The Surgeon's Studio

by Stayrr

“Primum non nocere.” First, do no harm. – Hippocrates Zheng Ren—an ordinary general surgeon in a cruel medical world whose efforts went unnoticed. His struggles are real…until he is blessed with a system and gifted with skills that exceeded even the best surgeons in the world. Alone in the world with no one to depend on, Zheng Ren uses his exceptional gift to challenge the skeptici

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The Surgeon's Studio #Chapter 33: Equipment Purchase in The System - Read The Surgeon's Studio Chapter 33: Equipment Purchase in The System Online - All Page - Novel Next

Chapter 33: Equipment Purchase in The System

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

After making several phone calls in a row and arranging everything accordingly, Old Chief Physician Pan spoke to Zheng Ren with a serious expression, "Go to the endoscopic unit and search for Chief Surgeon Shi. Check if there are any missing instruments and try to allocate them if possible. If you can't, we don't have a choice either. I'll wait for you in the office, so give me a phone call as soon as the surgery is a go."

A soldier always carried out his tasks swiftly. Zheng Ren understood Old Chief Physician Pan's instructions and knew that he was willing to wait in the office just to save some time.

Like a soldier hiding within enemy lines, Old Chief Physician Pan was waiting for an order to launch a surprise attack.

Zheng Ren nodded in silence.

Verbal responses were pointless. The only thing Zheng Ren could do to repay him was to complete the surgery without making any mistakes.

Zheng Ren quickened his pace to the third inpatient department and finally reached the endoscopy unit at a trot.

Chief Surgeon Shi suppressed his surprise and cooperatively asked what equipment Zheng Ren needed.

Since the Sea City General Hospital endoscopy unit was going to invite a professor from Imperial Capital to perform an ESD procedure in the near future, all the preparations had basically been completed in advance.

Basic instruments—hook knife, injector, dissecting forceps, endoscopic electric knife—were available, but the most important instrument required to resect the inflamed appendix—the endoclip—was missing.

Chief Surgeon Shi had no need for an endoclip since he had merely wanted to perform submucosal dissection.

Gritting his teeth tightly, Zheng Ren left the room by making an excuse of going to the washroom and went to a deserted, quiet location before entering the System.

He went to the Shop and started searching for ESD-related instruments.

Zheng Ren's heart shattered immediately when he saw the price tag—16000 experience points—below the full set of ESD equipment. That was too expensive and currently way beyond his affordability.

Helpless and dejected, a light bulb suddenly went off in his head. Maybe he could purchase the instrument separately.

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He then clicked on the endoclip and was delighted to find out that he actually could!

However, Zheng Ren had mixed feelings when he noticed the price tag—2200 experience points—under the endoclip.

He was happy as he would be able to proceed with the surgery with the missing instrument located.

A sense of loss gnawed at him at the same time, too. He had been poor since childhood and spending almost all his "savings" to purchase a surgical instrument directly was a huge deal to him. In fact, he almost had a myocardial infarction when he thought about it.

He had no choice but to spend the money to repay Old Chief Physician Pan's trust.

Enduring the intermittent heartache, Zheng Ren clicked "Purchase" and watched his savings instantly change from the 2332 to 132 experience points. Damn... he was as poor as a church mouse now.

After the purchase, an endoclip simply appeared in his hands, and the nickel-titanium alloy gave him the illusion that it was worth a king's ransom.

How should he take it back to reality? The confused Zheng Ren asked the System loudly and as expected, there was no response from the cold, insensible System.

Perhaps he should give it a try and head back to reality. Grasping the endoclip firmly like a drowning man clutching at a straw, Zheng Ren summoned his mind back to the real world.

Zheng Ren felt something hard and cold in his hands the moment he opened his eyes.

Good. He could bring any instrument he purchased in the System back to reality.

Chief Surgeon Shi was stunned when he noticed Zheng Ren return with the endoclip and asked out of curiosity, "Little Zheng, do you have friends working in a medical device company? Johnson Johnson or Philips?"

Domestic manufacturers had not started producing this sort of medical instrument yet due to limited applications within the country and the lack of considerable profit. Thus, international companies, with Johnson Johnson leading the market, would produce them and import them to China.

Medical sales representatives would never discuss this sort of advanced medical instrument with Zheng Ren, who was presumably a junior doctor judging by his age. Even chief residents were not qualified to initiate discussions with sales representatives on this issue.

The only people qualified for the usage of newly developed equipment or technology was a senior consultant or at least a deputy chief of the medical team.

Zheng Ren had come back with an endoclip after a few moments of absence, so logically speaking, he must have had a friend who was working as a medical sales representative in one of those international companies.

Chief Surgeon Shi's speculation was reasonable, but he would never have guessed the existence of a medical System in Zheng Ren's mind—a System that would become enraged easily at trivial matters and threatened to erase its host from the face of the earth when provoked.

"No. I went to a conference last time and was interested in it, so I bought it afterward," replied Zheng Ren perfunctorily.

Chief Surgeon Shi remained doubtful. Who would purchase a single piece of expensive instrument that was meant to be used in a surgical device? What was he going to do with it when it served no function in a surgery when used alone? Take it back home and enshrine it?

However, it was obvious that Zheng Ren had no desire to tell the truth. Left with no choice, he gave the brand-new, polished and delicate endoclip an envious stare while slobbering in jealousy.

"Chief Physician Pan, all the equipment is ready. When can we start the surgery?" Zheng Ren dialed Old Chief Physician Pan's phone number and reported the situation.

"Okay, I'm on my way." Old Chief Physician Pan hung up immediately after Zheng Ren gave him the news.

Zheng Ren's cell phone rang a few minutes later. It was Old Chief Physician Pan, who instructed him to prepare for the surgery and informed him that the patient was already on her way to the endoscopy unit.

Chief Surgeon Shi of the endoscopy unit also received a call from the chief of the medical administration division, as the hospital management placed a high value on this patient and wanted the endoscopy unit to prepare everything in advance. The chief even informed Chief Surgeon Shi that Secretary-General Chen was currently on his way to Sea City General Hospital to observe the surgery along with the director of the hospital.

The endoscopy unit was turned upside-down instantly as everyone started making preoperative preparations as soon as they could.

Old Chief Physician Pan was the first to reach the scene. He merely stood beside Zheng Ren silently like a firm and steady anchor without asking Zheng Ren again if he was confident about the surgery.

After the chief of the medical administration division brought the chief anesthesiologist to the endoscopy unit, the atmosphere in the room started to turn gloomy.

The surgeons from the general surgery department arrived at the scene along with the female patient who was lying on the stretcher trolley with her feet hanging off it. The lady was just too tall.

Chief Surgeon Liu had a dark expression. He had a bad feeling about this—Zheng Ren knew how to perform the surgery proficiently.

Like an arrow on a tensed bowstring, it was too late for Chief Surgeon Liu to voice his objection.

The patient was lying on the endoscopy operating table, and preoperative informed consent documents had to be signed by the director of the hospital and Secretary-General Chen, so anxiety was pointless at this moment.

Zheng Ren glanced at the countdown timer on the upper right corner of his vision—four hours and fifteen minutes left.

Ten minutes later, Director Xiao and Secretary General Chen arrived at the endoscopy unit.

Despite being the surgeon in the upcoming surgery, Zheng Ren was sitting at one corner of the office without any hint of presence.

On the left-hand side of the long table sat Xiao Keming, the director of the hospital, Fu Guangshi, deputy director in charge of clinical work, Old Chief Physician Pan, and various consultants from the general surgery, endoscopy, and anesthesiology departments. On the right-hand side of the long table sat Secretary-General Chen, the office director, and the patient's agent and assistant.

DIrector Xiao was the first to initiate the discussion

"The city places a high value on the patient, so Chief Surgeon Liu from the general surgery department will explain her condition."

A short sentence, but it was spoken powerfully.

"The patient is diagnosed with simple acute appendicitis. She has undergone three days of conservative treatment which has been ineffective. Tenderness noted on the right iliac fossa region and we've found rebound tenderness this morning, which is suggestive of an increased severity and a possibility of perforation." There were dark circles underneath Chief Surgeon Liu's bloodshot eyes, which made him appear low-spirited and disheartened.

Only a few of them knew his condition was a result of an overnight battle with Zheng Ren. Those unaware of it thought that he had actually worn himself out for the sake of the patient.

Chief Surgeon Liu hesitated for a while and said regretfully, as if possessed by a drama queen, "The general surgery department had discussed this case many times and we've come to the conclusion that conservative treatment isn't a viable option anymore. She has to undergo surgery as soon as possible."

"Chief Surgeon Liu, may I ask what is your plan for surgery?" asked a well-mannered middle-aged man with a pair of spectacles on the right.

"We can perform an open appendectomy or laparoscopic appendectomy." Chief Surgeon Liu made no attempt to mention Zheng Ren's surgical technique. "Judging by the patient's condition, I recommend an open appendectomy. Since her subcutaneous layer is thin, we can make an approximately three to four-centimeter incision and she'll be able to walk around after one day of rest. Recovery can be expected after five to six days."

"Er..." The expected time of recovery had exceeded the requirements given by the organizing committee of New Idea Model Contest, but this was an expert's medical opinion. They had to listen to him.

Most of them had a proper sense of priorities. An outburst of temper at this moment would do the patient no good.

The patient's agent and Secretary-General Chen had the same thought in mind—it would be a pity if the patient missed the final.

"We can do a woundless appendectomy without delaying the patient's recovery process. She can still participate in the final three days later." Old Chief Physician Pan interrupted Chief Surgeon Liu abruptly with a thunderous voice and an aura that overwhelmed everyone in the room, like a ferocious tiger descending from the mountaintop.

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Chapter 34: I'm Done Talking. Who Agrees And Who Doesn't

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Old Chief Physician Pan's words shocked everyone.

The agent and Secretary-General Chen's eyes shone brightly at his words. They had heard about this surgical technique on their way here, but the chief surgeon from the general surgery department, who was in charge of treating the patient, had not mentioned the woundless method at all. Before they could ask about it, this elderly man who appeared dignified and trustworthy had unexpectedly and directly announced it.

Old Chief Physician Pan looked like a righteous man especially with his square face, thick eyebrows and clear eyes. He might lose out to a young, handsome boy in a contest of attractiveness, but if it were in terms of the sense of security he gave off, he outdid everyone in the room including the hospital directors.

The awe-inspiring aura of those who had gone to war boosted Old Chief Physician Pan's trustworthiness.

"This elderly man is..." asked the surprised agent carefully.

"Instructor Pan has a very impressive background. He is a war veteran with a Class II Merit Citation. After returning from his military service, he became a chief physician in charge of a ward specifically for senior officials in the military hospital.

"After his retirement, he was re-employed to Sea City General Hospital and became a chief physician in the emergency department. He is now working on the development of the emergency department into Sea City Emergency Center," Secretary General Chen explained, being familiar with Old Chief Physician Pan and crossing his professional boundaries to introduce the man. Considering his remarks inadequate, he added, "Instructor Pan is a demon."

"Sea City General Hospital has never performed an appendectomy using an endoscope!" Chief Surgeon Liu stood up abruptly and began to feud.

He was aware that Zheng Ren was likely able to perform this surgery. In all honesty, he regretted his obsession with regaining his reputation by disputing with a junior chief resident. In the end, he had no way out of this embarrassing mess. Why did he even torture himself in the first place?

Chief Surgeon Liu's instinct was to prevent Zheng Ren from performing this surgery at all costs. Otherwise, he would lose the initiative and the consequences would be disastrous.

"You haven't done it, but it doesn't mean that the others haven't done it too." Old Chief Physician Pan could not back off as well. Since he had decided to give Zheng Ren his full support, nothing could be held back and there would be no retreat from this situation.

Trust—a basic lesson learned in the army.

"I can guarantee that Zheng Ren will finish this surgery successfully," Old Chief Physician Pan stood up and declared without giving Chief Surgeon Liu a chance to respond. "I've my own judgment as a senior military doctor. If the surgery ends up in failure, I'm prepared to accept the punishment as well."

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Old Chief Physician Pan gave Chief Surgeon Liu a cold sneer during his speech.

"My soldier—Zheng Ren—is the best surgeon for appendectomy in Sea City General Hospital. Best in this city! Best in this province!" yelled Old Chief Physician Pan.

Oh, Old Chief Physician Pan actually valued this surgeon that much?

Curiosity gnawed at the hospital director, Secretary-General Chen and the agent, none of whom had heard of Zheng Ren before this. However, the expression of Fu Guangshi, deputy director in charge of clinical works, fell immediately upon hearing the name.

"Zheng Ren performed forty-nine appendectomies—various difficult surgical cases included—within sixteen hours yesterday. In addition, all of them were done perfectly without a single flaw at all." Old Chief Physician Pan paused momentarily before continuing. "Let Zheng Ren perform the surgery. We have a contingency plan even if the endoscopic appendectomy fails. This is the best solution we have right now."

Old Chief Physician Pan took in his surroundings with a high and mighty aura, just like a king of beasts.

"I'm done talking. Who agrees and who doesn't?"

Silence reigned in the room.

A few seconds later, Chief Surgeon Liu said, "I—"

"You're not qualified!" Old Chief Physician Pan interrupted Liu Tianxing immediately. "Your appendectomy skill isn't better than Zheng Ren, so shut up!"

Chief Surgeon Liu was enraged instantly. 'What do you mean by my skills aren't better than Zheng Ren? I'm a chief surgeon who has performed over a thousand appendectomies in my entire life. Are you humiliating me?' he thought.

"You're not convinced?" Old Chief Physician Pan looked askew at him disdainfully. "What about the forty-nine surgical video recordings, did you forget them?"

Even though the hospital director and everyone else had no idea what forty-nine surgical video recordings Old Pan was referring to, they noticed Chief Surgeon Liu, who claimed to be Sea City Supreme Scalpel, cowered instantly as he sat down red-faced and nearly buried his face under the table.

"It is settled. Doctor Zheng Ren will perform the appendectomy, is that okay?" Waving his hand and making the decision, Director Xiao turned around and asked for the agent's opinion.

The medical field was alien to the agent, but she knew how to read people. Even though the surgeon had been relegated to one corner of the room and she had no idea how good he was, Old Chief Physician Pan's retaliation against Chief Surgeon Liu had boosted her confidence.

The decision had been made. The most difficult step had been solved.

However, the agent refused to have the surgery broadcasted and even requested an arrangement of female surgical assistants to help Zheng Ren, who would be the only man in the surgery later. There was nothing that could be done about his gender, though.

The director of the hospital, the agent, and Old Chief Physician Pan would stay in the conference room and wait for the surgery to end. After assigning a highly-skilled anesthesiologist to assist with the surgery, the chief anesthesiologist returned to the room and joined the crowd as well.

After preoperative preparations were finished, Chief Surgeon Shi from the endoscopy unit was also pushed out of the operating theater by the patient's assistant, who had changed into a sterile surgical gown.

This was the most dramatic patient Zheng Ren had seen in his entire life, but her actions would not induce any antipathy in him.

There were only three people left in the operating theater—a female anesthesiologist, a female assistant, and Zheng Ren.

The assistant, who was wearing a sterile surgical cap and mask, bowed to Zheng Ren and apologized. "Doctor Zheng, I apologize."

"Huh?"

"Miss Zhou Jinxi is going to become a celebrity in the future, so we'd like to avoid gossip as much as possible. I hope you don't mind," explained the female assistant.

Now only did Zheng Ren realize the model's name was Zhou Jinxi, but her dream of being a celebrity in the future was none of his concern. Zheng Ren did not idolize any celebrity and this surgery's success was the only thing he cared about at this moment.

The surgical scrub was performed, the surgical site disinfected, the surgical drapes applied, and the surgery officially begun.

Zheng Ren placed the surgical drape on the operating table and inserted the colonoscope into the patient's natural orifice. When Zhou Jinxi's fair-skinned, collagen-filled thighs that were brimming with youthful vitality and The-Part-That-Must-Not-Be-Named were no longer visible through the scope, only then was the surgery broadcast live in Xinglin Garden.

The System was intelligent enough to avoid any situation that may cause trouble.

404 was indeed a powerful and ferocious God-Beast.

[The demon is live-streaming again? Doesn't he need rest?]

[Eh? This anatomical structure is wrong. Is he performing a laparoscopic appendectomy? Why does it look like a colonoscope? Let me read the case again.]

[F*ck! Using a colonoscope to perform an appendectomy? The demon is going to heaven!]

Ten seconds after the live broadcast started in Xinglin Garden, every viewer who had read the case clearly started bombarding the screen with comments.

Most doctors within the country had no idea what an ESD procedure was.

Even if a few doctors had some knowledge about it, they had never seen it before.

Even if they had seen it before, they had not done it personally.

Even if they had done it personally, they had not attempted it in an appendectomy.

There were only a handful of surgeons who had performed an appendectomy through ESD in this country.

The viewers started informing their friends and colleagues and asked them to quickly log into Xinglin Garden to watch the godlike surgery—the endoscopic transrectal appendectomy.

Xinglin Garden was merely a niche website for professionals without a large investment toward its development.

The live broadcast room was full in less than a minute after the livestream started as the technicians of Xinglin Garden had never expected one thousand viewers to watch a live broadcast at the same time.

[Is the surgeon wishing for a trip to heaven? How are you supposed to perform this surgery? Can anyone share a video of this surgical technique with me?]

[Don't bother with it. I've searched for it just now but there isn't any result at all. Barely anyone I know has knowledge about the ESD procedure.]

[Popular science, I'll explain it briefly. In 1994, a Japanese scholar invented the IT knife for the purpose of submucosal dissection, but it could only be used in the esophagus and gastrointestinal tract. In 1999, a Japanese expert performed an ESD procedure to remove gastrointestinal tumors that hadn't reached the muscle layer. In 2010, the endoscopy unit at Harbin Medical University Affiliated Second Hospital tried to perform an appendectomy with an ESD procedure, but so far, this surgical technique hasn't been introduced for large-scale usage in this country.]

[How are you supposed to do it then?]

[Just keep quiet and watch the video. He is indeed a demon. Not only can he perform surgery beautifully, he is even one of the top surgeons who can use a new surgical technique skillfully as well. God, please accept my worship.]

In the operating theater, the colonoscope had passed through the rectum and was currently sliding deeper into the colon in search of the inflamed appendix.

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Chapter 35: Website Crash

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Zheng Ren raised his head and stared at the screen opposite him. The internal walls of the patient's intestines were pink, and intestinal motility was slow because of general anesthesia. The colonoscope quickly passed through the rectum and entered the colon.

[Why is he moving so fast? Isn't he worried about intestinal perforation?]

[There is no such thing as "slow" for a man who can complete a simple appendectomy within three minutes.]

[That's right. Stronger animals are usually faster in the animal kingdom. A tiger can actually shoot its load more than ten times in just a minute.]

The live broadcast room had a tendency to become a real-life operating theater when the viewers, who were actually "experienced" individuals, could make dirty jokes naturally and shamelessly.

The atmosphere suddenly became naughty, peaceful, and harmonious.

[He didn't stop or even probe when the colonoscope reached the splenic flexure. Oh my God, that was terrifying...]

[Didn't you notice that the lens moved a little just now? I assumed that there was a flick in the surgeon's wrist which caused the colonoscope to drift around the corner.]

[Is he really that good? Any anatomy gods here? Please come forward and explain. The colonoscope should reach the appendix soon, right?]

...

...

Zheng Ren's movement was swift as he had performed more than a hundred similar cases in the System last time.

Zheng Ren believed that there were many surgeons who had performed more appendectomies than him in this country, but using a colonoscope to resect an inflamed appendix? He was undoubtedly the most trained surgeon in this field.

More surgical training resulted in proficiency. There would be solutions to mistakes encountered which meant that the chances of unforeseen events would decrease tremendously.

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The colon and appendix appeared on the screen.

He then used an injector with a mixed solution—indigo carmine, epinephrine, and normal saline—to improve the delineation of the appendix.

Zheng Ren started incising the mucosal layer with the instrument.

His hand movements and manipulation of the instrument had to be performed in reverse, just like an inverted image in a mirror. That was the difference between this surgery and open surgery.

The blood vessels were clearly visible after one mucosal layer was incised with a needle knife. After that, a pair of forceps was used to initiate the blunt dissection of the submucosal layer.

This was a delicate surgical task as performing the blunt dissection of the submucosal layer through the colonoscope was much more difficult than under direct vision.

The anesthesiologist beside Zheng Ren was captivated by the swift movement on the screen.

She had worked in the operating theater for many years, so it was natural that she knew its difficulty even though she had not performed it personally.

Blunt dissection was preferred by most high-skilled surgeons due to advantages such as decreased trauma and less bleeding from the dissected edge. However, if something went wrong with the procedure—from uncontrolled strength or a lack of anatomical knowledge—and an iatrogenic intestinal perforation arose, excreta in the intestines would flow right into the peritoneal cavity.

This medical error would lead to a severe peritonitis, which was treatable if the patient was lucky. Otherwise, they would have to receive treatment under observation in the ICU for approximately ten days. If luck was not on their side and the condition was complicated with septic shock, they risked losing their life.

Thus, the surgeon's skill and overall qualities were the most important factors in performing a blunt dissection.

However, blunt dissection was usually performed using fingers or a pair of hemostatic forceps under direct vision.

Zheng Ren's method was to manipulate the colonoscope and a pair of forceps through the instrument port outside the body. One could only imagine the extreme difficulty of such a delicate task.

'Please don't make any mistakes,' the anesthesiologist prayed in her heart and fought the urge to remind Zheng Ren of it. He was manipulating the instruments with undivided attention and the patient's assistant was on the scene as well. If he was distracted for even one second and perforated the intestine...

Fortunately, what she was afraid of did not come to pass. Zheng Ren manipulated the colonoscope and forceps dexterously while dissecting the mucosal layers as if with his own bare hands. Whenever a blood vessel was encountered, he would use the hook knife to cut it directly instead of rupturing it, causing it to bleed before using the knife to achieve a hemostatic effect.

There was a huge difference between these two methods, and the anesthesiologist, who was highly experienced, admired Zheng Ren for his superb standards.

Soon, the submucosal layer was exposed.

Zheng Ren replaced the forceps with a transparent cap to push the connective tissues away from the submucosal layer and dissected the layer further with the endoscopic electric knife.

After the dissection was complete, the intestinal wall was then incised and the colonoscope entered the peritoneal cavity.

The mesoappendix was divided, the appendix well skeletonized, and the appendiceal artery ligated.

After that, Zheng Ren replaced the instrument again and inserted the endoclip purchased from the System into the instrument port.

The inflamed appendix was in a severe edematous state due to failed conservative treatment for three days and was on the verge of perforation. Any unnecessary increase in strength would cause it to burst and the surgery would end in failure.

The anesthesiologist involuntarily held her breath upon seeing this as though her heavy breathing would cause the edematous appendix to rupture.

Holding the inflamed appendix with a pair of forceps and placing the endoclip at the base of the organ, Zheng Ren resected it and clipped the mucosal surfaces together.

The endoclip with the resected appendix was removed and the intestines were irrigated. After ensuring that there were no obvious bleeding spots and the mucosal surfaces were tightly sealed, the colonoscope was then removed.

"The surgery is complete. You can administer drugs now," said Zheng Ren.

"Huh?" The anesthesiologist was taken by surprise. That was true. The surgery was basically complete after the appendix was resected.

However, something seemed wrong. She had expected the surgery to go on for five hours, but how long had it been?

She glanced at the time on her cell phone—merely nine minutes had passed.

"Chief... Chief Zheng, is it really over? You don't need to recheck the surgical site?" the anesthesiologist started stuttering.

"Recheck? I've done that." Zheng Ren took off his surgical gloves, folded both arms across his chest, and sat on a stool against the wall.

"Er..." The anesthesiologist was left speechless. Staring at Zheng Ren's confident expression, she really wanted to pinch his ear and roar, 'Can't you just check it again? Don't you know that the hospital management places a high value on this surgery?!'

However, she fought the urge to do so in the end.

She had already calculated the required dosage of reversal agents to let the patient regain consciousness, but had not expected to perform the injection so soon.

According to its precalculated value, a reversal agent was intravenously injected to reverse the effects of muscle relaxant, and a mixture of atropine and neostigmine in a 1:1 ratio was injected afterward.

Slight movement was noted in the patient two minutes later.

The anesthesiologist glanced at the patient's vital signs on the electrocardiogram and yelled into her ear, "Zhou Jinxi, Zhou Jinxi!"

"Huh?" Zhou Jinxi mumbled through her nose.

"The patient is awake. Come and transfer the patient," the anesthesiologist announced to Zheng Ren after confirming the patient's status one last time.

"Doctor Zheng, I'm sorry to bother you." Zhou Jinxi's assistant stood in front of Zheng Ren and bowed apologetically.

Apology? He must be exhausted. Otherwise, why would he hear traces of apology when the assistant expressed her gratitude? However, the inside of her surgical gown became clearly visible when she bowed and allowed gravity to pull her gown downward.

'Those are rather small...' The thought flashed past Zheng Ren's mind.

"Please leave first. We've arranged nurses to escort Miss Zhou back to her sick room," said the assistant softly but firmly.

Oh, so that was what all this was about. Zheng Ren smiled after realizing that the assistant preferred not to expose Zhou Jinxi's private parts to a man.

Well, it was understandable as she had the potential to be very popular in the future. Some day, if someone spread today's incident onto the internet, tut-tut... That would be troublesome.

Zheng Ren nodded in response and left the operating theater.

He had no idea that the entirety Xinglin Garden had entered a half-paralyzed state because of this surgery.

A live broadcast room could accommodate one thousand viewers at most. The moment Zheng Ren resected the appendix and clipped the mucosal surfaces with the endoclip, thousands of comments flooded the entire screen which exceeded the threshold of the technical bandwidth. As a result, the livestream crashed and one thousand viewers were disconnected at the same time.

The hornet's nest was immediately stirred up.

When viewers reconnected to Xinglin Garden and realized that the livestream had turned off after the surgery was complete, they started expressing their dissatisfaction by turning the forums upside down.

Numerous phone calls began bombarding the CEO of Xinglin Garden as well.

How could a professional website be established without financial investment from a few moguls?

It was beneficial to be acquainted with more of them as the website grew further.

However, that was also the reason why the CEO had to feel their wrath today.

There were various types of senior experts supporting the website. Some of them were cultivated, some were easily irritable, but all of them shared a similar quality—they were intellectual individuals.

That the CEO had to feel their wrath was an exaggeration, but the fact that they had expressed their dissatisfaction and disappointment was more than enough to drench the CEO of Xinglin Garden in cold sweat.

Hence, a group of skillful technicians started improving the website and gave Xinglin Garden a system upgrade. Who actually caused so many professors to be unhappy at the same time? What happened in the livestream that actually crashed the entire live broadcast room? These questions had piqued the CEO's curiosity.

Their answers, though, were completely beyond his imagination.

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Chapter 36: Acute... Acute Myocardial Infarction!

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Zheng Ren had no idea that the largest medical expert website in the country had crashed due to the surgery he had just performed.

He left the endoscopy unit operating theater in good spirits.

Cen Meng, who was not allowed to enter the conference room due to lower rank, was standing in the corridor, obviously anxious and irritated.

He was startled when Zheng Ren exited the endoscopy unit.

In his imagination, Zheng Ren had been struggling and could not possibly have finished the surgery so soon as this was the first time anyone used such an advanced, unfamiliar surgical technique in Sea City General Hospital.

He had assumed that he knew Zheng Ren well and was aware of the limited surgical choices he could perform with his low standards, but that had not been the case recently.

Something must have gone wrong in the surgery. There was no other explanation for it!

That realization made Cen Meng's heart jump.

His gloomy mood brightened up instantly as he approached Zheng Ren with a warm smile on his face.

"Chief Zheng, do you lack any surgical instrument or require an assistant? I wanted to slot in a doctor from the endoscopic unit for you but the patient's side disagreed with my suggestion." Cen Meng tried to express his "kindness" and hope at the same time.

How he wished that Zheng Ren had messed up the surgery.

"The surgery is finished, so here I am," replied Zheng Ren with a smile.

"Fi... Finished?" Cen Meng was dumbstruck.

Even though Cen Meng had more or less expected this result, he was still devastated that Zheng Ren had so quickly completed a surgery that he had not seen or even heard of.

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Zheng Ren walked past Cen Meng, whose expression was blank and eyes as dull as stones, and gave him a gentle tap on his shoulder before going into the conference room. "What else could it have been?"

Zhou Jinxi's agent, who still had a phone in her hands, gave Zheng Ren an astonished look when he entered the room.

"Doctor Zheng, how was the surgery?" asked the agent carefully, fearing the worst from Zheng Ren.

"Everything went well. The resected appendix is in the operating theater. You can take a look at it before sending it to the pathology lab." Zheng Ren walked toward Old Chief Physician Pan, met his gaze briefly, and sat down.

The director and deputy director of the hospital concealed their amazement well. Meanwhile, the chief of the medical administration division started instructing medical staff to transfer Zhou Jinxi back to the ward and gave Zheng Ren a penetrating stare before leaving the room.

Old Chief Physician Pan asked Zheng Ren softly while everyone went to check on the patient, "How was the surgery?"

"Good. There won't be any problem at all," answered Zheng Ren clearly as he understood what Old Chief Physician Pan had in mind.

A sly smile formed on Old Chief Physician Pan's honest face. "Take some rest. After this is over, I'll take everything we deserve."

Zheng Ren nodded in response.

"I appreciate your hard work," said Old Chief Physician Pan before he stood up and left the room.

Hard work? It was just a nine-minute surgery.

Ding dong! A bell rang in Zheng Ren's ears and the System's robotic female voice emerged at the same time.

[Sudden Mission: The Soldier Dies For His Comrades accomplished. 30 skill points and 300 experience points obtained.]

Well, that was stingy... He had purchased an instrument for 3200 experience points for a reward of only 300 points.

[Time used: 1:12:36. Extra 13644 experience points obtained.]

Zheng Ren was startled by the new reward as he grumbled internally. Calculating it was not required as it was obviously the unused time to completion from that allocated by the System.

One second for one experience point; that was awesome!

The exhilarated Zheng Ren felt that there was a bright future ahead of him.

Suddenly, he recalled that the endoclip he had purchased in the System's Shop was still in the operating theater.

His hair stood on end instantly.

He took off like a scalded cat; that treasure cost him 3200 experience points! There was no way he would throw his item away even though more than ten thousand experience points had emerged out of nowhere and went into his experience pool.

The stretcher trolley was wheeled out of the operating theater. Zhou Jinxi had awakened from the general anesthesia and her vital signs were stable. Meanwhile, her agent was staring at the resected appendix in the kidney dish in Old Chief Physician Pan's hands.

Although none of them knew about the surgical process, Old Chief Physician Pan was able to explain how the appendix was edematous, where the sign of perforation in the appendix was, what would have happened if surgical treatment was not performed in time, and so on.

Chief Surgeon Liu from the first general surgery department and Chief Surgeon Sun from the second general surgery department were standing at one side with dark expressions. Chief Surgeon Liu's complexion was chalk-white, as if his cadaver-like face had been smeared with hydrated lime powder.

The terrified agent was listening to Old Chief Physician Pan's explanation while mumbling about how lucky she was to have had the surgery done on time.

The stretcher trolley had already left the endoscopic unit when Old Chief Physician Pan finished explaining the patient's condition. The whole corridor was quiet with only a few people still lingering in the area.

The agent walked toward Zheng Ren with a polite smile, bowed slightly, shook his hand enthusiastically and asked, "Doctor Zheng, when do you think Little Zhou will recover?"

"She can get out of bed tonight and walk with care in two days. There shouldn't be any delay to her recovery and she can attend the contest in three days, but her diet needs to be taken care of. Liquid meals only for the next few days and no high-intensity exercises allowed."

The final three days later would not be affected!

This was precisely what the agent wanted to hear from Zheng Ren. Dark gray clouds drifted away instantly and allowed the sunlight to fill her world with joy.

She took out a business card and handed it to Zheng Ren. "Doctor Zheng, your surgery skill is unparalleled. This is my name card. Give me a phone call when you visit Sorcery Capital in the future. Don't consider yourself as an outsider."

"That's kind of you." Zheng Ren accepted the business card and put it away.

Her fingernails were too red and her lipstick too seductive. Those were definitely not Zheng Ren's preference.

There were only four people—Zheng Ren, Old Chief Physician Pan and the two chief surgeons of the general surgery department—left in the empty hallway after the agent took her leave.

Old Chief Physician Pan grinned victoriously but made no attempt at being a gracious winner.

He stood in front of Chief Surgeon Liu and pointed his index finger. "The emergency department will handle every emergency general surgical case in the future. They are no longer under your responsibility."

Total dominion with no room for bargain.

It was a notice, not a discussion.

The chief surgeons lowered their heads, unwilling to meet Old Chief Physician Pan's vile attitude.

However, that was just the beginning...

Another finger was extended as Old Chief Physician Pan said slowly, "Since the general surgery department doesn't need to handle emergency surgical cases anymore, I'll apply for reallocation of medical staff from the general surgery department to the emergency department to solve the overstaffing issue."

A fundamental solution! It was ruthless!

Old Chief Physician Pan's demand threatened the core of the general surgery department.

The chief surgeons raised their heads instantly and Chief Surgeon Sun pleaded, "Old Chief Physician Pan, I didn't offend you. Please allow some discussion on this matter."

Chief Surgeon Liu stared at Old Chief Physician Pan with trembling hands. He knew that retreat was not an option because there was an abyss right behind him.

"I disagree," Chief Surgeon Liu rejected his request directly.

"You disagree?" Old Chief Physician Pan raised his eyebrows and radiated a murderous aura. "Have you no sense of shame?"

Have...

You...

No sense of shame...

Simple, rough, and direct.

"You want to hold on to resources when you can't perform surgery well? Let me ask you this: have you no sense of shame?!"

"..."

The chief surgeons of the general surgery department were shocked. Were they getting scolded? How many years had it been since anyone scolded them?

"You tried to put a spoke in my wheel by sending every patient with acute appendicitis from the surrounding rural areas to us. Fine, I won't deny them because we can perform appendectomies well and aren't afraid of your tricks. However, you want to take up resources when you can't even do your job properly? You're ruining Sea City General Hospital's reputation!" reprimanded Old Chief Physician Pan coldly.

Zheng Ren, who had just retrieved his instrument from the endoscopy unit, was confused. What the hell just happened?

"Do you think you're a veterinarian?" Old Chief Physician Pan continued scolding Chief Surgeon Liu like he was punishing his own grandchild. "How dare you say you're the Sea City Supreme Scalpel? Poor moral standard! Unsatisfactory diagnostic ability! Terrible surgery skill! What the hell makes you think that you're worthy of the title of Sea City Supreme Scalpel?!"

"Shameless b*stard!" Old Chief Physician Pan's angry roar echoed in the corridor.

Blood started surging toward Chief Surgeon Liu's brain as he stared at the backs of both Old Chief Physician Pan and Zheng Ren leaving the hallway, with a change in color perception as if he had gone colorblind. He was still dazed by the scolding he had just received, which had sent him back to his junior doctor days. The chief physician was scolding him, and he was feeling anxious...

His chest started becoming heavy and there was a blurriness in his vision that painted everything in black and white. He tried desperately to press his chest with his hand but could not move at all.

The muscles around his lips started contracting. He experienced a sharp pain at the precordium as if he had been stabbed in the middle of the chest, with the knife twisting and damaging every structure around the wound.

His consciousness began to fade away, and Old Chief Physician Pan's voice echoed in his ears—shameless b*stard!

The last of his consciousness flew away and Liu Tianxing crumpled to the floor with a loud bang like a puppet suddenly released of their strings.

Chief Surgeon Sun snapped out of his thoughts, flipped Chief Surgeon Liu over quickly, and concluded that the man was having an acute myocardial infarction.

"Help!" shouted Chief Surgeon Sun bitterly while resuscitating him.

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Chapter 37: Advance, Hepatobiliary and Pancreatic Surgery

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Old Chief Physician Pan and Zheng Ren heard the call for help and rushed back to resuscitate Chief Surgeon Liu, which was a simple but annoying task.

They took their leave only after Chief Surgeon Liu had been sent to the CCU.

Liu Tianxing was fine since his condition had mainly been triggered by rage. However, Old Chief Physician Pan exonerated himself from the matter, and Zheng Ren wondered if the old man was descended from Zhuge Liang himself with that kind of ability to hold an argument.

Old Chief Physician Pan gave Zheng Ren a holiday so that he could return home and get some rest.

Zheng Ren needed to organize his thoughts as well, so he packed up his belongings and rushed home.

He felt like he had been cut off from the outside world for ages even though only two to three days had passed.

He had been blessed with the System in Professor Ichiro Moriyu's failed surgery, but had been forced to work in the hospital for almost thirty straight hours after being threatened with elimination by the same System. He would have definitely drunk the energy elixir had there been more surgeries awaiting him.

Well, better to save it for future use if his body was still able to endure the fatigue.

He had not realized how tired he was in the hospital just now, but once he returned home, his body became leaden as if all the exhaustion that had accumulated over the past thirty hours of intense surgery instantly overwhelmed his body.

Little Zhao, who rented the house together with Zheng Ren, was livestreaming at the moment.

Little Zhao was an online streamer in the food and drink genre, who usually bought lots of seafood from the market and gave live commentaries while eating the stew he made from them.

Zheng Ren avoided the camera's field of view carefully and greeted him with a hand gesture before returning to his room.

He then took off his shirt, lay on his bed, and entered the System.

The emotionless and monotonous robotic female voice remained silent as usual. Zheng Ren inhaled the fresh air in the System deeply, which was as refreshing as described by elementary school textbooks. He could even feel his energy recovering to a certain extent as well.

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Zheng Ren, who had been visiting the System a few times, figured that this small world had the ability to speed up energy recovery.

However, it was merely speculation as there was no related data shown in the System.

He sat in front of the skill trees and began calculating his earnings—skill points and experience points—like a pinchpenny.

He had 1067 skill points in the general surgery skill tree and 15013=180 points in his inventory, which were altogether still insufficient to reach the Expert rank of 5000 skill points. Since there were enough skill points in the general surgery skill tree, he had decided not to spend his savings just yet.

There were 13213644300=14076 experience points in his experience pool, which he could use to purchase a set of surgical equipment in the Shop, but he had no intention of doing so because it was better to save it for a rainy day.

A child used to growing up in poverty was like a rat preparing various kinds of food to get through the winter so that it would not freeze to death in the frigid weather.

Putting his inventory aside, Zheng Ren began to think about the reward—intensive training in the System's operating theater for 20.83 days—from the System's Hostility From Peers mission.

It was a tremendous and precious reward.

The last time Zheng Ren entered the System's operating theater for little more than fifteen days, his initial Graduate rank in general surgery had shot up to Expert and he could now perform appendectomies perfectly.

What about this time?

This sort of mission reward was far more practical than skill points.

"Great Shining System Deity, how do I receive the intensive training from the mission reward?" asked Zheng Ren as he stared at the fox statue lying in front of the thatched cottage.

[Please select a branch of the skill trees for intensive training.]

The System answered Zheng Ren's question this time.

A screen with various surgical subspecialties appeared before him.

Zheng Ren believed that he had achieved at least a first-class standard in his appendectomy skill; he was perhaps one of the best in the country after being intensely trained in appendectomies last time.

What should he learn next?

It had to be related to general surgery as its skill tree had already been developed. It was better to master a subspecialty completely before moving on to another surgical branch.

Also, Zheng Ren figured that he should consider the needs of emergency surgery in the emergency department. Old Chief Physician Pan highly valued him and the System had even given him a mission called The Soldier Dies For His Comrade. He would probably be expected to develop the emergency department in Sea City General Hospital for the next few years.

Thus, Zheng Ren started deleting the general surgery subspecialties that did not fulfill his requirements.

General surgery specialty...

Breast surgery, uncommon for emergency surgery. Deleted.

Thyroid surgery, uncommon for emergency surgery. Deleted.

Anorectal surgery, uncommon for emergency surgery. Deleted.

Hepatobiliary and pancreatic surgery... Acceptable.

Gastrointestinal surgery... Acceptable.

Zheng Ren was stuck in a dilemma between hepatobiliary and pancreatic surgery and gastrointestinal surgery.

Acute cholecystitis and hepatic rupture were frequently encountered in the emergency department. However, acute intestinal obstruction and gastric perforation were common in the emergency department too.

Which subspecialty should he choose?

Zheng Ren was having a hard time making a decision as he stared at the screen in front of him.

A lightbulb went off in his head after a long time. Perhaps he could try to consult the System?

However, the System seemed to be emotionally unstable. It would answer his questions occasionally but would ignore him most of the time, and even threatened to eliminate him once...

What could he possibly do when the System was bound to him?

"Great Shining System Deity, what should I choose, hepatobiliary and pancreatic surgery or gastrointestinal surgery?" Zheng Ren gave it a try and asked.

There was a flicker on the screen and all other surgery subspecialties were dimmed, leaving only hepatobiliary and pancreatic surgery alluring Zheng Ren like a flirtatious prostitute.

This hint was more than enough even though the System did not use its robotic female voice to communicate with him.

Zheng Ren clicked the hepatobiliary and pancreatic surgery option on the screen. Then, with a sudden flash of bright light, the operating theater started forming itself around him.

The operating table, simulation mannequin... Everything looked so familiar but this time, the disease had changed from acute appendicitis to various acute and chronic cholecystitis.

"..." Zheng Ren was at a loss for words.

He merely wanted to check his inventory and rest up for the intensive training later, but why did the System begin his training unexpectedly?

Well, it was too late to regret it now. After his attempt to negotiate with the System ended up in vain, he had no choice but to start his training in cholecystectomy.

Since the System did not threaten him with elimination this time, Zheng Ren was able to calm his mind and gain more experience during the process.

He actually felt energetic instead of tired after performing numerous surgeries in the System, even clearly recalling all the literature and information around hepatobiliary and pancreatic surgery that he had read many years ago.

A simple open cholecystectomy was at the same tier as an appendectomy—a tier-one surgery.

In fact, it was possible for house officers to perform an appendectomy personally under the close supervision of clinical tutors at the end of their housemanship.

However, no one dared let house officers perform a cholecystectomy.

Anatomically speaking, a cholecystectomy was much more complicated than an appendectomy.

Zheng Ren began the training with an open cholecystectomy to familiarize himself with the anatomical structures and prepare himself for a complicated laparoscopic cholecystectomy.

Time was easily forgotten and he would lift his gaze to check the countdown timer only after finishing an operation.

He truly felt that time was more precious than gold in the System.

Zheng Ren felt slightly uneasy after 20.83 days had passed.

Hepatobiliary and pancreatic surgery was far more complicated than an appendectomy, after all.

It was obvious that an appendectomy was incomparable to hepatobiliary and pancreatic surgery since it was merely a tier-one or tier-two gastrointestinal surgery.

When the countdown timer reached the last second, the operating theater vanished before Zheng Ren's eyes and he raised his hands subconsciously to clutch at the fading theater.

Unfortunately, there was only air in his grasp.

While he was absorbed in his own thoughts, numerous crystal-clear white lights flooded into the System and transformed into a trickle of brilliance, which made the mysterious world vivid and full of life.

[Please take note that training time for surgery has been unlocked in the Shop.]

Huh? He could buy that too? Zheng Ren went to the Shop quickly and began searching for it.

...

At the same time, the live surgery broadcast room in Xinglin Garden had been fixed. Hundreds of doctors waiting eagerly on the homepage started swarming into the livestream room to secure a spot as there was a limit on the total number of viewers in each room.

It was as if a new channel had been added into a game.

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Chapter 38: A Blessed Sorrow

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Peng Jia was the CEO of Xinglin Garden and his office was located on the thirty-eighth floor of a landmark building in Sorcery Capital.

He sat in a bright, spacious room, staring at the slowly flowing waters of Huangpu River, visibly dazed and confused.

He met a ghost today!

In order to establish a professional website, Xinglin Garden had a set of strict rules that included account registration with a medical practitioner's license number and the prohibition of unregistered random visitors from browsing the site.

Extreme measures needed to be taken to ensure professionalism. That was Peng Jia's character.

He had a goal and the executive ability to pull it off. After five years of hard work, Xinglin Garden had become the number one website in the country and its reputation was far greater than any other would-be runner-up.

No one would shake Xinglin Garden's foundations for the next five years.

Everything had been going so well and he was riding high on the crest of his success until this morning, when Peng Jia received a report from a forum department manager stating that the server was restarted due to an overloaded server.

This simple issue was a problem?

Peng Jia responded perfunctorily instead of figuring out what sort of post could lead to a system breakdown, which was what he would have done several years ago. He had devoted all of his attention to the capital market and Xinglin Garden's registration in said market was of utmost importance to him.

It was just a server reboot, not a big deal at all.

However, Peng Jia received a phone call right after the department manager had finished reporting.

The caller, the personal secretary of an elderly professor at Union Medical College Hospital, inquired about the reason for the live surgery broadcast room's sudden breakdown.

There were only a handful of doctors who hired a personal secretary within the country.

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Peng Jia dared not neglect this issue any more as this mogul was one of his benefactors. After repeated affirmations and apologies, he prepared himself to investigate the source and find out what sort of livestream had aroused the interest of that elderly man.

"Toot-toot-toot." Another phone call came in before this one had even finished.

After seeing the caller ID, Peng Jia quickly apologized to the elderly man, promising to begin repairs as soon as possible and invest more resources into its maintenance.

He then hung up on the first caller and accepted another call from another elderly man.

The question was the same. It was about the live surgery broadcast room.

Startled and curious, Peng Jia began wondering what sort of live surgery broadcast could attract the attention of these moguls.

Fortunately, Peng Jia did not receive a third phone call. Otherwise, he would have considered this a supernatural event.

These elderly men had a high social status and were extremely difficult to meet or even call as their personal secretaries' permission had to be acquired before he could even request an audience. He was the CEO of the top domestic website but merely a speck of dust underneath their fingernails. However, the fact that these men had called him for an inquiry today as if they had discussed this issue beforehand had been completely beyond his expectations.

It would have been fine if they were just making a simple inquiry, but the unpleasant tone in their voices had induced fear in Peng Jia.

He put his phone down and quickly asked about the situation while rushing to the server room to personally oversee the software debugging process.

A few speculations took form his mind on his way toward the server room. Moreover, his cell phone was ringing off the hook as every doctor with his number around the country also bombarded him with the same question.

Upon reaching the server room, he watched the recording of the surgery livestream in the backend server and understood everything instantly.

A demon had come to his own website to broadcast his surgery live.

That was great!

Peng Jia made a few calls immediately to purchase a new server and increase the maximum capacity in a live broadcast room to three thousand viewers.

Peng Jia always thought that servers cost a fortune, but this time, he did not even ask about the price but made only one request—the server had to be installed within one hour.

Anything was possible as long as the payment was satisfactory.

The manufacturer came through without hesitation and installed the new server within fifty-six minutes.

After debugging was completed and the website was operational, Peng Jia ordered every staff member to shut down posts on the website when necessary so that the live surgery broadcast room would remain operational at all times.

The live surgery broadcast room went back online after a breakdown of thirty hours and fifteen minutes.

That was a job well done. Peng Jia patted himself on the back for being decisive, as it was exactly the kind of ability required by the founder of this kind of medical website.

He picked up his cell phone elegantly and began to call back those two elderly men.

Whatever he had to do was not important. It was these men's satisfaction after their wishes had been granted that mattered the most to him.

Hundreds of viewers swarmed into the live surgery broadcast room as soon as the server was rebooted, which made Peng Jia glad that he chose to take this matter seriously instead of performing a simple restoration just to save money.

He did not believe that a system breakdown would occur again with the new server installed.

As he reported the situation to one of the elderly men with a bright smile on his face, a helpless web engineer approached him and said, "President Peng..."

"Talk to me later," replied Peng Jia impatiently, covering the mouthpiece on his phone.

"No..." The engineer added quickly. "The server is overloaded again."

"..." Peng Jia fought the urge to curse.

He ended the phone call politely and went to the mainframe.

"Is it the live broadcast room again?"

The engineer replied with a husky voice, "The live broadcast room is still operational, but the system resources are critically low due to the sheer amount of account registrations."

Peng Jia would normally be exhilarated if told that the number of account registrations had skyrocketed.

However, the website had just experienced a system breakdown. If another one occurred again in such a short period of time... a dark future awaited him.

"Why the hell are you not doing anything?! Quick, turn on the backup server!" Peng Jia howled in exasperation.

"It has been turned on." The engineer was drenched in cold sweat as he stared at the mainframe display. "Ten seconds after the live broadcast room went online, 366 viewers entered the room. At the twentieth second, 983 entered the room. At the first minute, 1360 viewers entered the room."

"I don't need data! I need..." Peng Jia roared in response.

"Er... President Peng, all the newly registered accounts have entered the live broadcast room. What do you suggest we do about it?" The engineer's voice had become croaky as he pointed at the data in the backend server.

The upgraded live surgery broadcast room had a maximum capacity of three thousand viewers.

Xinglin Garden was not a professional livestream website after all. Most users normally posted medical-related content and only a minority of people would broadcast surgery, so Peng Jia did not implement the most advanced servers available as it was simply a waste of resources.

Well, this was a problem today.

The number of viewers in Xinglin Garden had shot up this bright, sunny morning as if a popular female online streamer had brought her fans to his website. The server had been overwhelmed just now and was about to face its doom for the second time...

The addition of the backup server could only push maximum capacity to around four thousand viewers.

"Make an announcement and stop all registration processes temporarily." Peng Jia made his decision instantly.

Finally, the live broadcast room's capacity was capped at four thousand six hundred viewers after new members were rejected and all servers had been merged.

However, Peng Jia was unable to bear the slowly increasing numbers, so he quickly grabbed his phone and ordered a business server with a more advanced configuration.

Price was not the main concern here. He only wanted it to be quickly installed.

Peng Jia lacked the courage to even look at the data in the backend server again, feeling as though his heart would stop beating every time the viewer count in the live broadcast room increased.

He returned to his office and stared at Huangpu River with a dark expression.

This was a blessed sorrow, but none of it would matter if he could not solve this issue.

What the hell happened? Where did this demon come from?

Zheng Ren, who had no clue that someone outside his world was distressed because of him, visited the Shop happily and searched for the option to purchase intensive training time for surgery.

He was instantly stunned upon clicking the Shop's purchase interface. What in the world was this?!

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Chapter 39: Visit The Hospital For A Livestream

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

There was an option to purchase intensive training time for surgery in the Shop but the price... was too expensive—3600 experience points for one hour.

He could buy a set of surgical equipment with the experience points for four hours of intensive training.

Zheng Ren's heart shattered instantly after calculating how much a set of surgical equipment was worth. Upon further calculation, he realized one second was basically equal to one experience point. Damn, the System sure knew how to settle its accounts.

After going through his heartbreak, Zheng Ren soon noticed a new change in the Shop—the addition of interventional radiology to the original hepatobiliary and pancreatic surgery.

Zheng Ren was unfamiliar with interventional radiology.

He only had a superficial understanding of it, such as percutaneous coronary intervention in coronary heart disease and the insertion of a stent to relieve jaundice in biliary obstruction.

Apart from those, Zheng Ren had no clue what it was.

Interventional radiology had been introduced in Sea City General Hospital once. There was no specific department for it, as only a few radiologists in the radiology department were involved in its training.

After treating a few cases of ruptured hepatocellular carcinoma with intraperitoneal hemorrhaging, as well as pelvic fracture with bladder rupture or hemorrhaging, interventional treatment for uterine fibroids had been introduced as well.

However, after a forty-five-year-old radiologist was diagnosed with hematologic malignancy, they gave up on treatment with surgical methods involving radiation exposure such as X-rays.

He was merely forty-five years old, after all, which was arguably the best age for a surgeon but had unfortunately been diagnosed with hematologic malignancy due to excessive radiation exposure. Everyone who listened to this story would be afraid of this kind of surgical technique.

What was the point in learning it anyway? Zheng Ren only wanted to put more effort into mastering cholecystectomy.

Rome was not built in a day and the same applied to surgery as well. After 20.83 days, Zheng Ren had merely become proficient in open cholecystectomy and laparoscopic cholecystectomy for simple acute cholecystitis.

Proficient, but far from perfection, like how he was for appendectomies.

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Well, that was useless. Zheng Ren had no intention of investing any of his precious training time in interventional radiology.

He felt some regret even though his current standard had reached the level of a deputy chief surgeon in cholecystectomy.

However, he was afraid that the System may suffer a system meltdown again and demand he perform ten perfect cholecystectomies...

When that happened... F*ck...

After careful consideration for some time, Zheng Ren finally gave up the opportunity to purchase training time for interventional radiology.

Every penny had to be broken in half before spending; that was the mindset he had after prolonged poverty. His heart would shatter in a moment if he was asked to use ten thousand experience points to learn non-essential interventional radiology.

More importantly, he did not have enough "money" to learn it even if he wanted to.

That was all for now. Zheng Ren was ready to leave but before that, he wanted to know his current general surgery standard.

There was a huge increase from 1067 to 1360 skill points in his general surgery skill tree, presumably due to an improvement in proficiency after his intensive training in the System, just like what he did with appendectomy last time.

Zheng Ren was glad he had taken a step further to achieve the Expert rank as he still yearned for the superb surgical manipulation he had performed under prime experience. How he wished he could reach the peak one day and command a view of the medical world.

Looking at the skill tree carefully, Zheng Ren noticed a tiny branch spreading out of the skill tree.

The branch originated from the general surgery skill tree and connected with various other skill trees—internal medicine, vascular surgery, obstetrics and gynecology, neurosurgery, and many more—like a deep-seated tree root.

Huh? What was going on?

Zheng Ren was momentarily stunned and quickly took a closer look.

It turned out to be a branch of hepatobiliary interventional radiology... Zheng Ren stomped his foot, annoyed. Interventional radiology again!

However, it actually made sense when he thought about it. After mastering hepatobiliary interventional radiology, he could spend some time learning anatomical structure from other subspecialties and start performing surgery afterward.

The principle was the same.

However, Zheng Ren remained uninterested. His goal was limited. Cholecystectomy was his only priority for the time being.

Before Zheng Ren could summon himself back to reality, the emotionless System appeared unexpectedly, which gave him a shock.

[Free customized lead apron with purchase of intensive training for interventional radiology.]

Er... Was this a buy one, get one free promotion or a clearance sale?

There was no such thing as a free lunch. Zheng Ren dropped the idea of getting free items from his mind almost instantaneously, rolled his eyes at the Great Shining System Deity and left the System.

...

Zheng Ren was not tired at all after leaving the System.

Despite thirty hours of emergency surgery in Sea City General Hospital and twenty days of intensive training in the System, Zheng Ren actually felt energetic and his body brimmed with vitality.

He could almost confirm his speculation that the System possessed an ability to replenish his health bar and mana pool when the host was in the mysterious world.

Should he go to work or continue his rest at home? In the end, he had decided to take a shower first before departing for the hospital.

He had not seen the postoperative patients in the general surgery department yet. As a surgeon, he would not be able to eat if he did not personally check his patients after surgery.

"Knock-knock-knock!" The knocking was soft as if the visitor was checking if Zheng Ren was asleep.

That must be Little Zhao, so Zheng Ren stood up and answered the door.

"Bro, you haven't slept yet?" asked Little Zhao charmingly.

They had been renting this house together for more than half a year. Before he rented the house, Zheng Ren had some wild thoughts about living under the same roof with a beautiful woman, a common plot in romance novels.

However, whenever the landlord brought ladies over to check the house, they would always refuse and escape faster than rabbits upon seeing Zheng Ren, which made him wonder if all pretty women were similarly reserved or if he was simply too plain-looking.

In the end, Little Zhao had become Zheng Ren's housemate.

Little Zhao was a good man who would share his food with Zheng Ren whenever he could not finish them in the live broadcast. From that, Zheng Ren had been able to save up some money.

"What's the matter?" asked Zheng Ren.

"Are you tired?" There was a gleam in Little Zhao's eyes, suggesting that he indeed had something on his mind.

"Just tell me what you're thinking of. Look at you, it's obvious you're up to something," Zheng Ren teased with a grin.

"I'll come in and tell you." Little Zhao squeezed past him without waiting for an invitation and sat on the bed, his expression becoming troubled. "Bro, the popularity of the food and drink broadcast channel has been decreasing recently, so I want to start a new livestream."

"Go ahead, but I don't have money for the investment."

"I don't need your investment." Little Zheng quickly dismissed Zheng Ren's worry. "There was a livestream video yesterday that went popular instantly."

"Okay?"

"An online streamer went to the hospital for medication and happened to see your consultation, so he broadcasted it live and the result was very good," Little Zhao explained his intention.

There was no point in hiding secrets since they were close to each other.

"It's not allowed in the hospital."

"I don't need permission. You can't stop me from consulting a doctor, right? I'll just sit outside the emergency department every day and start a livestream if there is any interesting gossip, or I can just read online novels to pass the time if nothing happens."

It seemed like Little Zhao had planned it thoroughly, so there was nothing Zheng Ren could say about it.

"Go ahead then, but I can't give you the green light from the hospital's perspective. You're on your own out there."

"I just want to know if there is enough interesting gossip in the hospital. If I don't start my livestream in the next two days, I'm going to starve to death." Little Zhao was getting more troubled and disheartened. It was what usually happened to those born at the bottom of the social hierarchy. He had a long, miserable past.

"Bro, you also know that I've got a girlfriend but I don't even have enough cash to visit her. I have a really tough life."

"Stop. I don't even have a girlfriend and have to rent a house together with you. Don't you think you have it better than I do?" Zheng Ren quickly interrupted Little Zhao so that the wounds Xie Yiren had unintentionally inflicted on his heart yesterday would not burst open.

"This sort of situation is common in the hospital and you'll meet all kinds of people, especially in the emergency department. If you want to go there for your livestream, let me teach you a trick." He smiled and added, "You've to establish a good relationship with the security guards."

Under normal circumstances, the doctors and nurses would not bother with trivial matters such as live broadcasts in the hospital.

What a joke. How would they have time for such a matter when the emergency department had to handle around one hundred to two hundred patients on busy nights? In any case, a livestream would not affect the patient's safety.

The excited Little Zhao replied quickly, "Of course, no problem. I'll still follow the rules."

"I'm going to the hospital to check on the postoperative patients. Do you want to come along?" asked Zheng Ren.

He could save some fare if Little Zhao, who owned a scooter, wanted to tag along with him. That was what Zheng Ren had in mind.

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Chapter 40: Doctor

Zheng Ren advised Little Zhao along the way, "Don't start a live broadcast if someone passes away. If he is a grumpy one, you might end up walking hand-in-hand with his soul across the Naihe Qiao."

Little Zhao took Zheng Ren's advice seriously. Soon, they arrived at Sea City General Hospital.

This was the first time Zheng Ren rode a scooter and he took a huge interest in it instantly. Its speed aside, the fact that it could easily weave through traffic was more than enough to pique his interest.

Zheng Ren parted ways with Little Zhao upon reaching Sea City General Hospital and went to the emergency department to look for Old Chief Physician Pan.

The emergency department remained chaotic as usual with multiple fistfights, injuries from falls and alcohol intoxication requiring gastric lavage... Zheng Ren was confused. Why had they drunk alcohol in the middle of the day? Not only that, but they had been binge-drinking as well.

Zheng Ren squeezed past a group of onlookers and walked straight toward Old Chief Physician Pan's office.

When he passed the resuscitation room in the emergency department, he heard a high-pitched whistling sound as if from a flute, a typical sign of an acute exacerbation of bronchial asthma.

The doctors and nurses were busy resuscitating the patient in the resuscitation room.

"2mL of diprophylline for intravenous injection!"

"Add one ampoule of epinephrine!"

"Tracheostomy set prepared. Notify the general surgery department to perform tracheostomy when necessary."

Zheng Ren changed his mind and went to change his attire first before going to the resuscitation room.

None of them greeted Zheng Ren as they were still busy trying to revive the patient.

A male in his twenties was lying on the hospital bed with a girl, presumably his girlfriend, holding his hand beside the bed and crying.

Zheng Ren observed the patient whose symptoms and diagnosis were revealed in the upper right corner of his vision.

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He spread his hands helplessly after seeing the diagnosis.

"Patient's family member, please leave the room," said Zheng Ren in a deep voice.

The girl in a red shirt raised her head with tears welling up in her eyes. In her opinion, Zheng Ren's words were indicative of an even more severe illness and the patient would require aggressive resuscitation in the intensive care unit.

"Doctor..." The girl could not form a complete sentence as she was out of breath from her constant crying.

"Don't worry, just leave the room first. I'll explain the situation to you later," replied Zheng Ren.

The girl was reluctant to let go of the boy's hand.

What beautiful love, but why had nobody developed such fondness for him? However, he was aware of his limitations, especially after acquiring the System.

Poverty, ugliness, and a strong body odor—and there had been no change of clothes after being fully occupied with work for three to five days. Who would like him in this state?

"You're delaying the rescue. Get out now!" Zheng Ren roared after noticing that the girl was still in the room. The words on the upper right corner of his vision had started to glow red, which meant that the boy's condition had worsened and was approaching a critical state.

Zheng Ren's tone was stone cold and impolite. "We need to rescue him, so leave now!"

A total lack of tender and protective feelings toward a girl; no wonder he had remained a bachelor until now.

The girl's crying intensified after she was pushed out of the room.

Every ambulant patient and family member in the emergency department noticed the commotion and gathered around the scene. Little Zhao also joined the crowd with a cell phone in his hand, his livestream having already begun.

"Wait here. I'll come out and explain his condition to you later," instructed Zheng Ren with a commanding voice before entering the resuscitation room and closing the door.

His method was simple and rough, but he had no choice because it was absolutely impossible to reason with the patient's family right now.

"Control the dosage, his condition will improve soon," said Zheng Ren.

"Chief Zheng, the patient already has signs of laryngeal edema," the nurse reported, shining a penlight into the patient's mouth.

"It's okay. Start a 10mg intravenous injection of dexamethasone, as well as an intravenous infusion of 250mL normal saline and three ampoules of diprophylline at sixty drops per minute. Attach an ECG machine first and pay attention to the oxygen saturation."

An intravenous fluid drip was quickly attached at Zheng Ren's request. The ECG reported a heart rate of 132 beats per minute and an oxygen saturation of 80 percent, which were the typical signs of acute respiratory distress.

The doctors and nurses on the scene waited for Zheng Ren's instructions but he merely stood beside the patient quietly with his arms folded.

"What about the resuscitation? Why did Chief Zheng administer three ampoules of diprophylline and do nothing afterward?"

"Keep quiet. This is our new chief resident and I've heard that Old Chief Physician Pan likes him very much."

"So what? We still need to resuscitate him. Are we just going to stand here and wait for the patient to die?"

Zheng Ren, whose hearing seemed to have improved somewhat after being in the System for a long time, overheard the nurses' whispers.

"It's alright." Zheng Ren turned around and smiled. "This patient's condition is special. I'm guessing that his symptoms will be relieved in around three minutes. The administration of a large dosage of drugs will slow down his metabolism and cause other complications to occur."

The doctors and nurses on the scene stopped their discussion after hearing Zheng Ren's polite and confident words. He was the chief resident, after all. He had to bear the responsibility and face the patient's parents if something bad happened to him.

The fact that they remained silent did not mean that they trusted Zheng Ren's decision, which was why they still paid close attention to the patient's condition.

The patient already had a laryngeal edema. Was he expecting to solve the problem by administering diprophylline only? What a joke!

However, a few minutes later, the patient's respiratory rate had gradually stabilized and his heart rate had decreased to 110 beats per minute, which none of them had foreseen.

His lips cyanosis had alleviated as well and his condition had improved drastically.

What... What the hell was this? After the doctors and nurses realized that the patient's condition had gradually improved as they did nothing at all, they turned to Zheng Ren in disbelief.

"Young man, are you awake?" Zheng Ren tapped the patient's shoulder gently.

The patient waved his hand to indicate a yes.

"Reduce the oxygen flow to 3L per minute. I'll explain the situation to the patient's family." Zheng Ren tapped the patient's shoulder gently again to comfort him and left the room.

"You, stand up and talk to me," said Zheng Ren a little roughly after exiting the room and noticing the girl sobbing on her knees.

"Doctor, how... how is he?"

"He is fine, so why are you even crying? The patient's condition has stabilized. I'm here to explain his illness and I need your cooperation," said Zheng Ren.

"Okay." Knowing everything was fine, the girl quickly wiped her tears, sniffed forcefully and stood.

The girl, who was in her early twenties, had short hair and slightly rough skin. It was obvious that her family was in a bad way. Her shoddy eyeshadow was a mess, with black powder smeared around her eyes, making her look like a huge panda.

She was wearing a red sweater and Zheng Ren could even detect a pungent chemical smell that was characteristic of cheap clothing from it.

Rich or poor made no difference in the doctors' eyes, but of course, it was a whole different story to the hospital authorities.

"The patient's condition is stable. I'm guessing that he can go home tomorrow after one night of hospital stay for observation," Zheng Ren reassured the girl.

"Huh?" The good news was unexpected and the girl was having a hard time believing it.

Little Zhao squeezed to the front of the crowd and found a position with a decent view as the live broadcast continued.

The crowd was dumbfounded as well.

"His face was purple when they carried him into the room. Is already he dead and the doctor is actually consoling his family?"

"Doctors wouldn't have the courage to do this. Perhaps his condition has really improved."

"Are you kidding me? Only a few minutes have passed. It's not like the doctor gave him an elixir of life and brought him back from the dead."

Soft whispers traveled among the crowd. Little Zhao, who was focused on the livestream, remained quiet as he was unsure if whatever Zheng Ren had mentioned just now was true. He merely moved the phone camera around and recorded the expression of everyone on the scene.

"Take off your shirt and the patient will be fine," said Zheng Ren.

Boom! An explosion occurred in the crowd.

Was he a perverted doctor? He dared ask the patient's family member to take off her shirt?! What a shameless b*stard!

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Chapter 41: Color Hypersensitivity

"What the f*ck! What kind of lousy doctor is this?!"

"I swear I'll kill him if he dared to speak to me in that way."

"Is this the medical standard of Sea City General Hospital?"

The voices in the crowd started to become louder and the raging fire was about to get out of control.

Little Zhao winked at Zheng Ren repeatedly to warn him about the imminent danger but went completely unnoticed.

"Why are you guys shouting? Are you doctors? If you're so smart, then you might as well treat the patients yourself!" Little Zhao, who believed in loyalty, stood up for Zheng Ren in the end.

"Did you buy this shirt today or just planned on wearing it today?" asked Zheng Ren while ignoring the exasperated crowd.

"..." The girl was stupefied.

In what way was her shirt related to her boyfriend's condition?

Even so, she nodded in response honestly. "Today is the first anniversary of our first meeting. I bought this shirt a few days ago but today is the first time I put it on. We initially planned to have lunch together but I didn't expect..."

Tears started welling up in her eyes again.

"Don't cry," Zheng Ren raised his eyebrows and proclaimed. "Your boyfriend suffers from a rare condition called color hypersensitivity. This shirt was the cause of his allergic reaction."

"..."

Not just the girl, but the crowd was flabbergasted as well.

Color hypersensitivity? What in the world was that?

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"To put it simply, it's fine if your boyfriend takes a short glance at this uncommon red color, but if he keeps staring at it, a stress response will occur in his body, hence the allergic reaction," Zheng Ren's confident voice soothed their minds.

His diagnosis was clear and the treatment was also simple.

"Take off your sweater and be careful later. We'll transfer the patient to the observation unit after this. He has to fast for twelve hours to prevent any sort of irritating food from causing another allergic reaction," Zheng Ren advised.

The girl nodded vigorously and took off her sweater without the slightest hesitation.

She wanted to fold her sweater and put it away, but was unable to do so as she only carried a small handbag with inadequate space.

Gritting her teeth, she threw the newly purchased sweater into the rubbish bin.

"Don't!" Zheng Ren understood the mindset of the poor and stopped her immediately. "I'll keep it for you. Keep all your valuables with you and you can take it from me when the patient is discharged. It's a pity to throw new clothes away."

Little Zhao and the crowd was dumbstruck. Was this the diagnosis?

A patient on the verge of death had been treated just like that?

"Chief Zheng, the patient's heart rate has returned to normal and oxygen saturation is at 100 percent. Can I transfer him to the observation unit?" asked a nurse.

"Sure, go ahead. He's fine now."

The crowd started buzzing with excitement and the scene became chaotic again as the patient was wheeled out from the resuscitation room to the observation unit.

"Has he really recovered? Was his condition really serious just now?"

"Very serious. I saw him with my own eyes when the ambulance came. His face was purple, his hands seemed to be purple too, and he was frothing at the mouth. It was a scary sight!"

"Stop talking nonsense. Would his girlfriend cry her eyes out if his condition wasn't serious?"

Little Zhao, who had regained his composure quickly, stared at his cell phone with dozens of comments flooding the live broadcast room. Obviously, this livestream had gained a good amount of popularity.

"Brothers, send me gifts for witnessing the awesome work of the divine doctor!" He had not forgotten to get his cut despite the hectic moment.

As the whole process had been completely unexpected, the viewers in his live broadcast room were extremely enthusiastic and started bombarding the online streamer with various stream rewards—free fishballs, airplanes, and even rockets.

[Broadcaster, what did he do just now? Can you explain it again because I didn't see it.]

[Broadcaster, can you send me your coordinates? I'll visit that hospital whenever I get sick. He is indeed a divine doctor.]

[I've sent you a rocket. Please send positive energy to the divine doctor!]

Little Zhao felt like a dog with two tails as he stared at the comments in the live broadcast room. How long had it been since his livestream had gotten this popular? There were so many rewards. Perhaps the emergency department was a better place for a livestream after all because it was livelier... No! It was due to Brother Zheng's superb medical skills. None of the viewers would be willing to send him rewards if he put a dead patient on his livestream.

Zheng Ren pushed the crowd aside and brought the patient to the observation unit on a stretcher trolley.

He passed Old Chief Physician Old on the way. Chief Physician Pan, who had not expected him to return so soon, walked over with his head up and a quick pace, unsure what he was up to.

"He'll be put under ECG monitoring for two hours. Everything should be fine once it stabilizes completely." Zheng Ren then advised, "Don't forget what I told you just now."

"Okay." The girl nodded in response.

"Doctor, thank you." The boy wanted to take Zheng Ren's hand and express his gratitude, but Zheng Ren was already at the doorstep. Left with no choice, he uttered his gratitude with difficulty.

"No worries," replied Zheng Ren as he walked out of the observation unit, and smiled upon seeing Little Zhao chatting with an onlooker with his cell phone up. Then, he walked toward Old Chief Physician Pan's office, knocked on the door and entered the room.

Old Chief Physician Pan was shocked upon noticing Zheng Ren. "Why did you come back so soon? Go home quickly and get a good rest."

"I'm still young. I can bear it." Zheng Ren smiled. "I can't relax yet until I've seen the postoperative patients myself."

Old Chief Physician Pan understood Zheng Ren's mindset as that was exactly what every surgeon would feel. They would have trouble sleeping if they did not examine their patients after surgery.

If the patient had a serious surgical condition, insomnia would be inevitable.

"Let's go for a ward round," said Old Chief Physician Pan.

That was precisely what Zheng Ren was waiting for.

He was a chief resident in the emergency department. If he went to the first general surgery department for a ward round without Old Chief Physician Pan's company, he would have definitely drowned in their saliva.

However, anyone who dared to criticize him while he was accompanied by Old Chief Physician Pan would feel the old man's wrath. That was beyond question.

They both valued efficiency, so they left the emergency department and darted toward the first general surgery department.

Old Chief Physician Pan explained the staff allocation progress to Zheng Ren along the way.

The hospital management was very supportive especially after witnessing Zheng Ren's outstanding surgical performance today.

However, one more week was required to allocate the nurses and equipment, and the hospital management had planned to place house officers under standardized training to fill up the vacancies in the emergency department.

Old Chief Physician Pan could not possibly trouble hospital management any further because It was known to all that there were not enough doctors in the hospital.

At least the plan was beginning to take shape which pleased Zheng Ren a lot.

Soon, they arrived at the first general surgery department, which was overcrowded with patients and had had beds added up to the end of the corridor. They could not even see where it ended at first glance.

Even Zheng Ren was a little surprised. Were all of these his postoperative patients?

Old Chief Physician Pan aggressively summoned the doctors in the first general surgery department and started the ward round.

There was no leader in the first general surgery department as Chief Surgeon Liu had been hospitalized in the CCU for treatment of his myocardial infarction. Thus, even if they wanted to disobey the culprit's command, they simply lacked the courage to do so.

Every time the group arrived at a patient's bed, the doctor in charge of that bed would quickly explain the patient's condition.

There were too many patients and normally, Zheng Ren had to spend some time trying to recall the identity of each one and the reason for their surgery.

However, Zheng Ren was able to remember every single one of them—their identity and surgical condition—clearly as if they had been seared into his brain. There was no need for the doctors to introduce the patients at all. He was unsure this was due to the System

"The patient's condition is stable with good recovery."

The constant repetition of that phrase pleased every patient and their family members. The cacophony of smells in the corridor seemed to have become less pungent as everyone's joy lightened up the atmosphere.

They walked to room number five. Then, a thin and withered figure appeared before Zheng Ren before they entered the room.

Thud! The figure collapsed.

Chapter 42: Postsurgery Ward Round

Zheng Ren instinctively pulled Old Chief Physician Pan aside, believing the sudden movement to be an attack from a patient's family.

As a doctor in the hospital, not knowing a self-defense might get yourself killed.

Half a second later, Zheng Ren realized that it was an old lady kneeling before him and Old Chief Physician Pan.

"Uh..."

"Old lady, what are you doing? Come, get up." Old Chief Physician Pan bent over to help her stand.

"Both of you are my saviors!" the old lady said as she gripped Chief Physician Pan's hands tightly. Tears were flowing down her cheeks.

Zheng Ren quickly scurried away into a corner. He was a mere chief resident who did not deserve an elderly person's fervent gratitude.

He did not want to push his luck. The System might give him another moronic life or death mission to complete.

"You living buddha, you saved my granddaughter," the old lady spoke through tears as she stood with the help of Chief Physician Pan.

Zheng Ren studied the old lady curiously.

When he spoke to the family prior to the surgery—including the parents of the pregnant patient—no one expressed much concern over the patient's wellbeing. In their eyes, the unborn son was the priority.

Now, this old lady here was thanking them for saving her granddaughter.

Zheng Ren suddenly felt that his surgical work was worth it in the end. He felt appreciated.

Old Chief Physician Pan was flustered but had dealt with such situations before. He ushered the old lady into the room with a few words. Zheng Ren carefully followed, wanting to check on the patient's recovery status.

A round of questioning informed Zheng Ren of the patient's wellbeing. A day after the surgery, she had already passed gas and was able to consume porridge.

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Her complexion was much better than the last time Zheng Ren saw her. She was half-prone on the bed.

When the patient saw Old Chief Physician Pan walk in, she tried to sit up to convey her heartfelt gratitude.

Old Chief Physician Pan pushed Zheng Ren ahead. "This man is who you should thank. He was your surgeon."

Realizing her mistake, the young pregnant patient became sheepish.

The husband, grandparents, and parents were all crammed into the small hospital room. Multiple hands shot out to help the patient when she tried to sit up. They avoided eye contact with Zheng Ren and their movements were stiff.

Their help was unceremoniously driven away by the old lady.

Perhaps in the old lady's eyes, only she could care for her granddaughter. The others were just ingrates and though she might be old, she was not oblivious.

Zheng Ren instantly got the patient to lie back down. Being able to pass gas and eat just a day after surgery was good progress. Zheng Ren did not want to chance her getting on her knees.

The information on the right corner of his vision stated that she showed no signs of infection or other complications. The threat of miscarriage had also vanished and she was on the path to a speedy recovery.

All was well. Zheng Ren gave a few words of encouragement to the patient and promptly dragged Old Chief Physician Pan out of the room.

"Not used to the thanks? This sort of expression is common for rural folks." Old Chief Physician Pan was in a good mood after witnessing the pregnant patient's recovery.

"I just don't like the family... Except for the old lady," Zheng Ren confessed. The incident with that particular family was a sore point and he wanted to get that off his chest.

Zheng Ren did not need to elaborate. Old Chief Physician Pan understood what he had experienced that day.

Anyone with at least five years of clinical experience would have had to handle similar scenarios. As for Old Chief Physician Pan, he had had it down to an art.

"You'll get used to it." Old Chief Physician Pan gave Zheng Ren a faint smile, unbothered by it all.

One had to have an open mind or be prepared to resign.

After completing their rounds in the first general surgery department, Old Chief Physician Pan took Zheng Ren to the second general surgery ward.

When Chief Surgeon Sun of the second general surgery department learned the two men were coming, he volunteered to accompany them without hesitation.

He hosted them with grace and warmth, very much like a chief resident would when the head of a surgical department dropped in for a check.

Once they left the second general surgery department, Old Chief Physician Pan commented to Zheng Ren. "That man knows his place."

They were done with the general ward patients and proceeded to the special demands ward.

When they reached the second floor, a shout was heard. "Miss, why are you on your feet?"

Old Chief Physician Pan and Zheng Ren were startled and quickly made their way into the room.

A slender and tall lady stood inside with her hands gripping the hospital bed guardrail.

The lady was seriously 1.8 meters tall. While there were still hints of frailty about her, her elegance shone through.

"Zhou Jinxi?" Zheng Ren asked in a confused tone.

Zheng Ren had never performed an endoscopic transrectal appendectomy in real life prior to this and was therefore unclear about the recovery process. According to existing literature, the patient would be able to stand, pass gas and consume liquid food after a day. Walking would possible be on the second day, and discharge on the third.

However... This Zhou Jinxi lady was on her feet just six hours after surgery.

Both Old Chief Physician Pan and Zheng Ren were shocked.

"Yes. It's you two..." Zhou Jinxi held onto the guardrail and carefully balanced herself. Her big eyes sparkled as she spoke.

"I am the chief surgeon of the emergency department, last name Pan. This man here is my soldier and the one who performed your surgery, Zheng Ren." Old Chief Physician Pan's voice was filled with pride when he mentioned Zheng Ren was his subordinate.

"Ah!" When Zhou Jinxi heard that Zheng Ren was the surgeon, she hopped onto the bed and hid under the blanket like a startled rabbit. Her scarlet face was obscured by the cloth.

"..." Was this shyness?

In the eyes of the stone-faced, unparalleled and godlike doctor, the patients he treated were genderless.

Heh, no wonder he was single to this day.

"Miss Zhou, we are here to check on your recovery," said Old Chief Physician Pan as his tone softened. He was well-versed with people's reactions and knew how to comfort Zhou Jinxi's timid soul.

Her assistant persuaded her for five minutes before she was willing to remove her covers. She answered Zheng Ren's questions with a red face.

Zheng Ren was grateful that her rate of recovery was exceptional. The difficult surgeries that he had to perform had all been on younger patients who stood a better chance when it came to postsurgery healing.

Zhou Jinxi's lower right quadrant of the abdomen showed no signs of pain. A physical check of the surgical site revealed no point tenderness, rebound tenderness or muscle guarding.

Zheng Ren would not be surprised if this lady tried to escape the hospital tomorrow, judging from her buoyant attitude.

His lips curled at the thought. He told the assistant to make sure Zhou Jinxi stayed in bed for a whole day before allowing her to move about.

Old Chief Physician Pan's phone rang as Zheng Ren was about to ask about passing gas.

"Hello. Yes, that's me." Old Chief Physician Pan answered the phone and walked out of the hospital room.

"Yes. I'll head over to the emergency room now!" His tone became awe-inspiring.

He hung up and turned to Zheng Ren, face stern and serious. "Mass poisoning in the city. 120 ambulances dispatched. Let's go."

"How many victims?" Zheng Ren asked.

"As of now, severe cases are in the dozens. We don't have the full numbers yet."

Dozens? This was truly a mass poisoning event.

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Chapter 43: Emergency Rescue!

Old Chief Physician Pan and Zheng Ren jogged in silence to the emergency department.

Once they arrived, Old Chief Physician Pan instructed the department to reject patients that had minor illnesses and to refer them to other hospitals.

He announced that a mass poisoning had happened and the general hospital was limiting their medical resources to only the critically ill. Most patients obeyed the orders and left on their own accord to seek medical attention elsewhere.

Some patients who were not in a rush stayed back to watch the drama unfold.

However, a small portion of patients started making a fuss. They had come all the way to the hospital only to be rejected? Weren't hospitals supposed to save the sick and dying? If they were not tending to the sick, who else was supposed to?

Old Chief Physician Pan gave the protesting uncles, ranting aunties, and raving hoodlums a cold stare. He did not dignify them with a response and headed off to manage the emergency department's clinical decision unit.

The patients who could be discharged were discharged, with the paperwork left for another day. The wards were cleared as much as possible to make room for the coming storm.

Five minutes later, the general hospital's administrative board arrived at the emergency department and got to work. A reshuffling of the rosters was done and more doctors and nurses were brought in to increase the emergency department's capacity.

After all, a big incident like this happened only once every few years. The emergency department did not require such capacity on an average day, and the timely reallocation of resources was expected for emergencies.

Seeing the arrival of the hospital administrative board, a middle-aged female patient ran up and clutched at the sleeves of the prominent Director Xiao.

A tantrum thrown by a middle-aged person was often frowned upon by the public and Director Xiao was no exception.

Seven minutes later, the nearby police force came to provide their assistance.

The national emblem shone under the light. People who were making a fuss quieted down.

Nine minutes later, the sirens of the ambulances could be heard from a distance. All the personnel were at their positions, ready for the battle.

Zheng Ren and the other nurses gathered at the emergency entrance to greet the ambulances. He was not obligated to be there but figured an early diagnosis could save a life.

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The ambulances arrived, tires screeching. Wisps of white smoke rose into the sky. There were tire marks where the ambulances pulled up in a hurry.

The stretcher that was pushed out made Zheng Ren stumble.

The patient's exposed skin was greyish blue, very much like an alien from the movie, 'Avatar'.

'This is a bad omen,' Zheng Ren thought. The patient was suffering nitrite poisoning.

Ever since he started training in the System, Zheng Ren's memory had improved by leaps and bounds.

Nitrite poisoning was a rare illness—mentioned in a few sentences in medical textbooks. Once he left medical school and entered the workforce, Zheng Ren had not seen a single case of it.

The few sentences from the textbook stood out in his memory, clear as day.

He concluded that this was a case of nitrite poisoning from the patient diagnosis in the right corner of his view. The patient was currently in a potentially fatal state of circulatory shock.

Zheng Ren grabbed onto the stretcher and started to dash.

Every second was critical in determining the patient's outcome.

"Nitrite poisoning! Prep the methylene blue and the potassium permanganate solution!" Zheng Ren ordered as he pushed the stretcher.

His voice echoed down the hospital corridor.

Little Zhao was hidden in an inconspicuous corner of the emergency department watching a livestream. When he heard Zheng Ren's voice and saw him pushing a stretcher down the corridor, his heart swelled with admiration.

Right now, this normal everyman who had no money, no house and no girlfriend was larger than life.

"Methylene blue, large volumes!" Zheng Ren instructed loudly as he passed Director Xiao.

He sounded like a director, his voice full of authority.

Director Xiao was momentarily surprised. In the background, that unreasonable middle-aged woman was still throwing a tantrum despite the police presence.

Zheng Ren let go of the stretcher and said, "IV line, 250 milliliters 10% glucose with 140 milligrams methylene blue. At the same time, flush the stomach with potassium permanganate."

The stretcher trolley left Zheng Ren's hands and the standby nurses at the emergency room took over expertly.

Zheng Ren walked up to Director Xiao and said seriously, "We need more methylene blue. Our usual stock in the emergency department won't be sufficient."

"You're bullying an old lady! I'm not done with you! This is an injustice!" The middle-aged woman grabbed at Director Xiao's collar and screamed like a maniac, ignoring the police officers by her side.

Without a word, Zheng Ren stepped up and flung the woman's arm aside.

He did so without restraint, and the annoying woman lost her footing and stumbled back into the crowd. Startled, she dropped onto the ground and started bawling, her two hands slapping the floor. "These doctors are trying to kill me! The police too!"

"Please take care of this. There will be more patients coming in." Like a king, Zheng Ren gave instructions to the police officers. Then, he turned to Director Xiao and said, "Our stock won't be enough and we need to ask the city council for help. If the city's stock is insufficient, we'll have to seek aid from neighboring districts."

With that, Zheng Ren turned and left, sparing no time to explain the situation.

Every second counted in the emergency room. Director Xiao's countenance was grim as he directed the chief of the medical administration division to stockpile all the methylene blue in the hospital. He did not bother to set his collar before calling up the city council.

Methylene blue, also known as methylthioninium chloride, was typically used for surgical markings. Hence, there was not a large supply of it in the hospital as demand was usually low.

The red blood cells of a healthy human or animal contained substances that could reverse the formation of methemoglobin such as vitamin C and glutathione.

If the concentration of nitrite ingested was enough to overwhelm the body's ability to equilibrate its oxidation, the person or animal would show symptoms of nitrite poisoning.

Methylene blue would be reduced to leucomethylene blue through catalysis by nicotinamide adenine dinucleotide. Leucomethylene blue could then reduce the heme group from methemoglobin to hemoglobin, regenerating the methylene blue. This reversible reaction allowed it to be reused.

This theory was not common knowledge to the emergency medical personnel on scene. Despite that, they were aware of the severity. Cyanosis, shallow breathing and low blood pressure; anyone with clinical experience would know the patient was already in a state of shock.

If they could not improve the patient's condition, the reduced blood perfusion would soon lead to a decrease in kidney function, cerebral edema and ultimately death.

After briefing Director Xiao, Zheng Ren went into the emergency room. At this moment, he never considered if the tone he took with the director would land him in trouble.

The patient laid on the emergency bed with his shirt cut open and thrown aside. His chest was peppered with countless patches connected to an electrocardiogram. Intricate but orderly cables transmitted electronic signals from the patient's body to the device which produced numbers and graphs.

Blood pressure 50/20, heart rate 40, oxygen saturation not detected!

Normally, such readings on a patient was a lost cause.

The matron was bent over setting up an intravenous line. Three jabs and none of them saw any blood flow. Cold sweat dripped from her forehead and drenched the sterile surgical cap in less than 20 seconds.

The patient's survival was dependent on the intravenous line.

The patient's blood pressure was at 50/20 with a weak pulse. Even the large veins like the jugular and the femoral vein were shrunken and difficult to locate among the muscle tissues.

"Allow me." Old Chief Physician Pan held a surgical kit. He removed the patient's pants and started to search for the femoral vein. A central venous line was a procedure done frequently back in the day but was rarely required now.

The situation was dire. Even after peeling open the skin and muscles of the inguinal area, the femoral vein might have become clear, transparent connective tissue that challenged a physician's eyes and experience.

Furthermore, this method was very slow. Zheng Ren could hear the sirens of the 120 ambulances within his mind.

Without hesitation, Zheng Ren entered the System and shouted, "I want to buy some intensive training time!"

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Chapter 44: Mission: A Buddha to All

The robotic female voice reverberated through space. However, it was not in response to Zheng Ren's shout. It was here to deliver a mission.

[Emergency Mission: A Buddha to All

[Mission Details: Rescue management of mass poisoning cases in the emergency department

[Mission Reward: 300 skill points, 1 silver chest, 30000 experience points for every 100 patients successfully rescued.

[Mission Duration: 1 day.]

The System was more generous this time around. Zheng Ren was dumbfounded by the mission. Its rewards were unbelievable. He did not know what the silver chest contained but the 300 skill points and 30000 experience points were enough to entice him.

However... Zheng Ren cursed. The System Shop had no central venous catheterization training.

'Are you f*cking kidding me?' Zheng Ren thought.

Every wasted minute, no, every wasted second could cost the patient's life.

Suddenly, the panicking Zheng Ren was blessed with an idea. Interventional surgeries usually started with an artery cannulation, right?

What he wanted to perform was a central venous catheterization, and while they were not the same procedure, the principles were similar.

Why not give it a try?

There was no time to debate the matter. Zheng Ren selected the interventional surgery training module and out came some options, the first of which was vein and artery cannulation.

Without a second thought, Zheng Ren selected it. He was no longer calculative, expending all 14076 of his experience points on intensive training time.

234.6 minutes; not even four hours. That was all the time Zheng Ren could afford.

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The System's operating theater rose from the ground. Zheng Ren entered without further delay. Taking a deep breath to calm himself, he started the intensive training.

...

...

Another patient was brought in from the ambulance, in just as severe a condition as the first patient—circulatory shock due to poisoning.

When the patient was pushed into the emergency room, Old Chief Physician Pan had just opened up the first patient's skin and was separating the subcutaneous tissue to find the semblance of a femoral vein.

"Venous catheterization kit, prepare for disinfection," Zheng Ren said in a scratchy voice, just waking up.

"Bring in a patient, stat!"

The patient was lifted onto the emergency bed as fast as possible and Zheng Ren got to work.

The patient was in supine position with their feet elevated 15 to 25 degrees above their head to increase venous pressure and blood flow.

This was to ensure venous pressure remained higher than atmospheric pressure, minimizing the risk of an air embolism during central venous catheterization.

Zheng Ren tore open the patient's top. His show of strength was nearly animalistic. He placed a 500ml water bottle between the patient's shoulder blades. As they were a tad underweight, Zheng Ren switched the water bottle out with a softer bottle of saline solution.

The aim of the bottle was to open up the chest area, allowing the shoulders to fall back and elevate the section between the clavicles. It would push the subclavian vein nearer to the clavicle and further away from the apex of the lung.

Then, Zheng Ren turned the patient's head to face him. This placement reduced the angle between the subclavian and jugular veins, making it easier to guide the catheter downward in the direction of the superior vena cava.

"Look here. Make sure the next patient is in the same position." Zheng Ren wanted to shout the words, but his sore throat made it impossible. The few nurses around him were his only audience.

"Yes!" the nurses replied.

The position was easy, the objective clear. It was not a difficult task.

Gloves went on his hand, a needle at the ready. Once the insertion point was located, Zheng Ren began the procedure.

He did not follow the textbook protocol of subclavian vein catheterization—puncturing one to two centimeters below the midshaft of the clavicle, with the needle angled horizontally and pointed in the direction of the sternoclavicular joint.

Instead, he chose the infraclavicular block as the insertion point, which was below the clavicle and lateral to the midclavicular line.

The nurses had seen subclavian vein insertions before, but the situations had not been as dire and the patients did not have such low blood pressure readings.

Had Zheng Ren lost his senses? Why did he pick the wrong insertion point?

In the midst of the chaos, they did not manage to warn him. Zheng Ren's hands were steady and quick, and the nurses could only watch as he pressed his left hand on the patient's chest.

He pressed down onto the skin with his left thumb until it was level with the costoclavicular ligament and marked the point, then removed his thumb and proceeded to puncture the skin there.

All this was curated from thousands of books' worth of literature regarding subclavian venipuncture and hands-on practice from the System's intensive training.

During training, all the simulation mannequins had been positioned in the correct way. At first, Zheng Ren completed the procedure in three minutes, which was a bit slow. Toward the end, he could finish with one simulation mannequin in under a minute.

He used 234.6 minutes in the System training to complete 452 venipunctures.

This number might have been lower than some doctors from the emergency departments and intensive care units of larger hospitals, but Zheng Ren had completed them in one go. All the simulations were high-difficulty patients with low blood pressure and low blood volume.

Challenges came with great rewards. Zheng Ren's phlebotomy skills could be considered among the best in the country.

No one would get the chance to perform hundreds over high-difficulty venipunctures. Only the System could provide such opportunities.

Blood flowed on the first attempt!

It was not standard procedure but the results were evident. The seasoned nurses around Zheng Ren were stunned.

This kind of high-difficulty venipuncture usually took at least five minutes. It involved multiple punctures and maneuvers to find the vein, seemingly dependent on luck. Five minutes to get into the vein was for experts.

Yet, how long did Chief Zheng take? Excluding the time it took to position the patient, it had been only two minutes. No, not even two minutes, one minute...or less. In the blink of an eye, venous blood was seen to flow out.

"Fix an IV line and administer the methylene blue." Zheng Ren held the catheter and raised his voice when he saw no one following up with the next step.

He could not shout as his throat was totally wrecked. The previous panic-induced a release of epinephrine and dopamine in his body, keeping him in an excitatory state.

"Oh! Oh! Oh!" The nurses around Zheng Ren woke from their stupor, took the venous catheter and connected it to the infusion tube.

"Maximum flow rate. Once the infusion is done, continue with the glucose solution. Then, perform a gastric lavage," Zheng Ren instructed.

"Yes!" replied the seasoned nurses in unison. They were from other departments but had been reassigned to face the emergency.

He allowed the nurses to administer the treatment and went to position the other patients.

Zheng Ren took the needle and thread from the catheterization kit and started to secure the subclavian vein catheter.

He moved without delay as if under an army general's command.

Once the stitches were done, he watched the glucose and methylene blue solution drip in the drip chamber. Only then was he reassured.

The next patient was already positioned for the procedure. Zheng Ren took off his gloves and rubbed his hands with an alcohol-based sanitizer. He opened the catheterization kit, put on a new pair of sterile gloves, and got to work.

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Chapter 45: Lightning Speed

Old Chief Physician Pan was in the zone, hands gripping the hemostatic forceps as he searched for the shriveled, pale vein.

Thinking back to the war, he was reminded of the many comrades who had suffered hemorrhagic shock. A femoral vein catheterization had been his bread and butter back in the day.

His eyesight was a bit blurry and he could not clearly make out the tissue structure beneath the skin. Perhaps it was old age catching up, but if he did not operate, who would? Youngsters these days very rarely had experience with such invasive methods. His familiarity was built on the lives of others. Where would these rash youngsters find that many patients with hemorrhagic shock to practice on?

Five minutes later, Old Chief Physician Pan finally found the femoral vein and successfully established a catheter access. A bottle of glucose and methylene blue solution was hung on the intravenous stand. He let out a long exhale as the liquid dripped.

Although he was slower than before, finding the femoral vein within five minutes—while not a perfect score—was a pass. He was satisfied with himself; he was still up to it.

Straightening his back, Old Chief Physician Pan could almost hear the cracking of his vertebrae.

One still had to accept his age. Old Chief Physician Pan gave a bitter smile and suddenly realized Zheng Ren was nowhere to be seen.

This chief resident that he wanted had put on a stellar performance, the current patient's diagnosis being one of many already.

Nitrite poisoning was something most people would go about their lives never witnessing. In his younger days, Old Chief Physician Pan had only come across one case and had had to flip through the books for the treatment. Unfortunately, the patient's illness was too severe and they passed away before methylene blue could be obtained.

The many surgeries before, plus this correct emergency diagnosis and treatment, was proof of Zheng Ren's abilities!

Where was he, though?

Old Chief Physician Pan looked around. What he saw made him gasp in surprise.

There were twelve beds lined behind him; seven or eight patients had been shifted into a special position. Some patients with central venous line access had been lifted onto stretcher trolleys and moved into the observation room.

Zheng Ren was hunched over, concentrating fully on central venous catheterization.

Old Chief Physician Pan sighed. Youngsters truly had quick eyes and deft hands.

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A moment passed and he realized Zheng Ren was not only quick, he was lightning fast.

Somewhere along the line, Xie Yiren had joined the fray. She quietly stood beside Zheng Ren and assisted him. Between opening the catheterization kit, disinfection, puncturing, stitching and stabilization...the whole process took around 30 seconds?

Old Chief Physician Pan thought he might even have overestimated the time.

As Zheng Ren was stitching and fastening the catheter, Xie Yiren was already preparing the next patient.

This was way too fast.

Other than Xie Yiren, Zheng Ren had about twenty medical personnel around him.

Some were moving patients from one of the 120 ambulances onto emergency beds.

Some were hastily preparing the glucose and methylene blue mixture solutions.

Some were attaching intravenous bottles to catheters and hanging them onto intravenous stands, their drip rate set to maximum.

Some followed Zheng Ren to secure the catheter with dressing once the stitching was complete.

Some delivered the patients that already had subclavian vein catheters to the observation room next door.

The whole operation was smooth and orderly like the flow of a river. In the time that Old Chief Physician Pan had taken to complete a femoral vein central venous access, Zheng Ren had accomplished more than ten subclavian vein catheterizations.

'Haih, I am old,' Old Chief Physician Pan thought to himself. He was a bit sad but grateful.

The future belonged to the young. He would contribute in whatever way he could.

"What is the stock level for methylene blue? And the central venous catheterization kits?" he asked.

"We're running out," the matron answered with dread in her voice. The sirens of the 120 ambulances melded into one. There were still the patients with minor poisoning or those who needed urgent medical attention but opted to come to the hospital in a private vehicle instead of waiting for an ambulance.

It was total chaos outside the emergency rescue room as more and more patients flocked to the hospital. Sea City General Hospital was the best medical care facility in the city. When something was not right with their family, the first thing most people would do was to bring them over to Sea City General Hospital for a check-up.

Even if the city responded swiftly with appropriate patient distribution, their control only extended over the ambulances. The patients in private vehicles all ended up in Sea City General Hospital.

Old Chief Physician Pan's eyebrows furrowed. What was happening here? Why had there been so many cases of nitrite poisoning?

He abandoned that train of thought. It was not something a doctor should concern themselves with. As medical personnel, he should be focusing on saving people.

Old Chief Physician Pan came up by Director Xiao's side. No words were exchanged, but the pair of weatherbeaten eyes shone with alertness. He stared directly at Director Xiao without any pretense.

Although the chief physician said nothing, Director Xiao understood the unspoken message.

The hospital still had a large supply of central venous catheterization kits, so those were not a problem. On the other hand, the whole hospital's stock of methylene blue had been exhausted, which meant that incoming patients would not be able to receive treatment.

Without treatment, the patients would simply be awaiting death in the hospital.

On the receiving end of Old Chief Physician Pan's knife-sharp glare, the already high-strung Director Xiao became furious. The glare read like a challenge to an argumentative man like him.

"Why are you looking at me? The hospital doesn't have enough stock. I've contacted the city!" Director Xiao roared in fury, as if expressing his displeasure at the situation and at himself.

The office director had never seen Director Xiao this angry. He nearly felt like going up to stop any fights from happening, but hesitated out of fear.

"You are the hospital director. Who the hell am I supposed to ask if not you?" Old Chief Physician Pan said. "If a patient dies, you're good as gone. I'll have you know that a lot of people are waiting for you to make a mistake."

The words were not said in anger or frustration, but as a cold reminder to Director Xiao of the truth. Even when swearing, Old Chief Physician Pan did not raise his voice, which made the reminder much more foreboding.

Based on what he said, Old Chief Physician Pan would not mind giving a nudge when push came to shove.

No one doubted the power behind Old Chief Physician Pan's nudge.

Unless the accident was ruled to be due to negligence, a director's position was untouchable. However, Director Xiao did not want much trouble. More importantly, he was a business director who came from the clinical field. All the commotion in the emergency rescue room rekindled the fiery passion in him.

Director Xiao went through a series of facial expressions. Then, he snatched the phone from the office director's hand and made a call. Once the call connected, he immediately shouted into the phone. "Methylene blue! I want all your stocks of methylene blue shipped to Sea City General Hospital!"

"I don't care about any problems that arise. If it doesn't reach us in ten minutes, I will hold a directors' meeting tomorrow and remove all your company's products from our shelves!"

High-handed and unreasonable.

During a critical time in the hospital, such tactics were a comfort to the people.

The uproar from patients and family members outside died down after hearing his call, as if a savage beast had been unleashed in the emergency rescue room.

Director Xiao made phone call after phone call.

There was no time to wait for the city council to arrange for supplies. According to standard procedure, it would take at least another 30 minutes to an hour to arrive when such a threat was at hand.

He could admit what Old Chief Physician Pan said was true. If a patient were to die, he would be in big trouble.

Rather than face this alone, Director Xiao was willing to rescind some lucrative deals; no one would come out of this unscathed.

Zheng Ren was in the eye of the tornado, wordlessly performing central venous catheterizations. Regardless of the patient's age or gender, he took a solid 25 seconds for each of them.

After each completion, a glucose bottle was hung above and methylene blue flowed like a mini waterfall into the patient's subclavian vein. The solution would circulate peripherally and then into the liver where it would take part in the metabolism process to remove the nitrite.

The hospital stock of methylene blue was diminishing. As the last bottle was opened and mixed with 10% glucose solution by a nurse, a Wuling SUV appeared in front of the emergency entrance.

The vehicle seemed to be in much more of a rush than the ambulances. One could almost see sparks erupting from the vehicle's sudden stop.

A middle-aged man with a beer belly came down from the car wearing a suit. He carried a box of methylene blue and hurried into the emergency department.

"Director Xiao, eight minutes!" The pale-faced man deposited the box on the floor. His breathing was loud and labored like a pair of bellows. He seemed incredibly tired.

Director Xiao's expression changed for the better when he saw the arrival of the methylene blue. He said to the man, "Inform the Health Department and ask about the situation in the city. Take the initiative."

Then, he went to monitor the patients with Old Chief Physician Pan and relocated patients who were responding well to treatment to other wards.

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Chapter 46: Unboxing Rewards

246 subclavian vein catheterizations. It took three hours in total including preparation time.

In the emergency department, all medical personnel had forgotten the passage of time and were solely focused on the lives that required saving.

They were all doing their best.

Zheng Ren completed another central venous catheterization and looked up. The emergency bed opposite him was empty. That was the last nitrite poisoning patient.

It was over? Really?

Zheng Ren was a bit surprised.

Repeating a procedure for such a long time was bound to paralyze a doctor, especially someone like Zheng Ren who had exchanged all his experience points for surgical training time in the System and practised a few hundred venipunctures. After that, he had performed two hundred more catheterizations in the emergency room. Although a catheterization was not comparable to an actual surgery, the sheer number of them was enough to make Zheng Ren feel tired.

Zheng Ren turned and asked, "Any more patients?"

"I'll ask." Xie Yiren had also noted the lack of patients and walked out to inquire, a spring in her step.

Watching Xie Yiren's retreating figure, Zheng Ren noticed the alterations made to her lab coat. The waist was pinched and showed off her perfect curves in each movement.

It was unlike the others, whose lab coats made them look shapeless and unflattering.

In a flash, Xie Yiren was back. Her mask was removed to reveal a flushed face. She spoke excitedly from the door, "Chief Zheng, there are no more patients. Old Chief Physician Pan said he would handle the hospital admissions and that you should stay put."

"Okay," Zheng Ren mumbled a reply.

Once the end was confirmed, fatigue flooded his body.

During the rescue, Zheng Ren had operated single-mindedly to save all the patients' lives.

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His lethargy, hunger and basic human needs had been overshadowed by the epinephrine and dopamine released in his body. He had been unaware of his body's needs.

Zheng Ren had not even kept track of the mission given to him by the System.

What was the mission again? Zheng Ren could not recall. Faced with the 'Avatar'-like patients that kept coming in, he had no time to think about the experience points he would gain.

There were only subclavian vein catheterizations, methylene blue infusions and nitrite poisoning on his mind.

Ambulance sirens and the desperate cries of families filled his ears.

The end. It was finally the end.

Zheng Ren walked to the door and the world suddenly started to spin. His vision went blurry and he knocked into Xie Yiren.

"Ah!" Xie Yiren pushed Zheng Ren away. A loud bang echoed as his head crashed into the door. His boneless body collapsed onto the floor.

Seeing Zheng Ren on the floor, Xie Yiren was stunned. A moment passed and she called out. "Help!"

That was the most-repeated word in the emergency department today, especially this afternoon.

All the patients with nitrite poisoning were already receiving treatment, so who was yelling for help? Did a patient suddenly take a turn for the worse?

A few doctors and nurses put down their non-urgent work and came to check on the situation.

They were surprised to find Xie Yiren shouting. "Little Xie, what's wrong?"

"Chief Zheng fainted!" Xie Yiren was still stunned and did not know what to do.

Did she cause it? Maybe... He was the one who fell into her... This pervert!

He was not injured, right? What if he hurt his brain?

Xie Yiren's mind was filled with images of trepanation and drainage for intracranial hemorrhage.

A few medical personnel hurried to help Zheng Ren up.

Zheng Ren was sweating profusely. The people who helped him up had wet hands after.

"Move him to the bed!" a doctor said.

Zheng Ren only fainted for a moment. He was half-awake now.

He could feel the changes in his body. Mustering all his strength, he spoke, "Help me sit, don't move me. 20 milliliters of glucose, injected, then another bottle of 10% glucose."

He was weak, lightheaded, sweating, and there was ringing in his ears—the symptoms of low blood sugar. Zheng Ren only realized now that he had not eaten for almost 24 hours.

The last proper meal he had was supper with Xie Yiren, the crayfish.

That seemed like a long time ago.

Hearing Zheng Ren's medical instructions, everyone's panic abated as they figured it was likely hypoglycemia.

Soon, a large syringe of syrupy 50% glucose solution was injected into Zheng Ren's veins as he leaned against the wall. Sitting on the floor, he gulped down the 10% glucose solution.

Sweat dripped down from Zheng Ren's hair. Some family members of patients were heartbroken to see him. They wanted to ask after him and maybe send him some food, but Zheng Ren's pallid complexion made them hesitant.

A human's heart was made of muscles. If these were the people who usually wrote nasty online posts about doctors without ethics, even their hearts would be wrung upon seeing the doctor who fought tooth and nail for each patient collapse from exhaustion.

A phrase appeared in their hearts: what a great doctor!

A few minutes passed and the symptoms of hypoglycemia abated. Zheng Ren felt revived.

Although he had little interest in food, he had to at least consume something at regular intervals.

The previous night of appendectomies had exhausted him. After today's endoscopic transrectal appendectomy, he had gone home and taken a small nap before coming in again to check on his patients.

He had totally forgotten to eat.

Tsk... He had to pay more attention next time.

The emergency department corridor was filled with hospital beds. Zheng Ren felt sincerely happy and giddy at the sight of the bluish tint gradually fading from the patients' skins.

This was perhaps the happiest moment for doctors and nurses.

Wait, the System had given him a mission with a pretty substantial reward. The thought slowly crept into his mind.

Zheng Ren took a big gulp of the glucose solution in his hand. The syrupy glucose entered his oral cavity and into his esophagus, all the way down to his stomach. He could feel his energy restored as the gastric mucosa[1] rapidly absorbed it.

He lowered his head and feigned resting to enter the System.

Sweat splattered from his lowered head like raindrops from a cloud hanging above.

[Emergency Mission: A Buddha to All, completed.]

The cold, robotic female voice of the System rang out as soon as Zheng Ren arrived.

[Completed a total of 246 subclavian vein catheterizations, zero failures.Total rewards are 750 skills points, three silver chests, and 75000 experience points.]

Jackpot!

That was Zheng Ren's first thought.

During the emergency, he had no time to think about the mission. Now that the crisis was over and he could reap the rewards, his happiness was only natural.

His general surgery skills set was originally at 1360. After the intensive training for cholecystectomy and venipunctures, plus the 246 subclavian vein catheterizations, it had risen to 1690.

A subclavian vein catheterization was a normal procedure without much complexity, and therefore the resultant increase in skill points was limited.

It was likely that most of the points came from the cholecystectomy training.

He still had 180 skill points saved. Including the skill point reward from this emergency mission, he now had 930 skill points at his disposal.

Based on his skill level in other types of surgeries, whatever skill tree he chose would instantly elevate him to the rank of Graduate.

The rank of a deputy senior chief surgeon was in his grasp. It felt really good. Zheng Ren figured he should give some thought to whichever specialty to invest points in.

After all, he was a miser who would split even a dollar.

The emergency rescue was an outlier. It was normal for humans to be impulsive.

These skill points and experience points were his just rewards. Floating before Zheng Ren, there were also three shiny, silver chests.

Zheng Ren did not play games and had thus never spent money for in-game treasure chests. Who knew that the System would contribute to his collection of life experiences?

As he was not a gamer, let alone a paying one, Zheng Ren had no basic knowledge of draw rates. He knew nothing about the generosity and harshness of Lady Luck[2].

His heart fluttered with intentions as all three silver chests opened.

The light was radiant!

[1] Glucose absorption occurs in the duodenum onward. Author may have mistaken their scientific facts.

[2] In some chinese online games, 欧皇 (European King) and 非酋 (African Chieftain) are used to call lucky and unlucky players respectively.

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Chapter 47: A Drop of Water in Need Shall Be Returned with a Spring in Deed

The radiant light subsided and Zheng Ren saw three books before him.

They were identical to each other.

The System was being lazy. There were no surprises as the silver chests held the same thing.

Zheng Ren did not consider this the short end of the stick. Perhaps if he had a bit more luck, he could have obtained a much better reward.

The three books were skill books that could raise any skill tree to the Graduate rank.

If he were to calculate their value, each of them was worth approximately 1000 skill points.

Zheng Ren was a bit disappointed. He would rather have had 3000 skill points. In addition to the 930 skill points he had saved, he would have been able to reach the general surgery Master rank.

He did some calculations and decided to store the three skill books away for another time.

Zheng Ren was still slightly traumatized by the System's death threat. He wanted to be equipped for the unforeseeable future.

A backup was necessary.

Much like the venipuncture skill set, if Zheng Ren had not had a few thousand experience points in reserve to purchase intensive training, he would not have been able to save so many patients.

He was not unintelligent. Back when he was in the orphanage, he read the many books donated by kind people from all over the world. After school, he would work multiple odd jobs to earn a living and still managed to get into the country's top medical school.

When it came to his postgraduate research, any supervisor who was not blind had been willing to take him.

Zheng Ren was gradually picking up on the System's behavior. Every mission given to him would beget patients of corresponding illnesses that required his attention.

In a way, the System had some minor predictive powers.

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Then... Should he take up interventional surgery? Zheng Ren pondered. The thought of putting on a lead apron to have a go at interventional surgery crept into his mind.

It was just a thought. For now, Zheng Ren had yet to turn it into action.

The experience points in the System were precious. 75000 experience points would buy him less than 21 hours of intensive surgical training.

For a completely unfamiliar surgical procedure, 20 hours was good for nothing.

This was different from when the System gave him 20 days worth of intensive training. Back then, there had been some distortion within the System's time and space, as if the surroundings would crack at any second.

Zheng Ren had a feeling the System was in danger then, which was why he had been given 20 days of intensive training. It was an act of desperation on the System's part.

Now, Zheng Ren would slowly save up his training time.

His biggest problem now was not improving his surgical skills, but getting some solid rest time. He was already suffering hypoglycemia.

Zheng Ren did not want to end up in a funeral house tomorrow, watching the detestable hospital administrative board deliver an insincere eulogy for him.

Inside the System space, he was able to recover mentally, but his physical body was lagging behind.

There was no new mission from the System but the space seemed to be altering. At some point, Zheng Ren sensed danger approaching and within a heartbeat, returned to the real world.

...

...

"That's him! That son of a b*tch hit my mother!" A loud cry sounded nearby.

"It's him! He was the one who trampled me! A doctor, no less! More like a piece of sh*t!" A middle-aged lady pointed at Zheng Ren and spat angrily. The lady who had grabbed at Director Xiao's neck was back in the hospital with renewed vigor.

She ignored the fact that Zheng Ren had not actually trampled her.

Zheng Ren's blood sugar was returning to normal. His body was clammy with a film of sweat slowly drying on his back.

Zheng Ren lifted his head and saw a giant figure looming above him. An exposed neck and arms were covered in tattoos of a dragon motif. A heavy chain, thick as a finger, hung on the heavyset man's neck. There were others with him.

The corridor was filled with anxious patients and families. They carefully gave way to the fierce-looking man.

There were few who dared to stand up to someone like him.

As the rescue work had already ended, the police force tasked to maintain order had left.

Hearing the loud voices, two hospital security guards peeked out from the security room.

"F*ck you!" the heavyset man swore. His eyes were narrowed as rage bubbled in him.

The guards had an amused look on their face. Without a second thought, the security room door was shut.

The loud bang serenaded the tense situation and Zheng Ren's trepidation.

Zheng Ren felt helpless. Such incidents were all too common in the hospital.

The security guards were contract laborers dressed in security uniforms. If a fight did break out, they would not dare get involved. If someone got hurt, they would be fired without question. The hospital would then provide compensation and apologize to the injured party.

Zheng Ren did not blame the security guards for turning a blind eye. They were just working-class men trying to get by.

Now, how would he deal with this situation?

He guessed he would have to take a beating.

Every day, there were cases of medical personnel being assaulted nationwide. Xiang Ya Second Hospital was the most gutsy hospital when it came to the matter, but what happened in the end? The whole situation was chilling.

Facing this mountain of a man, a thought crossed his mind. If he was injured, would he be able to perform surgery on himself under local anesthesia?

Although he was afraid, he did not show it.

He knew it would not help his case.

He was going to get a beating regardless, so why make the effort to beg for mercy?

Zheng Ren silently got up from the floor. He shook his shoulders and neck.

A few trembling doctors and nurses wanted to defuse the situation but were overwhelmed by the heavyset man's aura. They were civilized people who had never been in a fight before, and were all bark and no bite.

"Oh? The little man wants to give it a go?" The heavyset man grinned. He clenched his giant fists. From a few feet away, Zheng Ren could hear his knuckles cracking.

Zheng Ren was not ready to fight back. He had no knowledge of close-quarter combat, so what were his chances?

He was only loosening up his muscles so that he could recover faster after the beating.

Silence enveloped the hospital corridor as everyone looked at each other quietly.

"What are you doing?" Xie Yiren burst into the room and ran to Zheng Ren, arms raised to protect him with her body.

A bitter smile formed on Zheng Ren's face. Xie Yiren's small and slender figure was nice to look at but it was useless in a fight. One punch would break her bones.

He covered her mouth with his hand and pulled her back so that she was behind him. He had accepted his fate. He could only hope that this little lady did not get involved.

The heavyset man was pleased with the terror he invoked in people. Like a cat that had cornered a mouse, he grinned cruelly at Zheng Ren. "You're quite a brave one. Wanna fight me?"

Zheng Ren smiled sardonically. It would be a joke to try to talk sense to this man.

This was the difference between the educated and the uneducated.

Zheng Ren tried to recall the self-defense techniques done by the man in the emergency operating theater before.

He realized that he was not capable of replicating them. That man must have been in many fights to be able to move so fluidly.

Luckily, Old Chief Physician Pan had gone to find more hospital beds. With his temper, he would probably have volunteered to join in the fight with Zheng Ren.

Zheng Ren was a young man and could take a beating. Old Chief Physician Pan was the opposite; a fracture could mean very bad things.

Zheng Ren hunched his body and guarded Xie Yiren in a corner. His hands were around his ears. The stance was incredibly awkward.

"Young man, this doctor is a lifesaving buddha," an old man murmured from one of the hospital beds in the emergency department corridor.

His quiet voice traveled through the soundless corridor. Many heard his words.

His symptoms of nitrite poisoning were mild, likely due to reduced food intake typical of the elderly.

After the administration of intravenous methylene blue, the blue tint had faded from his skin and he was on the path to recovery.

"Dad, stop talking," a 40-year-old man whispered into the old man's ear while giving the heavyset man a placating smile.

"Coward!" The old man slapped his son across the face in a fit of anger. "Was this how I brought you up?"

This time, the old man's voice was louder. Two bulging veins appeared on his head.

There was not much strength in him. His voice, though raised, was still soft.

However, the slap was a wakeup call for everyone present. The atmosphere in the hospital corridor was momentarily charged.

The slap had shaken the middle-aged man. "Dad, control your emotions. Watch out for your blood pressure." If his father lost his temper and suffered a brain aneurysm, there would be even more trouble.

"A drop of water in need should be returned with a spring in deed!" The old man struggled to get up from the bed. "This doctor has spent all his energy saving people and you're all just going to sit there and watch him get beaten up? Go away! Don't hold me, I don't have a son like you!"

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Chapter 48: Doctor, Thank You

The middle-aged man, who was well-mannered and slightly plump, turned red after being scolded and slapped by his father.

The patients may not have known what had happened when they arrived at the hospital, but more than a hundred family members on the scene witnessed everything through the open door of the resuscitation room.

Most of them had no idea why Zheng Ren had provoked the unreasonable old woman, but none of them were fools. They could vaguely guess the reason behind that incident.

The slap had landed on the face of the elderly man's son, but many onlookers on the scene could feel the heat burning in their cheeks as well.

The sight of the old man struggling to get up off the bed and refusing to heed his son's advice sent needles into every onlooker's heart.

It caused pain rather than numbness.

"Don't you have any shame coming here?" A lady in her thirties stood up and pointed angrily at the arrogant elderly woman by the huge man—the Black Tower. "Aren't you sick? Didn't you say you were dying? How are you still alive and kicking? Are you having terminal lucidity? Hurry home and buy yourself a coffin. It would have to be very thick just to contain your attitude."

"You—" The harsh words confused her. Before she could retaliate, the middle-aged woman walked to the middle of the corridor, placed her hands on her waist and criticized loudly, "My family member was the first to reach here and he was nearly dead at the time. You weren't even sick and yet you're constantly creating a f*cking mess!"

"That's right. I saw her hitting the police officer too."

"Yes, she said she was dying and even grabbed the director's collar. If Doctor Zheng hadn't shoved her aside then, the antidote wouldn't have arrived on time and the patients could have died."

"It wouldn't just have been one or two casualties if that happened."

Every family member had the same thought on their minds.

All patients had had skin with blue-gray discoloration when they arrived at the hospital. Moreover, the disease had been so quick that perfectly healthy men had turned blue and collapsed in moments, skirting the line between life and death. It had been an unbearable sight for everyone.

It was clear to everyone that the resuscitation process had been done without delay in the hospital and the patients' conditions had gradually improved.

After someone took the lead in retaliating against these interlopers, a second stepped up...

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A third...

Then the fourth...

More and more people joined the crowd.

A larger crowd boosted the courage and intensified the guilt of those who did not dare stand against the Black Tower earlier.

Like a fire burning deep within their souls, it made them uncomfortable.

The elderly man was right—doctors were lifesaving buddhas, and that troublesome elderly lady... was simply an imp.

The uproar was continuous and unrelenting. Nobody knew when the verbal assault turned physical, but someone suddenly threw a water bottle at the Black Tower and his lackeys.

This was immediately followed by even more bottles raining down on the group of troublemakers.

Black Tower, whose face had turned purple after realizing that he had incurred the wrath of the public, pointed at the crowd and tried to restore his image by arguing with them, but what could he do when he was constantly pelted by bottles? Left with no choice, he buried his head under his arms and escaped the hospital.

The doctors and nurses around Zheng Ren started persuading everyone to calm down and prioritize recuperation once the troublemakers had fled the scene.

"Doctor Zheng, thank you." A family member walked toward Zheng Ren and bowed deeply.

"That's too kind of you. It's my responsibility anyway," replied Zheng Ren with a silly smile.

Xie Yiren poked her head out and stared at the scene curiously.

Other family members expressed their appreciation to Zheng Ren one after another.

These honest people may flinch and yield to evil forces, but this did not mean that they did not understand the principle of justice. The majority of them may have preferred to deal with it in silence, but no one would retreat if an opportunity arose.

The commotion went on for some time and Zheng Ren, exhausted, finally finished receiving thanks from almost all the family members.

This scene... made Zheng Ren feel like they were paying their respects to the deceased at a funeral... and of course, he was the aforementioned corpse.

"Where is Xie Yiren?" asked Zheng Ren upon turning around and noticing that she was missing.

"She said she was going to buy food for you," replied a physician as he hurried back to document some medical records.

It was one thing to rescue patients in the emergency department, but it was another to complete lots of annoying and draining paperwork after that.

Oh, Xie Yiren was much better in terms of intimacy and care toward people.

'I accidentally ran into her just now. Do I need to apologize to her?' This thought lingered in Zheng Ren's mind for some time.

As a single-minded and insensible man, it was not unusual that he did not understand what had transpired then.

After the ward and hallway became quiet, Zheng Ren decided to forget about it and go for a ward round instead.

When he visited the ward, there were still approximately a hundred patients left in the emergency department. The observation unit in the emergency department had been fully occupied and even the corridor was full of extra beds.

No one informed him that the addition of hospital beds was currently prohibited in Class Three Grade A Hospitals.

The patients' conditions were stable and their 'Avatar'-like bluish-gray skin had slowly regained their original yellowish color, which had a particularly dramatic visual impact.

Zheng Ren's mind was at ease as long as the patients' conditions had stabilized. He then instructed the doctors on duty to inform him immediately if there were any changes in the patients' conditions.

His clammy skin, which was due to diaphoresis secondary to hypoglycemia, felt extremely uncomfortable.

After giving it some thought, Zheng Ren called the anesthesiology department and informed them he was going for a shower if the situation did not require his attention. Unexpectedly, the anesthesiologist was particularly enthusiastic in his agreement. Zheng Ren then hung up and went straight to the operating theater.

The change in the anesthesiologist's attitude compared to before was presumably due to his overwhelming admiration for Zheng Ren performing dozens of surgeries consecutively.

Other departments did not offer showers; the operating theater was the only place that had such a high-end arrangement, which was why anesthesiologists would feel particularly annoyed at doctors who came to take a shower for no reason whatsoever. Zheng Ren had initially planned to politely discuss this issue but failed to anticipate the anesthesiologist's enthusiasm.

Even though the conspiracies and deception of the outside world were also common in the hospital, highly-skilled medical personnel tended to get special privileges. That was beyond question.

Zheng Ren felt comfortable and refreshed after taking a shower. The anesthesiologist then handed him a Yuxi[1] and they started taking a puff in a small smoking area.

Smoking was prohibited in the hospital, but there were just too many chain smokers in the medical field.

The anesthesiology department had converted a small storage room with a window into a smoking area. That way, smoking addictions could be fed and second-hand smoke could be prevented from lingering in the hallway.

"Chief Zheng, when did you become so proficient?" The anesthesiologist expressed his admiration. "Those who worked overtime last night idolized you despite their exhaustion."

Zheng Ren responded with a sheepish grin.

"Dozens of appendectomies in one night; that was awesome." The anesthesiologist smiled. "Let me tell you something, beware of Chief Surgeon Liu. He is definitely not a good guy."

"Alright, noted."

"I've been working for almost thirty years and I'm in my fifties now. What haven't I experienced so far?" the anesthesiologist said earnestly and sincerely, "A postgraduate student from Union Medical College Hospital came to our hospital ten years ago. Three years after that, Chief Surgeon Liu seized a medical dispute that wasn't even related to him and persuaded the patient's family members to make matters worse. As a result, the student was sent to the suburbs to raise rabbits."

Sea City General Hospital had a long history. During the Great Famine, a piece of land in the suburbs had been requested by the city to serve as a farm to help sustain itself. After the Chinese economic reform[2, living conditions improved and the crops produced continued to feed medical staff at Sea City General Hospital.

However, the farm had been sold to a real estate agent a long time ago and converted to a series of high-rise buildings since.

This was what Zheng Ren had heard on the grapevine, anyway.

"Mistakes are inevitable in the medical profession, right? Even with those, someone will be there to trouble you at all times." The anesthesiologist continued giving Zheng Ren advice and experience. "From nothing to something, and a small issue to a huge matter."

Zheng Ren nodded vigorously as he felt the same way too.

"Follow Old Chief Physician Pan closely. He is a great god," the experienced anesthesiologist concluded.

These sorts of heartfelt words would usually be vague and indirect. The anesthesiologist on duty today had given a lot of advice, a hearty talk despite their unfamiliarity, and Zheng Ren was grateful for him.

Then, his cell phone rang; it was Old Chief Physician Pan.

Zheng Ren picked up the phone quickly and pointed at it to signal that he had to leave.

The anesthesiologist felt slightly regretful because he had not yet managed to ask about the nitrite poisoning incident. However, it was probably unwise to stop Zheng Ren who was likely exhausted after the intense rescue operation. After they bid farewell to each other, Zheng Ren left the operating theater and answered the call.

"Little Zheng, someone is looking for you," said Old Chief Physician Pan.

[1] 玉溪, a cigarette brand in China.

[2] Known in the West as the Opening of China.

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Chapter 49: Vicissitudes of Life

Zheng Ren hurried back to the emergency department and saw Old Chief Physician Pan chatting with someone in the hall. They seemed very happy and laughed heartily from time to time.

That person looked familiar, but who was it?

It was practically impossible for Zheng Ren, who had late-stage face blindness cancer, to remember anyone unless he met that person every day.

This was a fact even if he had an IQ of over 150 or a photographic memory.

It was undoubtedly a SS difficulty rank to ask someone with face blindness to posthumously identify a stranger with whom he had met only a few times.

"Chief Physician Pan, I've returned," said Zheng Ren as he approached them.

"Old San was looking for you and said that he wanted to thank you, so get off work, have your dinner and rest up at home," replied Old Chief Physician Pan.

Zheng Ren finally got a clearer look at the visitor and Old Chief Physician Pan's words reminded him of the man's identity. He was the butler of the richest man in Sea City—Elder San.

Why would Chief Physician Pan address Elder San as Old San? Zheng Ren could not figure out their relationship.

"Elder San, we meet again." The corners of Zheng Ren's lips curled up gently and elegantly.

"Doctor Zheng, you've done extraordinary work despite your young age. Very impressive indeed," Elder San complimented.

"Let's not stand on ceremony here." Old Chief Physician Pan waved his hand and stopped their small talk authoritatively. "The hallway is full of hospital beds, so I'm not going to invite both of you to my office. I heard Zheng Ren was unconscious due to hypoglycemia just now. Old San, take him to dinner quickly. I'm warning you, if anyone dares to force him to drink, I'll trouble you tomorrow."

Elder San smiled and waved his hand to assure Old Chief Physician Pan that this would not happen.

"Chief Physician Pan, how about the patients..." Zheng Ren was worried about any unforeseen event that could happen to the hundreds of patients with nitrite poisoning.

That was usually the case for anyone working in the medical field. Even the most skilled doctors could not prevent an accident from happening.

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They were saved, but who could guarantee that there would not be any liver or kidney failure? Who could ensure that the profound circulatory shock secondary to nitrite poisoning would not cause any complications?

"Do you think that the hospital will stop operating in your absence?" Despite the rebuke, Old Chief Physician Pan's gaze was full of kindness as if he was staring at his youngest and most beloved son. "I permit you to shut down and sleep tonight. I won't look for you even if the sky collapses."

Zheng Ren nodded in response.

Every doctor—be they junior doctor, experienced senior attending doctor, and those who did not have the luxury to return home such as chief residents, deputy chief consultants and senior consultants—would have their cell phones on all the time.

If their phone rang in the middle of the night and the call was from the hospital, their adrenaline would soar immediately before the call was even answered. Having a lie-in and waking up on the wrong side of the bed were atypical of them.

It was just like how Sea City General Hospital mobilized every single person it could to join the huge rescue operation today. Hundreds of patients were waiting to be saved, and a lot of medical staff had to work together to achieve that goal.

If they were relying on Zheng Ren alone... Most of the patients would have gone cold.

Zheng Ren smiled and nodded.

"Doctor Zheng, this way, please." Elder San's words and mannerisms were tailor-made to make others comfortable and warm.

After bidding farewell to Old Chief Physician Pan, Zheng Ren and Elder San left the emergency department.

There was a black limousine parked in front at the main entrance. However, Zheng Ren had not studied luxury vehicles before, so its manufacturer and degree of grandeur remained a mystery to him.

An honest-looking chauffeur in a suit and bow tie opened the car door and invited them into the car with a slight bow.

Zheng Ren noticed that the doors were hinged at the rear and opened outwards in opposite directions, unlike ordinary family cars or SUVs that had conventional doors which opened in the same direction.

After Zheng Ren entered the car and spoke with Elder San for a while, an overwhelming fatigue consumed his body.

The human body was not made of steel after all.

His body had automatically secreted adrenaline during the resuscitation process, which made him forget his exhaustion and hunger, but all of them came back with greater intensity once everything had been resolved. The only thing Zheng Ren wanted to do right now was to lie in bed and get a good night's sleep.

Even a luxury vehicle could not escape traffic congestion when night fell.

Almost half an hour later, the black limousine finally reached the entrance of an simple, plain-looking and small courtyard.

There was a black, sumptuous signboard on the lintel with four quaint and unsophisticated words written on it—Red Clay Small Pavilion.

Two servants at the entrance opened the car door and escorted both Zheng Ren and Elder San into the courtyard in silence.

The soft susurration of a stream flowed through a rock garden of a small courtyard, creating an illusion of a corner of paradise in the bustling city.

However, Zheng Ren showed no interest in these unique designs as he lacked a single artistic cell in his body.

What a joke. Those who could afford these splendid decorations had no financial difficulty, but Zheng Ren had endured countless hardships just to survive. How could he possibly have the luxury to appreciate these impractical items?

A lady in a red trench coat and sporting black shoulder-length hair welcomed them as they entered the courtyard.

"Doctor Zheng, it's nice to finally meet you," the lady... or perhaps the girl greeted politely.

Her pastel-white skin glistened as if she was a fairy carved from solid, pure jade. She was stunningly gorgeous.

She had lovely eyebrows and beautiful hair that danced with the wind. Her eyes shone brightly like dazzling stars as though her gaze held the power to see through Zheng Ren's heart.

Zheng Ren actually found it difficult to estimate her age.

Judging by the open-mindedness and a good sense of judgment in her gestures, she was perhaps in her late thirties or early forties, as those were the temperaments of a successful career woman who had been working for more than ten years.

However, from her eyes and brows that had a slight hint of youth, she appeared to only be in her twenties.

Zheng Ren was momentarily stunned. Smiling gently, he walked forward and extended his hand.

Her cold fingers brushed lightly against Zheng Ren's palm like a dragonfly skimming the surface of the water. It gave him the impression that she was unconcerned with material values or ordinary life.

"I'm Bu Li, Bu Yunge's daughter. Doctor Zheng, this way, please." The woman called Bu Li courteously gestured to invite Zheng Ren into the house.

He was able to recall the identity of Sea CIty's richest man with the surname Bu. Moreover, Bu Yunge had had at least ten multidisciplinary consultations before his surgery, so it was natural that his name was still fresh in Zheng Ren's memory.

However, he felt the name Bu Li sounded strikingly old-fashioned for Bu Yunge's daughter.

After they entered the house and sat down, some chefs with white toques so tall they almost touched the ceiling brought cooking utensils to the dining table and started cooking various delectable dishes on the spot.

Zheng Ren had never seen such a scene before, but he was not interested in or impressed by the spectacular view.

In his opinion, they were just escargots and undercooked steaks.

Zheng Ren's calmness piqued Elder San's curiosity. The atmosphere was lively, especially as the various anecdotes he shared whetted Zheng Ren's interest as well.

Bu Li would join the conversation from time to time and comment on the dishes or national goings-on. Although she was not very chatty, her words enriched Elder San's jokes and stories.

Zheng Ren's appetite was not satisfied as the food tasted bland and the steak was undercooked, which made him miss the food skewer stall in front of his house.

If he could simply indulge in some barbequed meat and a cold bottle of cola, he would be content.

The lethargy on Zheng Ren's expression was getting worse. Elder San and Bu Li, both smart and savvy, met each other's gaze before Bu Li said, "Doctor Zheng, regarding my father's surgery, I would like to thank you for doing the right thing."

"You're welcome. That's what doctors are supposed to do," replied Zheng Ren with a smile.

"There's no such thing as supposed. If my understanding is correct, you had to take the fall no matter how well your performance was." Bu Li understood the trouble Zheng Ren had faced.

All worldly affairs were similar.

Zheng Ren kept quiet and smiled.

"It was actually a blessing in disguise. Doctor Zheng, Old Pan actually thinks highly of you after you were transferred to the emergency department. You have a promising future ahead of you," replied Elder San.

"Haha, I'm used to it by now." Zheng Ren then added calmly, "You'll meet all kinds of people in the hospital, so you'll learn to take everything easily after a while.

"For example, the caregivers for most vegetative patients are usually their mothers.

"Spouses normally prefer to give up on treatment.

"The child who cares for their parents was not the most favored one at home.

"If any woman comes for treatment of ectopic pregnancy, you have to first catch the man who sent her to the hospital and not let him escape. Otherwise, no one will pay for her medical expenses."

Zheng Ren's voice was calm and dull as if he was an elderly man who had understood the world thoroughly, sitting alone in front of the fireplace with a blanket on his knees and recalling the past while cold wind rampaged outside the house.

The vicissitudes of life turned the atmosphere gloomy there and then.

Elder San nodded as he had already experienced these matters.

Bu Li's gaze was dull as she replied, "Doctor Zheng understands worldly affairs well. Every family has its own issues, but they're similar to the problems frequently encountered in society. That's just not worth it."

After letting out a heavy sigh, she smiled warmly and lifted the gloomy mood as if spring had fallen. "Let's not discuss this any further. Doctor Zheng, I've something that requires your assistance."

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Chapter 50: Suspected Nasal NK/T Cell Lymphoma

"Please, go ahead," replied Zheng Ren.

In order to ease future consultations with the doctor, the patient's family members would normally try to promote a friendly relationship first by inviting him over for a meal.

However, the richest man in Sea City should not worry about such an issue at all. Zheng Ren had a vague feeling that it was going to be another troublesome case.

"Thank you for your trouble, Doctor Zheng." Bu Li clapped her hands and a female assistant entered the room with a stack of radiographic films in her hand.

"These are my brother's films," explained Bu Li.

Zheng Ren noticed some hidden annoyance in Bu Li's eyebrows when she mentioned her brother.

"I'm sorry, Doctor Zheng. He is my half-brother," explained Bu Li as she keenly perceived the thought on Zheng Ren's mind and added, "He has been suffering nasal ulceration for half a year and there hasn't been any improvement despite various treatment plans."

'Hey, he should go to the otorhinolaryngology department. I'm just a general surgeon,' Zheng Ren complained silently and continued listening to her story.

"The first-class experts in this country suspected he had nasal NK/T cell lymphoma, but the results after three pathological tissue biopsies showed that it was just simple inflammation. My father was worried and distressed about this issue. Then, he was found to have pancreatic cancer," said Bu Li.

Zheng Ren had already detected countless grudges and resentments within Sea City's richest family from Bu Li's story, but these were none of his concern.

This sort of gossip was life-threatening and Zheng Ren would like to stay as far away as possible from them.

He picked up the thick stack of films, trying to read them facing a light source. The assistant beside Bu Li then came back with a brand new radiographic film viewer.

'Damn, that's really professional. No wonder this is the richest family in Sea City,' Zheng Ren complimented internally.

"I need to see the patient myself."

"He is a little irritable, so you may not be able to examine him," said Bu Li.

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"Just one look will be fine. I've a rough idea about his condition already," replied Zheng Ren.

'How am I supposed to know if the patient has nasal NK/T cell lymphoma if I don't see the patient? You guys are asking a general surgeon to diagnose his condition when a specialist with decades of experience couldn't even figure out his problem. Is this an example of a drowning man clutching at straws?'

At least they had been fortunate enough to encounter Zheng Ren, who possessed the power of the System.

Zheng Ren's words surprised both Elder San and Bu Li. They stared at each other briefly before Elder San left the room in silence.

The room instantly became quiet as the chefs had already packed up their utensils when the assistant had come in earlier.

Zheng Ren pretended to be serious but was in fact absent-mindedly looking at and comparing each of the films. He had devoted his life to the medical field for more than ten years, including his time spent studying medicine, and even if he did not clearly understand the films, he at least knew how to act professionally.

A loud voice could be heard in the corridor twenty minutes later. It was unclear, so Zheng Ren had no clue what the commotion was about.

Soon, the door opened.

Elder San entered the room while holding a fourteen- or fifteen-year-old boy with one hand,

"I'm sorry, Doctor Zheng. This boy has developed fear of hospitals and doctors after frequent consultations," explained Elder San.

Zheng Ren was shocked at the sight of Elder San holding a constantly struggling boy with one arm behind his back and admired silently, 'No wonder those people respect Elder San so much. Look at that arm strength. He probably has a handgrip strength of a hundred kilograms.'

The boy's condition and final diagnosis were shown in the upper right corner of Zheng Ren's vision when he fixed his gaze on the boy.

Well, that was awkward.

Wealthy families were indeed chaotic.

"Elder San, you're too polite. Let the child go. It's better not to let him create a mess here," said Zheng Ren.

Behind Elder San stood a man whose expression sank immediately. "Miss, are you humiliating the young master?"

"Huh?" Bu Li hissed through her nose as she looked askew at that man with piercing eyes.

"You seized the young master directly after stating that his presence was required, then you want him to leave after taking one glance. Do you think you're fooling a monkey?" The man refused to give up. "The young master has been in a bad mood after Master Bu fell sick and even had a nosebleed this morning. If you continue humiliating the young master any further and cause his condition to deteriorate, I will definitely report this issue to Master Bu."

"Up to you." Bu Li waved her hand casually.

The man gritted his teeth, unable to do anything about her attitude. Left with no choice, he stared at Zheng Ren and asked, "You're a professor? Which hospital are you from?"

The contempt in his tone was obvious when he emphasized the word "professor".

Zheng Ren was less than thirty years old. He could not possibly be a professor.

"You flatter me." Zheng Ren was not bothered as he had developed an immunity to this sort of mocking tone after encountering various incidents in the hospital.

"You asked for the young master's presence. What have you understood so far?" asked the man fiercely.

"Have a care how you speak!" Bu Li scolded. "He is the surgeon who performed the surgery on my father!"

"Professor Ichiro Moriyu performed the surgery on Master Bu! Miss, if you don't explain yourself today, the young master and I will visit Master Bu to demand an explanation! You don't have any authority yet in the Bu family!"

Zheng Ren was experiencing a headache. A war within a wealthy family. That was boring.

"Are you sure you want to hear it?" Zheng Ren tilted his head and stared at the man with a smile on his face.

"Is there a problem?"

"Come in and close the door if you've made up your mind."

The astonished Elder San and Bu Li stared at Zheng Ren in silence.

"His condition is special. Are there any unrelated parties here?" asked Zheng Ren.

"Just spit it out!" answered the man impatiently.

"Good." Zheng Ren then pointed at the nearest MRI film on the radiographic film viewer. "There are indeed signs of nasal NK/T cell lymphoma in the films, so the diagnosis isn't wrong.

"But judging by his medical history, this diagnosis is invalid."

"Don't talk nonsense!" The man was getting impatient.

"I think the patient is using recreational drugs," said Zheng Ren.

It was a simple statement, but its effect was that of a small stone thrown into a pond, sending ripples in ever-widening circles.

The startled Elder San gave this some thought.

Bu Li gave Zheng Ren a puzzled look. How did he come to the diagnosis with a quick glance at the patient and reading the MRI films for twenty minutes?

Even senior professors in Imperial Capital and Sorcery Capital were unable to diagnose the patient with certainty. What was the source of his confidence?

"Bullsh*t!" yelled the man in exasperation. Then, he glared at Bu Li and complained, "I'll definitely report to Master Bu what happened today."

"Up to you," replied Bu Li coldly before asking, "Doctor Zheng, there aren't any needle marks on his body."

"It's mixed with glass particles. During inhalation, those particles rupture the nasal capillaries and facilitate the entrance of recreational drugs into the bloodstream. Hence, the high is further intensified."

The child in Elder San's grip stopped struggling immediately and gave Zheng Ren a horrified stare as if he had seen a ghost.

The child was very good at covering his tracks. He had not expected someone to see through his tricks so easily.

"Go to the hospital and take a blood sample for a toxicology screen. If he had a nosebleed this morning, that means the chemicals in his bloodstream haven't completely metabolized yet and can still be detected in the blood test," Zheng Ren concluded.

Zheng Ren's confidence and the terrified look on the child's face made the trio believe the explanation instantly.

That must be the truth, but who could have guessed it?

Elder San put the child down and assumed a fist-and-palm salute. "I misjudged you, Doctor Zheng. Still waters run deep."

Zheng Ren failed to grasp the hidden meaning in Elder San's words. He did not care who Elder San supported—Bu Li or the young boy—because the rivalry over a wealthy man's inheritance would definitely end up in turmoil.

After noticing that the boy had been released, the man wanted to step forward and help him, perplexed. However, his legs had been drained of energy after realizing the truth and he staggered after taking one step, almost falling to the ground.

"Doctor Zheng, you must be tired. I'll instruct someone to send you home," said Elder San lightly. Zheng Ren had no intention of staying any longer, so he agreed to his suggestion and left the room.

In front of the door stood a man dressed completely in black. He was the brute with a baseball bat in the emergency department yesterday, the one whom Elder San addressed as Little Six.

"Send Doctor Zheng home." Elder San made some arrangements. "Also, give Doctor Zheng an explanation for what happened this afternoon."

Then, Elder San assumed a fist and palm salute again to bid farewell.

"Doctor Zheng, this way, please," said Little Six politely.

"I still don't know your name yet. What's your surname?" asked Zheng Ren.

"That's very nice of you, but just call me Little Six. You're the Bu family's savior, and that means you're my savior too, so there's no need to be so polite." The smiling Little Six's tone was as humble as dust. The ferocity with which he held the baseball bat in the emergency department last time had disappeared into thin air.

As they walked out of the main entrance, Zheng Ren frowned upon seeing a traumatized man standing alone outside the door.

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Chapter 51: Discharge Against Medical Advice

The golden chain as thick as a finger dazzled against the night sky.

"Doc... Doc... Doctor Zheng, I was wrong." Black Tower had lost his usual savagery and looked incredibly pathetic after waiting for god only knew how long outside the door.

Zheng Ren ignored him and asked Little Six, "Brother Six, is this your car?"

An Audi Q7 was parked in front of the main entrance. Zheng Ren recognized this model, unlike Bu Li's high-class luxury vehicle which was beyond the knowledge of the people at the bottom of the social hierarchy—Zheng Ren included.

"You're too polite, just Little Six will do." Little Six grinned and pointed at Black Tower. "Doctor Zheng, how are you planning to deal with him?"

"Deal with him?" asked Zheng Ren curiously.

Zheng Ren had never experienced this sort of underworld dispute, nor was he interested in finding out about it.

"I was instructed by Elder San to protect you. My brothers went to take a short break after seeing the huge rescue operation this afternoon and the police officers that even arrived on the scene to maintain order, but I didn't expect him to trouble you then!" Little Six was getting exasperated and the scar on his face seemed to become alive as it radiated a bloodthirsty aura.

The arrogant Black Tower merely lowered his head without any inclination to defend himself as if he had transformed into Peppa Pig in Little Six's presence.

"Oh... Have you eaten yet?" asked Zheng Ren.

"Not yet." Little Six was stunned momentarily. After realizing that Zheng Ren made no attempt to look at or even mention Black Tower, he quickly walked past Zheng Ren and opened the door to the passenger seat.

"Thank you." Zheng Ren smiled.

After Zheng Ren entered the car, Little Six walked toward Black Tower and kicked him without saying a word. Black Tower then fell to the ground instantly as if there had been a loss of structural integrity.

"You're lucky Doctor Zheng can't be bothered with you." Little Six placed his foot on Black Tower's cheek and twisted it, grating his face against the rough pavement with a sound that reminded Zheng Ren of a grinding contusion. "Hand in your company's demolition and relocation contract tomorrow, and leave Sea City once and for all."

Then, Little Six turned around and left him.

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Plain and simple.

Little Six entered the car, ignited the engine and left the exquisite courtyard under the rich velvet blanket of night.

"Doctor Zheng, I'm a thug, so don't feel too disgusted at some of my actions," said Little Six with a grin. "These guys don't know which way the wind blows. They act foolishly in public and still seek to prevail over others. I'm guessing it won't take more than a few years for them to meet their doom at last."

In the alleyway hung a red slogan—crime prevention is everyone's responsibility!

Zheng Ren smiled and nodded in response.

"Doctor Zheng, where is your home?" asked Little Six.

After giving his address to Little Six, Zheng Ren thought for a while and suggested, "There's a food skewer stall at the intersection. Since you haven't had your dinner yet, why don't we stop there and fill our stomachs first?"

Little Six was slightly surprised. "I thought you had your dinner just now?"

"Escargots, foie gras with fish roe, and the meat was undercooked. I haven't had my fill yet," answered Zheng Ren truthfully.

"Hahaha!" Little Six laughed. "Doctor Zheng, you're a jolly man. I'm not used to Western food as well, and I think roadside stalls are much better than French cuisine."

It was just a simple statement, but their friendship had strengthened further.

Zheng Ren and Little Six finally satiated their hunger after consuming dozens of food skewers. He then exchanged his phone number and WeChat ID with Little Six before going back home to rest up.

Little Zhao was nowhere to be seen when Zheng Ren returned home. After washing up casually, Zheng Ren undressed and lay on the bed for a deep slumber.

His mind dragged him into the oblivion of sleep because he knew everything would be fine.

It was already six o'clock in the morning when Zheng Ren woke up from a dreamless sleep.

A cold shower invigorated him.

He went to a restaurant downstairs to have breakfast before going to the hospital via public transport.

A clamor could be heard from even the main hall when Zheng Ren reached the emergency department. Too many patients had been admitted yesterday and there were hundreds of people—patients' family members included—squeezing into the emergency department that had a total area of less than one thousand square meters. It would be strange indeed if there had been pin-drop silence in the department.

However, the noise itself soothed Zheng Ren's heart.

Only a living man had the right to be rowdy and complain about poor infrastructure.

Patients and family members greeted Zheng Ren as he walked into the emergency department corridor. The fact that these patients, who had 'Avatar'-like appearances yesterday, had lost their blue discoloration today pleased Zheng Ren even more.

He smiled and waved to the patients all the way to the duty room and changed his attire.

The emergency department was operating in an orderly manner. After Zheng Ren accompanied Old Chief Physician Pan for a ward round in the morning, Old Chief Physician Pan then went to the hospital to deal with allocation of medical staff and equipment into the emergency center.

Since their poisoning had been treated and they had recovered physically, a few patients started approaching Zheng Ren to request hospital discharge.

He provided the same explanation every single time. "Liver functions will deteriorate after acute poisoning. During the resuscitation process with methylene blue, there may be exudative inflammation which can irritate the gastrointestinal organs such as intestines, bile ducts, pancreas and so on."

In summary, patients had to remain hospitalized or stay in the emergency department for one week, and hospital discharge was possible only after their conditions had stabilized without any signs of complications.

Since their lives were no longer in peril, they changed their minds from simply receiving treatment to receiving treatment in better conditions.

It was just an inadvertent psychological request, but it troubled Zheng Ren greatly.

Numerous phone calls were made to Zheng Ren, Old Chief Physician Pan, senior consultants of each department, and even the hospital directors inquiring about the patients' conditions and requesting transfers to better sick rooms.

It was extremely difficult to request a deluxe private sick room during this sort of large-scale food poisoning incident.

Thus, after enduring the unbearable noise in the emergency department corridors for two more days, the patients, who assumed their conditions had indeed stabilized, began building up their determination to solve this problem—self-discharge.

No matter how Zheng Ren persuaded them, they always had a thousand reasons to argue with.

Zheng Ren also felt helpless with the limited infrastructure in the hospital. Some elderly men... Almost everyone had inadequate rest, and some people with cardiovascular disease even started experiencing symptoms such as arrhythmia.

Left with no choice, Zheng Ren used a standard template and made a form for discharge against medical advice—self-discharge would be allowed only after signing the document stating that the patient or their family member insisted on a hospital discharge against doctor's orders. The doctor had explained the possible complications clearly and the patient would be held responsible for any potential consequences that may arise from their decision.

The form dispelled some patients and family members' plan of leaving the hospital. It was just one week, anyway. It would be over soon.

However, most people decided to ignore Zheng Ren's advice and signed the documents.

The corridor gradually emptied after some patients left the hospital.

There were no major emergency cases this fine day and Zheng Ren did only two minor wound closures without requesting Xie Yiren's assistance.

It felt good to be able to enjoy some leisure time as Zheng Ren sat in his office and stared blankly at the yellowing leaves through the window.

His lifespan would be cut short if today had been as busy as yesterday and the day before.

Every patient who had suffered nitrite poisoning had gotten out of danger due to timely resuscitation, with the silver lining being that no large-scale deaths had occurred.

Zheng Ren overheard from the nurses' gossip that a chef in the largest braised meat chain store in the city had mistaken nitrite salt for edible salt, which had caused the mass poisoning.

Why would a braised meat restaurant have nitrite salt? Zheng Ren speculated that it had been used as a preservative to make stale meat look more desirable.

Was the boss arrested? How severe was the punishment? These were none of his concerns.

His mind was focused solely on the fact that he had to perform emergency hepatobiliary and pancreatic surgery. Since the intensive training time in the System had been inadequate, he had no choice but to perform an old-fashioned open cholecystectomy instead.

He was more proficient in open cholecystectomy since he had not practiced laparoscopic cholecystectomy yet.

Zheng Ren had his own plan in this issue. In order to prevent any potential accident happening during surgery, he needed to familiarize himself with local anatomical structures, which he could not do by simply dissecting cadavers in medical institutions.

Now that he had a good knowledge of the local anatomy of the gallbladder area, he just needed an opportunity to purchase intensive training time for laparoscopic cholecystectomy.

More than twenty days of intensive training were simply not enough.

Nowadays, most people chose to perform the laparoscopic over the open option in hepatobiliary and pancreatic surgery, and that included simple cases of pancreatic cancer and gallbladder cancer too.

Zheng Ren disagreed with this method because it was difficult to remove tumor tissue through a tiny scope. Moreover, if the surrounding tissue was contaminated with tumor cells, the patient may face an increased risk of metastasis.

However, hepatobiliary and pancreatic malignancies were rarely seen in the emergency department, so mastering emergency cholecystectomy was his only concern at the moment.

Zheng Ren had an urge to pour all 930 skill points and 75000 experience points from his inventory into the hepatobiliary and pancreatic skill tree.

Perhaps he would have done that a long time ago had the System not threatened him with elimination.

The threat of elimination was like the Sword of Damocles hanging above Zheng Ren's head, forcing him to be prepared all the time to face some unpredictable danger.

During his free time, Zheng Ren would revise hepatobiliary and pancreatic surgery again and again so that he could familiarize himself with local anatomical structures and its surgical procedures.

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Chapter 52: The Initial Construction of The Emergency Operating Theater

Reading could increase skill points as well, but the increment was very minimal.

After one whole day of revision, Zheng Ren's skill points in the general surgery skill tree had increased from 1690 to 1690.12...

Zheng Ren had no idea that the System's skill points could go up to two decimal places.

'When can the System assign a mission to me?' Zheng Ren prayed eagerly.

Only the System's mission could compel Zheng Ren to consume more than twenty hours of surgical intensive training in a targeted manner.

The day passed by uneventfully.

Normally, chief residents had to stay in the hospital all the time for at least half a year, but the same rules did not apply to Zheng Ren. After all, the emergency department could not perform major emergency surgery due to a lack of medical staff and wards.

The doctors on duty would call Zheng Ren regardless if they could not handle difficult cases.

Thus, Zheng Ren went home after work, continued his revision, washed up and slept.

The following days were dull and boring, and the System had become quiet with no new missions assigned to Zheng Ren, which made him curious and slightly anxious with anticipation.

Meanwhile, Old Chief Physician Pan would visit hospital management every day but with unsatisfactory results.

After five days of hard work, only a dozen nurses had been assigned to the emergency department. As for the doctors... Unfortunately, there was a shortage of doctors in every department.

In the end, the hospital management could not bear Old Chief Physician Pan's well-timed visits every day and made him a promise—any doctor who agreed with the transfer would be assigned to the emergency department.

Old Chief Physician Pan fought the urge to curse. Why would he waste time and effort to ask for favors if the emergency department was so likable?

Well, he had no choice anyway.

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After discussing this issue with Zheng Ren, he decided to take things slowly and strike while the iron was hot by storming appendicitis and cholecystitis cases.

Zheng Ren guaranteed that he could finish the surgery alone as long as nurses with basic skill levels were assigned to him, and with the secondment of two anesthesiologists, the emergency operating theater started to take shape.

Old Chief Physician Pan took credit for these achievements. None of them would have happened if the organizer had been someone else.

Five days later, Old Chief Physician Pan officially announced the establishment of the emergency operating theater and emergency wards, and that was when Zheng Ren finally received a mission from the System.

[General Mission: The Initial Construction of The Emergency Operating Theater.

[Task: Complete five cholecystectomies in the emergency department.

[Reward: 50 skill points and 1000 experience points. The higher the surgery completion rate, the greater the reward.

[Time: One week.]

The System spoke to Zheng Ren at last, which filled him with joy like rain after a long drought. It was simply too inefficient to increase his skill points by reading medical literature alone.

After one week of revision and various wound debridements and closures, Zheng Ren's general surgery skill tree had increased from 1690 to 1692 points.

It would take thirty-three years for him to reach the Master rank at this rate.

That was precisely the time required for an ordinary doctor to reach higher positions.

However, Zheng Ren was an exception. He had the System, and he was proud of it.

A social gathering was inevitable in a newly established department because it was important for everyone to develop a sense of belonging in a foreign place.

Everyone was able to participate in the gathering as there were no patients at the moment. It would be impossible for the whole department to have a meal together once it was up and running.

Old Chief Physician Pan felt satisfied and complacent during the celebration as the emergency department had finally taken a crucial step toward the development of the emergency center under his impetus.

Regarding staff allocation... Medical staff was like water in a sponge. He could always get some by squeezing it a little harder.

The patients in the emergency department observation unit had known the department was going to receive an upgrade to the emergency center. Thus, they made silk banners in advance to show their sincere appreciation while joining the fun at the same time.

Sea City General Hospital emergency center would surely hold on to these silk banners well. In the future... Ahem... In case they were visited again, they could boast to doctors and nurses unfamiliar with them that they had given the silk banners because blah, blah, blah...

Even though there were no grand opening flower stands or red ribbon cutting ceremony, Old Chief Physician Pan was very satisfied upon receiving the patients' heartfelt gratitude.

...

...

Cui Heming, a postgraduate student, had gone to Imperial Capital after his graduation from Project 211[1] to set up a business and established an internet company with a decent income of a few million yuan per year.

After his company had entered a successful transitional period, something annoying happened.

His mother had been suffering from tinnitus and dizziness recently. The attacks were frequent and she dared not be involved in any activity due to an increase in severity of symptoms afterward.

He was forced to put his work aside and return to Sea City so that he could bring his mother to the hospital for consultation.

The company's repeated phone calls requesting instructions, as well as the fact that there had been no definitive diagnosis for his mother's condition after visiting Sea City, Imperial Capital and Sorcery Capital, upset Cui Heming greatly.

He even encountered a strange diagnosis in Sea City General Hospital when a doctor in the emergency department asked his mother to get a tooth extraction. Could a tooth extraction cure tinnitus and dizziness? Cui Heming denied that claim with pure logic and probability granted by his high education.

It also made him realize that the medical standard of Sea City was very poor.

Even so, he had heeded the doctor's advice for some inexplicable reason and brought his mother to Peking University Third Hospital in Imperial Capital for consultation.

He could not get a definitive diagnosis in the general outpatient department, and further consultation had to be made in the specialist outpatient department.

He then searched the internet and found a few well-reputed senior professors at Peking University Third Hospital. Everything had been simple thus far.

However, he was stumped by the process in the specialist outpatient department.

He went to queue very early in the morning but failed to acquire an appointment registration number for the department.

There were hundreds of people trying to make an appointment in the specialist outpatient department for medical advice. When Cui Heming stared at the crowd and overheard someone complaining about not being able to get an appointment registration number even after a month, anxiety gnawed at him further.

He made up his mind and purchased the registration number from a ticket scalper.

The normal registration fee for the specialist outpatient department was 100 Yuan, but the ticket scalper sold it at an inflated price of 5000 Yuan.

That was a little heart-wrenching, but Cui Heming endured it anyway.

His mother's recovery was of utmost importance so that he could devote all his energy to his career. He could not possibly purchase that with a mere 5000 Yuan.

His consultation session was at three o'clock in the afternoon, so Cui Heming brought his mother to Peking University Third Hospital ninety minutes earlier.

He was thoughtful enough to place a small blanket on the hard plastic bench for his mother and sat like a statue so that his mother could lean on his shoulder. Her dizziness and tinnitus would aggravate after physical activity and this issue had troubled him for a very long time.

It was his turn at last. Cui Heming cheered up and pushed his mother in the wheelchair into the consultation room.

The specialist was an elderly professor with white hair that provided patients with a sense of security. Cui Heming made a simple comparison between him and the young goofball in Sea City General Hospital and ridiculed that brat numerous times in his mind.

After obtaining a detailed history and going through the imaging films Cui Heming had brought, the elderly professor asked Cui Heming to bring his mother for a few tests that he ordered.

'Tests again! Bloody tests!!' Cui Heming was losing his mind.

Even so, he put up with it and patiently brought his mother to undergo the tests. When he returned with the imaging films two hours later, the elderly professor was already preparing to leave work.

After hanging the CT films on the radiographic film viewer, the elderly professor put on a pair of spectacles with a presbyopic lens and studied them carefully for ten minutes.

"Has she had a dental implant in the last two years?" asked the elderly professor slowly.

"Yes," answered Cui Heming.

"That's weird." The elderly professor pushed up his spectacles and pointed at an image of a denture. "Nowadays dentures are made of acrylic resin, but this is made of amalgam, which is very rare."

"Huh?" Cui Heming was caught in a trance and a detestable figure appeared in his mind.

"Call your dentist and ask about the material used in her denture," said the elderly professor as he started packing his belongings. It seemed like he was ready to get off work.

Cui Heming picked up his phone quickly. He was familiar with the dentist since he had been performing dental check-ups for his mother for more than ten years.

"The dentist in Sea City said that it was indeed made of amalgam." Cui Heming put his phone away and admired the elderly professor even more. How knowledgeable was he to be able to figure out the material used just by looking at the imaging films?

"Nonsense!" The elderly professor was annoyed. "Here... Here..."

The elderly professor tapped his finger twice on the film. "There are two types of dentures. The first type is inlaid with gold which was very common a decade ago. Another type uses acrylic resin which is more popular nowadays. Two different metals will form a primary cell in the oral cavity and amplify bioelectricity. How can she not feel dizzy or have ringing in her ears in this condition?"

Cui Heming was slightly confused. He could not understand the elderly professor's explanation but a familiar term stood out in his mind—a primary cell!

[1] A project of National Key Universities and colleges initiated in 1995 by the Ministry of Education of the People's Republic of China, with the intent of raising the research standards of high-level universities and cultivating strategies for socio-economic development.

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Chapter 53: Unworthy Purchase of 5000 Yuan Registration Ticket

"Primary... Primary cell," Cui Heming stuttered.

"Yes." The elderly professor forcefully took down the film and turned off the radiographic film viewer. "She'll be fine after a tooth extraction."

"..." Ten thousand alpacas broke into a furious gallop in Cui Heming's heart.

The same diagnosis as the young doctor in Sea City General Hospital?!

"Are... Are you sure?" asked the absent-minded Cui Heming subconsciously.

"Of course I'm sure." Despite being questioned, the professor was not angered. "This disease is explained in dental textbooks. The amalgam denture is particularly strong and durable, and basically doesn't need to be replaced in during one's lifetime. They were also quite popular a decade ago as they were cheap, but have obvious disadvantages; the replacement crown requires a square-shaped space and mediocre dentists won't be able pull it off."

During his explanation, the elderly professor had opened his locker and changed his clothes.

"The dentist who made your mother's denture was kind, but also failed to notice that his patient has a golden tooth." He then added, "This condition has become rare in the past ten years since we essentially use only acrylic resin to make dentures now."

It was true, then! However, it still felt ridiculous in Cui Heming's opinion.

All his hard work and effort for days had been in vain? The diagnosis made after paying 5000 yuan to a scalper was the same as the diagnosis of a doctor from the emergency department in Sea City General Hospital?

Was this not nonsensical?

"Yes?" asked the elderly professor, who assumed that Cui Heming did not believe his explanation as the man was merely standing still, lost in thought.

"No... Nothing..." Cui Heming could deride a doctor in Sea City General Hospital as being lousy, but he simply lacked the courage to do so in Imperial Capital.

"A doctor from the emergency department in Sea City said the same thing too. He also asked my mother to get a tooth extraction," he blurted out the truth inattentively.

"Yo? The emergency department? The medical standard of the Sea City emergency department is very good." The professor smiled. "Let's go. I'm leaving work now. Come here directly tomorrow. I'm not going to consult any further and will just perform a tooth extraction on your mother instead."

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Cui Heming did not dare ask why the professor could not perform it now and had to delay it until tomorrow. He imagined it was because everyone had gotten off work and no nurses could assist the procedure, not to mention the lack of equipment.

However, since the diagnosis was clear, it could be easily resolved.

The next day, the symptoms Cui Heming's mother previously experienced disappeared after the tooth extraction.

On the third day, she was energetic and could even start applying light makeup.

Cui Heming's mother, born of a respectable family, no longer looked sick and was resplendent and elegant after beautifying herself.

Cui Heming was exhilarated after his mother's full recovery and booked a flight ticket back to Sea City.

His feelings about the doctor in Sea City General Hospital were indescribable. After hesitating for a long time, he finally made a silk banner and prepared to present it to the uncredited doctor after his mother's constant insistence.

The whole trip between the cities took nearly a week. Since Cui Heming was eager to return to Imperial Capital, he paid the extra cost to obtain a silk banner as soon as he got off the plane and went to Sea City General Hospital with his mother.

They saw a bustling scene upon arrival at the Sea City General Hospital emergency building.

A lot of people were just watching the festivities while holding silk banners outside the building.

This was awkward. Was he supposed to throw the silk banner into the doctor's office without greeting him and shooting the breeze?

"Brother, what happened? Why are there so many people sending silk banners?" Cui Heming lit up a cigarette and approached a random onlooker to ask about the situation.

"The emergency department in Sea City General Hospital has been upgraded to an emergency center. This is the grand opening ceremony." The man accepted Cui Heming's cigarette happily and took a deep drag. "Yo, this is a real Chunghwa[1]."

Of course. He was the boss of a small company with an annual income of a few million yuan. It would be disgraceful if he smoked fake Chunghwas.

"What's the matter with this huge crowd and their silk banners?"

"Huh? You don't know?" The man turned and stared at him as if he was looking at a monster.

Cui Heming was stunned as well. How would he know? However, he had become a smooth talker after working in business for years, so he immediately put on a smile and explained, "I brought my mother to Imperial Capital to consult a doctor, so I've no idea what happened recently."

"Let me tell you, Chief Zheng from Sea City General Hospital is amazing!" After realizing Cui Heming was out of the loop, the man started excitedly telling the story of the nitrite poisoning, the major rescue operation that followed, and especially the fate of the braised meat restaurant owner.

That braised meat restaurant was a first-class old shop in Sea City and had more than twenty branches, which was why it became the hottest issue in just one night.

Cui Heming was flabbergasted.

"You didn't see it, but there weren't enough ambulances and the city even mobilized private ambulances to handle the emergency situation that day. Dozens of sirens wailed like a baby in distress. It's the kind of noise that makes you sick."

"No one died?" Cui Heming found it difficult to accept this ending.

It was not that he hoped for deaths to have happened, but some things were inevitable especially when medical resources were limited in such a large-scale rescue mission.

"Tut-tut, I initially thought lots of people were going to die too." The man blew smoke into the air happily. Cui Heming fought down his murderous urges at being left dangling.

"You weren't there, but every patient had the blue skin color of the aliens from 'Avatar' when they were sent here. Oh, have you read any martial arts novels? Imagine that they had been poisoned with a deadly toxin from the Western Regions."

"..." Cui Heming failed to make the connection.

"Chief Zheng... There, look at that doctor next to that elderly chief physician. He's young but his skills are amazing. He diagnosed the condition on the spot, allocated the special antidote from all over the city immediately and saved everyone."

Cui Heming followed the man's finger and saw the doctor standing beside the tall and strong Old Chief Physician Pan. He was indeed the doctor who informed Cui Heming that night that his mother would recover after getting a tooth extraction.

"Brother, I haven't asked. What are you doing here with a silk banner?"

"I'm here to thank Doctor Zheng." Cui Heming was ashamed of his harsh words then. "Doctor Zheng gave me a diagnosis and treatment plan but I refused to believe him, so I brought my mother to Imperial Capital and bought an expensive registration number from a ticket scalper for 5000 yuan. In the end, the diagnosis was the same as the one given by Doctor Zheng..."

"Hiss..." The man beside Cui Heming gasped in astonishment. He had not anticipated that Chief Zheng's diagnostic ability and medical skills had reached the level of senior professors in Imperial Capital.

After finishing the cigarette, Cui Heming approached a trash can and threw the butt into its ashtray. Then, he mentally prepared himself to present his silk banner and apologize for his behaviour from that night.

A man needed to be responsible for his own mistakes and stand firm even if he had to receive physical punishment.

Just as he worked out a long list of compliments and was about to walk forward, a car stopped in front of Sea City General Hospital emergency building.

"Chief Zheng, my father has a stomachache. Can you take a look at him?" yelled a middle-aged man anxiously as he got down from the driver's seat.

"..." Shoot! His psychological preparation had gone to waste.

Cui Heming froze on the spot and saw over twenty medical staff, who had been posing for the camera in front of the medical department, scatter immediately. A stretcher trolley was pushed out approximately ten seconds later and an elderly man was transferred onto it.

When he looked again, Chief Zheng Ren had already gone.

[1] Chunghwa is a premium brand of Chinese cigarettes produced by the Shanghai Tobacco Group, a subsidiary of China Tobacco. Due to its popularity in the Chinese market, it is considered the most representative brand of Chinese cigarettes and is known as the "national smoke".

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Chapter 54: Intensive Training Again In The System

The patient's diagnosis was displayed in the upper right corner of Zheng Ren's vision—chronic cholecystitis.

Zheng Ren's heart sank immediately as this was clearly a complication of acute food poisoning.

The risk of complications would be minimized if the patient underwent an intravenous infusion of antibiotics for one week, but antibiotic misuse by idiotic doctors had become a trend in the country these days.

There were indeed idiots among doctors. For example, there was the usage of triple-drug therapy—including quinolone, which was metabolized by the kidney—as postoperative prophylactic antibiotics in an underaged patient with an uncomplicated appendicitis case.

The vast majority of doctors had good intentions, and they placed disease treatment and saving patients' lives as their top priorities.

However, their intentions were usually and ruthlessly destroyed in reality.

Veterinarians in charge of the medical industry had issued regulations to restrict the clinical usage of antibiotics. Their prescription was justified only when the patient exhibited signs of pyrexia, positive bacterial culture, derangement in routine blood investigations and so on.

However, only a few people knew that meat and milk actually contained a large amount of antibiotics from animal husbandry. Even producers had no choice. How could they meet the increasing demands of the market if they stopped using antibiotics and production fell?

Would they force everyone to be a vegetarian? Zheng Ren would be the first to disagree as he was very fond of eating meat skewers.

This was a troublesome issue and there was nothing Zheng Ren could do about it.

It was good enough if he could manage the emergency department in Sea City General Hospital.

"Do an emergency bedside B-scan ultrasonography. I'm guessing that he has cholecystitis." Zheng Ren quickly made a diagnosis.

"Chief Zheng, how did he get cholecystitis when he was previously well?" asked the patient's son in distress.

"I told you, an acute toxic liver injury will result in exudation and the exudate has a chance of accumulating around the gallbladder. Physical function declines with age, and constant stimulation for one week can lead to cholecystitis," Zheng Ren explained.

However, this type of cholecystitis was uncommon. In fact, its risk was less than 10 percent.

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Luck was the predominant factor in this issue. Obviously, it had not been on this patient's side.

It was inappropriate to discuss bad luck with the patient and his family members. Zheng Ren was indeed insensible, but that was limited only to women. He was still emotionally mature and was a smooth talker around patients.

This elderly man had the honor of becoming the first patient of the emergency ward.

His B-scan ultrasound showed that his gallbladder was 95x47mm in size, with marked asymmetry in its wall and striated thickening at 3mm. The gallbladder wall had normal echogenicity with echogenic debris noted within the gallbladder itself.

The ultrasound report concluded that he was indeed suffering from late-onset chronic cholecystitis. Other tests—routine blood investigations, coagulation profile, Hepatitis B serology test, HIV and syphilis tests, renal and liver function tests and so on—were then performed in the emergency department.

Electrocardiogram findings were normal with his sinus rhythm noted.

Zheng Ren instructed a nurse to insert a nasogastric tube for gastric decompression before inviting the patient's son to his office for preoperative counseling.

The son was dejected as he was the one who insisted on a hospital discharge due to the noisy environment disturbing his father's rest.

He did not expect his father to have cholecystitis just as Zheng Ren predicted.

Zheng Ren had had a good relationship with the family members of the patients who had been receiving treatment in the emergency department observation unit, so he chose to comfort the patient's son first after they had sat down in his office.

After that, he began explaining the patient's condition based on his ultrasonography.

This was not a simple case of acute cholecystitis, and its cause had been explained previously. Acute food poisoning would cause transient derangement in liver function, which would result in exudation. The exudate would accumulate in the gallbladder fossa and infiltrate the gallbladder, finally causing acute cholecystitis.

The possibility of young men getting cholecystitis was very minimal. After all, they were in better physical shape and had stronger immune systems, so their bodies would be able to deal with inflammatory responses easily.

Older men were different and could not handle inflammation well, hence the cholecystitis. If conservative treatment with antibiotics was used, it would not have much effect.

After listening to the explanation, the family member stated that he would follow Zheng Ren's arrangements.

It was a sign of trust in the doctor after a period of acquaintance.

If the major rescue operation for nitrite poisoning had been unsuccessful, he would not have so unhesitatingly agreed to Zheng Ren's suggestions.

"Let's do cholecystectomy then." Zheng Ren decided for a surgery in the end.

The old man was prepared for surgery straight away as he was in intense pain and had fasted long enough due to having a decreased appetite after experiencing discomfort in the morning.

The test results came back half an hour later and the patient had no contraindications for surgery. After counseling the patient and acquiring signatures on the preoperative informed consent documents, Zheng Ren brought the patient to the operating theater on the third floor of the emergency building.

According to the initial design plan for the emergency building, the first floor had the emergency department, observation units, B-scan ultrasonography room, CT scanner and various auxiliary departments. The emergency wards were located on the second floor with fifty-two sickbeds, and the third floor with a few thousand square meters was designated for operating theaters. This full-flow design was among the top in China.

Various surgery departments had set their sights on the high-class operating theater, which was the main reason Old Chief Physician Pan had been so eager to develop emergency surgery. If the emergency department had no use for it, someone else would take over instead of letting it go to waste.

Deep inside the operating theater on the third floor lay an interventional radiology suite, which was dedicated specifically for interventional radiology.

The suite had been constructed based on a new design—a hybrid operating room.

A hybrid operating room was an advanced procedural space that combined the traditional operating theater with interventional radiology.

This was advanced technology as ordinary Class Three Grade A Hospitals did not have hybrid operating rooms.

However, the hybrid operating room in Sea City General Hospital had been idle for a long time. The hospital management would be held responsible for wasting resources recklessly if no one tried to seize the opportunity to assume control of it.

The operating theater was fully equipped with disinfection facilities and the still air was maintained at a constant temperature to control airborne infection. Anyone who took a deep breath in this room would get the feeling that the air could purify one's soul.

Zheng Ren went to the male locker room to change into surgical attire while the other doctors assisted with the patient transfer.

He was convinced that, instead of conspiring against him, the System had actually predicted that he would perform cholecystectomy in the future. Well, what was he waiting for? It was time to spend all his skill and experience points in the System for intensive training in laparoscopic cholecystectomy!

In the male locker room's smoking area, Zheng Ren lit up a cheap Ziyun [1]and took a deep drag comfortably before diving into the System.

As he entered, he decided not to spend his skill points, which were but a drop in the ocean. There was no way he could achieve the Master rank and receive a skill upgrade anyway.

He opened the Shop interface, clicked on cholecystectomy and exchanged his entire stock of 75000 experience points from the last mission reward for 20.83 hours of intensive training. Then, as the operating theater formed around him, training had officially begun.

It saved time performing surgery in the System as the mannequins were anesthetized in advance.

In reality, a cholecystectomy required at least two hours from start to finish, but in the System's operating theater, Zheng Ren could simply focus on mastering his skills without having to wait for the anesthesia to take effect or consider the patient's condition and postoperative recovery.

The first laparoscopic cholecystectomy took Zheng Ren nearly an hour to complete. After all, he had not been qualified to perform a cholecystectomy even when he was still in the first general surgery department even though it was just a tier-one surgery.

Subsequent surgeries became much smoother after he had familiarized himself with it.

The time required for each surgery gradually decreased just like during the intensive training for appendectomies. In a sense, one just needed to practice general surgery repeatedly to master it.

In the end, Zheng Ren required only ten minutes to finish a laparoscopic cholecystectomy.

No matter how Zheng Ren made the best use of his intensive training time, in less than twenty-one hours, he merely did eighty surgeries in total.

Even so, he felt particularly good as those practice runs were more than enough to handle this situation.

After his intensive training ended, Zheng Ren turned around and checked his general surgery skill tree, which had increased from 1692 to 1930 skill points. He was unsure if this sharp increment had anything to do with the difficulty of the operation.

Long, gray wisps of smoke still hung in the air when Zheng Ren returned to reality. He then stubbed out the cigarette that he had just taken a puff of, put it back into its pack, changed into surgical attire and went into the operating theater.

Xie Yiren, who had already prepared herself and was standing in front of the instrument table, gave Zheng Ren a warm smile as he entered.

The first cholecystectomy was about to begin.

[1] Yunyan (云烟) is a cheap cigarette brand and the Zi (紫) version has better quality among Yunyan.

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Chapter 55: A Live Broadcast of Cholecystectomy

Single room 303 in the special demands ward.

Chief Surgeon Liu Tianxing lay quietly on the bed as Cen Meng sat by him. Neither of them said anything as they were immersed in their own trains of thought.

Random dot-pixel patterns of static flickered on the television on the wall opposite them with its monotonous, dull noise lingering in the room.

Chief Surgeon Liu broke the silence after a while.

"The patient's diagnosis is correct?" asked Chief Surgeon Liu in a croaky voice.

"Yes. Preoperative preparations have been completed and the patient is undergoing general anesthesia now," answered Cen Meng.

"This is a difficult cholecystectomy. First time... Are you sure Zheng Ren is performing laparoscopic cholecystectomy for the first time?" asked Chief Surgeon Liu suddenly.

"I'm sure. He has done a few appendectomies, and he is probably talented in this field as all of them were done well, but I'm sure he has never performed any cholecystectomy—laparoscopic or open surgery—before this!" replied Cen Meng.

"He did assist in cholecystectomy, if I'm not mistaken."

The surgical assistant's main responsibility in laparoscopic cholecystectomy was to hold the laparoscope, a task far more boring than holding a retractor in an open surgery.

It was fine as long as he had not performed it personally.

Chief Surgeon Liu nodded and closed his eyes. "Youngsters have a tendency to act high and mighty after learning one or two surgical techniques. This sort of attitude will do him no good."

"Yes." Cen Meng was aware that Chief Surgeon Liu was going to deliver a speech. As a firm supporter, his job was very simple—answering yes or no would be enough.

"When you're performing surgery, especially an unfamiliar one, accidents are bound to happen without the supervision of a senior surgeon," Chief Surgeon Liu mumbled with his eyes closed as if recalling something from his past and added, "Cholecystectomy is just a tier-one surgery, but do you know why surgeons below chief resident rank are not allowed to perform it?"

"Sometimes there will be morphological changes in the cystic and common hepatic ducts due to inflammatory reactions. The damage will be irreversible once the common hepatic duct is cut." Cen Meng had personally performed more than ten laparoscopic cholecystectomies, so he clearly remembered these precautions.

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"Correct, what more with beginners, who can't even differentiate left and right, using a laparoscope for the first time. Chief Physician Pan really has gotten old. How could he let Zheng Ren perform a surgery that he doesn't even know how to do?"

"Accidents will definitely happen with such bold courage."

"We just need to quietly watch the show."

Chief Surgeon Liu opened his eyes as the sound of static from the television suddenly disappeared.

The anesthesiologist seconded to the emergency operating theater today was Cen Meng's classmate, so he would know exactly what Zheng Ren was doing through his "double agent".

A camera system with video recording and streaming functions had been installed in the laparoscope, but no surgeon wanted to broadcast their surgery live and let others observe their operation.

After persistent requests and some unknown promises, Cen Meng's classmate finally agreed to furtively upload the surgery process to him via Bluetooth.

Cen Meng knew that Zheng Ren had no experience in laparoscopic cholecystectomy. In order to make Chief Surgeon Liu happy, he had connected the footage to the television in the special demands ward so that they could watch Zheng Ren's surgery in real-time.

There was no sound, but the laparoscope had been turned on. Perhaps he was insufflating carbon dioxide into the peritoneal cavity to create a pneumoperitoneum.

The laparoscopic camera soon began to shake. The duo spying on Zheng Ren's surgery from the special demands ward were experts, so they knew that he had made a hole and was prepared to insert the laparoscope into the peritoneal cavity.

Silence reigned in the ward, causing the atmosphere to become tense as they felt more anxious watching the surgery than if they had been performing the surgery themselves.

Zheng Ren's sensational forty-nine appendectomies in one night and endoscopic transrectal appendectomy as his coup de grace, a surgery even Chief Surgeon Liu had never heard of, had anxiety gnawing at Cen Meng.

He must have no clue how to perform this surgery. Moreover, this patient had had exudative inflammation for five days and the adhesions would be very severe, which would make the surgery even more difficult.

...

...

There was a sudden change in the traffic monitoring of Xinglin Garden.

Hundreds of viewers swarmed into a single live broadcast room, but after learning from his mistakes last time, CEO Peng Jia had adjusted the maximum viewer capacity of this particular account to ten thousand viewers and even made a contingency plan in case of system failure.

[God hasn't performed surgery for days. I really miss his awesome and smooth appendectomies.]

[What surgery is he performing this time? Let me have a look...]

[Laparoscopy! Laparoscopy! I'm so excited because I've just started learning laparoscopic surgery. I'm not sure how good this god is in performing laparoscopy.]

[Would you dare broadcast your surgery live if you're in his position? He must be very skillful!]

Hundreds of viewers came into the chat shouting '666'.

Everyone was still buoyed by the crazy night of appendectomies a few days ago, but how good the surgeon was in performing laparoscopic surgery was an entirely different issue.

The atmosphere in the special demands ward was not as lively as that of the live broadcast room. Even though Chief Surgeon Liu and Cen Meng were convinced that Zheng Ren had never performed or underwent any training for laparoscopic surgery before this, they could not help but feel nervous about this operation.

Soon, the laparoscope entered the peritoneal cavity and the triangle of Calot appeared on the television with severe adhesions .

This sight finally put a satisfied smile on Chief Surgeon Liu's face.

If he had been the one performing this surgery, he would need to brace himself and lyse the adhesions within the triangle of Calot very carefully. Otherwise, any iatrogenic perforation would end up killing the patient.

If the surgeon was a beginner... No, even if Cen Meng was the surgeon, the only solution upon seeing this would be to transfer the case to Chief Surgeon Liu as he simply lacked the courage to perform such a difficult surgery without supervision.

[Wow, this is actually a laparoscopic cholecystectomy!]

[Who said the god doesn't know how to perform laparoscopic surgery? Come out, I promise I won't kill you.]

[It seems like the host surgeon doesn't perform laparoscopic appendectomies because his incision is so small that he just simply doesn't need to use a laparoscope at all.]

The viewers were very excited to watch this surgery in Xinglin Garden. No matter how proficient the surgeon was at appendectomies, it was still a simple appendix resection and a normal resident surgeon's job after all.

There was a saying that only a master chef could cook simple Chinese cabbage with potatoes well.

The same phrase applied to appendectomy as well. Judging by the flawless appendectomies the host surgeon had performed in the live broadcast so far, the viewers had concluded that he was a demon with a high skill level.

Even so, everyone was born with different innate talents and it would be impossible to improve one's abilities any further once a certain standard had been reached.

Appendectomy observation was meaningless as it was impossible to use it as a reference in terms of skill level or... physical strength.

However, laparoscopic cholecystectomies were different.

At the beginning of the twenty-first century, domestic hospitals had just started performing laparoscopic surgery and many departments—thoracic surgery, general surgery, and gynecology—had also gradually begun to popularize minimally invasive surgeries.

When the older senior consultants of various departments resigned ten years later, the new generation who had mastered the art of laparoscopy became frontline surgeons and made laparoscopic surgery a common practice in the country.

The advancement of minimally invasive surgery with laparoscopy had been rapid since then.

In 2001, a surgeon from Imperial Capital took eight hours to treat a patient with esophageal carcinoma using a thoracoscope. Now, as long as the tumor was not situated at the higher level of the esophagus, the surgery could be finished within two hours.

Laparoscopic surgery had replaced traditional open surgery as the mainstay of modern medicine.

When the severe adhesions in the triangle of Calot appeared onscreen in Xinglin Garden's live broadcast room, countless comments began flooding the screen.

[The god really likes to perform difficult surgery, huh?]

[The triangle of Calot is in a chaotic mess. I'm guessing that the host surgeon will need around three hours to complete the surgery.]

[How is he going to separate the structures when the gallbladder neck is covered in adhesions?]

The closer they looked, the more anxious they felt. The gallbladder was almost completely covered by a thin membranous layer due to exudative inflammation. Forget the dissection of the anatomical structure, even the gallbladder itself was indistinguishable.

Chief Surgeon Liu and Cen Meng were instantly relieved and put on satisfied smiles upon seeing this.

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Chapter 56: Failed Public Humiliation Plan

There were severe adhesions around the gallbladder, wrapped in the omentum and a capsule formed by exudative inflammation, without any clear view of its anatomical structure,

Zheng Ren continued making two incisions—one below the xiphoid process and another two centimeters below the costal margin on the anterior axillary line—without hesitation after observing the condition of the peritoneal cavity through the laparoscopic camera.

Liu Tianxing smiled disdainfully as, in his opinion, Zheng Ren's consecutive movements had a completely different meaning.

Most experienced surgeons would give up on laparoscopic surgery and resort to open cholecystectomy after seeing such severe adhesions.

The operative view in open surgery was more direct, after all.

Watching Zheng Ren's dexterous finger movements and blunt separation techniques with a pair of hemostatic forceps, Liu Tianxing did not doubt that the man could complete an open cholecystectomy.

However... he was just a young man, after all. Adversity was a precious fuel for greatness, but in the medical field, especially in its current harsh environment, any mistake made during a surgery would damage the surgeon's reputation forever.

Liu Tianxing went down memory lane and a figure appeared before him.

It was that of an outstanding student with decent behavior and skill at surgery, but was also slightly arrogant at times.

What happened to him in the end? He was sent to a suburb to raise rabbits.

Young men were impulsive and radical. They simply did not understand that discretion was the better part of valor.

Time was required to understand that public opinion could obscure the actual truth.

During the period of the Republic of China, Liang Qichao was diagnosed with a malignant renal tumor after experiencing hematuria, undergoing nephrectomy afterward. The surgeon was the director of Union Medical College University and a demon from the urology surgery department at the time.

The result? There was a small tumor located on the right kidney and postoperative pathology determined that it was benign. However, his hematuria persisted and the symptoms were not alleviated despite surgical treatment.

The surgeon did not resect the wrong kidney and Liang Qichao agreed. Based on current diagnostic standards, he had probably been suffering rare autoimmune nephropathy, but it was impossible to diagnose this disease at the time due to limited diagnostic abilities and resources.

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Liang Qichao acknowledged that result, but his students and friends remained unconvinced.

All of them were literati with great influential power, so new rumors were handed down that the demon from Union Medical College Hospital had resected the wrong kidney during the surgery on Liang Qichao, which had damaged Union Medical College Hospital's reputation since then.

That had happened in the era of the Republic, but what about now? There were actually plenty of irresponsible reports about anal suturing and other random things as well.

Chief Surgeon Liu smiled lightly and picked up his phone.

"Little Wang, it's me, your Brother Liu.

"Yes. There is something I need to tell you. I've a subordinate who disobeyed direct orders from his superior and is currently performing a surgery that he can't possibly do well with his standard yet. He has someone powerful at his back but is actually acting with utter disregard for human life.

"Yes, that's true. I'm very angry as well, but there's nothing I can do about it. I even had a myocardial infarction due to rage and I'm hospitalized for observation right now.

"Yes, that's exactly what I mean. This immoral phenomenon mustn't be condoned and justice needs to be served so that the public in Sea City will believe in our medical system again!

"Alright, thank you very much."

After hanging up, Chief Surgeon Liu smiled. "This kind of person should be punished via public humiliation."

Cen Meng was obviously distracted and did not respond. His face sank and appeared slightly pale under the light.

'Little Cen, what kind of attitude is this?' thought the annoyed Chief Surgeon Liu, but he merely expressed his dissatisfaction with just a word. "Huh?"

"Chief... chief, he is separating..." Cen Meng stuttered.

Chief Surgeon Liu had forgotten to watch Zheng Ren's surgery while focusing on the phone call earlier.

This was the kind of surgery that even he had found particularly difficult to deal with, so was it necessary to watch any further?

He raised his head and saw that Zheng Ren was performing blunt dissection of the adhesions around the gallbladder with the dexterous manipulation of both the laparoscopic dissecting forceps and grasping forceps as if they were extensions of his bare hands.

Basically, the gallbladder had been freed while he was on the phone...

This... How could he be so skilled?! Was this not his first time performing laparoscopic cholecystectomy?!

Blood started surging to Chief Surgeon Liu's brain and caused his vision to become blurry, so he quickly shut his eyes and calmed his emotions.

At the same time, comments proclaiming '666' flooded the live broadcast room in Xinglin Garden.

[He is so good with the forceps, it's like he is performing surgery under direct vision.]

[Who said this demon doesn't know how to perform laparoscopic surgery? This operation is by far the best surgery that I've ever seen.]

[Those movements are nimble. I wouldn't even dare lyse the adhesions with a scalpel. Is he not afraid of damaging the hepatic duct at all?]

[Young man, your low standard limits your imagination. You can learn a lot from this video.]

In the livestream, the gallbladder, sticky mess around it and all, as well as the anatomical structures of the triangle of Calot had been exposed after merely a few minutes of manipulation with the grasping and dissecting forceps.

Everything had become clear and distinct.

With that, the difficulty of the surgery dropped from an S rank to a D rank. A surgeon with any kind of experience with this sort of surgery would be unlikely to make a mistake with such clear anatomical structures.

[That was impressive. The adhesions were so severe but it took him only a few minutes to completely expose the underlying structures.]

[This separation process can be written into medical textbooks as every step was done very clearly. I assume the surgery can be finished within the next five minutes.]

[It seems like a dream, I'm asleep right now. From the moment the laparoscope was inserted until now, it has only been around eight minutes and the surgery is finishing soon.]

Yes. The surgery was almost over.

Zheng Ren had tackled every complicated issue in the surgery in a very simple manner within a few minutes. The only thing he needed to do right now was to separate the gallbladder from the gallbladder bed with an ultrasonic dissector, clamp the cystic duct and cystic artery, and finally remove the gallbladder.

The surgery was uneventful with an estimated blood loss of less than 10 milliliters. Any possible doubts were handled without hesitation, the manipulation was done confidently and the whole process was smooth sailing.

Only experienced surgeons who had performed hundreds of similar operations would understand how skillful this surgeon was in these few minutes of performance.

Excellent knowledge of anatomy, proficiency in surgery, stable hands, meticulous personality... and expertise in laparoscopic surgery.

That was amazing!

It was truly outstanding!

Innumerable comments going '666' overwhelmed the live broadcast room in Xinglin Garden.

It was a pity that the website was not meant for entertainment and had no virtual gifts in the system. Otherwise, even if Zheng Ren had kept quiet about it, he would have earned more than ten thousand yuan in profit for a surgery completed within twenty minutes.

In the special demands ward, Chief Surgeon Liu closed his eyes and tried to calm his chaotic mind and heart.

'Don't be angry. Don't be nervous,' Chief Surgeon Liu warned himself. This body belonged to him. What would he do in the future if something went wrong with it due to rage?

He felt calmer a few minutes later.

Silence hung in the air and the only sound that reached his ears was Cen Meng's heavy breathing.

Chief Surgeon Liu lacked the courage to open his eyes and watch the surgery progress; he worried that his blood pressure would skyrocket again after witnessing Zheng Ren's proficiency in lysing the adhesions around the gallbladder and in the triangle of Calot.

"Little Cen, is his surgery going smoothly?" asked Chief Surgeon Liu.

"..." Cen Meng remained silent because he was unsure how to respond to that question.

"How is it?" Chief Surgeon Liu was displeased.

"Chief... Chief Surgeon Liu, the surgery is complete," answered Cen Meng softly after a few moments of hesitation.

What? Finished?

No way!

That was impossible!

Chief Surgeon Liu ignored his control of his blood pressure and snapped his eyes open, only to see that the image on the television was way beyond his expectations. It was not adhesiolysis, the separation of the gallbladder from the gallbladder bed, or even the clipping of the cystic duct and artery with an absorbable or titanium clip.

Zheng Ren was aspirating the residual bile in the gallbladder fossa with an aspirator...

That was... too fast...

Chapter 57: The Demon In Sea City

[I'm speechless. God, are you accepting any disciples?]

[Which hospital is the god working at? I can't fight the urge to further my studies anymore.]

[My fifty-meter surgical sword is craving blood. I'm going to surgery now. Wait for my good news, everyone.]

The live broadcast room in Xinglin Garden was barraged with '666'.

The subsequent procedures were nothing new as they were similar to surgical wound closures in open surgeries. The battle would be over in two to three minutes.

Only a few viewers stared at the operation on the screen in distress. They were veterans of this live broadcast room who had witnessed this surgeon's idea of using protein-based surgical glue to close the subcutaneous layer, and were worried about missing any details in this surgery.

However, the following surgical steps were plain and simple, pure textbook, with no additional moves.

If they had to pick out a difference, it was that the host surgeon was very stable in his manipulation, and every step was done clearly and purposefully.

The host surgeon had actually finished a surgery with a difficulty level of 9.5 without making any mistake, and many viewers failed to grasp what had just transpired.

Of the attending doctors and deputy senior consultants, who had performed dozens or more surgeries so far, only a few of them could understand the essential steps of this operation.

"He didn't even have an assistant. Who was the camera holder just now?" mumbled the perplexed Chief Surgeon Liu who was shutting his eyes tightly to avoid watching Zheng Ren's surgery for a split second further.

The camera holder was basically a surgical assistant whose job was to ensure a clear operative view by holding the laparoscope. It was the same as a surgical assistant holding the retractor in open surgery, but a camera holder was much more important in comparison.

If a surgical assistant was unavailable, a self-retaining retractor could at least be used.

However, a laparoscope could not be fixed, and if the camera holder was unable to keep up with the surgeon's pace, the operative process would be affected.

Chief Surgeon Liu was unable to come up with an explanation despite racking his brain. How was Zheng Ren able to finish a laparoscopic cholecystectomy in less than twenty minutes when he did not even have an assistant?

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Cen Meng was momentarily stunned after listening to Chief Surgeon Liu's mumble. Then, he took out his phone and sent a WeChat message.

He received a reply shortly.

Cen Meng smiled bitterly upon reading the message. In the absence of a surgical assistant, the camera holder turned out to be a scrub nurse—Xie Yiren...

He finished a laparoscopic cholecystectomy just like that?

Yes, that was it.

Zheng Ren began suturing the surgical wounds. Even though the three incisions were less than one centimeter each, he still had the habit of using absorbable sutures to close the wounds with the running subcuticular suture technique.

"Chief Zheng, do you have obsessive-compulsive disorder?" Xie Yiren had begun tidying up the surgical instruments and, upon noticing it, found Zheng Ren's choice of wound closure funny.

A reverse cutting needle with a size seven or four suture thread was more than enough to suture this sort of incision, but Zheng Ren was willing to spend more time to perform a running subcuticular suture technique instead.

"Haha, I want to do everything perfectly," replied Zheng Ren with a smile.

The surgery progress bar on the upper right corner of his vision reached 100 percent after the last surgical wound was sutured.

Zheng Ren was satisfied.

The intensive training in the System's operating theater had proven to be very effective.

Zheng Ren was aware of the difficulty of this surgery, but he had performed more than a hundred cholecystectomies with similar difficulty levels in the System.

Practice made perfect—that was the moral of the story.

At the end of the operation, the patient woke from his general anesthesia. Patient transfer was initiated and the resected gallbladder was sent to pathology.

The patient's family member was sitting on a hard plastic bench outside the operating theater, visibly anxious and restless.

One of his classmates led a group in a Class Three Grade A Hospital in Imperial Capital, but they had recently fallen off contacting each other. Would it be inappropriate to seek him out only when trouble arose? After hesitating for a few seconds, he opened WeChat on his phone and started consulting his classmate.

Soon, he received a response—It was very difficult to perform surgery on this type of cholecystitis, especially when the B-scan report showed a severely edematous gallbladder wall, indicating that it had been inflamed for a few days.

His heart sank immediately.

"It can't be helped. That's the most common complication of acute toxic liver injury, and antibiotics can't prevent this occurrence either. I once encountered a patient whose liver was badly damaged due to pesticide consumption and was on conservative treatment with antibiotics. In the end, he developed fungal infection complicated with cholecystitis," his classmate shared.

It was framed as advice but just made the man's heart sink deeper into the ground.

"You should have told me earlier and sent your father here; the success rate of the surgery will be at least 30 percent higher. This sort of surgery requires patience to lyse the adhesions. It'll take at least three hours to complete the surgery, and that doesn't even include the time taken for anesthesia to take effect and wear off. All things considered, the surgery will require at least four to five hours to complete, so don't worry."

He felt stabbed again.

"Besides, I think the possibility of successful laparoscopic surgery is quite low. It's highly likely that the surgeon will ask you to sign another set of documents and change to an open surgery instead."

There were other messages from his classmates.

Those who studied medicine and engaged with the medical field generally had low emotional quotients and were more direct in their conversations, just like his classmate.

Then, the doors of the operating theater opened and Zheng Ren appeared at the doorstep with a surgical stretcher trolley.

The patient's son quickly put his phone away and approached Zheng Ren anxiously.

"Chief Zheng, do you want a signature again? Was the surgery not going well and you decided to change to an open surgery instead?" asked the patient's son nervously, failing to notice the stretcher trolley behind Zheng Ren.

"The surgery went on smoothly. Do you want to look at the gallbladder?" asked Zheng Ren.

"..." Smoothly? The patient's son was slightly confused.

How long had it been? The surgery had been finished within one hour, including the time taken for anesthesia to kick in and wear off? His classmate had mentioned all these to him just now, but what about the speculated four to five hours of surgery time?

Zheng Ren watched the patient's son stand still like a statue without any response or attempt to assist with the patient transfer.

"What's wrong? Come and lend me a hand," said Zheng Ren.

"Uh..." The patient's son snapped out of his thoughts and asked anxiously, "Are the adhesions serious?"

"Yes, severe adhesions."

"So how did you finish it so quickly?" The more questions the patient's son asked, the more uncertain he was about the current situation. Was it possible that the surgeon closed the abdomen straight away after realizing that it was actually a difficult case? Many people had heard similar rumors.

"Are the difficulty and duration of the surgery related?" Zheng Ren pushed the stretcher trolley and said, "Please press the button for the elevator."

The patient quickly called the elevator and returned to help steer the trolley.

Something just did not sound right. Should the surgery not have taken longer if it was more difficult? Why did Doctor Zheng's words contradict his understanding of the situation?

The surgery was too quick. His family and friends, who had been informed about the case, were still on their way to the hospital when the patient was transferred back to the ward.

After ensuring that the patient's vital signs on the ECG monitor had stabilized, Zheng Ren then returned to his office to give medical orders.

The patient's son left the ward and went to the operating theater when the rest of the family arrived. He wanted to see what the resected gallbladder looked like.

The nurse from the operating theater retrieved the specimen container with the resected gallbladder in it after he explained himself.

There was slender gallbladder tissue with a smooth surface inside. All pus collections had been set aside after they had been removed.

The patient's son was relieved to see no blood on it, as laypeople judged the situation by the amount of blood on the specimen. If there was no blood on it, it meant that the surgery had been successful. He then took a photo of it as a souvenir.

Just as he was about to return to the ward, there was a notification on his WeChat.

He opened it and saw that it was a message from his classmate.

"Don't worry about it. Even though Sea City General Hospital has an average medical standard, they shouldn't have any problem removing the gallbladder." His classmate "comforted" him in an outrageous manner.

"The surgery was complete and everything went well," he replied to the text message.

"!!!!!" His classmate replied with five exclamation marks.

"Really." The patient's son sent the photo he took just now.

The gallbladder, pus collections and adhesive tissue were clearly visible.

Normally, pathological specimens did not contain any pus collection as they would simply break into shreds during dissection, leaving nothing to send to pathology.

However, the photo showed the removed pus collection and adhesive tissue still intact next to the gallbladder, which had been cleanly resected with its anatomical structures well visualized.

"Since when did Sea City have such a professional surgeon?!" asked his classmate in WeChat.

If he had not seen it with his own eyes, he would definitely not have believed that someone actually possessed the skills to resect the gallbladder so professionally.

The patient's son read his classmate's response and felt a sense of pride in his heart.

Chief Zheng from Sea City General Hospital was indeed a demon!

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Chapter 58: Bronze Rank in The King

Zheng Ren documented the surgery while recalling its preoperative process.

He had gained a lot from the intensive training in the System's operating theater. Moreover, he had a feeling that the increment in his overall skill level had had some effects on certain subspecialty surgeries as well.

Should he put all his savings of 930 skill points into the general surgery skill tree?

After contemplating for a while, Zheng Ren decided to wait.

Old Chief Physician Pan was extremely satisfied with Zheng Ren's surgery. After the patient had recovered from general anesthesia, his side effects were not serious and he did not even feel much pain.

It was indeed a wise decision to force Zheng Ren's transfer to the emergency department. This thought put a delighted smile on Old Chief Physician Pan's face.

However, the establishment of an emergency center could not depend solely on one doctor. No matter how strong Zheng Ren was, even if his body was made entirely of metal, how many nails could be made out of him in the end?

The more outstanding Zheng Ren's performance was, the heavier the burden on Old Chief Physician Pan's shoulders.

The patient's condition was stable. Zheng Ren proceeded to oversee the emergency department while Old Chief Physician Pan rushed to the medical administration division.

Naturally, his purpose there was to demand more manpower. The surgical assistant in Zheng Ren's surgery today turned out to be a scrub nurse. It would be utterly humiliating if anyone caught wind of this.

Old Chief Physician Pan strode toward his destination. His presence had annoyed the chief of the medical administration division greatly these past few days.

Dark clouds swarmed above Chief Zhou of the medical administration division instantly upon seeing Old Chief Physician Pan through the window.

If hospital management transferred doctors from any department to the emergency department, he would definitely offend the senior consultant of the corresponding department.

After all, every clinical department had a shortage of medical staff, so it would be very difficult to make an interdepartmental transfer.

Most importantly, no doctors wanted to work in the emergency department.

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The emergency department was just like Siberia—a place for exiled criminals.

The fact that Old Chief Physician Pan was here at the medical administration division again made Chief Zhou pull at his hair in frustration.

If this situation continued, Chief Zhou firmly believed that Old Chief Physician Pan would consider the medical administration division his home.

The very thought of seeing that square face every day at work sent a chill down Chief Zhou's spine.

"Chief, this is the information you requested."

Chief Zhou's eyes shone brightly. Why did he not think of her before?

"Little Chang, how long have you been working in the medical administration division?" Chief Zhou put his thoughts into action quickly before Old Chief Physician Pan could arrive at the office.

"Five months. I'll be able to return in another," answered the lady whom Chief Zhou addressed.

Little Chang's full name was Chang Yue, a twenty-five-year-old woman who stood between 162 and 163 centimeters and sported a pair of black-framed spectacles.

Despite her young age, she was neither carefree and joyous but appeared mature and prudent instead. She was a bachelor's degree holder from the third batch of undergraduate students within the province. In Sea City General Hospital, this type of doctor was the least favored and had very limited opportunities for promotion.

After her graduation, she had come to Sea City General Hospital by chance and was hired as a resident doctor in the obstetrics and gynecology department.

A few months ago, a female patient was admitted to the ward in the obstetric and gynecology department due to post-miscarriage vaginal bleeding. She was accompanied by a paramour but unfortunately, her husband was on the scene as well.

The cuckold lost his mind instantly and cut his unfaithful wife's carotid artery with a fruit knife on the spot. Blood splattered up to the ceiling and everyone fled in terror.

Everyone was frozen to the spot when the man walked out of the ward with a bloodstained fruit knife, but Little Chang was unusually calm and started speaking to the man about ideals, life, worldly affairs... The conversation continued until police officers arrived on the scene.

The man had cried with tears and snot flowing down his cheeks as he gave up without a struggle.

Her skills in initiating conversation made her a king in this category.

Logically, Little Chang should have been commended, but things did not develop as planned.

One of the frightened patients had had an accidental prenatal disturbance as she ran out of the ward and ended up having a miscarriage.

The patient's family members sued the hospital and demanded compensation of one million yuan.

In the end, Little Chang had to take the fall as she had been the doctor on duty that day. She received admonition and was suspended for six months.

Such disorganized nonsense was common in the hospital and the only difference was who the scapegoat would be each time.

Little Chang merely assumed that she had run out of luck and reported to the medical administration division without crying or argument.

She always completed her assignments well. One could imagine her being a brick that could be utilized anytime and anywhere.

Chief Zhou had initially planned to let her continue working in the medical administration division, but she just smiled and rejected his kind offer twice.

Trouble would be inevitable if she returned to the obstetrics and gynecology department. Those who framed her would probably feel guilty upon seeing her but would not mind digging a pit for her again if the need arose.

The chief of the medical administration division had witnessed this dark side of people countless times in his life.

Such being the case, what about transferring her to the emergency department?

"Little Chang, your admonition is coming to an end. What are your plans after this?" The chief of the medical administration division put on a kind expression and asked softly.

"I'm going to continue my clinical work. I don't know how to perform other tasks, anyway," answered Little Chang in a relaxed manner.

"It'll be troublesome in the obstetrics and gynecology department in the future."

"You're right." Little Chang was well aware of her situation.

"I've an idea. Why don't you give the emergency department a try?" The chief of the medical administration division had no time to explain further and stated his intention directly when Old Chief Physician Pan disappeared from the transparent French window.

"The emergency department?"

"Old Chief Physician Pan has set up an emergency center recently. I think you'll benefit more in the long run if you go there." The chief of the medical administration division was sincere and earnest in his explanation. "Old Chief Physician Pan is different from the others. He was born a soldier and is very protective of his own subordinates. If you encounter similar incidents again and your superior is Old Chief Physician Pan, he will definitely not ask you to take the blame for his safety."

"..." Little Chang kept quiet and gave it some thought.

Her double eyelids were conspicuous despite her small eyes, which made appear that her eyelids were actually bigger than her eyes.

Her eyelashes were long and radiated an aura of an elf with every blink, but her gaze remained indifferent no matter who she was talking to. Even as she faced the chief of the medical administration division, who held the power to decide her fate, her tone was respectful but did not contain the slightest mote of flattery.

Not only was there a lack of flattery, she even appeared slightly... apathetic.

"What do you think? Old Chief Physician Pan is a god. If you want to have a breakthrough in the medical field with your current educational background, it's better for you to work in a newly established department." The chief of the medical administration division was trying to brainwash Little Chang like a Grandma Wolf constantly tempting the little white rabbit.

The little white rabbit smiled in response. "Even if I want to go, I still have one more month of admonition."

"Don't worry about it." The chief of the medical administration division waved his hand immediately after knowing that Little Chang had been persuaded. "Anyone who dares to have a different opinion will come to the medical administration division to get their dues, or maybe they will go to the emergency department instead."

Perhaps, in his smugness, the chief of the medical administration division worded his last statement wrong, which embarrassed him slightly.

Incidentally, Old Chief Physician Pan barged into the office.

He sat directly on the couch in the office and asked, "Chief Zhou, where are my men?"

"Haha, Old Chief Physician Pan, you arrived just in time." In order to conceal his embarrassment, the chief of the medical administration division smiled and said, "Little Chang has agreed to work in the emergency department."

"Little Chang?" Old Chief Physician Pan glanced at the lady before him, obviously unsatisfied.

He needed male doctors who could perform surgery, not female doctors.

The medical industry had always treated women as men and men as livestock. Naturally, Old Chief Physician Pan was dissatisfied by the fact that he had lost one of his livestock to work his butt off.

However, Old Chief Physician Pan recognized this female doctor and admired her attitude since the rumors around her had been widely spread within the hospital.

Old Chief Physician Pan did not refuse the offer, but continued to ask, "Do you think one is enough?"

"There is a batch of students under training this year. I'll give them to you as long as they agree to stay, how does that sound?" Chief Zhou's promise was basically pie in the sky.

After arguing for some time, Old Chief Physician Pan solidified Chief Zhou's impression that he would be a thorn in the chief's side every day if his manpower remained inadequate.

Then he said, "Little Chang, pack your stuff and return to the emergency department with me."

Little Chang nodded obediently.

She took her bag with only a few items in it and followed Old Chief Physician Pan.

The chief of the medical administration division sighed in relief after Old Chief Physician Pan disappeared from view. He had managed to overcome today, but what about tomorrow?

He hoped Little Chang was good at her job and could satisfy Old Chief Physician Pan's needs temporarily.

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Chapter 59: I Don't Want To Perform Surgery

Old Chief Physician Pan and Little Chang chatted casually along the way.

The untalkative and reserved lady did not shamelessly lick the new chief physician's boots but held the emergency department in high regard. Every sentence was straight to the point, which pleased Old Chief Physician Pan greatly.

Especially with the two recent events involving the medical administration division—the endoscopic transrectal appendectomy and nitrite poisoning, in Chang Yue's words, Old Chief Physician Pan was a good commander and had contributed to the success of these two operations.

Old Chief Physician Pan finally managed to get new staff for the emergency department and the first thing he did was to assign Chang Yue to Zheng Ren and to give a few instructions, such as obeying Zheng Ren's commands, devoting her effort to the establishment of the emergency center and so on.

Zheng Ren had just issued postoperative medical orders and was about to document the details of the surgical case when Old Chief Physician Pan gave him a junior laborer. Thus, he explained the patient's condition briefly and threw the work to Chang Yue.

Chang Yue did what she was told obediently without impatience or flattering Zheng Ren. She put down her bag without asking for a locker, called the patient's family member for history-taking and started recording their details.

Zheng Ren went for a ward round in the meantime. The wards in the emergency center were separated from the emergency department observation units, and there was only one patient in it at present—the elderly man who had undergone a cholecystectomy.

The patient had fully regained consciousness from the general anesthesia. He felt slightly nauseous but no emesis was noted.

He complained to Zheng Ren several times about the discomfort caused by the nasogastric tube, but after coaxing and even lying with good intent, Zheng Ren finally managed to calm the patient down.

The nasogastric tube had been inserted into the nostril, passed through the nasopharynx, esophagus and finally to the stomach. Gastric contents could then be aspirated by negative pressure.

When the tube passed through the nasopharynx, the swallowing action would stimulate the pharyngeal mucosa, which was why the patient had been experiencing discomfort.

Well, nothing could be done about it.

After Zheng Ren was done checking the patients, he returned to the office and saw that Chang Yue had finished writing the medical record and was on her way downstairs to request a key from the matron.

The case documentation had been completed in such a short time?

Was this junior doctor not serious in her work? That was Zheng Ren's first assumption. If she was unable to take her job seriously, he would still have to do all the work personally in the future.

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There was no way he would hand over such an important task—medical case documentation—to a sloppy doctor.

Even though Zheng Ren had the System to aid him, it was his habit to handle every clinical matter vigilantly.

If he was unfortunate enough to get caught in a medicolegal issue, all his arguments would be invalid if messy medical records were used as evidence.

However, after casually reading the medical record, Zheng Ren was instantly impressed by Chang Yue's work. This lady was good!

The medical record was simple, clean and straightforward. There were no unnecessary points or format errors, just as required by medical documentation standards.

Important points from the patient's medical history and physical examination findings that he mentioned earlier had been written concisely but clearly.

Moreover, she had questioned the family member for further information and recorded additional changes in the patient's condition as well. A surgeon's medical case documentation would never reach the standard of a physician's as it was predetermined by the nature of their work.

Not a single flaw could be found and the record conclusively proved that the patient had to undergo surgery, or his condition would worsen and end in death.

'This is very good.' Chang Yue had received Zheng Ren's preliminary approval through a medical record.

The nurses were idle since there was only one postoperative patient in the ward. Thus, the newly arrived matron made the best use of this time by training the nurses so that they would not panic and delay the resuscitation process when dealing with an emergency.

After Chang Yue received her key, she put her bag in the locker and returned to the office.

"The case is well documented."

"I won the first place in a regional medical record documentation competition," answered Chang Yue truthfully.

Zheng Ren admitted that he had no idea what sort of competition that was.

At least she was highly skilled in recording medical cases, but as for her other qualities, they would require careful observation in the future.

Regarding his first... she should be his second colleague because the first place belonged to Xie Yiren forever. Regarding his second colleague, he deemed it necessary to ask about Chang Yue's requirements and plans for her future.

"I don't want to perform surgery. I just want to become a good physician," said Chang Yue.

"Hematophobia or is it something else?"

"No, I just like to chat with people."

It was a simple conversation, but Zheng Ren knew that she was not interested in assisting with his surgery. At least she could write medical records well and take care of his patients, which were also equally important.

After all, he could devote all his attention to surgery after throwing all his other chores at her in the future.

During their conversation, a phone call from the emergency department came in about a suspected acute appendicitis case which required Zheng Ren to confirm the diagnosis.

Zheng Ren then brought Chang Yue to the emergency department.

The patient was a young male college student who had been sent over by his classmate.

The diagnosis was confirmed and he was admitted to the ward for preoperative preparations.

Zheng Ren had achieved at least the Master rank in his appendectomy skill. Objectively speaking, Zheng Ren figured that he was a grandmaster whose skill could rival every surgeon in the province even though he had not yet reached the peak.

After examining the patient, Zheng Ren started reading medical literature to hone his skills. A slight increase was better than nothing. That was his mindset after experiencing prolonged suffering since childhood.

He assigned the chores—patient-doctor communication, preoperative counseling and preparations—to Chang Yue.

"Ding-dong!" The System gave him a mission all of a sudden.

[Long-term Main Mission: The Best Surgeon.

[Task: There is still a long way to go to become the best surgeon. For every ten operations completed, depending on the degree of completion, a reward will be given accordingly.

[This mission will not overlap with other missions.

[Reward: 10 skill points and 1000 experience points will be rewarded for every ten tier-one surgeries with a completion rate of 80 percent. One tier-two surgery is equivalent to two tier-one surgeries. One tier-three surgery is equivalent to four tier-one surgeries. One tier-four surgery is equivalent to eight tier-one surgeries. The System will announce a new calculative index when more advanced surgeries are complete.

[Time: Forever.]

This mission... Zheng Ren savored the moment for a while. The System must be encouraging him to perform advanced surgery. If this was a long-term main quest, he would have a continuous flow of income hereafter.

As he recalled the forty-nine appendectomies and one endoscopic transrectal appendectomy he had performed just recently, some heartache crept into his chest.

It would have been better if the System had assigned him this main mission earlier as he would have easily gained a few hundred skill points and several thousand experience points. Even though these rewards were incomparable to those gained in the sudden mission, they were still extra profit.

Ninety minutes later, Chang Yue had made the necessary preparations and Zheng Ren brought the patient into the operating theater.

Twenty minutes later, Zheng Ren brought the patient back to the ward before Chang Yue even had time to sit down and take a sip of water.

The twenty-minute surgery included fifteen minutes of anesthesia as well.

Zheng Ren was delighted to see the 10 percent progression rate under the long-term main quest—The Best Surgeon—that he had just received.

Chang Yue was a little surprised, but hid her emotions well.

She continued her busy work afterward. She took over the patient, gave postoperative advice, and waited for Zheng Ren to finish documenting his perioperative procedure before she started writing the postoperative records.

Zheng Ren felt refreshed, having passed all that tedious paperwork to Chang Yue.

His mood improved further when he recalled that the laparoscopic cholecystectomy—a tier-three surgery—had contributed to 40 percent of the progression rate.

Unfortunately, Zheng Ren had performed only two surgeries on the first day of the emergency center's grand opening, which dissatisfied him to an extent.

Chang Yue was prepared to leave work in the evening.

On the other hand, Zheng Ren volunteered to stay in the ward twenty-four seven as there was no corresponding doctor in charge of the emergency ward. He even considered terminating the tenancy agreement on the house he had rented together with Little Zhao.

Originally, chief residents were required to stay in the ward at all times. It had previously been a special situation in the emergency department.

It was inhumane, but it was how things were.

It was just a temporary measure, though. Zheng Ren would not have to do this any further once the emergency center was fully staffed in the future... In the meantime, he had to stay in the ward twenty-four hours a day, seven days a week and four weeks in a month until the next chief resident took his place.

Just as Chang Yue was about to leave work, Old Chief Physician Pan returned cheerfully with two familiar-looking women following closely behind him.

"Zheng Ren, I brought two more pairs of hands for you."

"..." Zheng Ren recognized them after taking a closer look. They were the twin sisters—Chu Yanran and Chu Yanzhi.

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Chapter 60: Difficult Choices

"You..." Zheng Ren was slightly puzzled. He still vaguely remembered that one of these two ladies mentioned something about coming back for training.

He did not expect it to be true.

"We're back," said the twins in unison.

Old Chief Physician Pan smiled and said, "Even though we don't have EICU, they can still engage in anesthesia first. You're lacking anesthesiologists, right?"

That was true. An anesthesiologist seconded from the operating theater would not be as attentive and diligent as his own.

Moreover, he had heard through the grapevine that the anesthesiologist was about to resign and move to a new unit somewhere in the South. Otherwise, it would not have been so easy to second him to the emergency department.

However, were these two ladies up to the task?

Zheng Ren could not refuse Old Chief Physician Pan as the old man had been running around hospital management all day just to demand more manpower. It was not an easy task, either.

"Can you come to the emergency department at night?" asked Zheng Ren directly.

"Yes."

"Okay. You can leave me your numbers and go home now." Zheng Ren showed no enthusiasm and was as calm as a millpond.

The Chu sisters, who had met Zheng Ren and frequently grumbled about his emotional quotient for some time, were mentally prepared to receive this sort of response.

This chief resident was an idiotic pig!

The twins smiled and said, "Don't forget to call us if there are any emergency cases."

Zheng Ren was reluctant to speak anymore and merely waved his hand in response. Then, he went back to his room and began reading hepatobiliary and pancreatic surgery literature.

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Rather than wasting time on chatting or cottoning up to the Chu sisters, he might as well utilize this time to read the book for a couple of hours and gain one or two skill points.

Zheng Ren's thoughts... No wonder he had not had any girlfriend so far. It would be very strange if he was in a relationship.

It seemed that reaching out to the hearts of others had recently fallen out of fashion.

...

...

Once everyone had left the department, Zheng Ren went to check on the two postoperative patients again, whose conditions had remained stable thus far. Then, he had dinner with the nurses, went back to his room and started reading the surgery book.

He already had 1931 skill points in his general surgery skill tree. He then calculated the potential rewards of the missions at hand—the long-term main quest and the mission called The Initial Construction of The Emergency Operating Theater.

Whether he could complete five emergency cholecystectomies within one week depended solely on fate and had nothing to do with his skill level.

As for the three skill books and the 930 skill points in his inventory, which were essentially his family inheritance, he felt reluctant to squander them all as they might save him in an emergency.

It was a peaceful night.

...

...

Cen Meng was in distress.

Everything had gone wrong ever since Professor Moriyu performed the surgery.

Not only did he fail to acquire a chance to further his study in Japan and enrich his personal development, he had actually gotten himself into trouble since.

Chief Surgeon Liu refused to acknowledge Cen Meng's presence during his visit as well. Perhaps Cen Meng was going to take the blame for all the failures this time.

However, this was not the worst issue yet.

He received a phone call from his uncle this morning.

Cen Meng's home was located out of town and the fact that he was able to work in Sea City General Hospital was all thanks to his uncle.

On the phone, Cen Meng's uncle said that he had abdominal pain and yellowish discoloration of his skin after returning from a meal with alcohol.

The symptoms mentioned were simplified but Cen Meng immediately realized that his uncle was likely suffering from acute obstructive cholangitis.

Cen Meng dialed 120[1] and called an ambulance for his uncle as it was too late in the day to pick him up personally.

The diagnosis was confirmed and his uncle required immediate surgical treatment, but Cen Meng hesitated when deciding who to be the surgeon for the surgery.

In the first general surgery department, Chief Surgeon Liu had been hospitalized, and a few deputy chief surgeons... Cen Meng figured that they were not up to par since Chief Surgeon Liu had been suppressing them for a long time. If he was merely performing a simple cholecystectomy, its success rate would be very high.

However, this was a cystic duct obstruction with a high risk of complications such as acute pancreatitis. Even in the absence of complications, the edematous cystic duct alone was enough to give Cen Meng a terrible headache.

Cen Meng could still give this surgery a try if Chief Surgeon Liu could supervise him.

There was no way he would perform this surgery under such circumstances.

Should he turn to Chief Surgeon Sun from the second general surgery department for help?

Cen Meng's uncle had a married daughter who had bought a house in Shenzhen City. Even though Cen Meng stayed in Sea City, his uncle still treated him very kindly as if he was actually a son.

A figure suddenly emerged and lingered in Cen Meng's mind.

Zheng Ren...

After witnessing Zheng Ren's performance in cholecystectomy last time, apart from envy, jealousy and hatred, Cen Meng had developed a different emotion as well. Since when did this kid reach such proficiency in surgery?

Surgery skills could be honed only through constant practice. There was no other way.

Both of them had worked together in the same department for several years, but Cen Meng had no idea that Zheng Ren was actually concealing his true standards.

Zheng Ren had performed four cholecystectomies in the last three days and each of them had been done beautifully. If the surgeries were considered entertainment, they would have made viewers relaxed and happy.

Thus, Cen Meng suddenly came up with an idea—let Zheng Ren do it.

This idea was like a devil. It could not be destroyed once it emerged.

Subconsciously, he had admitted the truth—Zheng Ren's standards of cholecystectomy and appendectomy were much higher than those of Chief Surgeon Liu and Chief Surgeon Sun.

As for himself... he was far worse in comparison.

If this had been an ordinary patient, Cen Meng would have definitely requested Chief Surgeon Sun supervise his surgery instead of letting him receive treatment in the emergency department.

However, Cen Meng hesitated as this patient was his uncle, who had treated him like a son.

After hesitating and contemplating for a few minutes, Cen Meng finally made up his mind.

He picked up his cell phone and pressed the dial button fiercely.

"Meng'zi, we're arriving soon." Cen Meng could hear his second aunt crying on the other end.

"Aunt, don't worry. Listen to me first." Cen Meng, who was holding the phone in his left hand, clenched his right fist tightly and buried his fingernails deep into his palm.

"Go to the emergency department directly and look for a doctor named Zheng Ren." After saying this, Cen Meng felt an overwhelming embarrassment, but finally let go of all his reservations and added, "Go to the emergency department and let him do the surgery immediately. Aunt, please don't mention my name."

"..." The other end of the phone remained silent.

Cen Meng's heart hurt so bad as if he had been stabbed by a knife.

"Meng'zi, your uncle treats you very well," said Cen Meng's second aunt a few seconds later.

"Aunt, that is exactly the reason why I asked you to go to the emergency department," replied Cen Meng directly. Once the shame had been dealt with, the rest of it became easy instantly.

"Doctor Zheng Ren from the emergency department is the best surgeon to perform hepatobiliary surgery in our hospital," Cen Meng explained anxiously, "But don't say anything about me because we had disagreements before. I'll visit uncle later."

"Okay... Alright then..."

Cen Meng hung up and took a few deep breaths, but was still unable to wipe out the resentment that was buried deep in his heart.

As a surgeon, he had actually informed his closest relatives that his skill level was not up to par. He felt utterly pathetic.

Cen Meng, born in the countryside, had been swallowing his pride and giving up his dignity just to seize every opportunity in life, but why was the result still the same?

He was uncertain about his future.

...

...

The ambulance drove straight to the emergency department of Sea City General Hospital. The doctor in the emergency department saw that the patient was in a critical condition and immediately phoned Zheng Ren.

The Initial Construction of The Emergency Operating Theater was almost complete after performing four cholecystectomies within the past three days, and the last three surgeries gave Zheng Ren a 120-percent completion rate according to the terms in the main quest.

In addition, Zheng Ren had performed seven or eight appendectomies these past few days. He had actually completed the main mission twice and received 20 skill points and 2000 experience points as the mission reward.

The patients' postoperative recovery had been satisfying. The first patient who had undergone an appendectomy had already been discharged from the hospital and returned home to rest.

Not only had he performed a few surgeries, he had been reading medical books as well over the last few days. Thus, he had accumulated 1945 skill points in his general surgery skill tree and was about to break through the 2000-point mark.

Zheng Ren was reading a book when he received the call. After knowing that a patient with obstructive jaundice had been sent to the emergency department via ambulance, he took Chang Yue downstairs immediately.

Acute appendicitis and acute cholecystitis were not life-threatening diseases, but a patient with obstructive jaundice might pass away at any time. Negligence was unacceptable.

[1] Telephone number for emergency medical service in China.

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Chapter 61: Sudden Reward From The Fickle-Minded

In the emergency resuscitation room, the doctor in charge of B-scan ultrasonography had already started examining the patient.

Before Zheng Ren had time to read the patient's condition in the upper right corner of his vision, a bell rang in his ears. "Ding-dong!"

Huh? A mission? Was this person suffering from a special disease?

[Sudden Mission: The Opponent's Submission.

[Task: Complete surgical treatment for acute obstructive suppurative cholangitis.

[Reward: 200 skill points and 10000 experience points. The higher the surgery completion rate, the greater the reward. If the completion rate reaches 100 percent, additional rewards will be awarded.

[Time: 6 hours.]

What the f*ck... Zheng Ren's eyes nearly popped out of his head.

Even though the System was not stingy, it was not particularly generous either. In the beginning, when the System had been unstable, the surgical intensive training time given to him had been calculated in hours. Once it had stabilized, the System came up with a new gameplay mechanic—experience points—and started calculating training time in seconds.

The System was indeed fickle-minded.

However, this time, the System was actually awarding 10000 experience points for a simple mission named The Opponent's Submission. That could be converted into precious surgical intensive training time!

Moreover, the time given for the completion of this mission was six hours, which meant that any remaining time would be converted to surgical intensive training time.

What in the world was this?

The confused Zheng Ren savored the thought carefully, only to realize the meaning behind the mission's name after a few seconds.

Someone who was hostile toward him had surrendered. That must have been the case.

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That made sense!

"Chief Zheng, there is a blockage in the patient's common bile duct," said the doctor in charge of the B-scan ultrasonography.

"He needs emergency surgery. Establish venous access, nasogastric tube insertion, urinary catheterization, and start preoperative preparations. Chang Yue, explain the surgery to the patient's family members."

No matter whose family this patient was related to, judging by the mission name, his condition could not be delayed any further.

"Do you know how to perform preoperative counseling of a jaundiced patient?"

"I'll let you review my documentation once I'm done writing," answered Chang Yue.

The nurses and Chang Yue started preparing the patient for surgery without delay.

"I'm going to the operating theater to prepare the equipment. Wheel the patient in as soon as signatures are acquired and preoperative preparations are complete." Zheng Ren scanned through Chang Yue's perfectly written preoperative documentation and left in a hurry.

He appreciated Chang Yue very much after getting to know her better these few days.

She was definitely the kind of person who could bring the dead back to life and send the living to heaven through conversation alone. In addition, all of her paperwork was flawless and indisputable, which greatly eased Zheng Ren's workload.

Chang Yue's preoperative counseling offered better results than Zheng Ren's.

Apart from that, Chang Yue's voice seemed to possess a miraculous ability to calm down the patient's family members without them realizing it.

Zheng Ren hurried toward the operating theater to make necessary arrangements for the operation.

Acute obstructive suppurative cholangitis was a tier-three surgical case, and the surgery was far more difficult than laparoscopic cholecystectomy with new technology.

Most importantly, the System had hinted that this patient was not suffering from a simple choledocholithiasis. It was a rare parasitic infestation of the bile duct!

Zheng Ren wanted to achieve perfection in the surgery, which was why he had to find someplace quiet and visit the Shop for some equipment purchase.

He was going to perform an unconventional operation, one that had never been done in the medical field thus far. It was a surgical technique that he inferred from and experimented with on dozens of mannequins in the System's operating theater.

Since it was a new technique, the newly established emergency operating theater definitely did not have suitable instruments. In fact, such instruments did not exist in the world, so he had no choice but to buy them from within the System.

In the operating theater locker room, Zheng Ren changed into surgical attire and went to the smoking area. Then, as usual, he lit up a Ziyun and took a deep drag, allowing the spicy tobacco to stimulate his nervous system before diving into the System.

He had previously spent all of his experience points learning laparoscopic cholecystectomy, so he could not buy the equipment even if he wanted to.

After completing the main quest several times recently, he had managed to save up some points, just enough for him to purchase a few instruments.

He opened the Shop and scrolled down the menu. From his familiarity, it seemed obvious that he had been planning to buy the equipment all along.

Zheng Ren clicked "Purchase" without hesitation and left immediately with the equipment in sterile packaging in his hands.

Pathetically, there were only 200 points in his savings after spending 1800 on his new equipment.

Upon returning to the smoking area, Zheng Ren stubbed out his cigarette, put it back into its pack, and entered the operating theater with the newly purchased equipment.

"Chief Zheng, what's this surgery about?" A slender figure appeared on the other end of the corridor.

Despite having spent two to three days together, Zheng Ren still had trouble distinguishing the twin sisters—Chu Yanran and Chu Yanzhi.

The question was unfathomable and Zheng Ren would likely never get the correct answer in his lifetime.

"Acute obstructive suppurative cholangitis," answered Zheng Ren.

"It's going to be a new surgery, then. Do you need assistants?" asked the twin.

"Hold the retractor if you have time. I'm going to perform an open surgery today."

"I'll assist you if you can accurately identify me," said one of the Chu sisters, who seized every opportunity to criticize Zheng Ren for his face blindness.

They no longer cared that Zheng Ren had absolutely no desire to court beauties.

"Yiren, prepare an automatic retractor holder," yelled Zheng Ren.

Xie Yiren's clear and melodious voice traveled from the storage room.

"Oh, that's boring. Can't you make a guess?" asked one of the sisters.

"The patient is jaundiced and needs immediate surgical treatment." Zheng Ren walked into the operating theater with a blank expression, which was barely visible in the first place behind a surgical cap and mask.

"When will the patient arrive?" the other Chu sister asked.

"It depends on when Chang Yue can get the family member's signature."

"Prep up, then, the patient will arrive soon." The Chu sisters went into the operating theater together and began preparing for general anesthesia.

The twins were definitely better at anesthesia than those undergoing standardized residency training. They claimed that they had anesthetized hundreds of surgical patients during their training in West China Hospital.

The anesthesiologist seconded to the department, who was going to resign soon, had become even lazier after witnessing their standards and would only take part in preoperative anesthesia administration from time to time.

Zheng Ren did not know if the sisters had actually anesthetized that many patients, but after observing several operations, he concluded that they were highly skilled at both general and epidural anesthesia. This was especially obvious during the general anesthesia recovery phase, where they could get the patient to regain consciousness right after he cut the last suture thread.

The patient was wheeled in five minutes later, just as the Chu sisters predicted.

Chang Yue and the nurses in the emergency ward had the credit for such a drastic response.

Preoperative preparations had been completed swiftly and Chang Yue had been able to persuade the patient's family members to sign consent forms. These two elements were indispensable.

After the patient was transferred to the operating table, the Chu sisters began intubating and anesthetizing him.

"Burn my calories!" shouted one of the Chu sisters childishly.

'That one is Chu Yanzhi.' This was the only time Zheng Ren could differentiate the two.

The younger twin—Chu Yanzhi—was slightly more active and childish than her older sister. She was also the only one who could say such a shameless and silly statement.

Her statement did not refer to burning calories for weight loss but rather focused her attention on the surgery at hand, like a superhero saving the universe in manga.

What a childish postgraduate student. Had all her studies been in vain and had she actually turned insane after being in the medical field?

Zheng Ren began performing a surgical scrub to decontaminate his hands.

"The anesthesia is complete," announced the Chu sisters in unison like a chorus.

Their lovely eyebrows and soft voices were a feast for the senses.

Zheng Ren put on a sterile surgical gown and a pair of sterile gloves before placing the last layer of surgical drapes on the operative field. After that, he took sterile light handle covers from Xie Yiren and installed it on the surgical lighthead.

That way, Zheng Ren could position the surgical lighthead according to his own needs.

The operative site was disinfected with iodophor-soaked cotton and wiped with dry gauze. Xie Yiren then placed the scalpel handle on Zheng Ren's outstretched hand.

Zheng Ren's surgery was again broadcast live in Xinglin Garden during the disinfection process.

[Watching the god performing surgeries is indeed beneficial. I could even feel some improvements in my laparoscopic cholecystectomy skill these past few days.]

[Even a fool can do it after repeated observation. What are you so proud of?]

[Huh? An open surgery today? Let me read the medical record. Wow, this is actually a case of acute obstructive suppurative cholangitis! Finally, I can learn new surgical techniques!]

An incision was made on the right costal margin. The scalpel cut through only the epidermis and dermis without damaging any underlying capillaries.

This was considered a meticulous action.

[It takes more than thirty years to master such incising skills.]

[Is the god planning to perform blunt dissection after making the incision?]

[Isn't this his habit in every surgery? Have you seen the god achieving hemostasis by cauterization? Cauterizing the subcutaneous tissue...]

[Barbeque smell with mushy meat. Your statement made me hungry. I'm going to indulge in some barbeque skewers after this surgery broadcast is over.]

The doctors chatted leisurely; the atmosphere in Xinglin Garden was relaxed and lively as none of them had seen the pathological tissue.

Zheng Ren bluntly separated the subcutaneous and fascial layer and opened the peritoneum. The moment the surgical field was expanded using an automatic retractor holder, the live broadcast room instantly went quiet.

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Chapter 62: Edematous Gallbladder

Intraoperative exploration revealed that there were no abnormal changes in the stomach and small intestine. The liver was normal in size and smooth with no irregularities or nodules commonly seen in cirrhosis.

However, the gallbladder was congested and visibly edematous, and it was slightly larger than half an adult man's fist.

The swollen gallbladder looked like an inflated balloon. From its appearance alone, any iatrogenic perforation would blow this surgery sky-high.

[Wow, how many gallstones have accumulated in this gallbladder?]

[It isn't necessarily caused by gallstones. It could be parasites, too.]

[Why do I have a feeling that the gallbladder will rupture at the slightest disturbance, causing bile to flow into the peritoneal cavity and contaminating the operative site? Damn it, I can't watch anymore. I'll probably have a nightmare about a never-ending surgery.]

Despite their claim, the anonymous doctor stayed. In fact, none of the viewers left the broadcast room, and more latecomers continued to come into the livestream to observe the surgery performed by the demon, who had become a legend in Xinglin Garden.

With the tip of his scalpel, Zheng Ren made a small incision 0.5 centimeters away from the liver edge. After that, he began his signature move—blunt dissection.

Most of the viewers were experienced surgeons with hundreds of surgeries under their belt, or they would not dare to even comment on the livestream.

However, none of them could reach Zheng Ren's level of skill at blunt dissection.

After repeated observation of his 491 appendectomies, some of them tried to perform a larger range of blunt dissections, but their results had been disappointing and in some cases nearly caused iatrogenic intestinal perforations.

During this period, a new discussion post appeared in Xinglin Garden for those who attempted the host surgeon's technique after watching the live broadcast.

Some of them initially thought that their skills were inferior, but after reading through the post, it seemed everyone was on the same level.

It was likely due to their own perspectives and that the host surgeon had actually performed many surgeries to achieve such expertise in his manipulation.

There was pin-drop silence in the live broadcast room as Zheng Ren bluntly dissected tissue with a pair of hemostatic forceps and his fingers.

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Zheng Ren's movements induced slight tremors in many viewers' fingers.

Like a butcher skillfully and effortlessly dismembering an ox, it was obvious that they could only observe this master at work without no hope at imitating his actions.

The edematous gallbladder, half the size of an adult man's fist, had extremely high surface tension. Even a simple open cholecystectomy would require one to proceed with the utmost vigilance, let alone blunt dissection, as a split-second distraction could rupture the gallbladder.

Even so, the host surgeon seemingly manipulated the instruments without a second thought. The medium curved forceps reached under the incised serous layer of the gallbladder surface and bluntly separated the tissue at a quick pace.

That speed... He must have a death wish.

However, no one would comment that on the livestream.

This was due to the humiliation of every one of the host surgeon's previous critics. To preserve their mortification, many nosy parkers had screenshotted their comments as evidence for the discussion forums.

A few seconds later, the tissue had been bluntly dissected up to the gallbladder neck. The host surgeon then began lysing the messy adhesions caused by inflammation in the Calot triangle.

His finger movements were proficient and slow, but every step was seemingly done without forethought, which frightened the doctors watching the livestream.

The surgeon was walking a tightrope! Generally, professors in Class Three Grade A Hospitals... Why Class Three Grade A Hospitals? Why was he suspected to be a professor? Any hospital below the rank of Class Three Grade A would not dare perform this type of surgery because of the high risk of medical error.

Even in a Class Three Grade A Hospital, ordinary attending surgeons and chief residents would never handle such a troublesome operation.

Only those of lead professor rank and above would possess the confidence to perform such a difficult surgery.

Even so, they would still tackle the situation with extreme care rather than simply using forceps to bluntly dissect tissue without hesitation like this surgeon.

Upon inspection, the host surgeon's movements were not fast but very precise. Then, like a painting, the anatomical structures of the Calot triangle gradually appeared in front of everyone.

This brat must have dissected a few cadavers. No! A few were definitely inadequate; he must have dissected at least dozens of cadavers.

In China, the number of cadavers, also known as silent mentors, was so limited that some medical institutions only had one cadaver per class for studying anatomy.

Few medical institutions had the luxury of providing a cadaver for a group of eight, let alone the mythical four-man team, for dissection.

For example, in a town of strategic importance in the northern frontier, whether it was just an ordinary school or medical institution, countless Kwantung Army[1] corpses from decades ago were still preserved for dissection purposes. That was exactly why the doctors from that medical institution did not know what a silent mentor was.

The Kwantung Army corpses were simply unworthy of that title—silent mentors—even though they had been immersed in formalin for decades.

As the number of cadavers was scarce, many doctors actually made up their minds to apply for part-time jobs in the forensics department.

Naturally, such special privileges were provided only to motivated doctors working in tier-three or four cities[2] due to a lack of licensed forensic pathologists.

The host surgeon in the livestream had definitely dissected a large number of cadavers. This assumption emerged in every viewer's mind at the same time and was proven during the gradual exposure of the Calot triangle.

The cystic duct and cystic artery were clearly visible. The host surgeon then began to ligate, resect and retrogradely remove the gallbladder.

The removal was just the beginning.

[He is very good at laparoscopic surgery, but I didn't expect him to achieve such a high standard in open cholecystectomy too.]

A dazed doctor expressed his thoughts in Xinglin Garden.

An expert would understand the difficulty behind this surgery. From the cholecystectomy alone, everyone firmly believed that the host surgeon would complete this surgery beautifully.

How much could they learn from this surgery? Well, it would depend on their individual talents.

[Are you stupid? How can he perform laparoscopic surgery if he can't do an open surgery well?]

[Not exactly. Nowadays, many junior attending surgeons start their practice in laparoscopic surgery. Hey, both of you have inadvertently exposed your age group.]

[The gallbladder had been resected. I've a feeling that there will be at least three to five gallstones of over three centimeters in it.]

The anatomical structures could be seen very clearly. After the gallbladder had been resected, the common bile and hepatic ducts were exposed in the operative field, and any surgeon could easily identify them.

Even so, Zheng Ren wanted to minimize risks of medical error and requested a 5-milliliter syringe so that he could confirm the common bile duct by bile aspiration.

After traction was applied to stretch the duct, an aspirator with a suction tube was then gently placed on Zheng Ren's palm.

The aspirator was plunged into the common bile duct as soon as it was incised.

It was done without a moment's hesitation. The huge amount of bile that had accumulated in the duct was aspirated before it was forcefully ejected by high intraductal pressure.

This detail attracted the attention of the doctors of Xinglin Garden.

Generally, the area around the common bile duct would be protected to a certain extent as bile leakage was inevitable.

However, the host surgeon had not taken any safety precautions at all. The incision on the common bile duct was the same size as that of the aspirator, preventing any bile leakage.

Everything was done perfectly. It appeared extremely simple and easy, but only those who had performed similar surgeries would understand the difficulty behind it.

[I suddenly feel sad. A few years ago, I performed an incision and drainage of an acute obstructive suppurative cholangitis. Bile leakage occurred during the surgery and resulted in postoperative infection. Initially, it was just a bacterial infection but it was further complicated by a fungal infection. The patient recovered only after one month of aggressive treatment.]

[The feeling is mutual. The host surgeon's manipulation is indeed stable. That incision had been made about the same size as the aspirator. Is it possible to master such a superb hand- and eyesight-based judgment through sheer practice?]

[That's talent, so curb your enthusiasm.]

[1] The Kwantung Army was formed in 1906 as a security force for the Kwantung Leased Territory and South Manchurian Railway Zone after the Russo-Japanese War and was expanded into an army group during the Interwar period to support Japanese interests in China, Manchuria, and Mongolia.

[2] The Chinese city tier system (Chinese: 中国城市等级制) is a hierarchical classification of Chinese cities. Cities in different tiers reflect differences in consumer behavior, income level, population size, consumer sophistication, infrastructure, talent pool, and business opportunity.

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Chapter 63: Parasites In The Biliary Tract

The doctors in Xinglin Garden understood everything that had been done up to this point.

It did not matter if they could perform the exact same procedures, but it would be humiliating if it had all been Greek to them.

Doctors who had received professional training still possessed this basic quality, at least.

'It's time to extract the gallstones.' Everyone had the same thought on their minds. Since the common bile duct had been incised, the next step would be gallstone extraction to alleviate the patient's obstructive jaundice symptoms.

A pair of custom-made lithotomy forceps, a conventional but rarely-used instrument in the operating theater, was then placed in Zheng Ren's extended palm. Xie Yiren had been attentively observing Zheng Ren's movements and necessary instruments would be handed over whenever required.

Many viewers in the Xinglin Garden live broadcast room were envious.

The host surgeon's scrub nurse was competent and far better than their own. Not only were theirs bad-tempered, they even needed to be reminded to pass the lithotomy forceps during unconventional surgical manipulation.

In most cases, they would realize that they had not prepared the lithotomy forceps and circulating nurses would be instructed to retrieve a pack of sterile lithotomy forceps from the sterilization room.

Inevitably, this trip would delay the surgery for a few minutes, but this was not the case for the host surgeon, who could perform the operation in a relaxed manner.

There was a more outrageous possibility—that the nurses returned with a pair of unsterilized lithotomy forceps! That was a nightmare!

Despite the doctors' envy, life still had to go on, right?

The forceps entered the common bile duct. One, two, three... Something was wrong. Why were the gallstones oddly shaped? Was it possible that those were not stones?

[Based on my decades of clinical experience, it seems like a biliary parasite.]

[Decades of clinical experience, are you bullsh*tting me? I don't even think experienced, elderly senior consultants know how to log into Xinglin Garden.]

[I'm now fifty-nine years old, so I'm actually a senior consultant with decades of experience who keeps up with the times. What are you going to do about it?]

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The subject in the Xinglin Garden live broadcast room changed in that instant.

However, judging by the strange shapes that emerged, they did not seem to be ordinary gallstones.

After removing the gallstones in the cystic duct and left and right hepatic ducts, the host surgeon began irrigating the ducts with warm normal saline while aspirating more sediment-like stones.

Then, a rare event occurred—the surgery came to a halt.

[Mayday, mayday. Did the live broadcast just crash? Anyone who sees this comment, please respond. I repeat, please respond.]

[Same. I feel so much better after seeing your comment.]

[It isn't a crash. The host surgeon is preparing the next equipment. I'm guessing a choledochoscope.]

After ensuring that there was no connection issue or livestream problem, this particularly uncommon surgery having an interlude was instantly barraged with comments.

All of them were guessing what had actually happened.

[I think the host surgeon is having diarrhea. I once suffered from acute enteritis and had to visit the toilet eight times while performing an appendectomy. Every time after I scrubbed up and changed into a surgical gown, diarrhea struck me again. That was indeed a tragic experience and makes me feel uneasy even until now. I'm looking for consolation.]

[Perhaps he wants to check if there is any malignant transformation after opening the gallbladder.]

[Maybe the host surgeon fainted.]

Hundreds of comments flooded the screen, which reflected the joyful atmosphere of the moment, but none of them worried about the surgery at all.

What a joke. Disregarding everything else, the blunt dissection and profound anatomical knowledge of the host surgeon were more than enough to fuel speculations that they were an elderly professor in their sixties. How was it possible that they could not complete a tier-three surgery?

In the operating theater, Zheng Ren had temporarily stopped the surgery to allow Chu Yanzhi to unpack the equipment he had purchased in the System, place the fiberscope on the surgical instrument table and put the connector on Zheng Ren. That way, he could see the operative field through the imaging in the fiberscope with his naked eyes.

Chu Yanzhi's height was the same as Zheng Ren's—172 centimeters. Therefore, she had to use a stool in order to put the connector on Zheng Ren's head.

"Chief Zheng, where did you get this equipment?" Chu Yanzhi had assisted in similar surgeries in West China Hospital but had never seen such tools.

"I made it myself." Zheng Ren shut down the whole conversation with a simple sentence.

"What a stingy person," Chu Yanzhi said, annoyed, "I'm not going to take it from you, so why can't you tell me?"

Zheng Ren felt helpless. He could not possibly tell her that he bought it from the System's Shop, and perfunctorily made-up a place was not a viable option either. What would happen if she decided to visit it for equipment purchase? Deception was a better course of action in this case.

His imagination suddenly ran wild like a dog that had broken its leash. If women had access to the System's Shop, would there be a big sale on Double Eleven?

After assisting Zheng Ren with the equipment installation, Chu Yanzhi said with excited curiosity, "Sis, we can perhaps write an SCI if this surgery is successful."

"It's possible as the impact factor should be equal to or more than three." Chu Yanran, who was sitting beside the ventilator with an anesthesia monitoring form in her hands, quietly observed the various data displayed on the ventilator and monitors, adjusting the drug dosage accordingly.

The Chu sisters would behave distinctively only during a surgery.

Zheng Ren was unsure whether this was the only odd way to accurately distinguish them.

The image in Xinglin Garden distorted for a moment before it switched to the fiberscope view.

[What the f*ck, it's a fiberscope!]

[That's indeed high class. We normally use a size-five urinary catheter for continuous irrigation to ensure that there aren't any residual stones in the ducts.]

[I have professors who know how to handle a fiberscope, but they seldom use it. Most people can't use it well, especially with forceps integrated with a fiberscope for the removal of residual tiny stones. This kind of microsurgery is on the same level as neurosurgery.]

The fiberscope advanced deeper and the atmosphere in the live broadcast room became tense and quiet.

The comments disappeared as everyone stared at the white silk thread attached to the walls of the common bile duct in shock.

They were not gallstones, but parasites!

These white silk threads were clearly not suppuration caused by inflammatory exudation, but rather elongated parasites dwelling in the common bile duct.

The gallstones that had been extracted were likely the end products of these parasites that had been wrapped and organized by inflammatory reactions.

[Who can guide me on the treatment in a parasitic infestation? I'm waiting. It's urgent.]

A junior doctor sought guidance in the livestream.

Generally, if someone took the lead, others would follow suit. This was a common phenomenon in the operating theater, but in the live broadcast room, not only was the situation similar, it was more unbridled.

However, this time, an eerie silence reigned in the live broadcast room. The lone comment flew from the right side of the screen to the left with no response.

The junior doctor was smart enough to remain silent.

Every doctor watching the livestream had a bad feeling. This surgery would very likely end in failure.

Was it possible that the host surgeon would observe the condition, performatively try to remove the parasites and give up after realizing that they had embedded themselves into the mucosal layer? After all, they could accidentally damage the common bile duct during parasite removal.

It was highly probable.

However, everyone was greatly satisfied after seeing the parasites cluster like dense, white silk threads.

Moreover, many viewers blindly trusted the host surgeon because they were omnipotent! Since they dared to broadcast their surgery live, they must have anticipated this condition.

They were again astonished upon recalling the earlier intermission in surgery.

Could it be that the host surgeon had diagnosed the patient with parasitic biliary obstruction and the necessary instruments had been prepared in advance?

Even if the instruments had been prepared, though, nothing could be done in this situation.

Parasite removal surgery was still in the preliminary stage in the current medical trend. After all, the risk of parasitic infection was low in developed countries, and most parasitic diseases remained in Africa.

Besides, expecting random medical experts to specialize in the surgical removal of parasites... was basically impossible.

Even if any doctor was willing to learn for the sake of boundless love, to improve their medical skill and for nobility, medical device companies would never invest in or design equipment specifically for surgical removal of parasites.

Even if the equipment was manufactured, Africa had limited financial power to purchase it.

This surgery had evolved from an incision and drainage of a "simple" obstructive suppurative cholangitis to an unfamiliar procedure.

What would the host surgeon do to complete this surgery with an unknown difficulty level?

Perhaps he just wanted to observe the situation and give up in the end?

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Chapter 64: New Surgical Technique

In the fiber-optic choledochoscope view emerged a tiny forceps-like instrument. Even though there were thousands of doctors watching the livestream, none of them could identify this device.

[Forceps? That's so small. How does the host surgeon plan to operate with it?]

[I'm completely confused. I'm going to watch the video replay a hundred times after the surgery is over.]

[Shut the f*ck up and watch the surgery!]

A few comments expressing their surprise were soon suppressed. This may be a new surgical technique and was likely more advanced than endoscopic transrectal appendectomy.

Perhaps this was the first appearance of a new surgical procedure.

Silence hung in the air as numerous pairs of eyes stared at the operative field, where delicate forceps grasped a white thread, only a few microns thick, with deadly hawk-like accuracy.

It was done without touching the mucosal layer of the common bile duct, which stunned the audience.

However, none of them spoke because the most crucial step was coming soon.

The parasites had tough filariform extremities that allowed firm adherence to the common bile duct. Since their fine hairs had embedded themselves into the mucosal layer of the duct, forceful removal would result in irreversible damage to the layer.

Severe injury would result in postoperative complications such as bacteremia or toxemia.

Thousands of eyes stared unblinkingly at the live broadcast with curiosity and anxiety tormenting their hearts.

However, to everyone's surprise, there was a slight twitch in the forceps and the parasite was pulled off.

What of the injury to the mucosal layer of the common bile duct that they had feared? It did not even exist!

[What the f*ck, what did I just see?]

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[Is the host surgeon also working as an animal trainer? Did they raise those parasites?]

[Please respect the host surgeon. They may be the teacher of your teacher's teacher. If you don't want to embarrass yourself after their identity is disclosed, don't use derogatory words. Thank you, my name is Lei Feng.]

The viewers were going crazy in the live broadcast room.

The preconceived nodus had been thrown out the window as the parasite was removed without any difficulty.

The forceps retracted and then extended again, presumably for parasite removal from the body.

The repetitive, mundane procedure and the host surgeon's precision were like that of a machine. Aside from the surgeon's accurate manipulation, the parasites were unusually obedient as they relaxed all their hair immediately after being clamped, allowing for smooth extraction. It was why the mucosal layer of the common bile duct remained unharmed thus far.

[Who can tell me what the hell the surgeon is doing?]

[Is he an alien?]

[Impossible. That's just ordinary equipment made of nickel-titanium alloy, judging from the familiar metallic luster.]

[Then why didn't the parasites adhere to the wall? Does the nickel-titanium alloy possess any property that intimidates them?]

[Oh my God. Host surgeon, please accept my worship.]

Parasite removal with forceps was a delicate task, and there were hundreds of parasites residing in the common bile duct, so complete removal was not easy either. No matter how fast or precise Zheng Ren's movements were, it still took him fifteen seconds to remove a single parasite.

In Xinglin Garden, a few experienced doctors with profound knowledge about equipment gradually noticed something peculiar with the procedure.

[I'm not sure if it's just my imagination, but the parasites seem to be spasming after the host surgeon grasped them with the forceps.]

[I noticed it too. The twitch was mild but that should be the key here.]

[I'm a postgraduate student who studies parasites, and I've been working on a related topic recently. I suspect that there is some mild bioelectric stimulation that caused the parasites to spasm.]

The doctors in Xinglin Garden had gotten closer to the truth in less than half an hour.

Xinglin Garden was indeed a professional website!

[That's awesome! Is this a new surgical technique?]

[The-Surgeon's-Name Biliary Parasitosis Removal, how does that name sound?]

[If you have enough data and your English level is up to par, write an article and publish it in The Lancet.]

The Lancet was a magazine published by the Elsevier Publishing Company in collaboration with Reed Elsevier Group since 1823.

The journal had founded that year by Thomas Wakley, an English surgeon who named it after the surgical scalpel called a lancet, as well as after the architectural term "lancet window", which was a window with a sharp, pointed arch to indicate the "light of wisdom" or "to let in light".

The Lancet was the top journal for surgery, similar to other magazines for science and nature.

Regarding the impact factor... The Lancet had achieved up to 33.6.

This concept could be difficult to understand, so to simplify comparisons, the impact factor of ordinary medical journals was between 0 to 0.1.

Medical journals in China had an impact factor between 1.0 to 5.0.

Thus, the fact that The Lancet had achieved an impact factor of 33.6 was truly impressive.

Article publishing in The Lancet, though?

It was a tempting idea as whoever managed to do so would have access to national research funds, a humongous supply of resources, academic status...

However, these had nothing to do with the viewers in Xinglin Garden.

After regaining their composure, everyone immediately realized that the host surgeon must have studied this kind of equipment for god only knew how many years and publicized it only after it had become fully operational.

Anyone who could devote their life to the continual performance of a single task deserved the utmost respect.

Birds of a feather flock together, especially in the medical field. The better one's medical standard, the higher their societal status. That was beyond question.

The host surgeon was highly skilled and could still devote their life to experiments... Could it be that they were a demon in the Chinese Academy of Sciences? Perhaps... Perhaps they were an expert from a foreign country?

Today's surgery was indeed enjoyable.

Even if they were not the researcher or surgeon behind it, viewers could still boast that they had witnessed the historical first appearance of a technique over drinks in the future.

After coming up with a publicly acceptable explanation, the live broadcast room was instantly bombarded with innumerable comments.

No one could read the overwhelming comments. This time, the livestream was barraged with words like bullets flying across the screen.

It was not for complaining, but rather how they expressed their heartfelt respect to the elderly researcher.

Zheng Ren had no clue that he had inadvertently become an old researcher or an expert foreign professor.

He was focusing his attention on removing the parasites and placing them in a kidney dish beside him.

Xie Yiren's exposed skin was chalky-white. No matter how courageous a lady was, she would still be afraid of such squishy worms.

It was not just one worm; Zheng Ren had already removed more than a hundred parasites from the patient's bile duct.

Chu Yanzhi had been hiding behind the ventilator for a long time and failed to come up with more childish retorts due to a lack of courage. No matter how many calories she burned, it would not be enough to relieve her intense perturbation.

Chu Yanran's face was ashen-grey as well, but she was much calmer than her younger sister. She dared not observe Zheng Ren's surgery and merely forced herself to focus on the boring numbers on the ventilator and monitors.

It took Zheng Ren more than an hour to remove all parasites—more than three hundred of them—residing in the bile duct.

Zheng Ren grumbled internally about the System while removing the parasites. 'No wonder it gave me such a long completion time. I thought it was going to give me a bonus, but I didn't expect to see so many parasites!'

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