief Physician Pan frowned and added, "Off you go. I'll call the operating theater if something happens."

The conversation was short and simple. There was nothing else to say at this moment.

Chief Zhou of the medical administration division had also arrived a long time ago. Without demanding Zheng Ren's presence, he began recording the current situation and authorized the emergency department to handle the emergency surgery on behalf of the hospital.

The System's robotic female voice rang out in Zheng Ren's ears as he quickly walked upstairs to the emergency operating theater.

[Emergency Mission: Pileup Crash.

[Task: Rescue the injured patients in the multiple-vehicle collision.

[Reward: Unknown.

[Time: One day.]

The System could not provide any details about the mission reward, presumably due to the fact that this was an unexpected occurrence with an unspecified number of casualties.

Zheng Ren had gradually figured out the System's behavior. The fickle-minded System could either predict the future, although only to a certain extent, or simply felt reluctant to give further information about it.

The liver surgery experience the System had awarded him should be enough to deal with the emergency case at hand, but he lacked knowledge in splenectomy since he had performed it only once.

If he exchanged 14920 experience points for surgery intensive training time, he would have little over four hours to practice.

Splenectomy was relatively simple compared to liver repair surgery.

More than four hours of surgery intensive training time should be just enough for Zheng Ren, who had achieved the Expert rank in general surgery.

It could be inadequate for being proficient in the surgical repair of a ruptured spleen, but he could definitely master splenectomy in that short a time.

Zheng Ren trotted all the way to the emergency operating theater. Xie Yiren was preparing the surgical instruments and the Chu sisters were preparing general anesthesia. Even the frequently absent and quiet anesthesiologist responsible for training junior doctors had also appeared in the operating theater and was silently assisting the ladies with preparations.

Since the surgery preparation was still ongoing, he figured it was time to change his attire and mentally prepare himself for the surgery.

After reaching the locker room, Zheng Ren exchanged his points for surgery intensive training time and began practicing splenectomy.

In a sense, a splenectomy was even simpler than an appendectomy.

In a complicated case of appendicitis, the inflamed appendix could be in an ectopic position, a huge headache for all surgeons, but the spleen was rarely ectopic.

It was basically location, dissection, clamping and removal. There was nothing difficult about it as long as the arteries, veins and ligaments were clearly visible.

Zheng Ren practiced forty-three splenectomies in 4.14 hours, averaging less than six minutes per surgery.

He would never complete the surgery so rapidly in reality, but in the System, all he had to do was cut through the abdomen, face various types of splenic ruptures and excise it without worrying about irrigation or abdominal wound closure.

The most difficult part of the surgery was the careful maneuvering around the abnormally developed short gastric arteries when handling the gastrosplenic ligaments to prevent damage to the gastric wall. Secondary to that was the location of the splenic artery and vein; if the anatomical structures could be clearly visualized, the chance of surgical failure was close to zero.

Zheng Ren even resolved several complicated cases of splenic tuberculosis, and the overall process was performed smoothly.

When his time was finally up, Zheng Ren glanced at his skill trees.

Based on his calculations, his general surgery skill tree should have increased from 2044 to around 2200 skill points after his revision, completing actual surgeries and the splenectomy intensive training.

However, he was flabbergasted upon seeing the skill tree.

The skill tree had grown directly from 2044 to 3154 points!

What the hell had happened?

After recalling recent events, Zheng Ren assumed that the tremendous growth in his skill tree was related to the three hundred liver surgery experiences the System had awarded him.

Whatever the case, it was good news.

Zheng Ren also decided to keep a closer eye on his skill trees from now on.

With 1529 skill points still in his inventory, he still needed a little more than 300 skill points for a skill upgrade from the Expert to Master rank.

He felt a tinge of regret. If a rank upgrade was possible, he would definitely have obtained it to ensure the success of the rescue operation. Besides, even if he used up every skill point now, he could still regain them from missions in the future, right?

The System also notified him that the main quest had been completed. Zheng Ren gave this some thought and figured that the gangrenous appendicitis case had been equivalent to tier-three or four surgery, which had completed it sooner.

After accepting the reward—1000 experience points and 10 skill points, he noticed that there was only one bar left in the mission completion rate.

Zheng Ren ignored the rewards as they were not useful right now.

He summoned his mind back to reality and changed into surgical attire before proceeding to perform a surgical scrub.

When he walked into the operating theater after decontamination, Xie Yiren handed him a pair of large forceps and a kidney dish containing iodophor-soaked cottons.

During disinfection of the surgical site, Xie Yiren informed Zheng Ren that the blood bank had prepared 16U of fresh frozen red blood cells and 1000mL of fresh frozen plasma for the patient, and the circulating nurse was currently on her way to retrieve them.

'I don't think those are enough,' Zheng Ren thought while disinfecting and draping the surgical site.

He put on a surgical gown and stood under the surgical lighthead. Then, a sharp scalpel was handed to him.

Zheng Ren accepted it and the surgery officially began!

IndexChapter 92 - He's Faster, That's All

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Chapter 92: He's Faster, That's All

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

The light reflected off the cold scalpel, radiating a bloodthirsty aura. Without hesitating further, Zheng Ren cut through the abdomen.

Instead of a standard incision, he chose to make a twenty-five-centimeter incision superior and lateral to the left rectus abdominis muscle.

This was completely different from his usual manner of surgery. Xie Yiren was momentarily stunned and grabbed a self-retaining retractor while staring attentively at his movements.

Chu Yanran, who was sitting beside the ventilator, fixed her gaze closely on the readings on the ventilator and various monitors while constantly spinning a pen in her right hand.

Standing opposite Zheng Ren, Chu Yanzhi asked, "Chief Zheng, do I scrub up and assist you?"

"No, the surgery will be over by the time you finish scrubbing up," answered Zheng Ren coldly without looking at her. After asking for a pair of medium-sized curved forceps and an aspirator with a suction tube, he plunged the aspirator into the peritoneal cavity as soon as the peritoneum was opened.

The dark red blood was quickly aspirated. A few seconds later, Zheng Ren instructed, "Chu Yanzhi, tell the circulating nurse to hurry up."

Chu Yanzhi nodded and ran out of the room like a scalded cat.

In Xinglin Garden, there were not many viewers in the live broadcast room.

It was morning now, the busiest time of day where every doctor was occupied with ward rounds, disease reports, surgery and so on.

Thus, "only" more than a thousand viewers were online at the moment.

[That's a severe hemorrhage. I can at least diagnose a splenic rupture in this case.]

[Blood pressure has dropped to only 60…]

[I hate emergency surgery the most, especially this type of rescue. Every time I'm done, my body will feel so sore that I need to rest for at least two days.]

Watching the turbulent flow of dark red blood in the suction tube naturally made every doctor in the live broadcast room feel the same way the commenter did.

The tension and suffocation of a rescue operation had subconsciously seeped into the viewers' hearts.

Only a few comments floated past the screen and most of them were from the same talkative viewer.

This sort of doctor preferred to calm his nerves through conversation.

After aspirating for approximately ten seconds, the amount of dark red blood was considerably diminised. Without waiting for complete aspiration of blood, Zheng Ren directly opened the peritoneum and inserted his left hand into the peritoneal cavity.

Xie Yiren immediately put a kidney dish beside Zheng Ren.

He extracted several large blood clots and threw them into the kidney dish.

"Rubber drainage tube," said Zheng Ren to Xie Yiren; it was a rare request.

Xie Yiren acknowledged the instruction and handed the pre-prepared rubber drainage tube to Zheng Ren, taking the kidney dish away at the same time.

That near-perfect coordination was simply amazing.

Zheng Ren started searching for something in the peritoneal cavity.

[Wow, is he going to occlude the porta hepatis? Is the liver ruptured as well?]

[Sure looks like it. The host surgeon must be anxious to stop the bleeding as soon as possible, but I think it's better to expose the surgical field first. His manipulation is simply too risky.]

[Based on what I've seen these past few days, I'm waiting for the above commenter to get humiliated.]

In the live broadcast room, they watched as Zheng Ren inserted the latex drainage tube after a brief moment of discussion.

If the surgical site was adequately exposed, he should have been able to see the passage of latex tube through the hepatoduodenal ligament that was extended between the omentum and porta hepatis, but he was currently manipulating the instrument without any direct view of the surgical field at all.

Subsequently, Zheng Ren quickly performed a peritoneal protection and used a retractor to open the peritoneal cavity.

There was a clear four-centimeter wound with irregular, jagged edges on the spleen, and blood oozed out of it like a river overflowing a dam.

The patient's hypotension was the reason behind his slow flow rate.

However, everyone in the operating theater and live broadcast room knew that death was imminent if the hemorrhage continued for another ten minutes.

Zheng Ren instructed in a deep voice, "Appendix retractor."

He used the retractor to pull the incision edge to Xie Yiren's side and adjusted its position before passing the tool to her. That way, she could help him expand the operative view to its maximum.

Then, he extended his hand again and a pair of dissecting forceps was gently placed on his palm.

The gastrosplenic ligament was clamped with the dissecting forceps before being ligated and incised. After that, he quickly ligated the short gastric arteries to avoid damage to the gastric wall.

[His movements are so f*cking fast…]

[The host surgeon's understanding of the anatomical structures has reached a very high level. Why do I have a feeling that they know where the short gastric arteries are without even searching for them?]

[You'll know after repeated executions. Young man, more surgeries and thinking are the keys to success.]

As the comments passed, the splenic artery was separated and exposed in the operative field. After ligating it using a 3# suture thread, Zheng Ren noticed a significant reduction in spleen size.

Subsequently, the spleen was removed from the splenic fossa. The splenophrenic ligament and splenocolic ligament were transected, and the vascular pedicle was treated using double ligation and transfixation with nonabsorbable suture ligatures.

These were accomplished in less than five minutes.

[That's very fast. I think I know why the host surgeon occluded the porta hepatis in the first place.]

[He is confident that occluding the hepatic hilum can minimize hemorrhaging as much as possible. If I'm not mistaken, the occlusion can go up to ten minutes, max.]

[Fifteen minutes, but we usually release it every ten minutes to prevent ischemic liver injury.]

The doctors in the live broadcast room understood the host surgeon's methods. Despite their astonishment at the removal of spleen in only five minutes, the surgery itself was not difficult. It only showed that the host surgeon had a deep understanding of local anatomy, no more.

Yes, that was basically it.

Apart from blind manipulation to occlude the porta hepatis, everything else was plain and simple, but how many surgeons in this world could finish it so quickly?

Everyone understood the principle behind it, which was why there were relatively few comments thus far. They were eagerly waiting to see what the host surgeon was going to do with the ruptured liver.

Liver surgery was ten times more difficult than a splenectomy.

After simple ligation of the vascular pedicle on the diaphragmatic surface using a 2# suture thread, Zheng Ren began extending the surgical incision to the right.

There was no bleeding from the subcutaneous tissue: a typical manifestation of hemorrhagic shock. This was due to peripheral vasoconstriction, which was a compensatory mechanism to maintain vital organ perfusion.

Despite the absence of bleeding, Zheng Ren remained vigilant and quickly performed blunt dissection, trying his best not to cause any further damage to the surrounding tissue.

A large sterile gauze was used to protect the peritoneum before he repositioned the appendix retractor and let Xie Yiren pull on it.

At this moment, Chu Yanzhi and the circulating nurse finally returned.

"Transfuse the blood!" Zheng Ren ordered while exploring the peritoneal cavity.

Resuscitation was of utmost importance and courtesy was absolutely unnecessary in this instant.

The circulating nurse and Chu Yanzhi each took a bag of fresh frozen red blood cells and hung them on the infusion stand.

Warm blood had to be used, so they had been trying to use their body temperature to thaw the bags on their way back to the operating theater.

After an identity check between the patient and his blood components, the circulating nurse placed a bag of fresh frozen red blood cells into the pressurized infusion device before putting another bag into her embrace.

"Give me a bag," said Chu Yanran, who was attentively watching the data on the ventilator and various monitors.

Without wasting any time, they divided up the blood bags and constantly changed positions to warm the frozen blood as much as they could.

The blood bag in the pressurized infusion device soon depleted and was quickly replaced with another.

Seeing the dark red fluid entering the patient's vein via the central venous line relieved everyone's anxiety to a certain extent.

IndexChapter 93 - Hectic

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Chapter 93: Hectic

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

The operative view opened up, revealing a 5cm wound on the left side of the liver. Despite the rubber drainage tube controlling the bleed at the hepatic hilum, there was still a significant amount of blood flowing out.

Zheng Ren immediately started to clean the wound. There were no signs of necrosis yet as the wound was still fresh.

An in-depth investigation revealed the tear to be on the inside of the liver, around 4cm deep. A few blood vessels were leaking dark red blood.

Zheng Ren extended his arm and a mosquito clamp was placed in his hand.

The ruptured blood vessels were clamped and ligated, followed by the damaged bile duct.

Once the bleed was controlled, Zheng Ren let out a breath of relief. The drainage tube indicated that the bleeding had stopped.

"Blood pressure?" Zheng Ren asked.

"80/60," Chu Yanran answered.

The ruptured spleen was removed and the bleed at the liver was controlled. In response, the patient's vital signs took a turn for the better.

The patient would be better after a transfusion of 16U of blood and 1000ml of plasma.

Zheng Ren assessed the area around the wound of the liver and said, "Call Su Yun. Ask if he is confident with handling a hemorrhagic shock patient post-surgery. If he is, get him to the ICU."

Chu Yanzhi hesitated slightly before dashing out of the operating room to wake the drunken man.

Zheng Ren cut out a part of the greater omentum and used it to plug the leak. Then, he used an interrupted mattress suture to close the wound. The distance between each stitch was precisely 1 centimeter.

[His stitchwork is perfect! You could use a caliper to measure the 1cm!]

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[Amazing! The surgeon is very attentive. He left a piece of the greater omentum at the wound to prevent capillary bleeding after blood pressure is restored.]

[To reach his level of skill, one cannot be anything but attentive. Young ones, let me tell you, you need to develop yourself with each surgery.]

[How many minutes have passed? Fifteen?]

[From my calculations, the whole operation took around 13.5 minutes from spleen removal to stitching up of the liver. It's not a big operation but their speed is impressive.]

[In a life or death situation, speed is key. Notice the surgeon did not make a small incision and just went for a 25cm cut. This surgeon is efficient.]

Xie Yiren had warm saline water ready when the suture was complete.

The abdominal cavity was irrigated, and after that, the mixture of bodily fluids and saline water was aspirated.

Zheng Ren double-checked the abdominal cavity and area of the splenic hilum. He placed drainage tubes at both the splenic hilum and the liver wound and began closing the abdomen.

"Su Yun is awake. He'll be there soon," Chu Yanzhi reported when she got back.

"Is he completely awake?"

"Sounded like it." Chu Yanzhi's hands were icy from the frozen blood bags. She rubbed her hands to warm them and as she thought of last night's amazing feat, a smile graced her face.

"Good. The ICU is better-equipped and better-staffed." Zheng Ren had to agree.

He predicted that the patient would not have many post-surgery complications, but to be safe, he wanted the patient to stay in the ICU for one or two days of observation.

The number of patients who would require the same treatment was not on his mind.

He only focused on the emergency at hand.

"Inform the ICU to prepare a ventilator. Patient arriving in 20 minutes," Zheng Ren ordered.

Suture, closure. The patient was intubated and sent to the ICU.

Chu Yanran sat atop the trolley bed with her legs tucked to minimize occupied space.

Her position was awkward as she clutched the ventilation bag to sustain respiration. She had to keep an eye on the patient's vitals during transport.

After transporting the patient, Zheng Ren rushed back to the emergency department.

Although the surgery was quick on his part, from end-to-end, it had taken nearly an hour.

In that time, other injured patients had been brought in.

At the emergency room, Old Chief Physician Pan was managing the crisis. The old chief was calm and collected as he assessed each patient's condition and triaged them to particular departments.

Zheng Ren's eyes swept across the room. There were many patients, but most of them had fractures or external head injuries that were minor. His shoulders sagged in relief.

He asked around and found two more patients that had come in with internal hemorrhaging. The more severe case was sent to the second general surgery department with Chief Sun heading that rescue. The other case was sent to the first general surgery department for the deputy chief to work on.

Old Chief Physician Pan was seated calmly amidst the chaos, his presence a source of comfort for many.

As the families of these patients had yet to arrive, medical administrative personnel were extremely busy. They were taking down patients' details, conditions, justifications for surgery—all information required by-law.

As medical lawsuits were on the rise, the hospital made sure to be extra cautious with legal procedures. The paperwork had to be perfect even in emergencies like this.

This was after receiving hundreds of lawsuit threats in a year.

Zheng Ren once heard an old physician say that back in the eighties and nineties, even though public safety was lacking, doctors were very much respected by society. People with injuries could come in and be treated as an anonymous patient. The lack of procedure meant quicker emergency response.

Now, if a doctor dared to do as such… Zheng Ren was sure one encounter with an unscrupulous family member would end their whole medical career.

Old Chief Physician Pan saw Zheng Ren and asked, "How did the surgery go?"

"Laceration at the liver, ruptured spleen. Surgery went well. The patient's in the ICU now," Zheng Ren summarized.

"Good." Old Chief Physician Pan nodded and said, "There's a lot of patients today but only a few had internal lacerations and all were from the Pentium Overpass incident. Fractures and external head injuries were the main conditions observed in the other patients. We'll have to monitor them."

Zheng Ren uttered a grunt of acknowledgment.

"We need to keep an eye out for delayed traumatic intracranial hemorrhage. Stay on guard," Old Chief Physician Pan instructed.

Zheng Ren nodded in assent.

As time passed, more patients with minor injuries were admitted. All 120 ambulances were overloaded but even so, a few victims could not catch one and had to walk to the hospital in the cold weather.

These patients mostly exhibited minor external injuries. It was likely that the sudden snow and frozen road made them lose control of their cars, resulting in a frontal collision.

Some of the patients were elderly people who had been on walks. The frozen pavement had caused them to slip and fall, leading to multiple cases of Colles' and intertrochanteric fractures.

Zheng Ren guessed that the orthopedic department would be bustling. Sea City General Hospital had four orthopedic departments and each received around ten patients.

This was excluding patients with Colles' fracture being treated in the emergency department.

Colles' fractures were largely caused by indirect trauma. It was a condition commonly observed when people tried to break their fall with their hands. The frozen ground played a role in today's incidents.

With the forearm extended and the hand outstretched, the force of a fall would cause the distal end of the radius to fracture.

The treatment was simple—resetting, immobilization with a splint and medication that improved blood flow.

Under normal circumstances, if the patient wanted to stay for further observation, they would allow it. However, with the emergency today, the doctors advised them to recuperate at home.

The whole emergency department was filled with patients. There were no available beds for observation.

Zheng Ren was not from orthopedics. He had only performed resetting once or twice during his housemanship and therefore was of not much use.

For the whole afternoon, he stuck to observing, diagnosing, and distributing the patients.

At 2:25 in the afternoon, a call came from the ICU. The hemorrhagic patient's condition required input from all departments.

The ground outside was frozen over like a layer of glass. People avoided the outdoors and the number of new patients gradually decreased. Old Chief Physician Pan noted the situation in the emergency room had stabilized and told the doctors on duty to call him if there were any problems. Then, he brought Zheng Ren with him to the ICU.

IndexChapter 94 - Retroperitoneal Hematoma

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Chapter 94: Retroperitoneal Hematoma

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Zheng Ren entered the ICU and felt hateful gazes directed at him.

'What did I do?' Zheng Ren thought.

He had never had any misunderstandings with ICU staff. The nurses…

"Chief Physician Pan, you're here." An ICU doctor walked toward them and started to explain the patient's condition.

"The patient was involved in a traffic accident and sent to the fifth orthopedic department at 9:18 am. He was diagnosed with a pelvic fracture. Blood pressure was at 100/60 mmHg but an hour later, it was at 85/45 mmHg. We suspected severe hemorrhage from the fracture and did a CT scan. The scan revealed a retroperitoneal hematoma."

The patient's records detailed the condition with a simple, clear-cut diagnosis. The hematoma was to be expected due to pelvic fracture.

Minor pelvic fractures rarely required surgery and were manageable with just rest.

The design of the pelvis naturally made it so. Fractures typically led to bleeding that would cause a small to medium internal accumulation. Usually, treatment with hemostatics and antibiotics was sufficient.

However, if the pelvic fracture ruptured any blood vessels, it would be the internal and external iliac veins, along with the common iliac vein.

These blood vessels were located at the retroperitoneal space and the bleed would be enveloped by the peritoneum. In most cases, the ruptured vessel was either a small artery or vein and the bleeding would stop due to higher retroperitoneal pressure.

However…

This patient seemed to be a special case. The odds of a case like this was less than one in a hundred.

It was likely that there had been severe laceration to one of the bigger arteries in the retroperitoneal space and the pressure could not staunch the bleed. The patient's blood pressure was at a level that indicated hemorrhagic shock.

The higher retroperitoneal pressure was tricky as it did not allow for standard general surgery methods to stop the bleed.

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If they cut open the retroperitoneum, the trapped blood would burst out due to pressure.

Zheng Ren looked to the side and saw Su Yun move a chair to the patient's bedside. He sat by the patient and scrawled something on a piece of paper as if making calculations.

Su Yun could be hungover but did not look drunk, just mildly dispirited.

The gloomy expression on a handsome face like his gave off a completely different vibe.

"Let's have a look at the patient first," Old Chief Physician Pan said steadily. He approached the patient and read his vital signs, then proceeded to view the CT scan.

"Pelvic fracture with ruptured arteries. Hematoma in the retroperitoneum." Su Yun heard Old Chief Physician Pan's voice and looked up. He did not rise from his seat or look at Chief Physician Pan, but only stared at Zheng Ren.

Zheng Ren knew what he meant.

The patient's condition was not suitable for open surgery, leaving only interventional surgery the only option for stopping the bleed. That was their priority now.

Su Yun's diagnosis and rescue plan were accurate. He was sharp.

"Little Zheng, are you confident?" Old Chief Physician Pan was not familiar with this manner of interventional surgery, but after the placenta abruption case, he had bought a book to study it further.

He was not capable of performing the surgery but wanted to make sure Zheng Ren was confident before rushing into it.

Sometimes, hot-headed youngsters need the steady hand of an older fellow to guide them.

A pelvic fracture with retroperitoneal hematoma and developing hemorrhagic shock was the perfect case for an interventional radiology-assisted surgery.

Nevertheless, Old Chief Physician Pan had never performed such surgeries before and wanted Zheng Ren's opinion.

"No problem," Zheng Ren replied confidently. "Get the paperwork. Prepare the blood and transfer the patient to the interventional radiology operating room."

Su Yun's black hair swayed as he bobbed excitedly. The tiredness in his eyes slowly disappeared.

The change in Su Yun made Zheng Ren cautious. 'What is this nancy boy up to?'

"I'll go in with you," Su Yun said, "These are calculations for contrast agent administration. Don't mess it up."

He handed the piece of paper to the nurse.

"Another calculation of contrast agent administration based on urine specific gravity?" the nurse said after glancing at the paper. She had a look of regret on her face. "Brother Yun, it's a shame you left for the emergency department."

"Haha." Su Yun gave a neutral response: a chuckle that accentuated his tousled hair.

Zheng Ren had no patience for Su Yun and his antics but the concept was correct. Using urine specific gravity for calculation, the contrast medium would provide a better chances for a hemorrhagic shock patient.

This was a high-level technique, something akin to a secret move from a Wuxia novel.

With the boom of the internet, this method of calculation was available online for reference. The problem was the complicated mathematics required, something beyond most medical students' grasps.

They would have to constantly monitor the patient's urine specific gravity and adjust the contrast medium. The whole process was exhausting.

Hence, anyone who suggested it was already heads and shoulders above others.

This man would do it. Zheng Ren and Old Chief Physician Pan excused themselves from the ICU and went to prepare the interventional angiography system.

After the placenta abruption case, Old Chief Physician Pan had managed to source some of the materials suitable for interventional surgery.

This time, Zheng Ren would be better-equipped. He would have the right instruments and another doctor with him.

…

Zheng Ren prepared himself in the operating room.

Xie Yiren was here. She had taken the time to study interventional surgery as much as possible and was ready to assist Zheng Ren.

However, he would not allow her to. This was not coronary bypass surgery that would have the patient's heart stopped. There was no need for her to be exposed to radiation.

As for Su Yun, Zheng Ren simply did not care if he wanted to help or not.

Between an annoying, sharp-tongued pretty boy or an accommodating, delightful lady, Zheng Ren did not need to think twice about his pick. He was very straight, after all.

They required minimal machinery as it was simply an embolization surgery. In the world of interventional surgery, embolization was the easiest procedure to perform.

Fifteen minutes later, Zheng Ren heard the sound of the stretcher trolley approaching.

The preparations in the operating room were complete.

The patient was gently lifted onto the operating table. Care was taken as not to aggravate the patient's condition. Zheng Ren activated the system and gave control access to the operating room, then began to scrub in.

Interventional surgery had the risk of radiation exposure, but personnel entering the area had to wear heavy lead aprons as they worked. Operating with pounds of added weight was much more difficult than a normal surgery.

However, in certain cases, interventional surgery was the only viable option. If they did not proceed, it would mean standing aside and watching the patient bleed to death.

Zheng Ren went to the storage room and took out a lead apron. Suddenly, he remembered something.

When he had accomplished the solo mission, the System had rewarded him a silver chest and a special lead apron that could turn radiation into energy.

The silver chest did not entice him after three consecutive unboxings had given him nothing but skill books.

The special lead apron seemed prestigious. According to its description, it could absorb and transform radiation into energy for its wearer.

That would be very interesting.

Zheng Ren returned the lead apron in his hand and snuck a peek at Su Yun. The man was occupied with positioning the patient and other presurgical preparations. Zheng Ren hurried into the changing room and accessed the System, intending to put the special lead apron to good use.

IndexChapter 95

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Chapter 95: 0095 介入医生的苦,你们不知道

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

1.0095 You Don't Know The Pain of An Interventional Surgeon

The special lead apron from the System was similar to the one in the hospital. The color and make allowed it to blend in with the other lead aprons on the clothes rack.

However, the System did not provide any explanation as to how the lead apron could transform radiation into energy. The getup only consisted of a vest with no apron skirt, headwear or goggles. Zheng Ren was mystified.

Whatever.

Zheng Ren had no time to investigate it further, so he put on the special lead apron alongside other normal gear. At the same time, the Chu sisters were starting general anesthesia.

General anesthesia was not necessary for interventional embolization surgery, but as the patient was in a state of hemorrhagic shock, seizures were a concern. If the guide wire broke in the patient's blood vessel… Now, that would make for an interesting day.

He washed his hands thoroughly and put on the sterile scrubs. The general anesthesia was complete and thus the surgery began.

"Do you have experience in interventional surgery?" Zheng Ren asked Su Yun.

Su Yun was already geared up and standing beside Zheng Ren like a shadow. Zheng Ren could only hope for such a handsome silhouette for himself but alas, life was unfair.

"Nope," Su Yun answered with a smirk. His eyes crinkled attractively.

Zheng Ren was speechless.

"I've seen you do it once, so I more or less know what to do," Su Yun said in earnest.

'Huh, do you think you're Saint Seiya? What doesn't kill you makes you stronger?' Zheng Ren thought.

Zheng Ren had nothing to say, but at least he had an assistant now. It would be much better than operating alone.

He would take Su Yun as an accompanying houseman.

The patient's blood pressure was at 60/40mmHg. Without saying another word, Zheng Ren opened the catheterization kit and took out his materials.

After disinfection, the first puncture attempt yielded blood.

It was a skill that Zheng Ren picked up after hours of intensive training in the System. He had also performed hundreds of catheterizations during the nitrite poisoning incident.

Su Yun's eyes brightened at this show of skill.

The first time he had witnessed Zheng Ren's skill at catheterization was during the placenta abruption case. He had dismissed it as a one-off stroke of luck. Now, this was the second time Zheng Ren managed to find the vessel at the first puncture. It could not be a coincidence.

Zheng Ren must have incredible skill to be successful on the first attempt, especially since the patient's blood pressure was so low.

Su Yun was quick to criticize but could recognize skill and talent.

"Guide wire." Zheng Ren held on to the vascular sheath and motioned with his other hand.

The wire was placed in his hand before he had even finished his sentence.

Zheng Ren was mildly impressed by the man. He had no experience in interventional surgery but knew what the next step was.

Su Yun was as quick as Xie Yiren when assisting in general surgery. This combination might work out.

Huh, he was quite the genius.

Thoughts were running through Zheng Ren's mind as he slowly inserted the guide wire into the vascular sheath within the femoral artery.

On the Xinglin Garden livestream, the bullet comments were flying.

[The surgeon just completed a spleen removal and liver trauma surgery. Now he's onto a pelvic fracture interventional embolization surgery? Which hospital does this stream belong to?]

[My mentor called up Xinglin Garden. They said the transmission originates from a teaching hospital in Montreal, Canada.]

[Oh? That's the hometown of Norman Bethune. Could it be that Old Mr. Bethune1 is starting a livestream to teach surgery?]

The origin of these mysterious livestreams was twisted into an unrecognizable mess.

Regardless of their identity, be they a foreigner or a Chinese citizen in a public or private hospital, the skills of the host surgeon or surgeons were indubitable.

For now, most people believed that it was a group of surgeons performing different types of surgeries. Hence, that it was a livestream from Canada was believable.

[Anyone who specializes in interventional surgery care to shed some light?]

[Yeah, I totally can't tell what's going on. I've seen a case like this in my hospital before. We didn't have an interventional suite. After getting informed consent from the family, they opened up the retroperitoneum and it was bad. Blood was everywhere. There was nothing we could do…]

[Thanks for the request! Pelvic fracture interventional embolization surgery mainly focuses on the internal and external iliac blood vessels. If the veins are damaged, the high pressure in the retroperitoneal space will stop the bleeding. It will be more complicated if the arteries are damaged, but simply put, the internal iliac artery can be embolized without much consequences…]

An interventional surgeon from a third-tier city explained away in the chat.

He specialized in interventional radiology-assisted surgery, but found the field was only known for coronary bypass and stent surgeries.

He had watched the livestream of the placenta abruption surgery multiple times and concluded that his skill was on par with the widely popular surgeon on screen.

Maybe not the same level, but close enough.

His conclusion gave him a confidence boost and since then, he had looked forward to the next livestream.

The life of an interventional surgeon was lonely.

Even when he was in the hospital, 95% of the staff had little knowledge of interventional radiology-assisted surgery, let alone an average Joe.

Hence, he visited Xinglin Garden every day hoping to catch the opportunity to talk about his field. Now, he got to showcase his knowledge in front of a few thousand doctors.

[Why? Wouldn't embolization of the artery cause ischemia?]

[If you refer to an anatomy diagram, the internal iliac artery has multiple branches. The external iliac artery is another case, though, as total embolization will cut off the femoral artery. It can lead to the loss of function in the whole leg. Hence, the difficult part of this surgery is the treatment of the external iliac artery.]

[Okay, I think I understood that. How hard will this surgery be?]

[I've done around 20 surgeries; the average duration of one was four hours. You guys don't know the pain of an interventional surgeon.]

As the third-tier city doctor explained the basics on Xinglin Garden, the livestream had already changed to the inside view. The guide wire and guide catheter had been inserted with the utmost precision and the embolization coil followed suit to seal off the ruptured internal iliac artery.

[The surgery was faster than your explanation.]

[What a quick surgery. God damn.]

[I am envious but as I've said, the surgery's difficulty is not in the embolization of the internal iliac artery but the superselection of the external iliac artery.]

Onscreen, behind the flurry of comments, a guide wire began the process of superselection of the external iliac artery.

The wire was very soft and thin, hence leading it into a blood vessel that was not much thicker was very difficult.

It was akin to playing table tennis with a whip: incredibly complicated. The superselection of the blood vessel was ten times more difficult, however.

[Look, this is where the real surgery begins.]

The interventional surgeon started to explain himself. Interventional surgery was rare in the country. In third-tier cities, there would only be one hospital that had an interventional radiology department and possibly three to five specialists shared among them.

In second-tier cities, there could be two departments in total but no more.

Every year, there was a significant number of liver cancer patients rushed into the Vice City hepatology department for fifteen-minute interventional radiology treatment.

However, actual super selective chemoembolization for liver cancer would require more time. Fifteen minutes was likely just enough to take an image.

However, there was a high volume of patients and very few doctors, so some corners were cut.

The interventional surgeon who rarely got to speak finally had the opportunity to share his insights on Xinglin Garden. His eager words began to flow across the screen.

[The superselection has to go beyond the 2nd-grade artery, possibly even the 4th-grade artery to avoid issues. Hence, every pelvic fracture embolization surgery takes a long time to complete successfully.]

This interventional surgeon stared at his phone and typed out each character diligently. He was thrilled at this chance to educate other doctors.

They would finally learn about the advantages of interventional surgery. He was cheery even though he was not at the operating table.

However, he had the fortune of explaining the details of a pelvic fracture embolization surgery to a few thousand doctors, live. He was ecstatic.

His eyes were fixated intensely on the phone screen to the point of watering.

Behind the stream of comments… It seemed like the superselection of the deep circumflex iliac artery was already complete. The contrast agent was being administered.

No, it must be a trick. His eyes were probably deceived. The doctor shook his head and blinked a few times. He looked back at the livestream and saw, right behind his wall of text, the deep circumflex iliac artery had been selected and the leak located. The embolization step was happening right now.

God! That was ridiculously fast! Had it even taken three seconds?

IndexChapter 96 - Bullseye

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Chapter 96: Bullseye

[Doesn't seem very difficult. I checked the time, five minutes per arterial branch.]

[That's because the surgeon is a superstar. The difficulty is set.]

[Could you perform an appendectomy in three minutes? I'm sure you can't even complete one in thirteen minutes.]

The trash-talking on Xinglin Garden was similar to that of any online forum.

In the interventional suite, the man next to Zheng Ren was blown away. Su Yun stared with his mouth agape at Zheng Ren as if he had just witnessed a miracle.

Su Yun had not been bragging when he said he could learn from observation alone.

After observing the placenta abruption case, Su Yun watched a few video clips of interventional surgery to obtain some level of understanding. He believed that he should improve his skills and become better than Zheng Ren.

Su Yun was anticipating a failed attempt at artery superselection, which would allow him to step in and save the day.

Who would have thought Zheng Ren could perform artery superselection at such speed and accuracy on the first try?

The diameter of the guide wire was 0.014 inches and one millimeter was equivalent to 0.03937 inch. It was around 0.3556 millimeters thick.

A 4th-grade blood vessel had an approximate diameter of 0.5 millimeters, which was very similar in thickness to the guide wire.

The manipulation of the thin and nimble guide wire into the blood vessel on the very first attempt… Su Yun belatedly realized he was absolutely outclassed.

Another person who shared the same thoughts with Su Yun was the interventional surgeon from the third-tier city hospital.

There was a minor difference between the doctor and Su Yun. Su Yun had talent and could pick up skills from just observing. On the other hand, the doctor had to sharpen his skills from assisting in countless surgeries. He had gone through dozens of pelvic fracture arterial embolizations.

No words could describe the hardship and struggle he faced.

Hence, if disappointment was all Su Yun felt, the doctor who witnessed Zheng Ren's surgery was totally baffled.

Superselective arterial embolization was an incredibly difficult procedure. To reach a 0.5 millimeter, 4th-grade blood vessel with a guide wire on the first try was a miracle!

He calmed down and for the first time, he wondered if he should go to this surgeon's hospital to learn more.

At this moment, he was just like the many doctors on Xinglin Garden who wanted to become the surgeon's pupil.

[I think that's the fourth 4th-grade blood vessel. I believe the bleeding has stopped.]

[Almost. Today I learned that complicated pelvic fractures could be treated like this. Our hospital has an interventional radiology department. I should ask them about this.]

Seeing how clueless these doctors were about interventional surgery, the specialized surgeon from the third-tier city started to type out a message.

[For orthopedics, before the removal of spinal neoplasm, one can use interventional methods to embolize the lumbar arteries. That way, the amount of blood loss can be reduced from 5000ml to approximately 1500ml.]

The god-like surgeon probably had no time to explain his methods. Well, he would be the one to answer these doctors' questions.

A flame of motivation flickered in him as he continued introducing the various applications of interventional radiology to the doctors online.

[The surgery is almost ending. That's the last artery.]

[The selection was perfect, all that's left is the embolization. Once the image shows no leak, the catheter can be removed.]

[This perfect surgery took…]

The surgeon looked at the time and unconsciously sighed.

23 minutes and 15 seconds…

If it had been him, that procedure would have taken 4 hours. That was the difference between him and the surgeon in the livestream.

He could not even bring himself to challenge that time.

The anonymous surgeon in the Xinglin Garden livestream was like an indomitable mountain that one could only appreciate from afar.

In the operating theater, Zheng Ren switched off the angiography system. He gave a signal and Chu Yanran opened the sensor-activated lead door. With her were drugs needed for the patient.

The guide catheter and vascular sheath were retracted from the patient's body. Zheng Ren turned around to leave. "Maintain pressure, stop the bleed."

Su Yun was stunned. Was he being treated like an assistant now?

He tamped down his dissatisfaction. After all, Zheng Ren had just performed a perfect surgery. Su Yun was no match for him, so what else could he say?

He nodded and used the sterile gauze to press on the puncture site, still a bit dazed.

From Su Yun's observations, Zheng Ren's performance had improved by leaps and bounds since the last interventional surgery. Could it be that the instruments and materials were incompatible then?

Su Yun's mind settled on that as the reason.

Chu Yanzhi came into the room and saw Su Yun's faraway gaze. "Hey, have you woken from your drunken stupor now?"

The line cut his heart like a knife.

Yesterday… He drank too much. How embarrassing.

He always regarded himself as a person who could hold his liquor, yet he lost to a goddamn girl. He did not take that loss lightly.

This was not a good day. He had been defeated by Chang Yue in a drinking game and outclassed by Zheng Ren in the operating room.

"Not fully there yet, I see," Chu Yanzhi said as she put the anesthesia machine aside. "If you can't tolerate alcohol, you should drink less. Look at you. If you keep drinking like that, it'll ruin your body. You're still young so you won't notice it…"

"Can you stop nagging?" Su Yun said, annoyed.

"Oh?" Chu Yanzhi smirked. "You drank yourself into a stupor."

Su Yun could not refute the statement. "Well, no one wants to marry a person who nags."

"Lightweight."

"Pack up your stuff, it's almost fifteen minutes."

"Lightweight."

"If you dare, come challenge me next time!"

"Lightweight."

This word alone was enough to shut Su Yun up.

Zheng Ren was happy to witness this whole exchange.

The patient's blood pressure was steadily rising as they transfused bags and bags of blood.

Fifteen minutes later, the pressure on the puncture site was removed and it was bandaged tightly. A few people lifted the patient onto the trolley stretcher.

The patient had not woken from general anesthesia and was equipped with a breathing tube. Chu Yanran operated the ventilation bag as they transported the patient back to the ICU ward.

As Su Yun was there, Zheng Ren did not follow.

The surgery was a success and that was all that mattered. Zheng Ren went to the changing room and removed the special lead apron that could turn radiation into energy. He wanted to see if it worked.

If he were honest with himself, he could feel the difference.

Although the surgery had taken just over twenty minutes, a heavy lead apron would have made anyone sweat through their clothes at that time.

Right now, his body was still dry and he felt refreshed. The pounds of weight did not seem to affect him. He was energized and if he had been in a video game, his energy bar would be full.

Hm… Maybe the next time he was tired, he could wear the special lead vest and stand under the X-ray machine to regain energy.

Or maybe he should not do that, as it could all just be the placebo effect. The System had given it to him without any clear guidelines.

Zheng Ren tucked away his mind-blowing idea. Holding the lead apron, he entered the System.

At that moment, a loud ring blared out.

IndexChapter 97 - One Should Be Down to Earth in Life

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Chapter 97: One Should Be Down to Earth in Life

[Emergency Mission: Pileup Crash completed. The emergency rescue of two patients was successful.

[Mission Reward: 200 skill points, 30000 experience points, 2 silver chests.

[Mission Duration: 9 hours and 23 minutes, totaling 52620 experience points.]

The cold, unfriendly voice of the System droned on.

The rewards from the emergency missions were uninteresting. Zheng Ren felt that the in-depth missions yielded better rewards.

Of course, the System could simply be a fickle machine that randomly rewarded him.

The two surgeries he did for this mission had been fast-paced but were not high-level procedures—both were third-grade procedures. Zheng Ren looked at the progression bar for the main mission. Nine of ten were done; one more was needed to complete the whole cycle. He would then gain some bonus experience points.

He had been busy the whole day. The time for rewards had come.

Zheng Ren sat down and checked his inventory.

His general surgery skill had gone from 3154 to 3161 points. The gain was due to the recent surgery and the book he read. He still had 1739 unused skill points.

His heart pumped faster as he neared the rank of Master in the general surgery skill tree.

The Expert rank had granted him so many skills that decided the outcome of difficult surgeries. He wondered what a Master rank would give him.

From the Master rank in interventional surgery bestowed upon him by the System, he knew there was a fundamental difference between the ranks.

During the placenta abruption case, Zheng Ren was just at Expert. Using incompatible instruments and materials, he had managed to complete the surgery without incident.

He was a Master when he performed the pelvic fracture arterial embolization surgery. Each superselective embolization of the external iliac arterial branches went smoothly as if the guide wire was a living thing that had found its own way to the damaged vessels.

It felt like the guide wire moved with his will.

Zheng Ren was eager to find out how a being Master rank in general surgery would feel.

General surgery was the start of his career and the first skill that he had invested in. Hence, he had a soft spot for the field.

It was only 100 skill points and one mission away. A smile graced his face.

Looking at his steadily growing skill tree, Zheng Ren thought he could see his future. The vast knowledge that he would gain from the Master rank spurred him forward.

Skill tree… That was weird. The highest skill tree Zheng Ren had was in interventional surgery, an area that had been strongly recommended by the System, followed by the general surgery skill tree.

His skills in other areas were too low to be counted, but there was one small sprout that had broken ground and risen to eye level.

This…

It was the cardiovascular surgery skill tree.

Zheng Ren realized that interventional radiology was applied in neurology, angiology and cardiology throughout the world. Angiology was probably one of the areas that heavily utilized it as iIt was useful in procedures like coronary bypass and stenting.

The boost in interventional surgery likely brought up his interventional cardiology skill and filled his cardiovascular surgery skill tree.

No; Zheng Ren checked the details again. The System had given him the Master rank and upgraded all the skill branches in the interventional surgery skill tree. He was now a Master in all types of interventional surgery, ranging from neurosurgery, peripheral vascular surgery, cardiovascular surgery and more.

It seemed that an emergency coronary bypass surgery might fall under the emergency department's jurisdiction one day.

He chased away the thought.

If a normal surgeon's stress level while operating was an eight out of ten, then a cardiovascular surgeon's stress level would be at ten.

He remembered an encounter many years back when he was still a houseman. He was resting with his mentor in the on-call room on a quiet night when they heard a shriek. Zheng Ren's drowsiness instantly vanished and he saw his mentor run outside without his shoes.

His mentor had managed to rescue the patient but hurt his foot in the process. The floor was smeared with his blood.

A cardiac arrest… The thought of it drained the energy from most doctors.

Most emergency rescues had a window of minutes before their success rate plummeted, but cardiovascular emergencies had seconds.

Even if Zheng Ren could perform such surgeries, he would need a specialized nurse to assist with the machines.

He thought about establishing a green channel for patients with chest pains, but it was a faraway dream. He would leave that to Old Chief Physician Pan. In the meantime, he should focus on leveling up his general surgery to the Master rank.

One step at a time.

Do not bite off more than you can chew.

Zheng Ren carefully put his special lead vest aside. Then, he went to look at the three shiny silver chests.

The two chests were from the latest mission while the other was from a previous one. He did not even bother opening it.

Zheng Ren was averse to the System's gimmicky, luck-dependent reward.

He was from a lower-class family that was struggling. A year ago, he had treated an old patient.

The patient was a mentally disturbed and skinny man who was only 50 years old but looked 70.

Through their conversations, Zheng Ren found out that the patient had once been a big shot in the financial world.

When the first shopping mall popped up in the center of Sea City in the late eighties, this man had the foresight to monopolize the city's shopping mall industry.

Back then, it was all about the money… It was an opportunity and he grabbed it.

He took three years to amass three million yuan worth of assets, which was equivalent to a few billion yuan now. Basically, he was the richest man in the city.

However, good things never last and in the early nineties, he developed an interest in slot machines.

Within a year, he had managed to burn through all his assets.

He quit at one point and got back into business, but the addiction returned.

The cycle repeated itself multiple times over ten years. In the end, he was destitute and ended up operating a minimart opposite the hospital, living the average life.

His wife was many years younger than him. Zheng Ren could tell she was a no-nonsense lady.

They had a normal relationship. Zheng Ren wondered why a smart, capable lady would stay with a man who lacked the strength to resist slot machines.

He never knew what became of them.

It had been a long time since Zheng Ren last saw the patient. The minimart had also disappeared following the rise of shopping malls.

All in all, it was not a happy story.

Zheng Ren had heard of pay-to-play in many online games these days. People paid to open treasure chests in hopes of rare items that would make their characters stronger.

He had never paid any mind to his luck, of whether he was a European King or an African Chieftain.

After all, one should be down to earth in life.

The silver chests were nothing compared to the skill points he earned through surgery.

He took one look at his skill trees and exited the System, satisfied. He did not look back at the chests.

Back in the changing room, he put on his usual scrubs and heard a voice from the operating room.

"The riders are no longer delivering. So, what are we eating?"

IndexChapter 98 - The Kind-Hearted Ones are Tender

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Chapter 98: The Kind-Hearted Ones are Tender

The snow outside was not too heavy, but the ground was frozen solid. It was too hazardous for riders to be delivering meals. It was going to be a hungry day for all homebodies.

Xie Yiren let out a whine from the operating room. Her mood instantly worsened as her hopes for good food were dashed.

Zheng Ren chuckled. Luckily, he was not a food connoisseur. He was not hungry and planned to swing by the cafeteria for a simple dinner when he had the time.

He left the operating room and headed to the emergency department ward on the second floor. As he entered the office, he saw Chang Yue standing before the window, watching the snow fall.

He had wanted her to follow him on his rounds but she appeared to be occupied. Zheng Ren decided that he could spare a few minutes.

Women had more appreciation for romance and Chang Yue was not an exception.

He went to his table and was about to sit when he noticed Chang Yue's face.

The corner of her eye seemed a bit damp.

"Chang Yue, what's wrong?" Zheng Ren asked.

"Nothing." She turned around to face him and the dampness was gone. Chang Yue had the usual expression that he was familiar with.

"If there's something wrong, you can talk about it. Help might come from where you least expect it," Zheng Ren said casually. He was already seated at his table with the medical book, Sciences of Hepatopancreatobilliary, open.

It was an informal inquiry. It would be awkward to not converse when they were face-to-face.

Chang Yue's resolve wavered, and she sat across Zheng Ren with a grave expression.

Hmm… Was she going to complain about Su Yun? From what he knew, Chang Yue was the one who made Su Yun pass out drunk, not the other way around.

Zheng Ren wondered.

"Let me tell you something, Chief Zheng. See if you can solve it," Chang Yue said.

Zheng Ren tasted a mild bitterness in his throat. This was not going to be a happy thing.

"The patient with gangrenous appendicitis; I've gone through his medical records. He never said much about his past but I deduced that he was once in the army," Chang Yue said.

Zheng Ren's eyes left the pages of his book. He listened attentively.

"He doesn't have much money. He was working as a laborer in the construction industry, moving ceramic tiles and all that. The site elevator was not working and he had to lug those tiles up 16 floors. When it came to payment, the owner claimed some of the tiles were broken and wanted him to pay for it. A few rounds of back-and-forth later, the owner suddenly fell to the ground and claimed that he hit him," Chang Yue said in a quiet voice that trembled.

The world was a cruel place. From the man's build, his army background was more than likely. Before sickness took him, he had to have been a fearsome one. Zheng Ren let out a sigh.

If the man wanted to, Zheng Ren believed he could have seriously injured the owner with a single punch.

"In the end, he did not get paid and had to compensate the owner," Chang Yue continued, "He spent some time homeless and that was when he felt the pain in his abdomen. He fainted and was brought to the hospital by Yanzhi."

'So that was the story,' Zheng Ren thought.

The man had a remarkable body. They had noted his speedy recovery during postsurgical monitoring and his body did not show the usual signs of heating up.

The latter cases usually indicated that the patient had a very weak immune system or extremely fast recovery.

"Right, has he passed gas and started eating?" Zheng Ren asked.

He had been so caught up with emergency surgeries that he had left Chang Yue with all postoperative follow-ups.

"The patient passed gas four hours after the surgery completion. We gave him 1000ml of Dextrose 10. At noon, I ordered him a bowl of porridge with pickled vegetables."

Zheng Ren smiled at that. Truly, the kind-hearted ones were tender.

"What did you want to ask me?"

Chang Yue was embarrassed as she said, "He seems like a good guy. I don't know many people, so I wondered if Chief Zheng could help get him a job?"

Chang Yue was a saint.

In the medical field, one was used to witnessing life and death. A soft heart would not survive.

This was the responsibility of the Welfare Department, not the hospital. The hospital already subsidized fees for the poor. It was also common to feed patients who could not afford to buy themselves a meal.

However, Zheng Ren did not find Chang Yue's request unreasonable.

The guy was undoubtedly strong and hardy.

Faced with such an injustice, even Zheng Ren could understand the man's anger.

However, the man had not lashed out at the owner, but was rather punished for the whole ordeal.

The financial loss had resulted in a delay in his diagnosis, causing the illness to worsen and developing into gangrenous appendicitis.

He was a good man.

Zheng Ren tapped his fingers on the table and thought about who he should approach for such a favor.

A person popped into his mind and he pulled out his phone.

"Brother Six, it's me, Zheng Ren.

"Yes, yes. There's this guy that I think would be of use to you. He's quite strong. You think you can get him a job?

"Nothing much. Solid pay, food, and shelter. Just temporary.

"Thank you. If he gives you any trouble, you can just fire him. Pay no mind to me."

The conversation ended and Zheng Ren put down his phone. He said with a smile, "Done."

Chang Yue was surprised.

The problem that had seemed insurmountable to Chang Yue was solved with a phone call by Zheng Ren.

She had little respect for leadership… However, now, she might make an exception for Chief Zheng.

He seemed all right.

"What's the job?"

"Should be security, I'm not too clear. We'll still need the patient's agreement," Zheng Ren replied.

Chang Yue's mood immediately brightened and a smile appeared. The sun rays reflected off her black-rimmed glasses.

"I'll connect with the patient. Thank you, Chief Zheng," Chang Yue stood up and thanked him sincerely.

"It's alright. Go on and pass the news to the patient." Zheng Ren suddenly remembered that he had a long list of things to do, from writing up the report for the pelvic fracture case, surgery journaling, and so on. A headache was developing.

Paperwork was the bane of his existence.

He was truly grateful to have Chang Yue. If he had to do all of the paperwork for the patients he saw, he would probably not have been able to have helped as many people as he had.

Watching Chang Yue walk away with a spring to her step, Zheng Ren smiled and switched on his computer.

His phone rang with a notification from the WeChat group. It was Xie Yiren asking about lunch.

There were limited choices in the hospital cafeteria and Xie Yiren avoided them at all costs.

She was adamant that the food served in the cafeteria was slop.

Zheng Ren disagreed with her. Although the cafeteria was not outstanding, the portions could fill a grown man and it cost one yuan per meal for hospital employees.

He scrolled through the chat history. Xie Yiren and the Chu sisters' messages filled his screen even though he was sure they were in the same room.

What had technology done to humans? Zheng Ren sighed and shook his head.

IndexChapter 99 - A Grandmaster of Communication

Index

Book

Chapter 99: A Grandmaster of Communication

Zheng Ren ignored the women bombarding the WeChat group with questions about dinner and focused on the open book before him.

Another 100 skill points and he would be a Master. It would be a much better reward than dinner.

Soon, the WeChat group fell silent.

A few minutes later, Chu Yanran, Chu Yanzhi and Xie Yiren walked into the room in their day clothes, searching for Zheng Ren and Chang Yue.

"Chief Zheng, we have decided it's your treat tonight. We'll get some takeaway for you when we return," Chu Yanzhi informed Zheng Ren.

Zheng Ren was speechless. "Why is it my turn again?"

"O great doctor, don't be cheap." Chu Yanzhi smiled brightly. "Look at his face! I told you he would have a heart attack if we asked him to pay for it."

"…"

"She's pulling your leg. We'll have dinner together and bring back some for you," Chu Yanran told Zheng Ren as she tugged her sister's arm.

Zheng Ren relaxed after hearing Chu Yanran's explanation.

"What great doctor? I'm just a measly hospital worker," he clarified.

"We gotta get Su Yun. He's in the ICU. He says the patient is more or less stable. Can you go check on him and pick him up for dinner? Get changed and we can leave soon," Chu Yanzhi said.

When did Chu Yanzhi develop respect for her seniors?

Zheng Ren pondered it for a while. He had wanted to check on the patient in an hour but now was fine as well.

He put on his white coat and went to the ICU with the four women in tow.

It was an odd combination. All four women with different personalities chatted away behind him, turning heads as they passed.

There was an indoor corridor connecting the emergency department and the inpatient wards, used to avoid having to wheel the patient through cold weather. That would be inconceivable.

The ICU was on the sixteenth floor of the First Inpatient Block. There were four elevators, one specifically for the transport of patients and three others that all went to specific floors.

A few minutes later, the elevator to the fifteenth floor opened. A few others got into the elevator without hesitation and they followed suit.

Although the elevator did not reach the sixteenth floor, Zheng Ren did not mind taking the stairs up another flight. Who knew how long they had to wait for the next one.

Ding dong~ The elevator reached the fifteenth floor. The elevator voice sounded very much like the System and Zheng Ren was momentarily startled.

They got off the elevator and went up the fire escape.

Suddenly, Chang Yue slowed down in front of him. She turned to one side and her ponytail swept across the air.

Oh? Zheng Ren had a bad feeling about this.

He was not wrong. Chang Yue's gaze was fixed on a silhouette on the fifteenth floor window ledge. The cold wind gently caressed black locks of hair as snow danced in the air. It was truly forlorn.

Chang Yue said nothing to the others and stalked forward like a cat., approaching the person by the window.

Xie Yiren was oblivious to the situation. As she opened her mouth to speak, Zheng Ren tugged her back and placed a hand over her mouth. Xie Yiren was about to struggle when he said, "Quiet."

She hesitated, then froze.

"Look there," Zheng Ren whispered in a low voice as he released her. He pointed at the silhouette and backtracked a few steps to press himself flat against the fire exit.

Xie Yiren, Chu Yanran and Chu Yanzhi followed him. They moved quietly, afraid to startle the figure.

The person was suicidal… Zheng Ren felt panic rise in him.

Every year, the hospital had several suicides. Once, a patient diagnosed with cancer came in for a checkup, then leapt from the top floor of the building. The family was on the first floor and taped the whole incident. In the end, they tried to extort the hospital for a few hundred thousand yuan.

The hospital administration then was hard-headed and fought the family for three years in court. Eventually, the family lost interest in pursuing the lawsuit.

That was the exception. Many patients lost their will to live after learning they had cancer and took their lives.

However… Cancer was not a death sentence. As medical practitioners, they had to present the brightest prospects possible to patients.

There was no one else there. The illumination of the corridor lights was in stark contrast to the lonely darkness outside.

They huddled in the unlit corner as Chang Yue approached the figure. When she was a few feet away, she coughed softly.

This was the critical point. The consequences were dire if the person reacted badly and jumped.

The figure was not startled. Things had not escalated yet.

When it was clear that her approach was not interpreted as being hostile, Chang Yue slowly inched forward.

Throughout the process, Chang Yue was incredibly calm and collected. She reached the window ledge and sat down with her knees curled up. Her movements were relaxed as if she was simply enjoying a warm afternoon sun on a winter day from the inside of the building.

Zheng Ren was thoroughly impressed by this junior doctor.

How was she going to start the conversation?

They were meters away from the two and could only see Chang Yue's lips moving silently.

"What is Sister Yue doing?" Xie Yiren asked under her breath.

"Persuading the patient to not jump," Zheng Ren replied in an equally hushed voice. He was worried that any sudden movement might undo Chang Yue's efforts. "Watch but don't speak."

A few minutes later, Chang Yue cocked her head to show them a gesture, fingers to her lips as if smoking a cigarette.

Zheng Ren picked up her cue and got out his packet of Ziyuns. He pushed a lighter into the half-empty pack and slid it across the floor to her.

With a surgeon's accuracy, the cigarette pack skidded silently across the floor and stopped right before Chang Yue.

She picked up the packet and lit a cigarette, then passed it to the sitting figure.

When they accepted the cigarette, Zheng Ren exhaled in relief.

Chang Yue was visibly making some headway with the woman. Zheng Ren saluted her. She was truly a capable person, one who had once managed to lower the defenses of a murderous cheater and convince him to go to jail for his actions.

Amazing!

In terms of patient communication, Zheng Ren felt that his abilities were merely acceptable.

Compared to other surgeons, he would consider himself above average, though not by much.

However, Chang Yue was in a totally different league altogether. His communication skills were puny compared to hers.

Zheng Ren was not a good liar and definitely would not be able to hold a casual conversation with murderers, let alone convince them to turn themselves in.

This current situation was another display of Chang Yue's capabilities.

On this dark, wintry night, snow piled up outside as lights flickered to life in buildings. A life was on the line.

Their bleak outlook was slowly altered with Chang Yue's ministrations. She had an easygoing and friendly smile on her face as she talked to the woman. The night seemed a little less dark.

Chang Yue was normally average-looking but now beamed with genuine compassion that made her face glow. It was a likable disposition.

Soon, a peal of laughter echoed from outside and everyone in the corner was relieved. Things appeared to be handled.

Occasionally, a patient or visitor would walk by and give Chang Yue and the woman outside an odd glance.

A few minutes later, Chang Yue helped the woman into the building. Their chatter resumed as if they were long-lost childhood friends.

Zheng Ren felt nothing but admiration for her.

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