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 289: Stay (Part 1 of 4) - Read The Surgeon's Studio Chapter 289: Stay (Part 1 of 4) Online - All Page - Novel Next

Chapter 289: Stay (Part 1 of 4)

Stay in Sea City? Why?

Zheng Ren was stunned for a moment. Had Su Yun's jibe come true? Did this professor want to stay behind and be his assistant?

Impossible.

Smirking, Zheng Ren chuckled at his own thoughts.

Normally, such a professor would be leading a dozen ongoing research projects with each team working their fingers to the bone every day. Leaving the projects unsupervised would make it very hard to move forward.

And all to watch him perform emergency surgeries?

Did the man think he was Mr. Bai[1] from The Grand Mansion Gate?

Professor Rudolf Wagner observed Zheng Ren's expression closely; he noticed a distinct lack of agreement, instead catching surprise and even amusement.

An international student had once told Professor Rudolf Wagner that the Chinese people were very reserved and reluctant to express their emotions.

At least, that was what Professor Rudolf Wagner had thought.

Zheng Ren thought the professor's request a joke but the professor misconstrued it as agreement. They both stopped talking; Zheng Ren changed his clothes in silence and left the operating room.

The emergency operating room, unlike many of its kind, was on the same floor as the changing room.

Zheng Ren saw the fiancée pacing back and forth anxiously as he exited the latter.

"Doctor, how's Brother Kai?" she asked desperately when she spotted him.

"He had a gastrointestinal perforation and will need to be on antibiotics for a few days after surgery to prevent any further complications," Zheng Ren said, "You can save on the surgery fee, but the antibiotics might be a bit expensive, it'll cost..."

"It's fine, really, as long as he's okay. I can borrow some money."

"Alright. I also told him off. Hopefully, he'll change his ways after this," Zheng Ren said.

"Thank you, thank you." The girl was overwhelmed with gratitude.

Zheng Ren waved before turning and heading downstairs through the fire exit.

Professor Rudolf Wagner silently followed him all the way back to the emergency ward.

"Zheng, did the boy get hurt from fighting his romantic rival?" the professor asked eagerly when they reached the office.

"Professor, if you hurt someone during a fight in this country, you'll need to bear the legal consequences," Zheng Ren answered.

"The same applies to my country too. However, most of the great romances speak of duels, the power, and the charms of a man..."

"No, professor. I won't comment on the traditional meaning of a duel. However, this patient is his own worst enemy." Zheng Ren sat before his computer and launched his workstation to begin writing the operative report.

"Zheng, you're no romantic, for sure." Professor Rudolf Wagner flicked his long, golden locks. Romantic... my *ss.

Zheng Ren could not care less about tradition and focused on his report.

Professor Rudolf Wagner strolled around, sighing occasionally as he looked about the ward.

He was mumbling to himself in his mother tongue. Zheng Ren neither understood nor wanted to understand him; the professor was probably thinking about how the resources here were lacking, unequipped to conduct research, or something else along those lines.

Sea City General Hospital was undeniably incomparable to the fount of great talent that was the research center of Heidelberg University.

Even Karl Marx was a graduate of Heidelberg University.

The university received abundant donations from charitable foundations and other organizations every year, ensuring deep pockets for anything they required.

Sea City General Hospital did not have the same luxury.

Shortly after, the creak of a stretcher trolley found its way inside. Su Yun and Chu Yanzhi were sending the patient over.

They transferred him to a hospital bed, where he was deftly hooked up to an ECG monitor by a nurse and given a quick checkup.

Su Yun noticed that there was only one family member left and did not know what else to do; therefore, he returned the stretcher trolley with Chu Yanzhi.

When he returned, Professor Rudolf Wagner had occupied his regular seat in the office and was observing Zheng Ren at work.

"Is the professor staying permanently?" Su Yun asked.

"I doubt so," Zheng Ren answered without raising his head.

"Zheng, you'd agreed for me to stay here," Professor Rudolf Wagner said seriously.

This... Zheng Ren froze a moment; he looked at Su Yun, then turned to the professor. He had no idea how the tiny shrine that was Sea City General Hospital had managed to attract a major deity like Professor Rudolf Wagner.

Nevertheless, the man was free to stay and well-off enough to afford his own meals... wait a minute. Zheng Ren suddenly realized someone had to be responsible for sustaining the professor's stay.

Xie Yiren's parents were returning soon, and he was still tight on money.

Was the professor trying to force him to resign? Then, a thought crossed his mind: Department Chief Kong had earlier mentioned a research fund that he had not known how to spend. What was he going to do, buy a house with it?

A meal ought to be acceptable.

Su Yun began to smirk as he watched Zheng Ren's expressions flick by like a Sichuan opera Face-Changing performer, already guessing the man's thoughts.

"Professor, where are you staying tonight?" Su Yun asked.

Professor Rudolf Wagner pretended to be gracious. "Just give me a space, I'll be fine."

"Are you able to perform surgery?" Su Yun asked.

The question was ambiguous. Professor Rudolf Wagner could not understand its intentions.

"If you're sleeping in the on-call room, I'll have to go back home. If you can handle surgery, by all means, be my guest. If you can't, I suggest you check into Shangri-La Hotel and rest."

Shangri-La Hotel was the only five-star hotel in Sea City. Department Chief Kong would most likely be spending the night there.

Professor Rudolf Wagner hesitated for a long time before saying, "No worries, I can handle these surgeries. I have a clinician's license, so common diseases shouldn't pose much of a problem. I also volunteer in the ER for 3 to 5 days annually."

The smile on Su Yun's face only grew when he heard the professor's answer.

Zheng Ren was unable to do anything but watch.

This rascal was obviously exploiting the professor, but Zheng Ren was indifferent. As long as there was no major surgery required, he could handle it by himself. The professor's presence would not make any difference.

"I'll leave then, Chief Zheng." Su Yun began whistling, now in an exceptional mood.

"Keep your phone on. I'll call you if anything happens," Zheng Ren said coldly.

"Oh my God! You don't have the right to call an off-duty doctor, it's his private time!" Professor Rudolf Wagner exclaimed.

Zheng Ren smiled and did not argue.

Su Yun saluted before briskly leaving the emergency ward.

A routine check on the postoperative patients confirmed that the young man's condition had stabilized; if the mild infection in his abdomen did not worsen, he ought to be able to be discharged after several days on intravenous antibiotics.

When Zheng Ren exited the ward, the girl followed him out.

"Thank you, Dr. Zheng." She was clearly well-mannered and thanked him with a deep bow.

"You're welcome." Zheng Ren did not put on any airs. He certainly deserved it after the surgery and his attempt to rehabilitate the patient.

"I'll try my best to raise the money. Can you please not stop his medication?"

"Oh my God..." Professor Rudolf Wagner cried out again.

...

...

Try to hum the chapter title in Zeng Yi's [2]voice~~ It's a new week already; I hope that everything goes smoothly at work and every day is happy, guys.

[1] The author used 白大爷, which appears to refer to Bai Jingqi, the main protagonist in The Grand Mansion Gate (大宅门), a 2001Chinese historical television series.

[2] Zeng Yi is a Chinese pop singer and member of the Chinese popular music duo Phoenix Legend.

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Chapter 290: The Night Shift God's Blessing (Part 2 of 4)

"What about medical insurance? We don't have to pay for hospitalization in my country. The insurance company would provide the sum total after discharge," Professor Rudolf Wagner said.

Zheng Ren came close to kicking him, but resisted the urge after some thought.

"I'll report the fee issue to Chief Pan tomorrow, perhaps some of them can be waived," Zheng Ren told the girl. "Take good care of him."

The girl gave her thanks again before Zheng Ren and the professor returned to the office.

"Zheng, do you people really need to pay for medical treatment?" Professor Rudolf Wagner asked doubtfully.

Zheng Ren did not engage further with the professor and simply offered a smile.

Finally remembering to check his phone, he realized it was already past ten in the night.

There was a missed call from Department Chief Kong at around nine o'clock. After thinking about it, Zheng Ren decided to contact the man through WeChat.

Chief Kong was already in Shangri-La Hotel and preparing for a return flight in the morning.

Zheng Ren checked his schedule; he would probably need to apply for leave tomorrow to send Department Chief Kong off. The chief had come all the way here, and Zheng Ren had not even had the time to bring the man out to a meal before getting called back for surgery.

Not sending the chief off at the very least would leave him with a bad taste in his mouth.

As he spoke to Department Chief Kong, he received a call from the emergency department about a patient who had come in with acute appendicitis.

Zheng Ren felt troubled. His good night's sleep yesterday did not mean he deserved to be deprived of it tonight.

Night Shift God, please be merciful.

Still, no matter how hard he complained, he had duties to fulfill.

He confirmed the diagnosis with the System's monitor before performing a routine check on the patient and processing admission. He then inquired about the patient's medical history and prepared for surgery.

Half an hour passed after he completed the procedure.

Another patient with acute appendicitis entered the ward.

Under normal circumstances, a chief resident would have a physician on duty to handle all miscellaneous procedures. However, emigration over the last two years had bled Sea City of its younger talent; any competent doctor above thirty had left for greener pastures.

Even the Sea City General Hospital inpatient department was short-staffed, let alone the emergency department.

Old Chief Physician Pan had been asking for more hands on deck, but resistance had been strong enough that no amount of authority could get him the doctors he wanted.

Chang Yue, Yang Lei and Su Yun were a few beautiful exceptions.

Zheng Ren busied himself comforting the patients and their family members and performing surgeries.

Tonight would probably be a sleepless night.

Professor Rudolf Wagner had demonstrated excellent basic skill in the first two surgeries.

He was not the main surgeon but adapted swiftly as the first assistant during the laparotomy for the appendectomy and endoscopic surgery.

Later that night, after those two surgeries, the emergency department was called upon once more.

Zheng Ren was numb and his heartbeat remained stable, having already mentally prepared for it.

This time, the patient had acute cholecystitis.

The entire procedure was familiar to Zheng Ren. There was so much to do that he set aside all the work that could be postponed to the next day for Chang Yue to follow up on. Once the patient completed their fasting, he brought Professor Rudolf Wagner along to the surgery.

What a long night. Some people refused to sleep, while others simply could not.

The entire night passed in what seemed like an instant.

It was a fruitful day.

A patient with fall injuries, a knife stab victim, five acute appendicitis cases, two acute cholecystitis cases and one gallbladder torsion.

Zheng Ren was exhausted after performing ten surgeries and going through the tedious details with their respective families.

Chang Yue arrived at work to a long queue of patients in front of her workstation; she jumped right into processing paperwork without any breakfast.

Su Yun was humming a tune on his way to work and was thrilled to see two dark circles under Professor Rudolf Wagner's eyes.

The Night Shift God stuck to tradition and had no mercy for newcomers.

Someone new to night shifts normally faced extraordinary circumstances; either there were a lot of emergencies or unstable and deteriorating postoperative patients.

In short, they would be put in their place on their first day with not a blink of sleep.

"Zheng, I'll head off and take a nap," Professor Rudolf Wagner said, yawning and completely ignoring Su Yun's condescending look.

"We need to do the handover," Zheng Ren said coldly.

It was not spite; he simply had no energy left to smile. He did not want to take the energy elixir yet, but his body was wearing thin after staying up all night and performing so many surgeries.

"Oh, you guys do your handover at 8 a.m., in my country... yawn..." Professor Rudolf Wagner let out another huge yawn in the middle of his sentence.

"Chang Yue, you'll be in charge of guiding the professor through the procedure," Zheng Ren said.

Change Yue was too occupied with her tasks to be affected by the intrusion of a foreigner.

She checked patients' conditions, changed wound dressings, recorded symptoms and requested signatures from patients' families.

Zheng Ren's words got through, but her mind automatically discarded everything unrelated to patients.

Yesterday night was...

Zheng Ren recalled the night he had attained the System. The entire general surgery department had been at work. It seemed surreal when he recalled it now.

Old Chief Physician Pan arrived at exactly at 8 a.m. with no idea why Professor Rudolf Wagner looked on the verge of collapsing.

He laughed and shook his head when he found out.

After the handover, Zheng Ren did his ward rounds before heading to the ICU to check on the suicide victim.

She was in a stable condition but still needed ventilator support. Orthopedics would take over later, but for the time being, Zheng Ren's mission remained incomplete.

Treatment for adenomyosis was considered elective surgery. Zheng Ren did not want to disrupt the treatment plan for the sake of his mission.

After Zheng Ren handed over his duties, he requested a few hours of leave from Old Chief Physician Pan to send Department Chief Kong off.

Old Chief Physician Pan called Office Director Ding of the general office since he, too, wanted to be part of the farewell party and could take the same car.

Soon after, Zheng Ren received a call from Officer Director Ding, who was in his car waiting outside the emergency building.

Ding Zhongtai was the office director[1] in Sea City Hospital. He had a rather interesting name, which had since become an awkward subject after Zotye Auto[2] became popular.

When they were all in the car, Office Director Ding checked the time and started chatting with Zheng Ren happily.

"Little Zheng, you're progressing so fast these days. You've exceeded all our expectations."

Zheng Ren was so tired that he was fighting just to keep his eyes open. Nevertheless, he managed to squeeze out a reply: "Not really. I'm just performing basic surgery."

"Unnecessary humility is essentially hypocrisy." Office Director Ding shook his head as he drove to Shangri-La Hotel at 80 miles per hour, flirting with the speed limit.

Sea City was not a tier-one or even a tier-two city. It was more difficult to reach the speed limit in bigger provinces, but here, where the population and thus number of vehicles on the road were smaller, it was nothing. During the Chinese New Year holidays, one could easily reach 120 miles per hour in the city if they were unafraid of getting a ticket.

Zheng Ren smiled and remained quiet.

"I know the truth about that day," Office Director Ding casually threw into their conversation.

[1] 院办主任 (office director) is also referred to as 院长办公室主任 (director of the dean's / chief's office) in 1.0291. It is believed that the author called him 办公室主任 in previous chapters, which translates to office manager / director. Even though the author addresses him as 丁主任 (Director Ding), it is hereafter written as Office Director Ding instead of Chief Ding to distinguish the position.

[2] The Chinese pronunciation of Zotye Auto, 众泰汽车 (Zhongtai Automobile), is similar to that of Office Director Ding's name, 仲太.

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Chapter 291: Beast of Burden (Part 3 of 4)

Was he referring to the day Professor Moriyu came to perform surgery?

Zheng Ren did not know Office Director Ding's intentions and thus maintained a cautious silence.

"Your skill is quite impressive." Office Director Ding grinned. "Old Chief Physician Pan has a good eye; no wonder he fought so hard with Director Fu for you."

"Haha." Zheng Ren chuckled dryly, his laughter reflecting his lethargy and lifelessness.

"Remember, you owe me one for that." Office Director Ding looked sideways at Zheng Ren as he drove and said half-jokingly, "Director Fu was not willing to let you go even if it meant defying Old Chief Physician Pan. It was only after I talked to Director Xiao that he agreed to transfer you to the emergency department."

"Thank you." Zheng Ren had no intention of reading between the lines. It was a chore talking to political animals and masters of manipulation like Office Director Ding.

Given the choice, Zheng Ren would rather perform another ten surgeries.

"Little Zheng, the documentary looks good. It sculpted a vivid image of you. I've got to say, you young chaps are very talented, but from the bottom of my heart, you're a little too impatient." After the pleasantries, Office Director Ding's supposedly casual conversation finally got to the heart of the matter: the documentary.

"You should have done this in your forties, when you've made your name and gained sufficient credibility. People spend most of their life chasing money and fame, why are you in such a hurry?"

"I wasn't aware of it." Zheng Ren yawned and closed his eyes subconsciously, saying half-asleep, "I only saw it after I returned."

His voice trailed off and he fell asleep.

Office Director Ding was stunned, and at that moment, the car in front of him suddenly hit its emergency brake as it hesitated to cross a yellow light.

Distracted by Zheng Ren's words, he was caught off guard by the car's sudden halt; he broke out into a cold sweat and slammed onto the brakes.

Fortunately, they managed to avoid an accident. Zheng Ren's body lurched forward from the inertia, but with his seat belt supporting his weight, he remained asleep.

Zheng Ren was truly out of it. Office Director Ding looked at him and decided not to wake him up, continuing to ponder the documentary.

Any mention on the news, no matter how small, would spark a bloodbath in the office, let alone a 15-minute documentary on the television network.

Even if it was only on Sea City News Network.

These youngsters were unaware of the stakes... Office Director Ding suddenly realized something. How many days had Zheng Ren been back from Imperial Capital? Yet, a department chief from there had rushed after him to Sea City to discuss matters.

Something strange was happening outside of his control.

Office Director Ding had never encountered anything of its sort and it baffled him.

The car was silent, the only audible sound being Zheng Ren's light snoring.

Upon approaching Shangri-La Hotel, Office Director Ding called Department Chief Kong.

Department Chief Kong had checked out and was by the door looking around when they arrived.

"Chief Kong." Ding Zhongtai alighted from the car and extended both hands enthusiastically.

Adding a third into the tangle, Department Chief Kong laughed and said, "Sorry to trouble you. Where's Little Zheng?"

"He performed ten surgeries during yesterday's night shift and is knocked out in the car," Ding Zhongtai replied, amused.

Dispassionately, Department Chief Kong extricated his hand and shook his head. "Office Director Ding, you people have a cruel hiring policy."

"Huh?" Ding Zhongtai was confused.

"Someone like Little Zheng will be treasured wherever he goes, but you treat him like a beast of burden," Department Chief Kong said casually after entering the car.

"Eh, don't put it like that, Chief Kong." Ding Zhongtai got in, ignited the engine, switched into gear and started driving. "I'm sure you're aware of the situation here in the northeast. So many have left that most departments are short on workforce. All our staff are overloaded with work. It's a common practice to have one night shift every three days."

Department Chief Kong did not continue talking. He glanced at the sleeping Zheng Ren and did not elect to wake the man.

"Chief Kong, please forgive me for our inhospitality during your visit to Sea City," Ding Zhongtai said, hoping to establish a closer connection to him.

"It's fine. I'm here for Zheng Ren, anyway," Department Chief Kong said, "Now that I've found and spoken to him, that'll be all. I still have twelve surgeries waiting for me this afternoon and have to rush back."

"Do you still have to do them yourself?"

"If I know the patient, I'll go up to them to take a look. Regular patients are handled by research graduates," Department Chief Kong said calmly.

Ding Zhongtai knew that it was the truth, but that was not important. He had successfully brought up the topic of surgery.

"Chief Kong, I have a friend and colleague who wants to go to Sorcery Capital, but doesn't have any contacts, you see..."

"If they want to come through me, tell them to say they're with Little Zheng." Department Chief Kong was dismissive.

Little Zheng... Ding Zhongtai felt insulted.

Was a meal with the director and having the Head Chief of office personally chauffeuring him to the airport not sincere enough? Did only Zheng Ren matter to him?

Ding Zhongtai hid his dissatisfaction. "Should they go directly to your office and ask for you?"

He had no standing to show his true feelings in front of the master from Imperial Capital.

"Sure, any physician can do that as long as they mention that they are friends of Zheng Ren's." Department Chief Kong smiled. "After Little Zheng's trip to Imperial Capital, all my research and postgraduate students complained that his time there had been too short."

"..."

Ding Zhongtai laughed dryly. He had something to say but decided against it after some contemplation.

He was quite close to Chief Liu Tianxing from the first general surgery department. A few days ago, Liu Tianxing had been diagnosed with space-occupying liver lesions, with a high risk of hepatocellular carcinoma.

The man was trying to pull some strings to get treatment in Imperial or Sorcery Capital.

In all honesty, an ordinary chief from Sea City would be treated like any layperson in Imperial or Sorcery Capital if they had no old friends or classmates to use as inroads.

Even early-stage liver cancer would devolve into advanced cancer in the time that it took to queue for admission alone.

However, using Zheng Ren's name... S*it! Would Liu Tianxing even be willing to do it? Was it a joke?

"Office Director Ding, if it's a general surgery... I've never seen Little Zheng perform surgical resection for hepatocellular carcinoma. If you go through me, I'll help you contact the general surgery department.

"However, if you need interventional surgery, there's no need for any hassle. Health is more important than saving face. Little Zheng can do it better than me. Just opt for surgery in Sea City; it's more convenient, and you don't have to go the extra mile."

Ding Zhongtai was once again baffled.

Was Department Chief Kong rejecting his request? That could not be. A department chief or professor from Imperial or Sorcery Capital would not say something like this.

It was not supposed to be a big deal. Why would the man offend a potential patient?

But...

"You really don't know?" Department Chief Kong sensed the tension between them and was unnerved by Ding Zhongtai's unusual expression in the rear-view mirror.

"Don't know what?" Ding Zhongtai replied without thinking.

"The reason I'm here was to confirm Zheng Ren's trip to Imperial Capital for interventional treatment for hepatocellular carcinoma."

Ding Zhongtai's hand shuddered, causing the car to sway slightly.

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Chapter 292: The Way of the Dragon (Part 4 of 4)

Officer Director Ding calmed down somewhat after a few minutes.

He struggled hard to tamp down his many questions and tried to continue conversing with Department Chief Kong.

Doubt soaking his words, he asked, "Chief Kong, is Dr. Zheng not needed in Imperial Capital to continue work on prostate interventional surgery?"

"Well, yes, but during the demonstrative surgery, I discovered that he was very good at the differential diagnoses of nodular hepatocellular carcinoma, which is why I decided to work with Mr. Zheng on another study." Department Chief Kong's voice was full of pride.

Truly he was akin to the expert horse tamer Bo Le[1, his sharp eyes discerning the extraordinary from the mundane.

His satisfaction and sense of accomplishment were through the roof.

Even though Zheng Ren was not one of his students, the man still owed him a favor.

Department Chief Kong did not consider his visit to Sea City uncalled for. Even Professor Rudolf Wagner had not stayed in Imperial Capital to wait for Zheng Ren; it was better to come in person to express his sincerity.

Ding Zhongtai stayed mum. He could tell that Department Chief Kong was gloating.

Nothing more needed to be said.

He cursed internally. Liu Tianxing, you b*stard! Go wherever you want for treatment!

He would not stick out his own neck any further.

Also, he was going to cut the man off from now onwards.

Ding Zhongtai had been present the whole time during Professor Moriyu's live surgery and knew about the whole ordeal.

He was aware of Liu Tianxing and Director Fu's cover-up, but back then, who was willing to offend an executive deputy director and a department chief to bring justice to a few young doctors?

The doctor was of extraordinary skill?

So what?

In a place like Sea City, a dragon would have to coil up; a tiger, crouch down.

He had never expected a dragon to get its way in Sea City General Hospital.

Director Fu had denied Old Chief Physician Pan's multiple requests for those young doctors.

Ding Zhongtai had kept this from Director Xiao since it was not under his purview; his main priority was to serve Director Xiao and occasionally report things that he wanted the man to know.

If there ever was a dragon in Sea City General Hospital, it could only be Old Chief Physician Pan.

He was already old and focused mainly on the emergency ward, thus he was no threat.

Now, there was another one.

Ding Zhongtai knew that he had to change tactics upon returning to his office. His demeanor became serious.

For the remainder of the journey, he was restless, managing only a few friendly exchanges with Department Chief Kong and keeping silent for the rest of it.

When they reached the airport, Ding Zhongtai woke Zheng Ren up.

Zheng Ren had been sleeping like the dead—he was confused upon opening his eyes and realizing he was already at their destination.

Chief Kong's smile embarrassed him. He apologized profusely, but Department Chief Kong dismissed it, choosing instead to reaffirm Zheng Ren's surgery schedule and specifying that the payment for each surgery would follow the specialist rate.

The money for this would be taken from the research grant.

Department Chief Kong did not reveal the exact amount of the grant and Zheng Ren did not bother to ask.

They accompanied Department Chief Kong to the security gate after claiming his boarding pass, and when the man disappeared from view, Zheng Ren yawned and turned to leave.

Ding Zhongtai decided to poke around. "Little Zheng, how long have you known Chief Kong?"

"About half a month," Zheng Ren answered lethargically.

"..." The answer confirmed Ding Zhongtai's speculations. He kept quiet, thoughts racing through his mind.

How would he emphasize the fact that he had done the man a favor?

Zheng Ren felt much better after his nap and was contemplating whether or not to regularly consume the energy elixir.

He was still worried about its side effects, if there were any at all. The System was certainly of no help in this regard.

What a dilemma.

After much thought, Zheng Ren chose to err on the side of caution and avoid taking the elixir unless he absolutely had to.

He would just have to endure his shifts as a chief resident.

Since he was still young, short naps ought to be able to pull him through.

When they entered the airport highway, Ding Zhongtai's phone rang.

He glanced at it briefly before rejecting the call.

"Safety comes first while driving," Ding Zhongtai said, laughing.

Zheng Ren nodded.

Any other physician in the office director's car would be busy sucking up to Ding Zhongtai, and he had never had to confront a situation this awkward.

His face darkened, but his phone rang again before his anger could be unleashed.

He dismissed it... and it rang again.

Ding Zhongtai cautiously activated his car's hazard lights and stopped at the side of the road to answer the call.

"Office Director Ding, Director Fu has just resigned!" the office clerk shouted from the other end.

"..." Ding Zhongtai's expression froze for a second before he smiled and said, "Noted."

He then hung up.

The drive back resumed. Ding Zhongtai hid his inner turmoil behind the unwavering smile on his face.

Zheng Ren was staring out of the car window, bored by the endless snow-covered plains.

The tiredness crept back as he watched the scenery go by.

Ding Zhongtai was first to break the silence. "Little Zheng, I'm sure you are aware that Old Chief Physician Pan fought to get you guys."

"Huh?" Zheng Ren was caught off guard, answering in a daze, "The hospital was short-handed since there were no new staff."

"You're a young and talented professional; you deserve to enjoy greater flexibility and convenience." Officer Director Ding smiled and said, "I've always wanted to transfer a few more people over, but because someone got in the way, my request didn't go through. Department Chief Kong had just criticized me for that. Upon my return... I will bring it up to Director Xiao again."

Zheng Ren did not respond.

"Don't worry. Even though the hospital is short-handed, with my assistance, I can still get you a few staff." Officer Director Ding's words were so sincere, it was as if he had been moved by his own gesture. "You're the hope of our hospital. Old Chief Physician Pan also does not have it easy; he was rehired after retirement just to build the emergency department. You guys have suffered all this while."

"No worries, we're fine." Zheng Ren interrupted Officer Director Ding midway, afraid to make any further promises or deals with the devil.

Little Zheng seemed to not understand the rules of social etiquette very well.

Ding Zhongtai kept the thought to himself.

However, it was easier to get on the good side of someone who was so learned that they lost out in every other human aspect.

"As you know, it's difficult to do that in our hospital." Out of habit, Ding Zhongtai redirected the conversation to how much trouble he had gone through for Zheng Ren.

It was the safest way of insinuating a favor.

Under normal circumstances, Zheng Ren should be thanking him politely. Those more theatrical would even shed tears of gratitude.

However... Why was Zheng Ren not saying anything?

Officer Director Ding stole a glance at Zheng Ren as he drove.

His chest almost exploded with anger.

This little doctor, Zheng Ren had f*cking fallen asleep again!

[1] Bo Le was a horse tamer in the Spring and Autumn Period, and the legendary inventor of equine physiognomy ("judging a horse's qualities from appearance"). By studying the body of a horse, Bo Le was apparently able to assess its hidden capacities with unfailing accuracy.

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Chapter 293: Flexible Shift for Second-Liners (Part 1 of 4)

After returning to the emergency building, Zheng Ren waved Officer Director Ding goodbye.

Officer Director Ding had composed himself and smiled at Zheng Ren. "Dr. Zheng, I have high hopes for you. Just come and see me if you have any requests. I will fulfil them as long as it's in my power to do so."

Zheng Ren returned the smile and nodded.

He did not hurry back to the emergency ward. Instead, he dropped by Old Chief Physician Pan's office.

There was an answer when he knocked on the door.

Old Chief Physician Pan was wearing his reading glasses and holding a magazine.

Zheng Ren noticed that it was a medical journal, but could not catch its name.

"Chief, I've returned." He stood upright.

"Take a seat." Old Chief Physician Pan removed his glasses before looking at Zheng Ren. "I have something to tell you: Fu Guangshi has resigned."

"Oh," Zheng Ren responded.

"Huh?" Old Chief Physician Pan was a little surprised. "You knew about this?"

"Su Yun told me that he would ask the man to resign as a last resort," Zheng Ren answered.

Old Chief Physician Pan looked at Zheng Ren with great interest, but laughed and did not pursue the topic any further.

"I heard from Su Yun that you participated in two research projects in Imperial Capital and are planning to publish it in international journals?" he asked.

"Su Yun's dealing with all that. I just performed the surgery," Zheng Ren said.

"This is major. You need to pay more attention to it," Old Chief Physician Pan said. "Your workload here is quite heavy and I'm thinking of how to reduce it. Do you have any ideas?"

"I'm still coping. Last night was an anomaly." Zheng Ren placed his hands on his knees and straightened his back.

"It's not that," Old Chief Physician Pan said. "Yesterday, in the operating room, did Chief Kong from Imperial Capital ask you to join a national research project?"

"Yes." Zheng Ren nodded. "Chief Kong said that he'll schedule twenty patients with nodular hepatocellular carcinoma every month for me to perform surgery on. I will head to Imperial Capital for one or two days to do so as part of the research."

"Hm." Old Chief Physician Pan fell into deep thought while tapping his fingers on a copy of Limited Views: Essays on Ideas and Letters.

"I can overcome those obstacles," Zheng Ren declared seriously.

The old man remained silent and continued to ponder.

The office phone suddenly rang.

Old Chief Physician Pan picked it up.

"It's me.

"Hmm? Sure, but we want those who can do their job. Don't just push every Tom, Dick and Harry in here.

"Okay, tell them to report for duty as soon as possible."

Old Chief Physician Pan hung up and smiled at Zheng Ren. "I'm glad that you've grown."

"Was it about the staff transfer?"

"Yes," Old Chief Physician Pan answered, "Ding Zhongtai said he had requested for Director Xiao to transfer two physicians over. This should be able to take some weight off your shoulders."

"Right."

"With both of them, on top of Yang Lei and Chang Yue, that'll be one night shift every four days." Old Chief Physician Pan did the math. "For surgery, you and Su Yun can work together or choose to be on different shifts."

Zheng Ren felt relieved instantly.

"Is Su Yun competent enough?" Old Chief Physician Pan asked.

His words were not befitting of a department chief.

Authority over personnel was supreme. It was already a huge milestone for a young doctor to be promoted to chief resident.

However, Old Chief Physician Pan was not using this to throw his weight around. It was simply something he often discussed with Zheng Ren.

Zheng Ren hesitated for a moment.

"For small procedures in general surgeries, Su Yun's skill is comparable to that of Chief Sun. In the cardiothoracic field... he's adequate. I heard that he performed a heart transplant on a mouse during his postgraduate study in Imperial Capital. He should be able to handle any emergency situations."

Old Chief Physician Pan's irises shrinked to needlepoints.

Someone who could perform a heart transplant was just adequate?

Even if it had just been an experimental surgery, Su Yun had exceeded expectations.

Nevertheless, Old Chief Physician Pan collected himself quickly, chuckling, "Put more effort into research. A successfully-developed surgical method could save countless lives in the future."

"Understood."

As they spoke, Old Chief Physician Pan's office phone rang once again.

Screaming erupted from the receiver as soon as it was picked up, so loud that it could be heard without putting one's ear to it.

It was another department chief calling Old Chief Physician Pan to kick up a fuss.

Zheng Ren just shrugged and laughed.

Every single department was understaffed these days. Not only were most doctors from the inpatient department working a night shift every three days, second-line physicians had to attend to over a hundred patients in the outpatient department before coming in to the night shift after.

Such working conditions were not changing within the foreseeable future.

Although there were more students enrolling into medicine due to universities expanding their admissions, in recent years, the number of students taking the final exam was declining. It would be lucky if 70% of them even chose to work in the clinical field after graduation.

The hospital working environment was quite toxic, which was why most of them dropped out halfway despite the seemingly healthy prospects.

If they chose to stay, most would choose to work in a department with lower risks such as oral surgery and oncology.

Since all the departments were understaffed, it was taboo among department chiefs to request a transfer.

However, Zheng Ren also knew that Old Chief Physician Pan was unafraid of anyone in Sea City General Hospital.

The man who fought Director Fu for Zheng Ren's transfer could not be cowed by any department chief.

After a few back and forths, Old Chief Physician Pan won the battle with ease.

The old chief was not angered by the fight he had just had, beaming as he put down the phone.

Zheng Ren stared blankly at Old Chief Physician Pan, confused.

"The newcomers will report for duty first thing tomorrow morning. You'll be switching to the flexible shift for second-liners," Old Chief Physician Pan said.

He had clearly been planning this all along.

Taking a flexible shift as a second-liner would mean that he would not need to stay in the hospital all year round.

Although this was not the usual procedure for a chief resident, Sea City General Hospital was not well-equipped enough to apply standard rules.

There were already insufficient staff on duty. It would be a joke if they wanted to follow the protocols of a large-scale hospital.

Especially in a place like the emergency department.

Zheng Ren laughed wholeheartedly.

"Go and check the wards. Keep an eye on a few post-surgery patients, especially the one with fall injuries. Even though her condition has stabilized, you should still be cautious," Old Chief Physician Pan reminded him.

Zheng Ren obeyed the man's orders and left. He could not wait to tell Xie Yiren about the flexible second-liner shift and texted her on his way to the ward.

When he reached it, Professor Rudolf Wagner was already snoring loudly.

Suddenly, Zheng Ren felt relieved that he had had to work the night shift yesterday. Otherwise, he would have had a sleepless night.

Chang Yue was still busy handling the post-surgery paperwork of seven to eight patients. The amount of documentation required could make any one doctor go crazy.

Paperwork was just part of the procedure. She still needed to change wound dressings, convey doctor's orders and communicate with patients' families. Especially for the latter, a doctor would need clinical experience to prevent any misunderstandings during their explanation.

Zheng Ren trusted in Chang Yue's abilities.

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Chapter 294: The Heavy Smell of Creamed Corn (Part 2 of 4)

Su Yun was not in the emergency department ward. Word was that he had gone to the ICU to check on the post-surgery patients.

It was languid again. Zheng Ren yawned; he remembered that the on-call room was already taken by a sleeping Professor Rudolph.

After some thought, he headed to the operating wing.

Although he did not have a surgery scheduled, the operating room was the most peaceful place to Zheng Ren.

He took a quick shower and put on a surgical gown, greeting the matron on his way to the men's duty room[1].

Zheng Ren slept fitfully and, before he realized it, it was already 3:30 p.m.

The operating room was still as silent as when he had fallen asleep. He got up and said goodbye to the matron before heading back to the emergency department.

According to Chang Yue, the professor had long since returned to Shangri-La Hotel to rest. He seemed to disapprove of the working hours, muttering something about inhumane working conditions.

Humane? A brick like Zheng Ren knew no such thing.

He brushed Professor Rudolph Wagner's reaction aside.

Looking through the documents for last night's patients, he noted that Chang Yue had completed all the necessary paperwork.

Old Chief Physician Pan had allowed Yang Lei to take some time off from the hospital; Yang Lei had taken over Zheng Ren's responsibilities as chief resident while Zheng Ren was away in Imperial Capital, and was now back home, spending time with his wife.

Zheng Ren watched the evening sun set on the horizon and smiled.

On his way to visit the patient with fall injuries in the ICU, he texted Xie Yiren.

She had just woken from her nap and was watching TV.

He gave her a summary of his ward round and told her the patients would likely no longer require 24-hour surveillance soon.

Xie Yiren was not fully clear on the situation but smiled as Zheng Ren delivered his update.

The call continued for a while further before Zheng Ren hung up. He had arrived at the ICU.

He pocketed his phone and changed into a clean set of clothes before entering.

Su Yun was ringed by nurses, talking animatedly.

There was a heavy smell of creamed corn in the air.

It was the peculiar smell of platelets, which Zheng Ren was familiar with.

Platelet transfusions were a rare form of treatment.

Availability was an issue, so whenever a patient required a platelet transfusion, their doctor could only hope for the best. Hence, the scent in the ICU brought relief to Zheng Ren.

As Zheng Ren entered, Su Yun gently clapped his hands together and set aside his pen and paper, standing to greet Zheng Ren. "You've rested?"

"Yes." Zheng Ren approached the patient from yesterday night's surgery.

"Their blood pressure has stabilized. There were signs of disseminated intravascular coagulation post-surgery, so we gave the patient 4 doses of platelets and 2 doses of fibrinogen. Initial urine output was 20ml, but after hydration, it's up to 60ml now," Su Yun said.

"So everything's fine?"

Su Yun had a cocky smile on his face. "Of course. Otherwise, I wouldn't be this relaxed."

There was a hint of fatigue in his expression that did not escape Zheng Ren's eyes.

"Did you sleep over in the ward?" Zheng Ren had thought Su Yun would rest at home or take some girl on a date.

"Of course." Su Yun blew at his fringe.

"I see. It's good that the patient's stable." The System display on the upper right corner of Zheng Ren's vision glowed a faint red, an improvement from yesterday's deep crimson.

The danger was not over yet, but things were not immediately critical.

With such severe injuries, only a miracle would allow the patient to recover within 24 hours of surgery.

If all went well in the next few days, they would be able to remove the breathing tube—the first step towards recovery.

The next would be moving from the ICU to the orthopedic department to immobilize the fractures. Only when that was done would Zheng Ren ask the patient if she wanted to treat her adenomyosis.

He had a few doubts about that surgery.

To date, the most effective treatment for adenomyosis remained a hysterectomy.

However, it also spelled the end of a woman's childbearing days, which could be of great impact to someone so young.

He would have to wait and see.

The System had given him seven days to do whatever he had to to complete the mission.

Zheng Ren shook his head and left the room.

Su Yun followed him out. The eyes of the ICU nurses clung to the handsome figure as he retreated from view.

"There may be two new staff reporting in tomorrow," Zheng Ren said.

"Okay. That's a relief," Su Yun commented.

They both knew Old Chief Physician Pan had been trying his best to increase staff numbers in the emergency department. However, due to the friction between him and Fu Guangshi, his request was never granted.

Now that Fu Guangshi had resigned, such problems were a thing of the past.

They left the ICU and headed straight for the emergency department.

Instead of the wards, Zheng Ren went to the observation unit.

There was a sea of waiting patients. A brief scan through the crowd gave Zheng Ren the information he wanted. Most of the patients would be assigned to internal medicine; it was the cold season and the flu was running rampant.

If an elderly person was not careful, they had a high chance of coming down with a fever, respiratory infection or cardiopulmonary problem.

The surgical department had it easier during periods like this.

One of the on-call doctors was cleaning a cut on a juvenile patient. The child's wails echoed through the entire corridor.

Such was life in the emergency department. Zheng Ren gave the patients a once-over. Satisfied that there were no misdiagnoses, he turned to leave.

At that moment, three women walked out from one of the branching hallways.

Night had fallen and the lights in the emergency department corridor were not the brightest.

Under the subdued lighting, the three figures, lightly dressed for the winter, moved with an elegance that matched their slender builds.

They were stunning, especially against a backdrop of pale, sickly patients and anxious families. Eyes were drawn to them as they sauntered along the corridor.

Many patients seemed to momentarily forget their pain.

"Oh, would you look at that," Su Yun cooed.

Zheng Ren did not turn around but could picture Su Yun's eyes lighting up. If that womanizer had not been in a doctor's coat, he would probably have wolf-whistled.

The three women were admittedly quite attractive, especially the one in the middle. Her facial features and figure stood out among the others.

Was she here to address an illness? No, it did not look like it.

Zheng Ren was curious and let his gaze follow them.

A moment later, his jaw dropped as his eyes zoomed in on the woman in the center, the prettiest among the three.

Su Yun noticed Zheng Ren's faltering steps and odd expression as he approached Zheng Ren, following his gaze and grinning.

"Boss Zheng, you can't be that weak," Su Yun joked.

Zheng Ren remained silent, ignoring the man's remark.

"I know we men tend to have wandering eyes but I advise you to focus on Yiren. She's a rare catch."

Seconds passed with no response, so Su Yun gave Zheng Ren a push on the shoulder. "Hey! What are you thinking?"

"What?" Zheng Ren seemed to regain his senses.

"What's up with you?" Su Yun was starting to suspect that there had to be more than met the eye. There had to be another reason Zheng Ren was staring at the woman.

"The doctors are busy. Why don't you check on them?" Zheng Ren said casually.

Su Yun's awareness was heightened.

A long time ago, there had been an undiagnosed female patient in the emergency treatment room displaying odd symptoms. It was Zheng Ren who had urged her to get checked out, which revealed endometriosis...

Could these women have some odd condition?

Su Yun frowned as he studied the three, paying particular attention to the one in the middle.

"Where are the doctors?" They passed Zheng Ren and Su Yun; the woman on the right noticed the latter and whistled.

However, she did not stop walking. There were more important things at hand than flirting with a pretty boy.

Su Yun shrugged. Such were the hardships of someone so good-looking.

The three women stopped at the entrance to emergency surgery but saw no one inside. The woman on the right made an inquiry.

Her voice was raspy, but it was hard to tell if it was natural or born of a smoking habit.

It was alluring, for sure.

"Go on then," Zheng Ren urged Su Yun again.

There must be something wrong. Succumbing to his curiosity, Su Yun trudged over to the women.

"May I know which of you needs a doctor?"

[1] It is believed that the author miswrote 'operating room'.

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Chapter 295: Drag Queen (Part 3 of 4)

None of them answered Su Yun's question.

Was it a private matter?

Zheng Ren's bizarre reaction spurred Su Yun's curiosity further.

Despite the possibility of a trap, he observed the women up close for any telltale signs of medical conditions.

Aside from their extraordinary good looks, there was nothing of note.

After a minute of silence, he tried asking again, "Which one of you is sick? And where is the discomfort?"

They gave no reply, instead exchanging odd glances with each other.

Su Yun was experienced at reading women but was stumped this time around, unable to decipher what they were communicating through their furtive looks.

Was it a gynecological issue?

Damn you, Zheng Ren. Su Yun cursed under his breath.

The standard procedure in the emergency department was to consult the relevant specialties for specialized illnesses.

The emergency center was a chaotic place. There was always a risk of a drunkard crashing into the examination room, so it was best for the pertinent examination to be done in the gynecology department.

"Is it a gynecological disorder?," Su Yun asked with a dashing smile, amping his charm as hard as he could. "Why don't you girls head over to the gynecological department? Just follow the arrows on the floor."

As the words left his mouth, he felt the temperature in the room drop.

Had he said something wrong? Was the woman pregnant and in need of an abortion? Su Yun's mind went through all manner of possibilities.

Maybe they had been overenthusiastic in the bedroom and gotten a beer bottle stuck in their nether regions? Such a thing would certainly warrant a trip to the emergency department.

It was not an uncommon occurrence.

Maria Hospital had had a patient who checked in with multiple golf balls in them a few years ago. The youth these days were quite out of control.

The only limit was one's imagination.

Su Yun was not judgmental but would prefer if they were more cautious. Risk of injury was not worth the pleasure.

However, judging from the reactions he was getting, he was mistaken.

What was going on?

The woman in the center, with the prettiest features and most attractive figure, said nothing and frowned.

Half a minute passed before she said abashedly, "Doctor..."

Her voice was hoarse in a way that reminded Su Yun of Anita Mui.

"Yes? You're the one who needs medical attention?" His nosiness surfaced.

"I... I... accidentally hurt my bottom," the woman stuttered.

A small smile appeared on Su Yun's face. He was right; it had been a shameful incident. All he had to do was bring them to the gynecology department. "What happened, then?"

"I... My testicles hurt," the 'woman' said in embarrassment.

Carried away by his victory, Su Yun did not register the patient's words. "Remember to be gentler next time. Was it too rough? Or maybe the position was uncomfortable? Just pay attention in the future. I'll take you to the gynecology department."

It was probably post-coital pain. Su Yun chuckled at the woman's straightforwardness.

"Doctor, I said my testicles hurt." Realizing the doctor had clearly misunderstood, the 'woman' gathered their courage and said, "I am a man and I said my testicles hurt."

What a whiplash!

Su Yun looked as if he had been struck by lightning.

His mop of black hair flopped lifelessly before sticking to his forehead.

He had to have heard wrong.

What did she say? Maybe he needed a hearing test.

"You—What did you say just now? Can— Can you repeat it?" Su Yun managed.

The 'woman' met Su Yun's gaze and said meekly, "Doctor, I am a man... and my testicles hurt."

Su Yun was stunned into silence.

A drag queen?

He had encountered a few in his life but none this realistic.

Despite his experience with women, Su Yun was not able to pick up on subtle differences.

"Doctor, can you take a look?" As the cat was out of the bag, the drag queen was no longer timid with his words.

His mannerisms retained the feminine coyness that tugged at the heartstrings of men.

Su Yun felt his worldview shift.

What was he witnessing here?

The hospital setting compelled Su Yun to hold onto his rational mind.

He turned away to not have to face the group. Whether the drag queen's companions were actually women or not, Su Yun did not deign to find out.

Damn it! Tricked by that damned Zheng Ren again!

Su Yun managed to maneuver his fingers to operate the workstation, retrieving the patient's name from the registration ticket and typing up a simple patient history. Then, he scheduled a B-scan ultrasound and gave the patient the necessary instructions.

Once the trio were gone, Su Yun breathed a sigh of relief.

"Good job." Zheng Ren walked over and gave him a thumbs-up. "I was stunned when I noticed. I'd probably be useless in your shoes."

A string of curses ran through Su Yun's mind when he saw Zheng Ren.

"Chief Resident Zheng, why are you here?" The on-call doctor who had been tending to the child's injury greeted them as he returned to the clinic.

"Ah, I came down to check on the floor. Internal medicine seems overburdened compared to surgery," Zheng Ren replied.

"In the dead of winter, there are fewer drunken brawls and drunk drivers. Just the occasional minor injury. I heard yesterday was a hectic night for you guys upstairs," the doctor said.

Zheng Ren rarely spoke to the other doctors but seemed to be in a talkative mood today as he regaled the surgeries of the previous night. "Oh, yesterday..."

Su Yun sat on one of the chairs, zoning out into the distance.

Some time had passed when Zheng Ren snapped him out of his daydream. "Come on, let's go."

"You!" Su Yun grabbed Zheng Ren's arm. "How did you know?"

"Know what? I don't know anything," Zheng Ren retorted reflexively.

"No, you clearly knew the patient was a drag queen! His getup and act were impeccable. A work of art! If he hadn't asked me to check his testicles..."

Zheng Ren could not hold back his laughter. "What are you talking about? All the doctors were busy and it was either you or me. I didn't want to give you the opportunity to smear my name in front of Yiren."

Su Yun thought about it. That was reasonable.

The two doctors walked back to the wards, one grinning joyously while the other scowled.

"I guess an image in the mind's eye is better than nothing," Su Yun said suddenly.

"Huh?"

"I had met some drag queens back in Imperial Capital but none of them were as perfect as this one. Of course, no one wanted me to check their balls then." Su Yun sighed. "If he had not brought up the testicles... Honestly, the mention of drag queens and man bits kinda churns my stomach."

"Didn't you just praise his art?" Zheng Ren pointed out.

"If only he had not mentioned his testicles," Su Yun repeated.

From the System's display, Zheng Ren had seen that the patient was suffering from acute testicular trauma. He was not interested in its cause.

It was not a major case and he was put off by Su Yun's constant teasing, so he found an opportunity to send the man away.

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Chapter 296: Actions Speak Louder Than Words (Part 4 of 4)

Chang Yue and the other nurses clocked out systematically. The mountain of paperwork had driven her up the wall.

That aside, she still had to interact with patients and their families, a task that required a lot of effort on her part.

She had to keep track of each patient's personality and disposition. Some patients were prone to complications and required more time to double-check their medication and procedure. Some patients were talkative, so Chang Yue would ask them more questions.

Most of the staff had left when Zheng Ren and Su Yun made their rounds. The patients were all stable.

Zheng Ren sat down and picked up a thick tome titled Fundamentals of General Surgery. A few pages in, he felt a disquiet that interfered with his reading.

What was this? It was an odd sensation he had never felt before.

Zheng Ren looked up and ruminated on it. Had he made a mistake on any of the patients today?

A few minutes later, he realized what was bugging him. He had yet to text Xie Yiren...

It was a habit he had developed in Imperial Capital and brought back to Sea City. Even when busy, he could feel a nagging voice in the back of his head reminding him to do it.

Zheng Ren chuckled at his own nature and took out his phone.

"You're only planning to text Little Yiren now?" Su Yun had been waiting for Zheng Ren to make this move the entire time. "Doing so at this hour; I'd say 90% of girls would already be pissed. The younger the girl, the likelier she would be mad."

Su Yun's words succeeded in making Zheng Ren anxious.

His fingers trembled slightly as he typed out his message, something that had not happened even when facing down the knife-wielding criminal back in Imperial Capital.

[Ward rounds completed. All patients stable. What are you doing?]

Zheng Ren kept it neutral.

Xie Yiren did not reply.

The grin on Su Yun's face widened as time passed. After five minutes without Xie Yiren's response, he said, "See, she's mad."

Zheng Ren stayed silent.

"This is why people don't shit where they eat[1, yet you chose to do so. Of course, it's convenient, but do you know what its downsides are?" Su Yun said with a smirk.

It was a rhetorical question, one that Su Yun did not expect a straight-faced man like Zheng Ren to answer.

"The convenience is a double-edged sword. See, now that Yiren is upset, would you not have to placate her? If there was an emergency surgery now that required the both of you to work together, wouldn't it be awkward?"

Zheng Ren followed Su Yun's line of thought... and agreed.

"Here's my advice, young man. Girls expect quality time. Why do you think I don't have a girlfriend? I simply don't have the time. Just keep things casual and you'll find life much simpler!" Su Yun continued.

Zheng Ren paid little attention to the narcissistic monologue that followed. Spending so much time with Su Yun had taught him how to tune out the man's shameless self-praise.

The sound of footsteps caught his attention.

Was it Xie Yiren? Zheng Ren could not identify anyone from how they walked, but in his current mood, every shadow in the corner could be her.

"Stop dreaming. The only way forward is for me to take the night shift while you go to her house to make it up to her." Su Yun squeezed Zheng Ren's shoulder. "Think through what you want to say to her."

Right then, a familiar silhouette appeared at the entrance of the office.

Standing there with a food carrier in her hand was Xie Yiren.

With a smile on her face, she called out in a funny accent, "Yoohoo~ It's time for food~"

It was the iconic tagline of the actress Shen Chang in the role of the nanny from I Love My Family, a drama series from years ago.

Being related to food, it had stuck with Xie Yiren since.

Zheng Ren stood up from his seat abruptly. The haze in his heart cleared up instantly upon seeing her.

Huh. Guess I was wrong, Su Yun thought.

"Come on, let's eat," Xie Yiren said as she shook the food carrier and bounded off to the on-call room before Zheng Ren could say a word.

Su Yun patted Zheng Ren's shoulder and muttered grumpily, "You... You're a lucky man."

Zheng Ren laughed and went after Xie Yiren.

When the two men arrived at the on-call room, Xie Yiren was already unloading the contents of the food carrier onto the table.

The carrier was tightly secured and gave off no odor, but the smell of a garlic-based fish dish filled the room as she opened it up.

Even Zheng Ren, who typically viewed meals as a time-consuming affair, felt his mouth water.

"Oh! Little Yiren's cooking is impressive!" Su Yun noticed Zheng Ren's awkwardness and quickly filled the silence.

Xie Yiren looked over her handiwork with pride. "I had this once when traveling with my mother. It was delicious and I begged her to stay for a week; I ate at the restaurant every day and went into their kitchen to learn how to cook this dish. Learned it on my first try."

She truly had an immense love for food.

Zheng Ren took a seat at the table. Once Xie Yiren had everything ready and was seated, they began to eat.

Delicious!

With each bite, Su Yun wondered why he did not have someone like Yiren. How lucky Zheng Ren was.

Not only was Xie Yiren not angry, she had even made food and delivered it to the hospital.

Su Yun cared little about her affluence. This gesture alone was sufficient.

"Hey, come on. Give the girl a review," Su Yun said, tapping his plate with his chopsticks.

The dumb*ss would not even utter a word of praise without Su Yun's prompting. Useless.

Despite that, Zheng Ren continued to remain mum. Instead, he gave Xie Yiren a sincere smile and continued to shovel food into his mouth.

Xie Yiren did not mind it one bit and watched Zheng Ren eat with a smile on her face.

He was quick with emergency rescue and surgery and was equally fast at eating.

They went through the food like a hurricane, leaving only scraps behind.

Seeing Zheng Ren enjoying her home-cooked food brought a newfound happiness to Xie Yiren's heart. Her eyes crinkled as her smile widened.

Was this what was being expressed through action? Su Yun felt confused.

Acts of love seemed to speak louder than words. He ought to put this to test in the future.

As soon as they finished their food, Zheng Ren's phone rang.

He frowned, but it disappeared as soon as he picked it up and saw Old Chief Physician Pan's name.

"Chief Pan.

"Oh. We can try. You know our hospital has no experience with TIPS[2, right? And the surgery doesn't really have a high success rate to start with.

"I know. We'll have to pay attention to the post-surgery hepatic encephalopathy. I'll go have a look now."

Although Old Chief Physician Pan was not present in the room, Zheng Ren spoke as if he was, sitting up attentively and smiling.

[1] Do not cause trouble in a place where you must be on a regular basis. Often used with workplace romances. The raw text wrote 兔子不吃窝边草.

[2] Transjugular intrahepatic portosystemic shunt surgery.

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Chapter 297: The Crown Jewel (Part 1 of 4)

"An emergency?" Su Yun frowned at the mention of the transjugular intrahepatic portosystemic shunt (TIPS) surgery.

The TIPS surgery was hands down the most difficult type of interventional surgery.

Of course, there were many new surgical methods that required certain medical facilities to pull off; the prostate interventional embolization, for example. These surgeries were already considered difficult, but the TIPS surgery demanded the most skill.

"There is a patient in the gastroenterology department, a friend of Department Chief Xia's, with complications. They had arranged for a surgery in Imperial Capital Hospital but the patient started vomiting blood and is now in critical condition," Zheng Ren explained as he rose from his seat and put on his white coat, shooting Xie Yiren an apologetic look.

Xie Yiren gave him a wave of support. Her brown-eyed gaze softened as she watched Zheng Ren hurriedly dress for duty.

Reassured, Zheng Ren strode confidently out of the on-call room.

"Can you perform the surgery?" Su Yun asked when he caught up.

"I can try." Zheng Ren had never done it before but had some training time saved up in the System. He was willing to spend all his points to save a life.

Postsurgical care was the most complicated part of a TIPS surgery.

To address decompensated cirrhosis and its resulting symptoms, esophageal varices and splenomegaly, there were two methods: the first was a splenectomy and porto-azygos disconnection. The second method was TIPS.

This surgery had barely 30 years of history in a clinical setting.

A German research team, headed by Richter, was the first to perform a transjugular intrahepatic portosystemic shunt surgery in 1988. In 1991, they published a paper detailing 16 successful procedures.

Later, Zemel (1991) and Ring (1992) also reported success.

In 1993, the procedure was introduced to other countries.

The first TIPS surgery locally was performed at the turn of the 21st century by Professor Xu Ke's team from China Medical University.

To this day, the procedure was rarely used in hospitals.

Why?

It was difficult.

Extremely difficult.

Moreover, the post-surgery survival rate was not high.

However, if the patient managed to recover, the benefits of having a shunt in place were huge.

Su Yun had recently started reading up on interventional radiology-assisted procedures and knew that TIPS was the crown jewel of interventional surgery.

Was Zheng Ren going to try it now? Did the hospital even have the necessary instruments and materials?

"Do we have the necessary items?"

"I'll call Manager Feng," Zheng Ren said as he scrolled through his phone contacts.

"Manager Feng, it's Zheng Ren.

"We're starting a TIPS surgery. Please send over the relevant materials immediately.

"Yes. Old Chief Physician Pan will handle the procurement documentation tomorrow.

"We need it in an hour!"

He hung up.

"Are you confident with post-surgery care?" He said, his footsteps quickening.

Su Yun recalled the TIPS procedure and its risks. "If we can't prevent hepatic encephalopathy, we can only prescribe amino acids to hopefully control its progression."

The key lay in managing the potential onset of hepatic encephalopathy.

Zheng Ren mulled the risks over as they arrived at the gastroenterology department.

Department Chief Xia felt some embarrassment when she saw him.

Their first meeting had involved the floating gallbladder.

After Zheng Ren was proven correct, Department Chief Xia had been reluctant to cross paths with the emergency department chief resident.

Even for emergency procedures, she called up Old Chief Physician Pan instead... It was the proper channel to go through as favors were traded among department chiefs.

"Good day, Chief Xia. May I know which room the patient is in?" Zheng Ren asked with a neutral expression. There was no pride or sarcasm in his tone. It was as if their previous encounter had never happened.

"Right this way." Department Chief Xia put aside her misgivings for the chief resident and brought the two doctors to the resuscitation room.

It was a male patient in his fifties with jaundice-yellow skin and a deathly miasma surrounding him. He held a basin in his hands to catch the dark venous blood pouring from his mouth.

It was like a scene from hell.

The strong stench of blood filled the room. Zheng Ren glanced at the System's display.

It gleamed a dangerous red.

The System diagnosed hemorrhagic shock, decompensated cirrhosis, refractory ascites, hydrothorax and electrolyte imbalance.

This patient had just recently undergone a splenectomy and porto-azygos disconnection...

Zheng Ren had been deciding between two procedures but was now left with one.

"The vomiting started three days ago. He had just come out of a splenectomy and porto-azygos disconnection surgery, hence the conservative treatment. We managed to control the bleeding with a combination of three hemostatic drugs and epinephrine, but when we were calling the ambulance for a transfer to Imperial Capital, the patient started vomiting large amounts of blood."

A cocktail of three hemostatic drugs alongside epinephrine was an extreme measure.

Administering more than three drugs only increased the risk of complications. A cerebral or myocardial infarction could worsen things.

Zheng Ren took a deep breath and calculated his remaining intensive training time.

After all, the TIPS surgery was the toughest procedure in the world of interventional surgery. Zheng Ren was not confident in his current abilities.

Department Chief Xia took note of Zheng Ren's sigh. An anguished smile crossed her face as she said, "I'm sorry it had to be you, but you're the only interventional surgeon we have in the hospital."

Her tone was unexpectedly sympathetic, but her reasoning was sound. Zheng Ren understood her feelings on the matter.

"Even a 10% chance is better than none." Department Chief Xia explained, "The patient was once my classmate, and his wife is also from the same school. Don't worry, Dr. Zheng. No one will hold it against you if you do not succeed."

The last sentence was to reassure Zheng Ren.

Either they performed an emergency TIPS surgery or the patient would vomit blood until he died.

A few more minutes of hematemesis violent enough to paint the floor and ceilings red, and the man would be gone.

If a standard TIPS surgery was a ten out of ten on the scale of difficulty, an emergency TIPS surgery would be an 11.

"Chief Xia, to be honest, I've never performed the procedure. The patient is in critical condition without any viable options. I can try my best, but there's no guarantee," Zheng Ren said.

"Thank you," she said sincerely.

Having a department chief say those words in front of the patient's family was a testament to Zheng Ren's abilities.

Su Yun smirked triumphantly.

In contrast, Zheng Ren's eyebrows creased in worry.

"Do you have the materials needed?" Department Chief Xia cut to the chase.

"I've spoken to the supplier. It should be here in less than 20 minutes. Let's prep the patient and the consent form..."

"I'll sign for it," Department Chief Xia interjected.

She seemed very close to the patient and his wife.

"Alright. Let's prepare for surgery," Zheng Ren said.

A bell then rang in Zheng Ren's ears.

[Main Mission: The Crown Jewel – First Stage

[Mission Details: Complete the most challenging procedure in the field of interventional surgery: the transjugular intrahepatic portosystemic shunt surgery.

[Mission Reward: The average completion time for the TIPS surgery is 4 hours and 23 minutes. No special reward will be given if the host exceeds it, but if the host completes the procedure in less than that, the reward will be bountiful.

[Rewards include 2 luck points, two gold chests, 200000 experience points.

[Mission Duration: 6 hours.]

Zheng Ren had planned to ignore the mission but a quick scan through the details made his eyes pop.

The luck points on top of the experience points reminded Zheng Ren of his time in Imperial Capital, and the System promised even more rewards if he finished the surgery early.

Was the TIPS surgery a main mission?

In the world of interventional surgery, TIPS was the ultimate challenge. Zheng Ren felt that he would have to unlock the entire skill tree before he could even attempt a TIPS surgery.

Main mission... Sure.

He wondered what the main mission was for general surgery.

This would be his first attempt at the procedure. Whether it was to save a life or to accomplish a mission, he would have to plan his approach carefully.

He still had some experience points that could be exchanged for training time. It would have to do.

Zheng Ren went through each step of the procedure in his head.

On the surface, the surgery was simple.

Under local anesthesia, access would be gained through the right jugular vein. The guide wire, guide catheter and angiographic needle would then be maneuvered to the hepatic vein, where the needle would be used to puncture the portal vein for stent placement, building a lasting connection between the portal and hepatic veins.

The difficulty lay in puncturing the portal vein and establishing said connection.

The puncture would be performed without any visual assistance. It was up to experience and luck.

Luck played a huge factor in TIPS surgeries, regardless of the skill of the surgeon.

That was why it was the crown jewel of interventional surgical achievement.

Zheng Ren was trying to figure out how to minimize reliance on luck.

As someone who had not even bothered trying his luck with the System's treasure chests, Zheng Ren was not willing to let it determine his success at the operating table.

Su Yun was a step behind him and noted his slower pace. Zheng Ren seemed deep in thought. "Are you sure about this?"

"No one can be 100% sure about anything," Zheng Ren replied.

"Professor Rudolph Wagner is sleeping in Shangri-La Hotel," Su Yun reminded him.

"Oh..." Zheng Ren had forgotten about the professor.

The professor was one of the world's top interventional surgeons. It would be wise to invite him to assist in the surgery.

Zheng Ren nodded and pulled out his phone.

It rang for a good 30 seconds before the professor picked up. "Professor Rudolph, it's Zheng Ren."

Zheng Ren ignored the sleepily-mumbled German greeting and got straight to the point.

"We have a TIPS surgery now. Please come and have a look."

He hung up without any additional explanation.

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Chapter 298: A Series of Failures (Part 2 of 4)

"Your brutal honesty never ceases to amaze me. Can't you be a little bit more tactful when speaking to a world-renowned professor?" Su Yun needled Zheng Ren.

"Heh." Zheng Ren huffed out an unamused chuckle. He made another call to Xie Yiren and Chu Yanran, instructing them to prepare for the surgery.

Once that was done, Zheng Ren called Feng Xuhui again to check on the status of the delivery and remind him of its urgency.

Lastly, he called up Old Chief Physician Pan to provide an update on the situation.

Zheng Ren and Su Yun arrived at the doors of the operating room just as the last call ended.

They changed their outfits in silence.

The patient had yet to be moved, so Zheng Ren did not rush. Seeing that Su Yun had already changed into surgical scrubs, he said, "You go on and help with the setup. I'm gonna light a smoke."

It was common to have a cigarette to calm one's nerves before a surgery. Su Yun made a noise of acknowledgment and headed into the operating room.

Zheng Ren went into the tiny smoking room and lit a cigarette. He took a long drag before entering the System.

Without any hesitation, Zheng Ren exchanged all his experience points for training time on top of the time he had been awarded before.

The System's operating room rose from the ground, fully equipped with simulation mannequins.

Zheng Ren began his intensive training.

Jugular vein catheterization was effortless.

The guide wire traveled down the vein and into the heart, and then the hepatic vein. All was going well.

Journeying through the venous network was easy for someone who could maneuver a guide wire into the smallest arterioles of the prostate.

However, the most difficult step was coming up.

From the hepatic vein, he made an estimate and proceeded with the puncture.

Failure...

He switched positions.

Failure...

Another position.

Failure...

A dozen attempts later, he had still not established a connection between the hepatic and portal veins.

How demanding...

How arduous...

No wonder it was the crown jewel...

After the 42nd failed attempt, Zheng Ren took a break.

Training time was precious but there was no guaranteed success if he continued stabbing in the dark.

The portal vein had a large lumen. Even its branching venules were wider than most other vessels.

It required a lot of luck to accurately pinpoint the position of the portal vein within the liver from the hepatic vein, and more so to successfully puncture it.

What other skills did he require?

Zheng Ren rifled through the library in his mind.

A dozen failed attempts would not lead to the patient's death.

The liver was a solid organ that could withstand the small-bore punctures of the puncture needle. The pressure within the organ would stem the resulting bleed.

However, there was a limit to the number of failed punctures before the liver became irreversibly damaged.

Zheng Ren ballparked the number at anywhere between 20 to 30 tries.

Hence, each TIPS surgery entailed up to 30 attempts at blind punctures. No wonder the average completion time was 4 hours and 23 minutes. The surgeons were all trying their luck.

Were Zheng Ren handling a real patient and not a simulation mannequin, he would not be as bold in his blind attempts.

He decided to pause practical work in favor of the theoretical.

After all, one ought to sharpen their axe before attempting to chop wood.

Zheng Ren left the System's training grounds and sifted through the volumes of information stored in his brain.

The memories of medical books and journals came to the forefront of his mind at the snap of a finger.

His Grandmaster rank in interventional surgery was essential for understanding and digesting the copious amount of information that he had once struggled to make any sense of.

Zheng Ren's proficiency in liver dissection was also a boon in this case.

All knowledge and skill were made possible by countless trials and errors throughout history, and the many lives that were sacrificed in the name of science.

The System had its downsides.

First, it was stringent with time. It counted each second that passed and once his time was up, Zheng Ren would be kicked out of the surgical training room. There was no negotiation.

Secondly, it expected the host to be independent. There was no guidance provided, no wise guru to pass on words of advice.

It was just Zheng Ren alone, fumbling through literature, knowing full well that some experiences were hard to put down in words.

He committed his mind to memorizing the whole TIPS procedure and integrating that knowledge with his experience of liver dissection. Then, he noted down all reported attempts at the procedure.

He called for a new simulation mannequin.

The previous mannequin was unusable after dozens of failed punctures.

Jugular vein puncture, access to the hepatic vein, followed by an attempt at a portal vein puncture.

Failure...

Failure...

Failure...

F*ck!

Zheng Ren almost went crazy.

He thought he had all the information he needed to succeed. The TIPS surgery was a combination of interventional methods and general surgery.

Zheng Ren was a rare two-headed snake, being a Grandmaster in the former and a Master in the latter.

He even had almost a thousand cases worth of experience in liver dissections. Such an experience would not have been possible without the System.

Yet... It was still not enough for the TIPS surgery?

Impossible!

Zheng Ren refused to think that he was incapable.

If he could not do it, there was no way anyone else could.

He had to have taken a wrong turn in the heat of the moment.

Where was his mistake?

Zheng Ren waved and dismissed the training room.

There was a limit on his training time but outside the System, time was even more precious. The patient was already on his way to the operating table.

Zheng Ren sat by the lake. His eyes fell on the realistic fox statue as he recalled his every step during the surgery. What was there to improve upon?

A burning sensation shook him from his quiet reflection.

Exiting the System, he tossed away the cigarette that had burned all the way to his thumb.

He called Su Yun; the doctor was to receive the materials from Feng Xuhui and then only ask for him once the patient was ready for surgery. Zheng Ren wanted some uninterrupted alone time.

Su Yun was perplexed but did not question Zheng Ren's decisions when it came to emergencies.

The call ended and Zheng Ren cleared his vision before entering the System once again.

What was his mistake?

Zheng Ren went through the steps of the TIPS surgery again. The difficulty was in that single step. The puncture needle was affected by blood flow in the portal vein.

Was the solution in radiology?

CT? MRI?

Suddenly, Zheng Ren remembered the reward from the mission, The First Stage of The Great Beginning. It was a passive ability, Integration.

Perhaps that was it?

It was worth a shot.

The simulation mannequin was a docile and compliant patient that could be maneuvered as he pleased.

Zheng Ren entered the surgical training room. He did not rush to perform the surgery, instead spending some time analyzing CT and MRI scans.

His time was ticking away but he remained calm and focused.

A sharpened axe was what he needed.

A few hours later, Zheng Ren's eyes ignited with understanding.

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Chapter 299: The First in the Hospital's History (Part 3 of 4)

In the System's operating room, Zheng Ren focused on the scans of the simulation mannequin. From CT scans to the NMRI, the 64-slice CT scan with 3D-image reconstruction, the B-scans, and the supine chest and abdominal fluoroscopy imaging, he went through them all.

There was some invariable connection between them.

However, Zheng Ren was met by one disappointment after another.

He had wasted almost half his surgery training time looking at those images.

What if... Zheng Ren rejected the thought. It was not possible. He was not able to fully consider all the symptoms as he was still fairly new to the System.

He would solve one problem at a time.

The life of the patient in front of him was crucial even though he knew the same thing would never stop happening in the real world.

Zheng Ren had never once thought himself capable of saving the entire world. Protecting his people and patients was enough.

He looked through the scans over and over again, performing punctures on the simulation mannequin with the angiographic needle.

Success came occasionally, but much more infrequently than failure.

Pulling it off was still a matter of luck.

Although all interventional surgeons in the world mostly depended on luck, Zheng Ren wanted to avoid it.

The NMRI was not practical for observing blood vessels. It was important when analysing the arterial vessels of tumor vasculature, but was not able to distinguish the venous channels.

What about CT scans?

Or 64-slice CT scans with 3D-image reconstruction?

Zheng Ren kept trying different combinations. He even included the positioning and landmarks of puncture sites with ultrasonography.

However, all his attempts were futile.

After countless puncture attempts on the simulation mannequin, Zheng Ren had gained lots of experience and drastically improved the success rate of the surgery.

On average, he got it right once for every twenty punctures.

It was not Zheng Ren's ideal outcome.

How would he solve this?

The System had provided him with all manner of convenience. Zheng Ren could experiment indefinitely if he had sufficient surgery time.

As the time passed, though, he felt as if his heart was oozing blood.

Had he used it to perform surgery, he could have earned 300 skill points for every TIPS surgery he completed.

It was much less rewarding than prostate interventional surgery. Zheng Ren speculated that it was because the latter was a novel method while TIPS surgery was already a mature procedure.

Although the rewards were slightly fewer, it was still better than doing nothing in the System's operating room.

He was still not giving up. He did not want to depend on luck when it came to surgery. There had to be a way... maybe... perhaps...

Time was passing by, every minute, every second.

Tick-tock... tick-tock... it was like the rhythm of Zheng Ren's bleeding heart.

After countless attempts and various test results, Zheng Ren was on the verge of conceding.

There were so many doctors in the world that had failed to come to a conclusion. How could he do that in just a few days? Even with the help of the System's operating room and simulation mannequins, this was too far a stretch.

...

...

Professor Rudolf Wagner was thrilled.

This was the first time Zheng Ren had personally called for him, possibly for help.

Zheng Ren was very skillful, but not necessarily in all fields of interventional surgery.

Everyone had their limits. Professor Rudolf Wagner was sure that TIPS surgery was Zheng Ren's weak point.

This was also part of why he had chosen to stay in Sea City.

He had put in his best efforts to close the distance between him and Zheng Ren, hoping the man would agree to follow him back to Heidelberg for research.

The workload here was too heavy. Professor Rudolf Wagner had almost broken down after one night shift.

Zheng Ren's determination to continue in such working conditions was perplexing.

Did he not know the value of his own gift?

Professor Rudolf Wagner stood in front of the mirror for a full minute after changing quickly, ensuring his scholarly appearance was authoritative and convincing enough before leaving Shangri-La Hotel. He then took a ride to Sea City General Hospital.

In order to adjust to the lifestyle in China, he had taken some time to chat with Chang Yue earlier in the day.

Professor Rudolf Wagner thought her an adorable girl with a warm personality.

She had helped him download ride-hailing and payment apps, converting 100 euros for the professor, and also taught him how to book a ride so that he could go anywhere he wanted.

Professor Rudolf Wagner was very pleased with the convenience it brought.

Even though he had only been here for less than two days, he had already fallen in love with the place.

On his way, the professor mentally ran through the TIPS surgery. He would be putting all of his energy and focus into it, giving his best to showcase the perfect TIPS surgery to Zheng Ren.

To be partners and not get pushed aside during surgical research, he needed to demonstrate that he was the man's equal.

Unless he was comparable to Newton, he would not be able to claim someone else's research as his own.

Such a thing was not his domain. Professor Rudolf Wagner wanted to get ahead on his own expertise.

The car reached Sea City General Hospital shortly. He alighted from it and rushed towards the operating room.

As he was not registered for the fingerprint lock on the changing room, he could only ring the doorbell.

The camera lamp on it lit up. "Who's there?"

Professor Rudolf Wagner angled his face towards the light and gave his most winning smile.

"Please hold, Professor," Xie Yiren said from inside.

Since it was an interventional surgery, Xie Yiren did not stand by at the operating table after preparing a sterile surgical pack.

With the exception of endovascular stenting and thrombolytic surgery, interventional surgeries did not require the presence of nurses.

They depended greatly on the surgeon's skill alone.

"Professor, I'll get the door." Xie Yiren soon appeared to let the professor in.

"Thank you, pretty lady," Professor Rudolf Wagner said gracefully, "Are you guys ready to start?"

"The surgery has started," Xie Yiren said casually.

The smile on the professor's face became even more charming. Knowing this was Zheng Ren's personal scrub nurse, he had to leave a good impression.

"Zheng called me to join in on a TIPS surgery. What step are they in now?" Professor Rudolf Wagner asked.

"Oh, they have just begun," Xie Yiren answered.

Hmm? Why had they not waited for him? Professor Rudolf Wagner was a little surprised.

"Have you guys done this before?" he asked.

"No, this is the first time," she said gently. "They are taking it very seriously. This is our first TIPS surgery in the history of our hospital."

Professor Rudolf Wagner felt slightly relieved.

TIPS surgery was extremely difficult. Even with Zheng Ren's exceptional talent, the man would not be able to succeed on the first try.

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Chapter 300: The Brave Fear Nothing (Part 4 of 4)

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

After he finished changing, Professor Rudolf Wagner entered the console room outside the operating theater.

Through the leaded glass, he saw the patient positioned at a strange angle. Before he could take a closer look, a tiny woman asked, "Who are you?"

Chief Xia from gastroenterology was confused by Professor Rudolf Wagner's entrance.

"Chief Xia, this is Professor Rudolf Wagner from Heidelberg University." Xie Yiren made the introductions, being familiar with the professor after he had assisted in Zheng Ren's surgeries the night before.

Chief Xia was at a loss for words. When had a German professor come to the hospital? Normally, the hospital's publicity would be off the charts when a professor came for a visit and exchange.

Could the man be a fraud?

She stared at Professor Rudolf Wagner doubtfully.

"I'm here for Zheng, beautiful lady," Professor Rudolf Wagner explained in stiff Mandarin.

"You're looking for Dr. Zheng? Why?" Chief Xia asked without thinking.

"Zheng has God's own hands," he answered, "I wish to form a research team on a novel surgical method with him, but Zheng has rejected my offer."

Chief Xia began sweating profusely.

Her first instinct told her that this foreign-looking expert was a fraud conspiring with Zheng Ren.

However, on second thought, it was pointless to be in denial.

Was he telling the truth?

She hesitated.

"Professor, you specialize in..." Chief Xia asked.

"Interventional surgery," Professor Rudolf Wagner said. "I began performing TIPS surgery twenty years ago. To date, I've completed more than three hundred TIPS surgeries and am probably one of the doctors in the world with the most under their belt."

This was an impressive number and the professor knew it.

It was rare to find an interventional surgeon who had done more than a hundred TIPS surgeries, but he had accomplished thrice that.

In terms of experience, no one could match him.

Especially since TIPS surgery required experience and luck... Professor Rudolf Wagner felt slightly disappointed as he thought of luck.

Many years ago, he had tried to improve the surgery to reduce its reliance on luck, but failed.

Perhaps it was a test from God. The adage placated him somewhat.

Chief Xia's eyes widened upon hearing Professor Rudolf Wagner's words.

If... if the professor was telling the truth, there was hope for her old classmate.

Truthfully, Chief Xia doubted that a young doctor like Zheng Ren could complete a TIPS surgery, especially an emergency one.

The possibility of that happening was near zero.

There was a vast difference between an emergency and non-emergency surgery, especially one that involved hematemesis and ascites.

An ordinary TIPS surgery required the patient be in the supine position with local anesthesia on the neck region. If the patient felt pain during the puncture, a dose of Dolantin would easily solve the problem.

On the other hand, patients in emergency TIPS surgery vomiting blood could end up choking on their own blood in that position.

That was why the patient had been placed in the lateral position for surgery, even if it was a little awkward...

Professor Rudolf Wagner was surprised to see the goings-on in the operating room.

Zheng was too daring!

This was TIPS surgery. A tiny mistake would lead to failure.

This was the man's first time performing it and he had still chosen to use such an awkward position.

Professor Rudolf Wagner could foresee Zheng Ren's disappointment after failing the surgery.

Let me save you, Eastern boy.

He kept the lid on his smugness.

In the operating room, the puncture on the jugular vein and insertion of the jugular sheath had been completed as they were not difficult.

What came next was crucial. Professor Rudolf Wagner wrapped his arms around his body, his entire focus on the screen.

After angiographic catheter insertion, suction commenced at an exceedingly slow and cautious pace due to the patient's constant spasms and blood-soaked retching. This emergency surgery was incomparable to any ordinary surgery.

At the same time, the live surgery broadcasting room of Xinglin Garden went insane.

Hemostasis with emergency TIPS surgery! This was the most difficult surgery streamed yet.

A few did not understand the hype around TIPS surgery, but were soon clued in by ecstatic general surgeons and interventional doctors.

The procedure was not very clear, but portal-azygos disconnection was a textbook method, known to all physicians who had been through medical school.

[The surgeon's about to defy fate!]

[They're going to perform an emergency TIPS surgery with the patient in a lateral position... if every surgery in the past hadn't been successful, I would have called this a failure already.]

[Just wait for the news of success, whelp. I have a hunch that this surgeon will achieve victory again if no accidents happen.]

[On that note, post-operative complications of TIPS surgery can be a handful. A few days ago, I received a patient who underwent TIPS surgery three months ago; he had been suffering from hepatic encephalopathy ever since the procedure.]

[There's usually no choice. It's between surgery and death. What would you have done?]

[Let's play a game; those who guess correctly will get a reward. How many punctures do you think the surgeon will have to perform before they succeed?]

Most doctors present did not even understand the question. It was too technical and would never even come close to the domain of those not from general surgery or interventional radiology.

Locally, only hospitals at a provincial level or higher could perform such a surgery.

Failing that, they would invite experts and professors to come over and perform it. One or two successful cases would be sufficient for them to brag about for a year.

Meaningless as it was, it was clout.

It was also part of their culture.

[Twenty times!]

[I think the surgeon will fail. The patient kept moving onscreen and is probably vomiting blood.]

[How would one even develop the images with lateral positioning...]

[The machine can be adjusted. However, the angle makes the surgery more difficult. I'm starting to pity the surgeon who has to perform the surgery under such circumstances.]

[I think it can be accomplished within ten attempts. We invited a professor from Imperial Capital who succeeded on the tenth try.]

[That's just luck. A few years back, we also invited a famous professor from Sorcery Capital to perform TIPS surgery, but he failed even after thirty attempts. I think the patient's liver was perforated from all the punctures but the portal and hepatic veins remained out of reach.]

The viewers' experiences soon fully conveyed the difficulty of the operation to all present.

Many of the doctors were dismayed from the descriptions of TIPS alone.

What kind of surgery was this? It was more like an attempt on the doctor's own life.

The procedure required quite a bit of luck. Multiple punctures would seriously injure the liver and increase the risk of hepatic encephalopathy after surgery.

Either reason was enough for the doctor to give up.

If they refused to get involved, the life and death of the patient would not be on their hands.

If they did, and the patient died or suffered from serious hepatic encephalopathy, there was a high chance of a medical dispute after.

This... this surgeon was truly brave.

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Chapter 301: Just a Bit More (Part 1 of 4)

Zheng Ren was in the operating room, his full concentration on the surgery.

He finally understood and realized a novel method of positioning. However, he could not put his theory into practice as the patient in front of him had not done the necessary tests.

His skill had improved by leaps and bounds, even if it did not benefit the surgery right now.

In the System's operating room, he had managed to reduce the number of attempts at punctures and intubation between the hepatic vein and portal vein branch to below ten.

He could already complete one TIPS surgery within two hours., even refining the prevention of hepatic encephalopathy.

The research and learning process had been highly beneficial to Zheng Ren.

Although he had exhausted all of his accumulated surgery time and experience points, it had been worth it.

An emergency surgery was no longer an issue, let alone a normal one.

When the angiographic needle superimposed at the anticipated location, Zheng Ren growled, "Prepare to puncture."

Su Yun acknowledged the order, holding the guide wire steadily.

Right now, stability was more important than speed.

Zheng Ren confirmed the point of egress and made a few final adjustments before pressing down the angiographic needle.

As expected, he failed.

Zheng Ren was not disappointed, though; this puncture had been a calibrative one and failure was its intention.

It made an impression on the venogram and functioned as a landmark.

Zheng Ren focused on the venogram, the three-dimensional image of the patient's hepatic vein and portal vein already taking shape in his mind.

"Move 1.5 cm upwards and 15 degrees to the right," he said as he inserted the guide wire.

Su Yun was startled. Under normal circumstances, Zheng Ren would not be fulfilling that role. What did that order mean? 15 degrees to the right?

After some consideration, Su Yun quickly understood.

The hepatic vein was very thick and would cause the guide wire to drift inside.

Zheng Ren confidently maneuvered the guide wire inside, using the vascular wall as an anchor. It was not of much help, but it was better than moving blindly in an empty space.

This was where surgical skill would come into play. Su Yun knew that one could only develop such skill through experience.

He reminded himself to angle his hand at 15 degrees to the right with the guide wire.

It was fortunate that he had a high IQ, he thought disdainfully. Were someone else to partner with Zheng Ren, they would not have been able to catch up. The man was fortunate enough to have met him.

Zheng Ren was also aware of this, but had not had the time to communicate what he had just recently learned in the System.

[Hah, that's the first time!]

In Xinglin Garden, there was a scoreboard being tallied in the bullet comments.

After so many live surgery broadcasts, loyal viewers had the impression that the surgeon would never fail.

Few of them were gloating, however; most were cheerfully keeping track of how many punctures the surgeon would need to complete the surgery.

[The puncture site was quite far from its target.]

[It's a little off. I'm not sure what the surgeon intended. If they were trying their luck, the odds don't seem to be in their favor.]

[I don't believe that the surgeon would make a puncture blindly. Remember when the embolization that led to the necrotizing intestine was used to mark a source of bleeding? I was panicking back then but the surgeon did it anyway.]

Soon, the surgeon began the second puncture under the comments.

The shadow of the angiographic needle shot down like black lightning.

The images of the portal and hepatic veins overlapped each other. Once the needle was in, the whole superimposed angiography was difficult to differentiate.

[Did it work?]

[I don't know, but the puncture site is great. I have a feeling it was successful this time.]

[We'll know when we see what the surgeon does next.]

It was as if the doctors in Xinglin Garden were in the operating room, performing the surgery themselves. They all had their hearts at their throats.

A few began suggesting that the surgeon had purposely punctured too far during their first attempt, but others disagreed. However, after the second puncture, the idea that these were blind guesses was no longer of any consideration.

Although it failed, success seemed more and more likely with the next puncture!

It was a confidence brought on by the dozens of live surgery broadcasts before.

In the operating room, Zheng Ren shook his head and stared hard at the image before saying, "Retreat 0.3 cm and 10 degrees to the right."

He was like the captain of a small boat in a rocky sea, facing down roaring waves and barking orders without fear.

His crew carried out his orders with determination, keeping faith that their boat would conquer the waves and reach shore safely under the guidance of their captain.

The guide wire withdrew slightly, its movement so tiny it was invisible to all but the most acute of senses.

The distance of 0.3 cm... was extremely difficult to measure.

Su Yun could feel the changes in the wire. He tilted it to the right by 10 degrees and secured it as much as he could after Zheng Ren withdrew it by 0.3 cm..

Zheng Ren checked it again. He was full of confidence.

It was completely different from the System's operating room! Zheng Ren clearly felt this discrepancy after only two real-life punctures.

After the System's mission rewards, he had already accumulated 6 luck points.

Although he still had no idea what they were for, Zheng Ren could clearly sense how the surgery before him diverged from the one he had had in the System's operating room.

The second puncture had been a tentative attempt at making another landmark to confirm the portal vein's location between the first two points.

This was the technique Zheng Ren had managed to work out.

However, the second puncture had almost successfully entered the branch of the portal vein, penetrating it just by a little. It suddenly dawned on Zheng Ren that he could have made it if he had an extra luck point!

He had never been more sure that at this moment!

If he did not succeed this time, he would get it with the next puncture!

With Su Yun securing the guide wire, he started the next puncture.

His finger was latched firmly on the button.

At that moment, the patient began vomiting vigorously.

As his body moved, the puncture site shook intensely. Under such circumstances, the god of luck did not favor Zheng Ren and the third puncture failed.

There was utter silence in the live surgery broadcasting room.

Most of them had expected success at the puncture.

[Too bad...]

After a while, a comment flew by slowly.

[No worries, it was just an accident. The next one will definitely be the one!]

[The next puncture site will probably have to be pinpointed, and that's quite reliant on luck.]

[... I suddenly feel a deep despair, like I've just opened up McBurney's point but the appendix was missing.]

[... that's the plot of a horror movie. Please don't talk about not finding the appendix at Mcburney's point. I performed an appendectomy several days ago for three whole hours and finally found the appendix near the splenic fossa.]

[Sending empathy.]

[Sending empathy 1.]

[...]

Chapter 302: Success and Failure Separated by a Hair's Breadth (Part 2 of 4)

The viewers digressed further and further, like it was a self-defense mechanism against anxiety.

In the operating room, upon encountering an accident, a surgeon would either take out their anger on their equipment or remain silent.

In the live surgery broadcasting room, they did not throw their tools and lash out at their assistants as they were not the ones operating. It was more relaxing to observe than to perform.

The host surgeon had failed at another attempt, but the viewers could not blame it on the surgeon and thus resorted to telling jokes for fun.

In the operating console room, Professor Rudolf Wagner stared at the images with piercing eyes.

He found it hard to believe that this was Zheng Ren's first TIPS surgery.

The man was so proficient! Were it not for the patient's sudden hematemesis, the third puncture would have succeeded.

Zheng Ren's talents were so exceptional they were borderline enviable, Professor Rudolf Wagner thought.

Su Yun felt sorry, but was not surprised.

He had already overlooked the fact that Zheng Ren's first TIPS surgery had been exceedingly skilled.

Something that happened so often would lose its novelty. Were Su Yun to be surprised every single time, his jaw would have fallen off by now.

He was numb to it, subconsciously expecting such performance.

Perhaps it was the same frustration that others once felt when they looked at him.

"Emergency surgeries are all like this, just be patient," Su Yun comforted him calmly.

"Sure." Zheng Ren nodded, nonchalantly pushing aside the mote of regret in his heart before adjusting and repositioning the guide wire to prepare for another puncture.

He observed the venogram carefully and noticed that the wire was not very far from the location, possibly not having moved much at all.

Maybe Su Yun's hand had followed the motion of the patient vomiting. There was no other explanation.

Such a perfect assistant. At least to Zheng Ren, Su Yun was indeed flawless.

"Move forward 0.5 cm, 25 degrees to the right... 23 degrees," Zheng Ren estimated.

Soon, the guide wire was back in position.

The experience he had gained from surgery on the simulation mannequin in the System's operating room had been tempered on the anvil of reality, and it felt transcendental.

This had to be it. Although Zheng Ren had failed again, he was never more confident.

He did not comfort the patient or tell the patient to stop moving.

This was not the emergency treatment room. The patient was not throwing a tantrum.

The rupture of the gastric varices resulted in a large amount of blood accumulated in one's stomach. It was an involuntary biological response, uncontrollable by the individual.

Like a burp or a fever, no one could decide if it came or went.

He had to use this short window of recovery between the patient's intermittent vomiting to operate quickly.

The patient had rapid, shallow breathing, but no signs of agitation.

Zheng Ren pushed the button.

From imaging, the dark shadow of the angiographic needle advanced through the hepatic portal and reached the branch of the portal vein.

Su Yun barely managed to suppress his shout. "It went in!"

"Hold it." Zheng Ren was not in a hurry. He was stable and determined like a ballast, keeping their boat afloat to conquer the raging waves and reach the shore of victory.

"Yes," Su Yun responded.

A successful puncture was just one of the key steps. Any mistakes after this would cause the surgery to fail, requiring the whole process to be repeated.

Everything had to be carried out cautiously, as if walking on thin ice.

[Damn... success on the fourth attempt! Awesome!]

[The third puncture could've been the one.]

[This surgeon has once again exceeded my expectations. From what I remember, our hospital has performed over dozens of TIPS surgeries and their average duration exceeds 4 hours with about 20 puncture attempts.]

Xinglin Garden was joyous. Even the physicians who had expected failure were relieved.

They did not want the surgery to fail, no matter if it was overseas or not.

There were not many bullet comments left. Although the most crucial step was done, the subsequent procedure was also very important—deployment of the stent graft.

There were two different views on the choice of stents.

An uncovered stent had the advantage of stability. Its metal mesh formed a cylindrical structure that could be anchored by the hepatic parenchyma cells, creating strong friction that prevented it from dislodging post-surgery.

However, the robust regeneration of the liver was a complicating factor.

After a year or more, the stent and thus the tract created from the TIPS surgery could become blocked by the regenerated liver.

On the other hand, a stent graft could prevent the risk regenerated cells blocking the tract, but required more skill to secure in place due to the lack of friction between the stent and parenchyma cells.

It all depended on how the surgeon would employ it.

After repeated experimentation in the System's operating room and thorough literary research, Zheng Ren had chosen to use a stent graft.

He was certain that he could secure it in the channel made by the angiographic needle.

Professor Rudolf Wagner remained silent in the operating console room.

This could not be Zheng Ren's first TIPS surgery! If one could demonstrate such competency in their first attempt, how could TIPS surgery be referred to as the crown jewel?

He had performed this procedure so many times and understood its difficulty intimately, which was why he was flabbergasted.

How many times had he been berated when learning TIPS? How many failures had he encountered? How thrilling had his very first success been?

The professor's mind was consumed by a series of flashbacks.

Impossible. This was definitely not Zheng Ren's first time performing TIPS surgery.

Even with the professor's current skill, he was unlikely to succeed with the third puncture, especially in an emergency where the patient was vomiting blood.

However, after the third attempt and failure, Zheng Ren had remained as steady as the position of the guide wire.

And the fourth puncture was successful!

Professor Rudolf Wagner fully knew how tremendous that had been.

Zheng's hands were God's own. The man's sole purpose of existence seemed to be for interventional surgery.

Professor Wagner's decision to bring Zheng Ren to his research lab in Heidelberg University was further reinforced, rock-solid as the Alps themselves.

Zheng Ren held onto the guide wire while observing the patient's condition closely. If the patient had any intense movements due to vomiting in the next second, it would result in the withdrawal of the guide wire...

That would f*ck things up.

Su Yun inserted a 10 mm stent graft along the wire.

They both switched the position of their hands. So experienced with each other were they that their cooperation was seamless.

The stent was successfully deployed.

Since this was his first actual TIPS surgery and the patient was intermittently vomiting blood, the guide wire could deviate from its position at any time.

Therefore, Zheng Ren kept the angiography on to observe the wire and stent in real time.

Suddenly, the patient started puking intensely, filling the operating room with a thick scent of blood.

They had to stop inserting the stent. Zheng Ren and Su Yun carefully held onto the wire, fearing it would be drawn out a few centimeters and cost them the surgery.

Redoing the entire operation was not the issue.

However, if they could not resolve the pressure buildup in the portal vein and gastric varices, the patient would die of massive blood loss.

It was a race against death itself. Each detail had to be perfectly executed.

Even so, a doctor could only do so much when up against the grim reaper. Not only did the execution need to be perfect, it had to be swift!

The faster, the better.

The patient finally stopped vomiting after half a minute, seemingly exhausted beyond measure.

Zheng Ren glanced at the man's vitals on the monitor and abruptly yelled, "Put me through the phone!"

The operating console room was to the right of the first assistant's position. Su Yun had only just allowed himself some relief that the patient had stopped vomiting blood with the guide wire's position still intact.

When he heard Zheng Ren shouting, he instinctively hit the covered button on the intercom to the operating console room.

"Yanran, Yiren, put on lead aprons and come in now. The patient's suffering aspiration!" Zheng Ren roared.

Since interventional surgery required exposure to radiation, Zheng Ren preferred not to let the girls in if possible.

However... complications had arisen when he was about to insert the stent.

Due to the intense vomiting, blood had been aspirated into the patient's airway.

The monitor alarm began blaring loudly.

There was instantaneous scrambling outside the room.

Chief Xia put on a lead apron and entered the operating room with Xie Yiren and Chu Yanran.

Zheng Ren had kept the radiation active since he needed to constantly monitor the position of the guide wire.

When the door opened, there would be a certain amount of radiation let into the operating console room... but not sufficient to cause an effect on the human body.

After all, X-rays travelled in straight lines...

"Suction!" Chu Yanran called out while she put on sterile gloves.

In an unexpected emergency, not only did everyone move faster, their voices were louder as well.

Almost every word was conveyed by yelling. It was an overall risk that one's demands would be buried under another's anxiety and become overlooked.

Chu Yanran reached her hand into the patient's mouth and removed the remaining blood clots piece by piece.

Xie Yiren quickly turned on an aspirator and inserted the tube along the corner of the patient's mouth.

"Not enough," Chief Xia said loudly, "Pass it to me."

She snatched the suction tube from Xie Yiren and glanced at Zheng Ren before saying, "I'm going to insert the suction tube from the patient's nasal cavity. It might cause agitation."

"Wait, give me ten seconds!" Zheng Ren said.

A suction tube entering the nasal cavity would induce the patient's gag reflex, causing coughing and retching.

The recently-inserted guide wire was in a precarious position, like a small boat in danger of being drowned by giant waves at any moment.

Given the patient's blood pressure was at a dangerous level, Zheng Ren did not have the time for another puncture.

It was a choice between saving the patient from aspiration or blood loss.

Chief Xia looked at Zheng Ren with astonishment and confusion.

The patient was suffocating, but this man wanted to wait for another ten seconds?

Was he that confident in his success within that time?

Success or failure,

Separated by a hair's breadth.

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Chapter 303: Stent-in-stent (Part 3 of 4)

In the live surgery broadcasting room, the video feed froze. Viewers waited for a few seconds, checked their Internet connections and, puzzlingly, found no issues with the latter.

[Why aren't they moving?]

[The surgery isn't complete yet. It can't possibly be finished after the puncture alone.]

[I wanted to see if the surgeon would apply a unique method to connect the hepatic and portal veins.]

A few bullet comments passed by, confirming that it was not a connection problem. The confusion only deepened.

Were there any other surgical methods they were unaware of? Was it going to be like the previous emergency surgery broadcast, where two surgeries were aired at the same time?

[No, the oxygen saturation in the patient's blood is declining!]

It did not take long before the issue was spotted.

Due to lag, changes to blood oxygen saturation due to aspiration were only just being broadcast, but no physician observing could miss them.

Before any of them had the time to process the shock, though, the operative field of the live surgery broadcast began to move again.

However, it was different from before, shaking tremendously like a documentary filmed with a hand-held camera.

It was nausea-inducing.

Those more prone to motion sickness were more heavily affected.

What had happened?

Through the operative field, the 10 mm stent graft was moving forward rapidly, advancing to the portal vein through the guide wire to find the mark left behind by the angiographic needle.

[Damn... I can't watch this anymore. What's going on?]

[Did the patient vomit blood again?]

[Very likely! Aspiration could have happened. Still, is the surgeon continuing the surgery under such circumstances?]

The viewers quickly guessed what had transpired.

However, the horror of the situation was too much to bear; most remained in denial.

It was almost over, but the patient had abruptly vomited so much blood... Was the surgery still going on?

Even though the surgeon persisted, many watching doctors had given up hope.

It was already extremely difficult to insert a stent in a stationary patient, let alone one in this state.

In the operating room, the patient's blood oxygen saturation was rapidly falling.

Chief Xia held the aspirator in her hand, stunned. Ten seconds? Would he be able to do it? It would still be manageable if the patient was deprived of oxygen for three to five minutes.

However, under such circumstances, it was better to fix it as early as possible.

Zheng Ren was asking for ten seconds...

As Chief Xia looked on, Zheng Ren and Su Yun had their eyes fixed on the screen. Zheng Ren was at full speed inserting the stent graft along the guide wire towards the puncture site between the portal and the hepatic veins.

Su Yun was trying his best to keep the guide wire in place, adjusting for the patient's movements to buy more time for Zheng Ren.

When unable to judge the scale of movement, Su Yun pushed the guide wire further in despite the damage within the blood vessel. It was better than withdrawing the wire and having to restart the entire surgery from the beginning.

After the 10 mm stent graft was in place, it was dilated and deployed against the vessel walls of the portal and hepatic veins.

The surgery was complete!

"Chief Xia, commence suction." Zheng Ren was not relieved yet. Aspiration could be life-threatening.

At his cue, she inserted the aspirator into the patient's nasal cavity.

At the same time, she compressed its outlet periodically and removed blood clots from the patient's nasal cavity, oral cavity and airway with every pump.

It had only been a short while and the patient was not in a good condition, so the matter had not been sucked too deep into the airway.

In less than three minutes, all the dark red blood clots were removed.

The patient's blood oxygen saturation began to rise.

"Zheng Ren, is it done?" Chief Xia asked with uncertainty.

"We've completed the first part," he answered. He had no intention of packing up and leaving the operating table yet.

Su Yun was still holding the guide wire in the patient.

The first part? Chief Xia did not understand.

What was going on?

After another two minutes, the patient was visibly calmer with no signs of agitation. Oxygen saturation of the blood returned to 98%.

"You guys can leave," Zheng Ren said.

Without hesitation, Chu Yanran and Xie Yiren left the operating room with their lead aprons.

He sounded like a department chief giving orders. Chief Xia was startled for a moment before following the other two out.

"8 mm stent graft," Zheng Ren ordered.

Su Yun passed him the finer stent and he began inserting it along the guide wire.

[Damn... the surgeon's technique is incredible!]

[How did they manage to insert that? I really admire that, it's amazing.]

[I'm speechless. This surgeon managed to pull off an emergency TIPS surgery. Too bad we can't download the whole process, it's the perfect operation.]

Xinglin Garden was flooded with praise from doctors.

However...

The surgery was not over yet!

Another stent graft was inserted through the guide wire.

[What kind of operation is this? Anyone care to explain?]

[Yeah, wasn't the stent graft successfully deployed? What is this stent for?]

[Could the surgeon be so busy that they forgot about the previously inserted stent?]

Their wild speculations did not seem likely, as they were not general or interventional surgeons.

This was because specialists from both those departments had turned off the bullet screen to avoid the comments from blocking their view of the surgery.

Double-stenting, also known as stent-in-stent, was a modified method recently developed by general and interventional surgeons to help with post-operative symptoms of hepatic encephalopathy.

If they began grafting with a smaller stent, the encephalopathy would be kept under control but the tract formed between the veins would be too narrow to reduce portal pressure.

With two stents, the tract would be narrowed as well, minimizing bleeding after surgery. Removal of the second stent could be decided later depending on the degree of hepatic encephalopathy to treat pressure buildup in the portal vein.

This was the most appropriate measure.

Of course, there was also a huge obstacle.

Stent-in-stent required both stents to overlap accurately, leaving no room for error.

Any unevenness would disrupt the stability of the inner stent and risk it being dislodged by blood flow.

The consequences of that... would be very serious.

Zheng Ren had chosen to do this without hesitating.

The System's monitor at the right upper corner of his vision had reported that the patient was showing symptoms of hepatic encephalopathy. Mild though they were, they would worsen with time and could be life-threatening.

The doctors watching the broadcast stared at their phone screens silently and unblinkingly.

Stent-in-stent; this surgeon was truly ambitious!

Did they not know when to stop? Completing the TIPS surgery under emergency conditions was hard enough; yet, this doctor was already looking at the patient's postoperative hepatic encephalopathy complications?

How confident was the world's top surgeon?

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Chapter 304: Abundant Rewards (Part 4 of 4)

There were no words between Zheng Ren and Su Yun, even as they performed a procedure as unconventional as the stent-in-stent technique.

Su Yun had gotten used to Zheng Ren's methods of operation. As long as it existed, any technique could be carried out.

Would the perfect assistant still need to ask any further questions?

Never.

After a connection was established between the portal and hepatic veins, there was a clear decrease in portal pressure which also slowed down bleeding in the gastric varices.

This in turn made the surgery less difficult as the patient was no longer as restless.

The second stent graft was inserted, much more easily than the first, into the jugular vein, the atrium and then through the hepatic artery, finally resting on the previous stent graft as directed by the guide wire.

At that moment, Zheng Ren moved more gently and slowly. Since the images were overlapping, he could not verify what was happening using the venogram alone and was forced to estimate the location from his own experience.

When the stent reached the puncture location, Zheng Ren made a few minor adjustments before deploying it at the sheath.

The second stent was retractable. The operation was slightly different from the first, but not by much.

Even Su Yun and the professor could not tell if the location of the stent was appropriate. Only Zheng Ren could.

They performed another venogram. This time, the contrast medium passed smoothly through the stent between the hepatic and portal veins. Primary imaging of the stents also revealed that they overlapped precisely, their ends not exceeding one another.

This meant that friction between the stents were maximised with minimal risk of dislodging.

The surgery was a success!

Zheng Ren turned off the equipment and removed the guide wire.

[Awesome! This guy's amazing!]

[Inclusive of the patient's fits, it all took one hour and 54 minutes. This is the shortest TIPS surgery I've ever seen!]

[I'm just a passerby who doesn't really understand TIPS surgery, but I think the surgeon did a great job.]

The doctors in Xinglin Garden began commenting via the bullet screen. Although the room had stopped broadcasting, they used it as a forum to continue discussing the surgery.

As Zheng Ren prepared to leave the operating table after withdrawing the guide wire, there was a crisp, pleasant notification of mission completion.

[Main Mission: The Crown Jewel – First Stage Completed.

[Mission Content: Complete a TIPS surgery

[Mission Rewards: Since it was the first TIPS surgery performed, in addition to it being an emergency surgery, its difficulty level was raised to 2. Duration of surgery was 1 hour and 54 minutes, 149 x 2 x 2 = 596 hours of surgery training time awarded. Luck points 2, two golden chests and 200,000 experience points.

[Mission Time: 6 hours, completed in 1 hour and 54 minutes, with remaining time of 4 hours and 6 minutes.]

The first stage of the main mission, The Crown Jewel, was complete. The rewards and experience points from the System were abundant.

Especially the surgery training time; he had been awarded over 600 hours!

That was equivalent to 25 days.

It was the largest hoard of wealth Zheng Ren had ever accumulated!

He was elated. Did this mean that he could afford to splurge once or twice in a blue moon?

He tore off his sterile surgical gown and entered the changing room, returning the special lead vest to the System and returning to the operating console room with a huge grin.

Professor Rudolf Wagner was deep in thought as he watched Zheng Ren enter the room, shaking his head and saying, "Zheng, your surgery was a masterpiece."

"You're exaggerating, professor," Zheng Ren replied with a smile.

The professor let out a soft sigh and did not argue the matter.

Chief Xia was not specialized in interventional surgery and thus did not understand what had happened, but Zheng Ren and Professor Rudolf Wagner's conversation implied that the surgery had been a stirring success. "Dr. Zheng, did it work?"

"You could say so," Zheng Ren said, "We just need to be careful of postoperative complications such as hepatic encephalopathy. Also, I deployed two stents. If the hepatic encephalopathy is not serious, we can consider removing the second one to enlarge the tract between the hepatic and portal veins, increasing blood flow."

Chief Xia nodded in silence.

"Is the patient going to be transferred to your department or the ICU?" Zheng Ren asked.

"We should be able to handle the postoperative complications better, so he'll follow us," Chief Xia answered with the force and dignity of a department chief.

Zheng Ren was unbothered. He had done extremely well in the surgery and deployed two stents. Since the outflow tract was slightly narrower than 8 mm, there was a much lower risk of developing hepatic encephalopathy than they would have had with a single stent.

The patient being transferred to gastroenterology was fine. After all, they were the experts in treating hepatic encephalopathy.

In the operating room, Su Yun had already bandaged the patient and, with Chu Yanran and the others, moved him onto the stretcher trolley for handover to the gastroenterology department.

Chief Xia made to leave with the stretcher trolley, but hesitated for a while before asking, "Dr. Zheng, I have a patient with decompensated cirrhosis and refractory ascites."

"If their family members are willing to accept the high risks that come with this method, they can come in for treatment." Zheng Ren smiled.

"Okay," Chief Xia said curtly and left.

Zheng Ren predicted more gastroenterology patients requiring TIPS surgery in the future, as long as his patient's postoperative condition remained stable.

From an epidemiological perspective, the 60s were rife with hepatitis B.

The country managed to bring it under control by the end of the 80s. Although it was not completely eradicated like polio, its infection rate was not as aggressive as before.

In other words, patients who had contracted hepatitis B would currently be in their sixties.

Failing to take Entecavir to control the hepatitis B virus over the years would result in symptoms similar to that of Chief Xia's patient.

Receiving TIPS surgery to treat their high portal pressure would greatly improve their quality of life and prolong their lifespan.

No wonder the System had rewarded him so generously.

He felt like he had finally figured out the System.

Su Yun interrupted his train of thought. "What are you laughing at? Do you also think you aced the surgery?"

"Ha ha, it will be fine," Zheng Ren replied perfunctorily.

"There are newcomers reporting in tomorrow, and you had such a huge emergency surgery today. Your luck is one of a kind."

Zheng Ren did not understand the connection between the TIPS surgery and being able to have flexible shifts from the next day, but he could not be bothered to argue with Su Yun and simply smiled.

Professor Rudolf Wagner walked out in a daze, his eyes all over the place.

"Ah, I forgot about the professor." Su Yun chuckled softly. "Had I known that you would pull it off it with such excellence, I wouldn't have called the professor over."

Zheng Ren was speechless. How would he have known otherwise?

"Will the professor think I called him over just to observe the surgery like a learning trip? If he's the type to hold grudges, this would be a thorn in his flesh. In the future, no matter what you say in the academic world, the professor would be the first to oppose you."

Su Yun's logic... seemed to make sense after Zheng Ren gave it some thought.

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Chapter 305: Can His Blindness be Cured? (Part 1 of 4)

Zheng Ren sent off Chief Xia and returned to the operating room.

Xie Yiren was cleaning up and sterilizing the operating room. After every surgery, there was plenty of work waiting for nurses.

Su Yun smirked when he saw her shoo Zheng Ren away when the latter offered help. What a lucky buffoon.

After being chased off by Xie Yiren, Zheng Ren returned to the emergency ward with Su Yun.

Since they had been away for a while, the first thing they did was to perform ward rounds. Zheng Ren had to ensure his patients' conditions were under control especially with so many surgeries yesterday.

As expected, all the patients who received surgery for appendicitis were not in the ward except for the one who had undergone open surgery.

However, the two patients who had gotten laparoscopic cholecystectomies... were not present in the ward as well.

The advancement of minimally invasive surgeries reduced post-laparoscopy pain, leading patients to underestimate their condition. It was simply impossible to make them stay in the hospital for further monitoring.

Zheng Ren's hands were tied. If the patient got into an accident on the way home, it would complicate the situation even further.

Such a thing had happened before and no doctor had any power over it.

If they forbade the patients from being discharged... there would be a surge in medical complaints, specifically regarding the patient's right to self-discharge.

It was an unsolvable issue.

All they could do was close their eyes.

Zheng Ren sighed and decided to call the patients' families to follow up about their conditions. If he suspected something was wrong, he would request that the patient returned to the hospital.

At the last ward, he was greeted by a smile as he opened the door.

"Ah, Dr. Zheng, you're here," a girl said cheerfully.

This patient had stood out. Zheng Ren remembered the girl being the fiancée of the young man who had been stabbed—the responsible girl.

"So, how's your fiancé?" Zheng Ren asked.

The hospital bed was raised into a semirecumbent position, its occupant still fasting with a nasogastric tube in his nose.

He looked much better, a blissful expression on his face.

"He's doing well today. We talked a lot," the girl said, "He said that he felt like some ghost had tried to drag him away yesterday. He was terrified."

She laughed heartily.

"Who said that?" the boy said in embarrassment, his face flushing red.

Zheng Ren simply grinned and did not speak.

"Do you feel any different after dying once?" Su Yun asked.

The boy's expression became serious, as if being reminded of something, and he sighed. "You might be right, doctor."

Silence filled the ward. The boy lowered his head and fell into deep thought.

After some time, he looked up.

"I dreamt that I died and Little Fang committed suicide. My old mother who had raised me cried her eyes out and also passed away. My entire family was destroyed." The boy's eyes reddened. Even though he had regained consciousness, the dream still chilled his bones.

Had he not been using a urinary catheter then, he would have probably wet himself on the operating table.

Zheng Ren remained expressionless. The corners of Su Yun's mouth curled slightly.

"What about the future?"

"I messed up. I know I was wrong." The boy raised his head, slightly ashamed, but his tone filled with determination. "I want to give Little Fang a good life and take care of my mother. None of my so-called 'friends' offered to help me when I was in danger."

Zheng Ren smiled.

From his condition, the kid would be fine.

There was nothing much to worry about as it was just a lesion in the colon, requiring only a suture to patch it up. As for the possibility of abdominal infections... for someone of his health, such an issue was unlikely.

That was it, then. Zheng Ren consoled the patient before leaving the ward with Su Yun.

"Did we treat his blindness?" Su Yun asked, laughing.

"Maybe. Who knows? It all depends on how he decides to live his life from now onwards. We did what we could," Zheng Ren said softly.

"Don't say that, boss. Fraudulence, threatening the patient and lying about his condition were atrocious acts that could result in the suspension of one's medical license. Please don't involve me in this. My shoulders are too frail to carry this burden," Su Yun joked.

Zheng Ren did not humor him. The man could never be serious in a formal conversation.

They strolled to the office as Zheng Ren contemplated doing some reading before bed.

It had been very busy yesterday; perhaps it would be more relaxed tonight.

All emergency consultations were complete. It was rare for him to slow down.

When they went into the office, Zheng Ren saw Professor Rudolf Wagner sitting inside with a solemn expression.

"Professor? Why are you here?" he asked in surprise.

Su Yun was silent.

Professor Rudolf Wagner was a world-renowned professor in interventional surgery. Why did it seem like Zheng Ren gave him no thought at all? He had completely forgotten about the professor immediately after leaving the operating room.

Truly one of a kind, he was.

"Zheng, I would like to sincerely extend my invitation to you once more. If you agree, I guarantee that we'll be able to establish a research lab for prostate interventional surgery." Professor Rudolf Wagner stood, his golden locks swaying in the air. "You don't have to worry about funding and patients. We can also discuss the issues of research team leadership further."

Su Yun was struck dumb.

From experience, he knew the importance of authority in a research project.

Most professors and experts did not understand their own research projects but were able to acquire funding, which was the main driving factor of one. Therefore, the first author in the published journal would usually be the one who obtained the funding.

However, Professor Rudolf Wagner was willing to bear all of that responsibility just to get Zheng Ren to go to Heidelberg University?

When had Zheng Ren become so valuable?

Chuckling, Zheng Ren said, "Professor, I'm really sorry. I'm very busy and can't leave. If it interests you, perhaps you can discuss this with Chief Kong."

Professor Rudolf Wagner's eyes lit up when he heard those words.

The fellow had just brought up a great idea.

A collaboration between top medical institutions would certainly give him a leg up when applying for funding from foundations.

"It's late, professor," Zheng Ren said, "You should head back and rest. Thanks for helping out yesterday."

Professor Rudolf Wagner looked into his eyes and said sincerely, "Zheng, if you can't go to Heidelberg, I'm willing to stay here for a period of time."

"You can help out in the day, then. It's quite busy then and you would be able to utilize your full potential," Zheng Ren responded perfunctorily.

In reality, he simply did not want to work during the same shift as Professor Rudolf Wagner. His luck was just so... terrible.

The Night Shift God had to have some deep hatred towards him. If the professor continued to stay for another night, Zheng Ren was afraid that it would be another sleepless one.

Professor Rudolf Wagner was finally persuaded to leave.

Zheng Ren exhaled in relief as he watched the professor climb into a car.

"Let's just take a look at the emergency department and then return to rest," Su Yun said.

He nodded.

Chapter 306: Lovey-dovey (Part 2 of 4)

It was 9.30 p.m. when they both arrived at the emergency department.

This was the department's busiest and most chaotic hour.

However, in the winter, most patients required attention from internal medicine for conditions such as acute gastroenteritis, acute myocardial infarction and acute cerebral infarction.

Zheng Ren was not worried about internal medicine as their patients simply needed to be admitted into the inpatient department. His main aim was to identify any misdiagnosed patients in the emergency observation ward.

After surveying a few observational units, Zheng Ren chose a few patients to speak to about their conditions. Doctors from the emergency internal medicine department had given appropriate treatment, so there was no need for Zheng Ren to do any extra work.

This should be the norm. He felt very relaxed.

Around the corner, he saw a girl who looked around eighteen or nineteen, possibly a university student, crouching on a chair beside the door to the internal medicine consultation room, hugging her stomach in agony.

An internal medicine physician was talking to her solemnly.

After checking the System's monitor on the upper right corner of his vision, Zheng Ren was stunned.

There was nothing wrong with the girl. The light green background of her diagnosis shone bright and lively.

What happened?

Could something be wrong with the System?

He suddenly felt anxious.

His medical skill had vastly improved in the last few months with the assistance of the System, especially in both surgery and diagnoses.

However, it was also why he feared that any problems with the System would cause a misdiagnosis...

Were it only a business transaction, Zheng Ren could not care less about a hiccup in the System. The worst that could happen would be having to start all over from the beginning.

However, as a doctor, a simple mistake could cost someone their life. There were no such things as second chances.

The fault tolerance in this specific profession was minimal.

That was why he was always very cautious about it.

As expected, today was the day of such an occurrence.

Zheng Ren hurried over. Su Yun was surprised by his alertness and followed him.

"What happened?" Zheng Ren asked.

"Chief Zheng, I was considering acute gastroenteritis, but she refused to be admitted for observation and resisted the relevant anti-inflammatory treatment. She's suffering pain but does not want to be checked nor receive treatment. What do you suggest?" the emergency internal medicine doctor reported, relieved to have him present.

"Can you take a look and advise her, Chief Zheng? Patients are piling up in there, I need to go." The doctor turned and reentered the consultation room.

Usually, doctors were reluctant to take on intractable, rare diseases or patients with low medical compliance. One wrong move could turn into a land mine and blow them to pieces.

What was the use of a superior?

To take the hit, of course.

Zheng Ren glanced at the girl. There was a boy beside her asking awkwardly about her condition.

Seeing the bumbling boy made him lose track.

He also wanted to show his concern to Xie Yiren, but where would he start?

"Hey, why are you staring at her boyfriend?" Su Yun prodded Zheng Ren softly.

"Ahem..." Zheng Ren was slightly embarrassed. He then bent down to ask, "How are you feeling?"

"Doctor, my stomach hurts," the girl said gloomily.

She did not seem to be in much pain. From her expression, Zheng Ren could not read any signs that she was experiencing insufferable agony.

Moments before, he was worried that her stomach pain could have been related to ectopic pregnancy and ovarian torsion that were very difficult to diagnose.

That did not seem likely.

"When did it first start?" he asked.

"I felt a sudden pain after dinner," the girl replied, gritting her teeth.

"Doctor, is her condition serious?" the boy asked worriedly.

"Have you taken any tests?"

"I didn't bring any money for tests," the girl said.

"I did," the boy interjected, "but she wouldn't allow me to use it."

Zheng Ren was baffled. Why had she refused to get checked if her stomachache was that serious? Who would be responsible if her treatment was delayed?

"This is not right, young lady." Zheng Ren tried to gently encourage her. "You need to be checked if you're feeling unwell and treat the issue. It's not good for your health if you keep on tolerating it."

"No, I won't get checked," the girl said stubbornly.

"..." Zheng Ren was speechless.

"Let's go to the treatment room and check on her," Su Yun said behind Zheng Ren.

"Doctor, just do anything you have to. I have money," the boy insisted.

"I'll leave if you proceed with payment." The girl was furious, pinching his arm as she lay in his chest.

No matter how he looked at them, they seemed to be torturing him for his bachelorhood... Zheng Ren felt frustration rising in his chest.

"We'll put the tests on hold. How about just a simple body checkup?" he said cautiously.

The girl finally agreed. As the internal medicine consultation room was crowded, they headed to the treatment room.

The boy explained their history intermittently between bouts of pain as they walked.

They were both students from a university in the development zone and had been together for almost a month.

Tonight, they had a movie date before dinner. It was then that the girl began to experience abdominal pain.

Since they were near Sea City General Hospital, they hurried over.

Su Yun approached the boy and whispered something into his ears; he looked startled before shaking his head determinedly.

"No history of intimacy. You can rule out ectopic pregnancy, but if you're doing the checkup, might as well take a look at it too," Su Yun said upon returning to Zheng Ren's side.

"Alright." Zheng Ren told the girl to lie on the treatment room bed, bend her legs and turn her head left. Then, he started examining her.

Her abdomen was tender, with no signs of hardening.

The most peculiar part was that there were no tender points. As he examined her body, the girl mentioned a tenderness in the middle left side of her abdomen.

However, Zheng Ren was very experienced in this regard; he had kept on checking other areas while he spoke to her and already pressed on it without her knowing.

It had not elicited any reaction, which was a stark contrast from the way she acted before.

Was she pretending to be sick? Why would she do that? Zheng Ren was confused.

The affection between the boy and the girl did not seem like they were here to make a scene.

Besides, medical troublemakers had disappeared after the incident in the gynecology department.

Was the girl pretending to be sick at such a late hour just to torture him for being single? When had the youth learned to play the game so well? Was this a new courtship tactic?

Zheng Ren was troubled.

The System's report on the health status remained green and there were no obvious signs after examination as well.

He determined that she was most probably faking her symptoms.

However...

Su Yun waved Zheng Ren over to the door. "Boss, come here for a minute."

Zheng Ren thought about it and acceded.

"What do you think?" he asked softly upon leaving the room, making sure the couple were not watching his departure from the corners of their eyes.

"10 o'clock. The girl should be fine by then," Su Yun said mysteriously.

He had also noticed Zheng Ren's trick during the examination. Such things would never escape his eyes as he was also a doctor.

What did he mean that she would be fine after 10 o'clock?

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Chapter 307: Both Pupils Were Equal in Size (Part 3 of 4)

"How do you know?" Zheng Ren was surprised.

"Nothing a single guy like you would understand," Su Yun said, "What did you see in the girl's eyes?"

"Eyes?" He tried his best to recall.

There was nothing unusual about her eyes. Pupillary light reflex? He had not performed the test on her, but the reflex pathway ought to be responsive. Furthermore, there were no constrictions on her pupils, both of which were equal in size...

At Zheng Ren's confusion, Su Yun barked, "You must be thinking about her pupils being of equal sizes!"

"Yeah, what else?" Zheng Ren was perplexed.

"Bah!" Su Yun was left speechless and looked at Zheng Ren with pity.

His gaze was sorrowful, as if that of deities and Buddhas who had descended to earth and looked upon mortal suffering.

"..."

"Can't you see the girl's dreamy eyes yearning for romance?" Su Yun said after a few seconds of silence.

"No..."

There was no book that could teach Zheng Ren how to see such a thing.

In the institution called society, Su Yun would be a top student and graduate with perfect scores.

"Let me put it this way; what time did your dormitory close during your school days?" Su Yun asked.

"Ten."

"That's all there is," Su Yun chuckled and said softly, "Didn't you notice that the girl checked her phone three times within ten minutes after your consultation?"

"I did, but I thought that was insignificant," Zheng Ren said.

"Anything unrelated to illness would be deemed useless to you, right?" Su Yun was aghast.

"You could say that. We're doctors; what else would we do other than treat diseases? Practice physiognomy?"

"Why did you threaten the boy on the operating table yesterday, then?"

"To treat his blindness," Zheng Ren argued.

The more Su Yun said, the more Zheng Ren believed the man's judgment. The girl was pretending to be ill and waiting for their dormitories to close at 10 p.m.

Where would these two youngsters go if their dorms were closed?

How lovely, Zheng Ren thought to himself.

Why was Xie Yiren not this forward? He had gathered the courage to offer her a hug twice but had been rejected both times...

Su Yun crept up to him as he ruminated, smirking and whispering, "Are you shamelessly wondering why Little Yiren doesn't take the initiative?"

Zheng Ren was stunned. Could Su Yun read his mind?

"How shameless can you be? Can't you take the first step?" Su Yun berated him angrily.

"I did make a move, twice even, but she blew me off both times," Zheng Ren said in embarrassment.

"You should keep at it. Start by holding hands. Do not rush. Little Yiren is quite shy and grew up in a strict household. You can't jump right into hugs," Su Yun said, "One step at a time. Also, are you aware of the move where you corner her by placing your hand on the wall?"

"Yeah." Zheng Ren nodded.

As a young adult in the modern era, even though he had never made the move before, he had seen it in videos online.

"You can try it if you get the chance. Girls like Little Yiren have high compliance. You only need to be slightly more aggressive, erm... like the way you take control of the operating table. You'll be able to handle ten Little Yirens."

Operating room... simulation mannequins... Zheng Ren's thoughts ran wild into the unknown like an unleashed dog.

A voice interrupted his fantasies. "Doctor."

He turned around and saw the girl still holding her stomach, but straight-backed with no visible signs of pain.

Zheng Ren checked the time. It was exactly ten o'clock.

"I think I'm feeling better," she said, blushing.

"Oh, that's good," Zheng Ren said in a daze. His mind was caught up with scenes unsuitable for children.

"We'll leave, then," the girl said.

"Are you really okay? I think it's better if you stay the night and remain under observation," the boy asked worriedly.

"It's fine, truly." She seemed slightly desperate.

"Okay, no worries. Go home and drink more warm water. Everything will be okay," Su Yun said, "Just be careful not to catch a cold. Stay safe."

The last sentence was a tease; the boy was oblivious but the girl's face turned red instantly. She nodded, a movement so slight it was barely visible.

The boy held onto her as they walked out, continuing to nag at her as he did.

"It's already late at night, what if something happened to you?"

The girl pretended to be surprised as she took out her phone to check the time. "Ah, it's already ten o'clock."

"We can't go back to the dorm..."

"What should we do? What if my stomach hurts after I go back?" she said pitifully.

As they got further and further, the scenario played out exactly according to her plan.

A purposeful smile appeared on Su Yun's face and he tapped Zheng Ren's shoulder. "Are you envious of them?"

"Yeah," Zheng Ren replied subconsciously.

"Don't be. Others should be envious of you. On that note, you're really lucky. How did Little Yiren fall for you? Peculiar," Su Yun said.

There was a turmoil of emotion within Zheng Ren when Xie Yiren's name was mentioned.

After spending an hour in the emergency department, they returned to the emergency ward after ensuring no other misdiagnoses.

Zheng Ren took his phone out to chat with Xie Yiren.

She had returned home. Chu Yanran had the night shift and had followed Xie Yiren back to the mansion near the hospital.

Zheng Ren had so much to tell her. They could converse smoothly and joke around in WeChat, but Zheng Ren was tongue-tied whenever they met face-to-face.

The ward was very quiet. Su Yun went to take a bath in the operating room. Zheng Ren washed up quickly and laid on his bed while continuing to chat aimlessly with Xie Yiren.

Their conversation was bland, but Zheng Ren felt content.

He felt a sense of security and his heart was no longer hanging in the air.

Corny as it was, home was truly where the heart lay.

The meaning of that saying had never felt more applicable to Zheng Ren.

Home is where the heart is.

When Su Yun returned, Zheng Ren was still texting and ignored his arrival.

He was still engrossed in his conversation when Su Yun laid down.

Even after Su Yun had fallen asleep, Zheng Ren kept texting.

Only when he dropped his phone on his face did he notice that it was already the wee hours of the morning.

They wished each other goodnight, unwilling to let the other end the conversation. Their standoff kept going on for a while until Xie Yiren could not stay awake any longer and drifted off to sleep. Only then did Zheng Ren go to bed with a sweet smile on his face.

Tonight, there was no interruption by the professor. Zheng Ren felt blessed by the Night Shift God.

It was peaceful, as if all the emergency cases had been relegated to the previous evening.

After a good night's sleep, Zheng Ren opened his eyes. The first thing he did was to check his phone for any messages from Xie Yiren.

"Hurry and freshen up, the newcomers will be reporting in soon." Su Yun leaned against the wall and said coolly, "You should leave a good impression on them or you might lose your authority as chief resident."

Zheng Ren was still in bliss; even Su Yun did not seem as irritating as before. He laughed and got out of bed before making it, then took his toiletries to the operating room to wash up before work.

A new day had begun.

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Chapter 308: No Vices (Part 4 of 4)

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Feng Xuhui had rushed to the emergency ward early in the morning with breakfast as usual, just as he had in Imperial Capital.

"Don't come tomorrow," Su Yun mumbled while brushing his teeth.

Those words made Feng Xuhui's hair stand on end. What sin had he committed that was so unforgivable? He was not even allowed to come tomorrow...

Since the day Feng Xuhui received guidance from an Imperial Capital legend, he had found his direction in life and remained determined to cling onto Zheng Ren, despite being less than successful so far.

In one stroke, he had introduced his company's product to the Imperial Capital market and been promoted to the general manager of the Northeast region, with a huge increment in allocated funds.

After the Imperial Capital product launch, he had returned to Sea City fully bent on sticking to Zheng Ren's coattails.

Everything had been fine during yesterday's TIPS surgery. What had changed?

The on-call room was silent but for the buzzing of Su Yun's electric toothbrush.

A few minutes later, Su Yun finished gargling, turned around and jumped when he saw Feng Xuhui standing there like a statue.

"What happened to you?" he asked in surprise.

Feng Xuhui was still in a daze and did not respond.

"Hey, have you lost it?" Su Yun did not understand why the man was in such a state.

After several attempts, Feng Xuhui managed between sobs, "Brother Yun, what did I do? Why won't you let me come here anymore?"

Su Yun immediately caught on and did not know whether to laugh or cry.

"You... Just tell me what it is. I will change it at once," Feng Xuhui said.

"You're overthinking it," Su Yun said nonchalantly, taking the soy milk Feng Xuhui had brought and taking a large gulp. "There will be new staff reporting to the department. The boss will have flexible shifts from now onwards."

"Tell me, if a female doctor is on shift tomorrow morning, and you simply knock on the door and enter: in what way will Old Chief Physician Pan kill you?" Su Yun bit into the steamed stuffed bun. It was a bit greasy; eating garlic now would require him to brush his teeth again.

After some thought, he decided against it.

Feng Xuhui finally managed a smile and approached him. "Brother Yun, thank you."

"Sure," Su Yun said dispassionately.

"The chairman is coming over tonight, you have to show your face," Feng Xuhui quickly said, prioritizing the most important thing on the day's itinerary.

He had just experienced a rollercoaster of emotions and was afraid that it could compromise his duty. That would be truly embarrassing.

"I'll be there if there are no emergency cases." Su Yun had an outgoing personality; back in Imperial Capital, he would have dinner invitations every day were he willing to attend them. "Right, I only drink Maotai. I'll take any year they have, just not the ones from 1982 and 1988; the market was flooded with fake liquors during those two years."

Although it was obvious that Su Yun was not treating him like an outsider, Feng Xuhui was still taken aback, but quickly retrieved his notebook to write down the man's requests.

"If we're drinking whisky, I prefer Scotch. Any Speyside brand would be fine but it's better if they're aged for at least a decade," Su Yun said while chewing his bun, "Only aging in wooden barrels counts. Time after bottling is just shelf life, not aging."

Feng Xuhui frowned.

Money was not the issue. Actually finding Speyside Scotch would be difficult in Sea City.

"To be honest, I'm not that picky. If your boss likes sake, we can get Ittekiyukon, especially the ones from 2008. It's lighter on the palate and has a better aftertaste. You won't get a hangover the next day." Su Yun was still going on.

Feng Xuhui finally remembered the dinner's main guest. "What does Chief Zheng prefer?"

"Him? He doesn't drink, he just smokes occasionally. If he doesn't feel hungry, he won't eat. He will be more grateful if you don't invite him to the dinner. You don't have to worry about what he likes to eat, either," Su Yun said.

Feng Xuhui wept internally, tears falling from his heart.

Why was it so difficult to suck up to this man?

Money, alcohol, gambling, lust; there had to be something Zheng Ren liked. However, after some observation, Feng Xuhui knew that Su Yun was telling the truth. He had to ask anyway in order to rule out errors in judgement.

This Chief Zheng only had a love for surgery.

Right then, Zheng Ren entered the room, refreshed after his shower.

"Yo, Manager Feng, you're here." The greeting came with familiarity.

After all, he had just asked for a favor yesterday. Not exchanging at least a few words of acknowledgement would be unbecoming.

He would look like an ingrate.

"Chief Zheng, our chairman is coming over tonight. We'll probably trouble you for a few hours." Feng Xuhui placed both his palms together and looked at the man with earnestness and supplication in his eyes.

"Oh, I'll be there if there's no surgery. No big deal." Zero interest.

"Is there anything you'd like to have?"

"Anything will do. I don't have a preference," Zheng Ren replied without much thought before starting on a bun.

Feng Xuhui's mind began to run wild again.

When the two men finished eating, he cleared the table for them and said his farewells before leaving.

He reported their words to the chairman and included the long list of requests from Su Yun.

...

Professor Rudolf Wagner arrived at 7.15 a.m. sharp.

No matter how classy he looked, his authority was undeniable.

Chang Yue and the others also arrived shortly after. Old Chief Physician Pan performed the shift handover at 8 a.m.

After that, Office Director Ding and the hospital administration chief came to the emergency ward with two other doctors.

So efficient, Zheng Ren thought. Director Fu had just resigned yesterday and the new doctors were already here.

Ding Zhongtai and Old Chief Physician Pan exchanged a few greetings. When he saw Zheng Ren's usual disinterest, he did not linger and left with the hospital administration chief.

There were two newcomers. Lu Tianran was from the first general surgery department, having graduated three years ago and was rather familiar with Zheng Ren and Yang Lei.

The other was a female doctor from internal medicine called Zhong Min. She had just completed standardized residency training and continued employment in Sea City General Hospital.

Lu Tianran was quite reliable, but Zhong Min was to be kept under observation for the time being. Regardless, these two new-bloods would strengthen the emergency department.

Even though Old Chief Physician Pan was orientating the two with a stern expression, Zheng Ren could feel the old chief cheering inside.

After asking Professor Rudolf Wagner to follow Chang Yue for the ward rounds, Zheng Ren brought Su Yun to the gastroenterology department to check on the surgery patient from the day before.

He did not want to walk around with a gold-haired, blue-eyed foreigner and draw unwanted attention. It would not suit his low-key personality.

There was a strange stench in the corridor of the gastroenterology department.

The department would be considerably relaxed if they only had enteritis and other inflammations to deal with. However, patients with ascites and hematemesis could be a handful.

Chief Xia was doing ward rounds with her subordinates. It was blinding to look at the group of white coats reflecting the sun's morning rays.

The chief offered a rare smile when she saw Zheng Ren and Su Yun. "Little Zheng, are you here to check on the patient post-op?"

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Chapter 309: Sump Syndrome and The Little Yellow Person (Part 1 of 4)

"We're here to check on the patient after TIPS surgery." Zheng Ren smiled warmly. "Which ward is he in?"

Chief Xia did not continue her ward rounds, personally bringing Zheng Ren to the resuscitation room.

The patient had managed to sit upright. Despite looking languish with a pallid complexion, the darkened skin on his face had returned to normal.[1]

"The patient vomited blood three times since last night. It was not much; approximately 150 mL. We think it was the stale blood accumulated in his stomach," Chief Xia reported, "Tests this morning showed that hemoglobin levels have returned to 79 g, coagulation remains slightly weak and blood ammonia is 63. After an examination, there were no typical symptoms of hepatic encephalopathy."

Since the patient had been implanted with two stents, pressure on the gastric varices was reduced but not completely relieved.

As long as bleeding stopped, other symptoms could be controlled with hemostatic drugs and orally administered cold saline-epinephrine solution.

Zheng Ren was more concerned about hepatic encephalopathy, though.

After surgery, some venous blood would not pass through the liver. The lack of metabolic reactions was the main cause of hepatic encephalopathy.

That was also why he had used two stents to narrow the inner radius of the outflow tract.

They could remove the second stent only after the patient adjusted to it, significantly reducing the risk of further hematemesis.

Zheng Ren went to ask the patient of his condition and pose a few simple math problems, such as the sum of 74777.

For patients with mild hepatic encephalopathy, such questions would be more difficult.

However, there was also a limit to multiple-digit addition.

Even doctors would be confused by too many numbers.

The patient's condition seemed promising. Zheng Ren decided to monitor him for another two days. If blood ammonia levels stopped rising, they could remove the second stent.

When they exited the ward, Zheng Ren spotted a genuine smile on Chief Xia's face.

The patient was her former classmate and they were close enough that she could sign his consent forms. Surviving without serious postoperative complications was truly something worth celebrating.

Zheng Ren planned to check on the female suicide victim in the ICU on his way back. He occasionally remembered having an unfinished mission about her adenomyosis.

It was not obsessive-compulsive disorder; he could perform TIPS surgery in order to level up his skills. The skill points he could earn with a high-level surgery was equivalent to the rewards of three to five missions.

Of course, experience points from missions could be used in emergency situations, but those were another story.

As he was about to leave, Chief Xia's expression turned serious, as if she had just made an important decision.

"Little Zheng, can you help check on one of my patients?"

"Oh? Does the patient require TIPS surgery?" he asked.

"No, it is one of those intractable diseases. The differential diagnoses were unclear and the patient is not in a good state," Chief Xia said, slightly embarrassed.

An experienced department chief admitting ambiguity in her diagnosis required a whole lot of courage.

If Zheng Ren had not done her a huge favor by taking on a gallbladder torsion and TIPS surgery in the last two days, Chief Xia would never have asked a doctor from another department for help. She would rather let her patient transfer to another hospital.

"What's the patient's condition?" Zheng Ren asked curiously.

"The patient is a 62-year-old female. Clinical symptoms presented sepsis with abdominal pain and jaundice," Chief Xia said as she led him to the ward, "An abdominal CT scan detected liver abscess and pneumobilia. The abscess is 5.2 x 4.2 cm wide."

Liver abscesses and jaundice were a fatal combination.

Zheng Ren quickened his footsteps as he listened.

"The results of magnetic resonance cholangiopancreatography (MRCP) showed biliary–enteric communications between the duodenum and bile duct. However, there was a low-grade filling defect in the liver and extrahepatic duct." Chief Xia matched his pace. "We consulted the general surgery department, who suggested a low success rate due to the patient's poor condition and an unknown diagnosis. Proceeding with exploratory laparotomy would have a high chance of failure."

"What about her medical history?" Zheng Ren asked.

"She had a cholecystectomy about twenty-four years ago."

Just a cholecystectomy? He was doubtful. It ought not to have any relation with this disease.

They reached the ward mid-conversation.

Two rows of lower-ranking doctors of the gastroenterology department quietly and obediently stood at attention in the corridor, holding medical file folders.

"Boss, look at those doctors. They're so well ordered," Su Yun said softly beside Zheng Ren.

"If we're doing this, the first person required to stand straight would be you," Zheng Ren snapped back as he was anxious to see the patient.

That would probably be true, Su Yun thought.

They entered the ward and Zheng Ren glanced at the System's monitor on the upper right of his vision.

An unfamiliar diagnosis appeared before Zheng Ren's eyes—sump syndrome.

Sump syndrome, also known as blind loop syndrome and enteric bacterial overgrowth syndrome (EBOS), was an uncommon complication stemming from a side-to-side choledochoduodenostomy.

Its clinical symptoms were caused by the accumulation of food, debris and calculi in the reservoir formed between the Roux-en-Y choledochojejunostomy and ampulla of Vater.

The patient's entire body had turned yellow, looking like a little yellow person.

Overall, she was in a poor state. Zheng Ren rubbed his hands, warming them to more closely match the patient's body temperature.

When his fingers came into contact with her body, they came away burning.

Her temperature was at least 39 C, most likely due to severe infection.

There was point tenderness on her upper right abdomen near the duodenum, accompanied by rebound tenderness. Percussion tests returned a dull sound, typical of gastrointestinal symptoms.

Zheng Ren frowned and fell into deep thought. "Chief Xia, we need a bedside ultrasound."

The self-reported medical history of cholecystectomy differed from the side-to-side choledochoduodenostomy as a predisposing factor. He had to verify it with other tests.

Even though the System had been rather reliable, as a doctor... especially one from a Class Three Grade A Hospital, he required solid evidence.

Otherwise, after the surgery, the patient's family members could file a lawsuit for fraudulent medical practices.

These things were not uncommon, but Zheng Ren had no control over them.

Regardless of his misgivings, he still had to perform the surgery and save those that needed saving.

More than ten minutes later, the doctor from the ultrasonography room returned to the ward with an emergency B-scan ultrasound trolley.

They plugged it in and closed the curtains. When the B-scan doctor began to apply the gel on the patient's stomach, Zheng Ren interjected, "Let me take a look first, alright?"

...

...

[1] Patients with liver disease typically have a darkened skin tone. This is not about physiognomy.

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Chapter 310: Douchebag

The emergency doctor from the ultrasound room recognized Zheng Ren, since most of his patients were from the emergency department.

He laughed. "Chief Zheng, are you planning to do the B-scan yourself?"

"I know a little," Zheng Ren retrieved the probe from him and moved it around the patient's abdomen to search for the location he wanted, looking closely at the image on the monitor.

There was obstruction at the far end of the bile duct. Zheng Ren switched between two different positions, lateral and anteroposterior, to confirm that the obstructions were not made of dense calculi but rather decomposing, fermented food debris.

The obstruction point matched complications from side-to-side choledochoduodenostomy and disproved the differential diagnoses of Roux-en-Y choledochojejunostomy and choledochoduodenal fistula.

It was apparent that dilation of the bile duct was the leading cause of the patient's obstructive jaundice.

There was also gas in the biliary tract as well as cysts in the liver that he strongly suspected to be liver abscesses.

All symptoms pointed to sump syndrome. From her condition, the patient required emergency surgery.

Zheng Ren put the probe back onto the B-scan ultrasound trolley and threw a piece of tissue on the patient as he thought about the procedure. "Wipe her down," he said casually.

"Chief Zheng, are you sure?" The B-scan doctor was very impressed by Zheng Ren's skill and was aware that he could never reach the man's level.

He might not have been able to do exactly as Zheng Ren had done, but the job was done, and he did not even have to lift a finger.

His question came as he wiped off the coupling agent on the patient.

"I'm quite certain of it," Zheng Ren said, "Chief Xia, if the family members agree, let's proceed with surgical treatment. Please inform them to seek me out in the emergency ward for preoperative preparations."

"Alright." Chief Xia nodded, her expression heavy and serious.

This patient and the one who underwent TIPS surgery the night before were entirely different.

Chief Xia did not know this one personally and could not guarantee for or sign off for the emergency surgery as she had then.

She had to communicate with the patient's family members and brief them about the condition at hand, but could also hand such duties over to Zheng Ren.

Zheng Ren left the gastroenterology department, still debating between a laparoscopy or laparotomy.

A laparoscopy would leave only a small wound. Patients in the emergency ward who had undergone a laparoscopic cholecystectomy all returned home after the first night of surgery.

However, to treat all the complications in a single surgery, an open cholecystectomy would be the best choice.

Still...

"Boss, the way you threw the tissue on the patient and told the guy to do the wiping made you seem like a f*cking douchebag," Su Yun chuckled.

At a moment like this, only Su Yun was able to joke around.

Zheng Ren was shocked but immediately understood what Su Yun was implying. Being distracted had let him drop his guard.

Douchebag... tsk tsk.

How fitting. Zheng Ren was amused.

Su Yun followed up with a serious question. "What were you thinking about?"

"I'm deciding between a laparoscopy or a laparotomy."

"You have to perform a laparotomy. It's difficult to remove food debris with a laparoscope. You would also need to administer antibiotics after a surgery, which is such a hassle. Most importantly, I don't want to hold the monitor," Su Yun said frankly.

Even though Su Yun looked delicate and frail, he preferred a wide, open surgical field, which was why he had chosen thoracic surgery as a research student.

Following the minimization of general surgeries, there was a steep decrease in open thoracotomy. An incision 40 cm long was rarely seen anymore.

Zheng Ren suspected that this was Su Yun's original intent behind learning heart transplants.

"Let's opt for laparotomy, then," Zheng Ren concluded, not because Su Yun did not want to hold a monitor, but because the patient had a very complicated condition. They could require a B-scan ultrasound probe to locate liver abscesses during surgery before puncturing and draining them of pus. Furthermore, they had to treat the obstructive jaundice with all the accompanying procedures.

They both returned to the emergency ward. Old Chief Physician Pan had assigned Yang Lei to the first shift.

Chang Yue had brought the professor around each ward to speak to the patients and discuss how they had violated orders against returning home last night.

After completing the ward rounds, she noticed that patient compliance rates had at least doubled simply from bringing Professor Rudolf Wagner along.

In Sea City, it was common to bring house officers around during ward rounds. However, no one had ever seen a foreign 'house officer' before.

The ward was in total order. Zheng Ren informed Yang Lei to prepare for surgery.

Since Yang Lei had made the request that day, Zheng Ren also intended to let him take over part of the surgery to let the man improve.

It was only several months ago that Zheng Ren had to deal with Cen Meng and Chief Liu not allowing him to perform surgery.

He had never expected to now be in a position to allow someone else to do it.

Come to think of it, everything seemed too mystical.

Shortly after, Zheng Ren received a call from Chief Xia to inform him that the patient's family members had agreed to the surgery and were on their way to the emergency ward. She would send the patient to the operating room after completing preoperative assessment.

Chief Xia was very efficient at her job, which was a trait that Zheng Ren admired.

Zheng Ren did not rely on Yang Lei or Chang Yue to conduct the preoperative briefing.

The family could be unclear about the patient's medical history. Zheng Ren wanted to clarify if they had withheld it on purpose or out of ignorance.

There was a vast difference between the two.

The family did not take long to reach the emergency room. They were two middle-aged men; the patient's sons, presumably.

Zheng Ren had seen them before in the ward.

They both looked friendly and positive.

Zheng Ren questioned them about the patient's past conditions. Their body language conveyed that they lacked the pertinent medical knowledge. In addition, the patient had received her surgery many years ago, when they were still children.

After confirming his speculations, everything went according to plan.

He briefed them on all possible outcomes of the surgery and also updated them about the patient's current condition. They had no other choice but to proceed with surgery, and even that had a 30% chance of ending in failure.

When he finished, they turned white and broke into a cold sweat.

Su Yun joined Yang Lei for the operating theater after completing preoperative preparations.

The family members signed the surgery consent form, which Zheng Ren passed to Chang Yue before leaving for the operating room.

Professor Rudolf Wagner and Zheng Ren entered the operating room and changed. The professor did not once again try to persuade Zheng Ren to form a research team in Heidelberg University in Germany.

Zheng Ren did not care about the professor's true intentions, being entirely focused on the upcoming surgery.

Sump syndrome. Hopefully, it was not too serious.

As he changed, he entered the System's operating room to practice ten related general surgeries.

All the surgeries were successful, as Zheng Ren had a Master rank in general surgery with experience in hepatobiliary anatomy on top of that. Local anatomy was extremely useful.

As long as one had a strong foundation, it would be easy to learn any surgery.

After ten rounds, he was very well-versed.

He had just finished changing and entered the operating room when the sound of the stretcher trolley reached him.

"Chief Zheng, I'm going to start anesthesia. Do you need anything?" Chu Yanzhi asked.

"General anesthesia. Nothing else for now."

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Chapter 311: Sump Cleaner (Part 3 of 4)

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Out of various surgical methods, an endoscopic sphincterotomy to clean the biliary tract left the fewest injuries to the patient.

Although the procedure was minimally invasive, international journal articles had reported a very high rate of recrudescence—approximately 30%.

The patient was already old; if recrudescence occurred within five to ten years, he would be in his seventies. General surgery came with great risk.

Hence, Zheng Ren ruled out an endoscopic sphincterotomy.

He not only had current symptoms to consider but also the long-term effects of treatment.

He entered the operating room just as Xie Yiren finished scrubbing in. She opened a sterile surgical bag with assistance from the circulating nurse and began preparing the machine.

"Zheng Ren, what surgical method are you using?" she asked.

In the operating room and the entire emergency ward, only two people could call Zheng Ren by his first name—Old Chief Physician Pan and Xie Yiren.

"Sphincteroplasty of the sphincter of Oddi, biliary tract cleaning and liver abscess drainage."

Xie Yiren nodded. Having multiple surgical methods was no issue to her.

She asked the circulating nurse to retrieve several instruments that could be required. If they did not have any ready to use, they could simply sterilize others with a high-pressure cooker.

Zheng Ren felt a sense of comfort as he watched Little Yiren busy organizing and saving him plenty of trouble.

He transferred the patient onto the operating table with Su Yun and Yang Lei before Chu Yanzhi1 commenced anesthesia. The professor did not offer any help; perhaps he thought it outside his scope of duties and stayed aside out of habit.

After anesthesia was administered and the sterile sheets applied, the surgery began.

Ding dong~ The System chimed in a new mission as Zheng Ren stood before the operating table.

[Emergency Mission: Sump Cleaner

[Mission Task: Complete the surgical treatment of a patient with sump syndrome.

[Mission reward: 2,000 skill points, 25,000 experience points.

[Mission Time: 4 hours]

The mission was rather ordinary and not too difficult for Zheng Ren. He had just completed the first stage of The Crown Jewel and was thus swimming in resources.

He checked the mission and its allocated time, then reached out with one hand. A hemostatic clamp with iodine bandages was placed in it.

The surgery was broadcast as scheduled in Xinglin Garden.

[What is today's surgery about?]

[I just found out. Sump syndrome... The surgeries are getting stranger every time. I'm still familiar with most general surgical methods despite not being from the specialty, but this is my first time hearing of this.]

[It's not that rare. It's rather common in general surgery and gastroenterology departments. They will encounter this disease several times a year, mostly in patients who underwent a side-to-side choledochoduodenostomy.]

[It sounds so high-end. I'm new to this surgical method, too.]

[There are many more strange things that you've never heard of. Montreal General Hospital is one of the five largest medical institutions in the world. I've seen almost all rare cases and my guess is that were this more common, they would not have this surgery broadcast. It's a shame that, as a neurosurgeon, I only get to watch general and interventional radiology surgeries on my phone. When will I get the opportunity to watch a brain surgery broadcast?]

The broadcasting room bullet screen began crawling with comments once viewers were aware of the condition being operated on. The initial steps were nothing special: the surgeon made a 15 cm subcostal incision on the right side of the torso.

Since the patient had an old surgical wound, the incision was a little unusual in order to avoid scar tissue.

What followed was blunt dissection. It would only be worth watching after the opening of peritoneum, and commenters used this window to flood the bullet screen.

The neurosurgeon's words had resonated with many and they began chatting together.

In a live surgery broadcast, doctors benefitted much more from the perspective of the operating field instead of the normal observation deck. It offered a better view than even the first assistant's

Modern medicine was an empirical science. All the doctors watching the live surgery broadcast in Xinglin Garden were aware of how rare the opportunity was to watch a skillful surgeon demonstrate surgery of so many rare diseases.

Until today, the demonstration had only involved general and interventional surgeries. Some of them were disappointed, but at the same time had greater expectations.

After a few minutes of non-stop comments, the viewers concurrently ceased talking to pay attention to the surgery as the peritoneum was exposed.

The anatomical structure of the peritoneal cavity had been altered by the previous surgery.

Furthermore, the disease had resulted in inflammatory edema and several unidentifiable adhesions.

[If I were him, I would have given up already. I'd just close it up in case the patient does not come out of the surgery alive.]

[The adhesions are so extensive; would it hurt the proliferated blood vessels?]

[Yeah, it is impossible to identify the tissues... This condition would make anyone feel like throwing in the towel after one look.]

Zheng Ren was not perturbed by the condition of the peritoneal cavity. He extended his hand and Xie Yiren placed a pair of blunt scissors on his palm.

The blunt end of the surgical scissors was used to separate the proliferated connective tissues, either by peeling them apart or cutting them off. He did it at a steady pace, neither too fast or too slow.

Su Yun frowned.

How was Zheng Ren differentiating the locations of abnormal blood vessel growth under such extensive tissue adhesion?

Such knowledge was definitely not in any textbook.

This was too peculiar.

At the same time, although he had requested to learn Zheng Ren's skills and techniques, Yang Lei realized he could not understand Zheng Ren's surgical methods now that he was at the table with the man.

After Zheng Ren separated the tissues, clamped them down and stitched up a rather thick vessel with a #4 suture, Su Yun piped up: "How did you manage to locate the vessel?"

"I felt it," Zheng Ren answered coldly.

His entire focus was on the surgery. He had no time to explain to Su Yun that the proliferated blood vessel also had pulsation. If one's tactile senses were sharp enough, they could feel it beating.

Zheng Ren had mastered this technique after countless practice runs in the System's operating room.

Most importantly, he did not know how to describe this minute yet extremely important technique.

[I suddenly have a feeling that this surgeon has laser-guided eyes and can see proliferated blood vessels hidden within the connective tissues.]

[Yeah, I thought that too. There is no other explanation for how they could perform blunt separation of the connective tissues without harming any blood vessels.]

[Until now, blood loss is below 5 mL. This is a display of skill at its finest.]

The doctors in the Xinglin Garden were intrigued. However... they could not figure out how Zheng Ren operated.

As he dissected the tissues layer by layer, the complicated anatomic abnormalities became clearer.

Even though Su Yun could not comprehend how Zheng Ren had managed to locate the vessels, he still understood the intention behind each step.

The appendix retractor and small surgical hook in his hands appeared without fail at the appropriate location every time to help Zheng Ren open up the next surgical field.

Finally, after five minutes, Zheng Ren separated the last connective layer and the room was instantly filled with the rotten, foul odor of pus.

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Chapter 312: Problematic Operation (Part 4 of 4)

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Zheng Ren reached out and an uncovered aspirator was placed in his hand.

In the surgical field, blueish-green pus was visibly leaking out from the ileocecal fossa.

He hesitated before putting the aspirator on the patient's thigh. "Pass me a scraper."

"Yes." Xie Yiren blinked and passed him the tool before picking up some sterile gauze.

Zheng Ren did not drain the pus by suction. Instead, he scraped at it and wiped it off on the gauze in Xie Yiren's hand.

It was a sample for subsequent microbiological culture. Xie Yiren had understood his intentions without a word.

Even though the greenish pus in the ileocecal fossa seemed to be caused by infection by Pseudomonas aeruginosa, they could not confirm it until they performed a test.

After collecting the sample, Zheng Ren began draining the rest of the pus with the aspirator.

Xie Yiren carefully put the contaminated tools aside and organized the sterile tools for closure later.

Everything was in order.

[Wow, it's green!]

[It's blueish-green. From the color of the pus, we already know the infection is extremely bad. Even after surgery, there's no guarantee that a combination of Tienam and vancomycin can actually control the infection.]

[The surgeon took a sample. This surgery seriously has no flaws.]

After Zheng Ren cleaned up the pus, he continued to examine the surrounding connective tissues and edematous adhesions.

The patient's gallbladder had been removed 24 years ago. Zheng Ren carefully searched for the biliary duct and separated it from the pancreas.

This was the most difficult step. He could feel Su Yun paying full attention to keep up with his thought process for each step, but Yang Lei seemed bewildered.

Zheng Ren felt slightly sorry since no one had control over their natural talent.

The pancreas was slightly swollen, but it was nothing serious. The patient would be put on somatostatin for some time to prevent uncontrolled acute pancreatitis.

"Yang Lei, remember to tell Chief Xia to administer somatostatin post-op, normal dose for three to five days," he said, getting the man to note down the key reminder.

Yang Lei acknowledged the order.

Zheng Ren continued to separate the hepatoduodenal ligament and explore the duodenum, soon finding the ileocecal fossa he had drained the pus from earlier.

Its wall was covered in abscesses.

Xie Yiren's view was obstructed from her angle, so Zheng Ren extended his hand and, in a rare display, said out loud, "Small scraper."

Before he could finish his sentence, a handy scraper was placed in his hand.

Surprised, he turned to look at Xie Yiren, who was smiling at him.

[The sight of abscesses is giving me a headache. When I previously encountered something similar, the patient suffered a fever for twelve days post-surgery.]

[Yeah, this surgeon isn't planning to scrape off those abscesses, right?]

[He better not... the abscesses are heavily attached to the intestinal tract so it's not advisable to puncture the intestine. Edema in the intestine makes the patient even more vulnerable.]

[Mortals, don't try to predict the surgeon's next step with your simple minds.]

[I can sense that the surgeon is going to scrape off the abscesses... He's moving, he's really moving! He's scraping them!]

Zheng Ren used the scraper to remove the surface layer of the abscesses, then asked for a mosquito clamp, searched for an area with more deeply-rooted abscesses and began separating them from the intestinal wall.

Su Yun held the surgical hook tightly and carefully, his breathing becoming shallower.

He was afraid to move for fear that the slightest movement would make Zheng Ren falter, leading to the rupturing of the swollen intestinal walls.

If that happened, in addition to leakage of intestinal contents, the edema would not subside even after they stitched the intestines back together. It could worsen to a point where the patient would require a second laparotomy.

What Zheng Ren was doing was incredibly bold given his skill. After all, he had done many surgeries involving similar separation techniques in the System's operating room.

Nevertheless, he was still very cautious. He patiently sought out small gaps and inserted the mosquito clamp to separate them.

This surgery was progressing at a painfully slow pace, at complete odds with the lightning speed with which he had performed the laparotomy.

In both the operating and live broadcasting rooms, viewers held their breath anxiously.

Five minutes...

Ten minutes...

Fifteen minutes...

At the 22nd minute, Zheng Ren retrieved the mosquito clamp and small scraper from the patient's peritoneal cavity. There was an irregularly shaped, 20 cm wide abscess on the clamp.

[My goodness, this is the best operation I've ever seen.]

[This looks like a microsurgery. It's hard to believe this surgeon did it with their naked eyes.]

[Bullsh*t; the difficulty of this operation doesn't depend on one's surgical view, it all lies with both hands. Its execution was so meticulous that the intestines remained uninjured while the abscesses were completely removed.]

Across Zheng Ren, his first assistant, Su Yun let out a long sigh.

"There's a problem in your operation," he said.

"Yes, I know," Zheng Ren replied, "but this patient has sepsis. This would reduce the risk of infection and increase the chances of survival post surgery."

"You're that confident?" Su Yun's words did not come with context, but Zheng Ren understood that he was referring to the great risk taken in scraping off the abscesses.

Perhaps, from another's viewpoint, it had been extremely risky. However, he did not feel the same way; all it had taken was a little extra effort.

It was worth it if the patient healed faster after surgery.

After removing the abscesses in the ileocecal fossa, Zheng Ren completely separated the duodenum. Then, he reached out again and the surgical blade was put into his hand.

At the same time, Su Yun also opened his palm.

An uncovered sterile aspirator was passed to him.

When the common bile duct was incised, Su Yun inserted the aspirator.

Rotten food debris, pus-like fluid and digestive juices were sucked into its tube.

Su Yun shook his hand slightly and tried his best not to leave anything behind.

The common bile duct was so full that the uncovered aspirator was obstructed after only 20 seconds.

Its hissing began to fade.

Zheng Ren covered the area with wet gauze once Su Yun removed the aspirator.

Xie Yiren had already prepared warm saline. Su Yun put the aspirator into a bucket of it and repeatedly rinsed the tubing; after clearing the obstruction, he continued to remove the contents of the bile duct.

This whole process was repeated five times before the bile duct was finally cleared.

[Does this mean the surgery is halfway done?]

[Probably. The next step should be sphincteroplasty of the sphincter of Oddi. The rest should be easier after removing the abscesses and obstruction of the bile duct.]

[This surgery is so intricate. However, how will the patient avoid postoperative infection?]

[That'll be dealt with by the ICU. Had they had not done this surgery, they would not have been able to control infection anyway with so much rubbish inside the body.]

[I read the diagnosis before surgery and saw that the patient has sepsis. The patient received this surgery quite late; hopefully the surgeon's skill can pull her back from the gates of hell.]

After suction was complete, Zheng Ren was relieved. He had been more worried about the bile duct having serious edema or containing a huge foreign body. Those would require him to expand his surgical methods and cut open the bile duct for extraction.

Luckily, that had not been the case.

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Chapter 313: Let Me Treat You To Dinner (Part 1 of 4)

After the separation of the hepatoduodenal ligament, Zheng Ren moved on to the lesser omentum and separated the adhesion between the hepatic flexure and the right lobe of the liver (lobus hepatis dexter).

He then pushed down the transverse mesocolon and cut open the retroperitoneum behind the duodenum to perform a blunt dissection.

His skill at blunt dissection had been initially developed when he was training at appendectomy. It was his best trait.

By his own estimations, that one skill alone could probably reach a Master level.

However, it was so common that most people did not appreciate its art. Zheng Ren glanced at Yang Lei and was a little disappointed when he saw that the latter had not noticed it.

It seemed like he had to point out the gist of the surgery from time to time for the man to understand it.

After finishing blunt dissection on the retroperitoneum, he moved the second and third portion of the duodenum towards him until the head of the pancreas (caput pancreatis) and the duodenum were closer to the surface of the surgical field. Then, he temporarily put gauze soaked in warm saline behind them.

Under normal circumstances, he would use the duodenum as an anchor point while performing the sphincteroplasty of the sphincter of Oddi.

However, the patient had undergone a side-to-side choledochoduodenostomy. He did not need to do this anymore.

Zheng Ren prepared to cut open the duodenum.

He used mosquito forceps to clamp it on both sides and cut open the middle region. Clamping was done between one to two mm, followed by an atraumatic needle and suture to patch up the duodenal mucosa and common bile-duct mucosa at 2.0 to 2.5 cm.

This step was performed with extra care to prevent the occurrence of duodenal fistula.

After making an incision on the sphincter muscle, he cut off the traction suture on both ends to check for any bleeding.

Then, he examined the opening of the pancreatic duct.

The opening of the duct was below the incision Zheng Ren had made on the duodenum. Directly on its right, there was leakage of pancreatic fluid.

He inserted a thin catheter into the duct to check for any signs of narrowing or obstruction.

It was important to make sure both layers were in line during a double-layer suture of the duodenum incision to prevent duodenal flexure and stenosis.

Zheng Ren did not suture directly on the incision as usual, choosing a vertical suture instead to avoid the risk of said complications.

[Hmm? This is a unique suture.]

It did not miss the keen eyes of a Xinglin Garden viewer.

After several broadcasts, loyal viewers firmly believed the host surgeon was above any mistake and began considering the benefits of the suture.

There were few comments on the bullet screen.

The viewers pondered and learned.

After suturing of the incision on the duodenum, Zheng Ren carefully retrieved the greater omentum to enforce coverage before positioning the abdominal drainage tube between the subhepatic region and the lesser omentum.

The peritoneal cavity was washed clean with warm saline and he checked for any active bleeding before administering three local antibiotics. He did not close up right away, though.

"B-scan ultrasound, sterile covers, 50 mL injector," he said.

Su Yun hesitated. "Do you really plan to do it right now?"

"Don't worry."

Su Yun did not persist. Soon after, the circulating nurse pushed over a B-scan ultrasound, wrapping the probe and connecting wire in sterile covers. Zheng Ren then began performing a scan directly on the liver.

Without obstruction from the skin and tissues, the image was crystal clear!

The 50 mL injector was inserted into the liver abscess cavity and sucked out yellowish-green pus under the guidance of the B-scan.

After almost 125 mL of pus was aspirated, resistance against the injector began to increase.

"Two vials of Cefoperazone, dissolve and rinse," Zheng Ren ordered.

After rinsing off with warm saline, the circulating nurse opened two doses of Cefoperazone and Tazobactam. Zheng Ren solubilized them and inserted them into the abscess cavity.

Finally, the surgery was complete. Zheng Ren carefully checked all the regions he had worked on for any bleeding or unattended foci of infection.

"Closing."

Xie Yiren changed into a pair of new gloves and passed him the clean tools she had prepared earlier.

The pace of the entire surgery was alternating wildly. Zheng Ren had been very slow and cautious when scraping off the abscesses and performing the sphincterotomy.

When closing the abdominal cavity, he had such speed that his movements seemed to leave afterimages.

He was sure that Su Yun would be able to follow his pace.

[My goodness, the only step I understood so far is this closure. How is it so fast?]

[You're just too weak, kid.]

[This is almost light speed. The surgeon was extremely slow when scraping off abscesses. Is this their way of adjusting their speed to the procedure?]

Not all the doctors had been able to understand the surgery.

However, every one of them knew the abdominal closure procedure.

The surgeon was operating at full speed, with his first assistant following closely. Together, they took less than three minutes to close the abdomen.

This speed... They were just too skillful, like rockets blasting off and leaving everyone else behind.

After the last suture, the patient began showing signs of agitation and the livestream stopped broadcasting.

The viewers were not willing to leave just yet, however; they treated it like a forum with everyone chatting against the empty video background.

Now, they could say anything they wanted with no issue.

Since abdominal infections were very common, this surgery had great reference value, especially in abscess removal, B-scan ultrasound positioning for catheter insertion and pus drainage, and rinsing the area with antibiotics.

The surgeon only had one goal—to treat and improve the patient's sepsis as much as possible.

With the source of the problem dealt with, the rest depended on the microbiological culture and antibiotics administration.

The surgery had been near-perfect. Many doctors were still hung up about it an hour later, staying behind to chat and share their thoughts.

By sharing their experiences, they could also improve their skill sets.

If only they could record some audiovisual material, many doctors thought greedily.

Those remained distant dreams, however. They were already incredibly lucky that someone had been confident enough to broadcast their surgery live.

There were few who dared to do such a thing. Who could guarantee that their surgery would not go wrong?

Only someone truly gifted would dare broadcast their surgery live.

The doctors in the live surgery broadcasting room did not disperse for a long time, expressing their admiration of the surgeon, who was not aware of them.

The patient had already woken up by the time Zheng Ren finished his last suture.

Both Chu Yanran and Chu Yanzhi were greatly skilled at anesthesia, living up to their status as researchers in Intensive Care Medicine.

Zheng Ren left the operating table and took off his sterile surgical gown, stretching his neck.

"Are you feeling discomfort?" Xie Yiren asked nervously.

Zheng Ren laughed. "No, I'm just relaxing."

"Oh."

She began cleaning the surgical tools, washing them and sending them for sterilization.

"Zheng Ren, you're not on shift tonight, right? Let me treat you to dinner," she said with her back to him.

A sudden gush of warm blood rushed from his heart, almost erupting from his closed fontanelle.

"You don't have to pay tonight, there's a dinner invitation." Zheng Ren was a little disappointed. Although it would be more lively with all of them present, how nice it would be if he could have dinner alone with Xie Yiren.

It seemed ages since they had gone out for crayfish and met the Chu sisters.

"Oh, okay," Xie Yiren answered.

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Chapter 314: There's Only So Much I Can Do (Part 2 of 4)

It felt rather nice not having to work through the night in the hospital.

Ding dong! The bell of mission completion went off.

[Emergency Mission: Sump Cleaner completed.

[Mission content: Complete surgical treatment of a sump syndrome patient.

[Mission Time: 4 hours. 1 hour and 14 minutes spent, remaining 2 hours and 46 minutes.]

Not too bad. Zheng Ren smiled.

He turned around, saw Chief Xia and asked, "Chief Xia, do we send the patient back to ICU or gastroenterology?"

Such patients could be transferred to the gastroenterology department right after surgery as this emergency operation had been an interdepartmental consultation.

Of course, if gastroenterology was not confident at handling postoperative care, they could also transfer the patient to ICU and take her back when she had stabilized.

Without hesitation, Chief Xia responded, "Why the need for ICU?"

Such a strong comeback. Zheng Ren laughed and did not push the matter.

"Little Zheng, your surgical skills are better than Old Sun's." Although Chief Xia was slight, her words were so powerful that they stunned Zheng Ren.

She was able to pass judgment on another department chief without much consideration.

He had no clue how to respond.

"Little Zheng, if the patient recovers well after the TIPS surgery, can you make some room in your schedule for the other patient with refractory ascites?" Chief Xia asked.

Her classmate was healing so fast, his progress was almost visible to the naked eye.

He was very clearly vomiting less blood after surgery.

It was why Chief Xia acknowledged Zheng Ren's skill and was continuing to invite him to treat other patients suitable for TIPS surgery.

"If I don't have any emergency cases, I can do it at any time," Zheng Ren chuckled.

"Okay, we'll wait until you remove the stent. If the effects are promising, we can do it immediately. If we keep on delaying the matter, the patient might not survive past a few days." Her straightforwardness was admirable.

At least they could save time on guessing games.

There was nothing to guess, anyway, since she was not Xie Yiren.

Zheng Ren went to change his clothes. Su Yun followed him into the changing room and said while laughing, "Looks like someone's progressing."

"Hmm? This surgery was still okay. All of them had been standard procedures, and I'm just carrying them out accordingly," Zheng Ren said.

"I'm referring to Xie Yiren. She asked you out to dinner. Too bad you guys can't make it today. Otherwise, this would have been a great opportunity." Su Yun closed in on Zheng Ren, his tone becoming conspiratorial and hushed. "Let me tell you a joke; it's a true story of one of my university friends."

"Go on."

"I have this friend. We share the same dorm, and he was so dense and stuffy that he wouldn't budge even if you hit him," Su Yun said as he changed, "He was courting a girl, but he was so passive. Watching him made me so anxious."

"Yeah, and the same applies to me," Zheng Ren said nonchalantly. He knew Su Yun was about to mock him.

"Look at your temper. You're being more and more irritable, that's not good." Su Yun was in one of his rare good moods. "With my help, he finally asked the girl out on a movie date. She had been interested in him for quite some time and had just been waiting for him to make the first move.

"As expected, the girl agreed when he asked.

"I told him that it was his best opportunity to hold hands during the movie. He had to pretend unintentionally to remove the handle between the seats after entering the cinema to reduce the distance between them."

"What happened next?" The thought of holding hands sparked Zheng Ren's interest.

"If the girl isn't interested, she'll put down the handle. If not, congratulations, everything will go according to plan," Su Yun smirked.

"This isn't a joke." Zheng Ren was confused, but Su Yun's words seemed to make sense.

He had already put himself into the situation and considered taking Little Yiren to a movie.

"Listen to me," Su Yun said, "He followed my directions and entered slightly late. When the movie started, they searched for their seats in the dark and he took the chance to lift up the handle. The girl didn't say anything and they continued to watch the movie."

Zheng Ren continued imagining himself in their shoes. It seemed to be the start of something good.

"About half an hour later, the coward finally gathered enough courage to extend his arm along the back of the seats and gently put it around the girl's shoulders."

"That's nice," Zheng Ren's eyes were shining. Su Yun's plan seemed feasible.

However, would Little Yiren take his hand away? That would be awkward.

"The girl whispered into his ear, 'Stop it, my heart's beating incredibly fast, touch it if you don't believe me'," Su Yun's smirk grew larger as he watched Zheng Ren.

"One's pulse rate is similar to their heartbeat," Zheng Ren mumbled. Suddenly, he said excitedly, "Was she implying that he ought to touch her radial artery? That way, they could hold hands."

He was completely immersed in a scenario where he and Xie Yiren were on a movie date.

"Bwa ha ha ha..." Su Yun burst out into laughter, tears rolling down his face.

Zheng Ren could not for the life of him figure out what had been so funny that Su Yun was roaring with laughter.

"My friend said the exact same thing and the girl got angry." Su Yun continued to laugh loudly. "Didn't you think of touching her chest?"

Stunned, Zheng Ren was at a loss for words.

The clear, blue sky above his head was obscured by a huge rain cloud and it started pouring.

"If only you had one-tenth of the talent you show in surgery, Xie Yiren would have been yours long ago." A hint of mockery appeared at the corners of Su Yun's mouth, his expression knowing.

Zheng Ren kept quiet.

"Anyway, I've told you the story. Just treat it as a learning experience," Su Yun said, "There's only so much I can do."

"Thanks." Zheng Ren recalled what just happened and felt like an idiot. "What happened to them in the end?"

"They have a three-year-old now. You need to make a move. The worst Xie Yiren would do is to slap you or call you a hooligan."

Zheng Ren was stunned.

After he finished changing with a heavy heart, Zheng Ren returned to the emergency ward.

It was in order and Professor Rudolf was busy following Chang Yue around. Zheng Ren truly had no idea what the German professor was thinking.

As usual, though, he put the thought aside as he could not make sense of it.

More importantly, he was not concerned with Professor Rudolf. His mind was still reeling from Su Yun's story.

He was truly lucky that Su Yun had given him the reminder, or he would have definitely said something stupid.

It seemed rather reasonable, especially for a medical student... okay, not many medical students would have said such a thing.

He was just too dumb. Zheng Ren was self-aware enough to know that.

His heart tied itself into a thousand knots and he kept thinking, losing interest in reading for the rest of the day.

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Chapter 315: Just Stay Over (Part 3 of 4)

A patient with appendicitis arrived in the afternoon. Zheng Ren opted out of the procedure, allowing Su Yun to lead instead with Yang Lei assisting. It was a learning opportunity for them.

Yang Lei was on the straight and narrow when it came to surgery.

Most other doctors were similar. They honed their skills through practice and repetition.

A fast learner like Su Yun was an exception, not the rule.

However, Zheng Ren was not aware that his own rate of learning was beyond human in the eyes of others.

When his shift ended, Feng Xuhui was already waiting for him.

Doctors were busy people. Around 80% of them would decline meal invites, especially those meant solely for socializing.

Feng Xuhui's humility and sincerity were enough to persuade them to accept, though.

Chairman Ma was at a hotel, waiting for them all.

Zheng Ren did not have the heart to turn down Feng Xuhui's cordial request and thus rounded up a few doctors into an Iveco, which ferried them to Shangri-La Hotel.

Chairman Ma had booked a private room for the event, clearly having planned for this for some time.

He had not planned to personally thank a junior doctor from a northeastern third-tier city, trusting Feng Xuhui to take care of that on his behalf.

Still, the doctor's name had come up repeatedly when he was overseeing product deliveries in Imperial Capital General.

Whenever Zheng Ren was mentioned, Department Chief Kong would sign off on any equipment or material being requested.

The same had happened with the supervisory deputy director. Once it was known to be such, Zheng Ren's wishes were greenlit all the way.

It was then that Chairman Ma knew he had underestimated the junior doctor.

Zheng Ren's skill at the operating table and the fact that he had saved another doctor's life were testaments to the high regard he was held in.

Chairman Ma had decided to personally attend the appreciation feast in Sea City.

He had heard that northeasterners loved to drink.

There were rumors that their alcohol tolerance was comparable to the Russians' due to their cold native climate.

In his youth, Chairman Ma had experienced two bouts of upper gastrointestinal bleeding from excessive drinking. Hence, he was worried about having to entertain the northeasterners.

Eventually, he hired two professional drinkers[1] from Imperial Capital to keep up with Zheng Ren.

...

The group from Sea City General Hospital entered the private room. Chairman Ma spotted Professor Rudolph Wagner among them and congratulated himself for picking the right event to attend.

He knew naught of the reason behind the professor's extended stay in China and cared even less; a chance to talk with the professor was all that mattered.

There were smiles all around as the guests took their seats. Chairman Ma and Old Chief Physician Pan struck up a conversation about business.

Zheng Ren was bored. He watched Xie Yiren sitting right across him and thought of Su Yun's words from this afternoon.

Everyone raised their glasses, but Zheng Ren simply watched with disinterest.

He could neither join in on the conversation nor the drinking. Life was especially lonely for someone like him.

Rather than attending such events, Zheng Ren longed for his scalpel and the operating table.

As he mulled over his life, he noticed Chairman Ma approach, bottle in hand, only to be obstructed by Su Yun.

It was a 1500ml bottle of Scottish whiskey. Su Yun whistled.

The whole room was noisy and rowdy.

Zheng Ren ignored it all. Channeling the focus he had while operating, he kept his eyes on Xie Yiren, studying the lines and creases that shifted on her face as she smiled and talked. He felt his heart calm down.

Chairman Ma's initial worries were manifesting in a very different way.

He had not expected the group from Sea City General Hospital to be such voracious drinkers.

At that moment, he recalled Feng Xuhui's words: Zheng Ren was a teetotaler but his assistant was the complete opposite.

One hour into the dinner, the professional drinker entertaining the men could no longer keep up with Su Yun.

Three bottles of whiskey had gone down like ordinary beers. Who could blame the man?

Their alcohol content was 58.5%, high enough that a spark could instantly ignite the bottle.

Each bottle was 1.5 litres, and they had gone through three bottles within an hour...

Just the thought of so much alcohol made Chairman Ma's head hurt.

He turned to the female professional drinker, who was with the women.

He had heard that she had a significantly higher alcohol tolerance than her male counterpart.

However, upon inspection, she was slumped over Chang Yue's shoulder, speaking as if they were best buddies.

Chang Yue's expression was neutral as she bit into a piece of meat on a toothpick. They were practically surrounded by wine bottles.

Truly insane! Chairman Ma groaned internally.

He had clearly misjudged the group's alcohol tolerance.

From their demeanors, Old Chief Physician Pan had identified the professional drinkers from the start.

He had planned to match them glass for glass, not backing down under any circumstances.

However, he had not accounted for Su Yun blowing through three bottles of whiskey with the male drinker, and on the other side, Chang Yue quietly outdrinking the other.

They were truly his subordinates!

Laughter filled the lines in Old Chief Physician Pan's face.

He was enjoying himself!

Feng Xuhui's forehead was drenched in sweat as he rushed around, catering to everyone.

The feast went on for over three hours before Old Chief Physician Pan signaled to the group. It was time for them to leave.

Staring at the inebriated two professional drinkers, Chairman Ma could only shake his head in disappointment.

...

...

The group exited the hotel into the cold, winter air. Those who had driven here went to their cars while the others got into the Iveco rented by Changfeng Microinvasive Surgery.

Xie Yiren had not participated in the drinking but her red cheeks implied otherwise.

Zheng Ren mustered the courage to approach her. "Yiren, can I escort you home?"

"Oh? Does Chief Zheng finally have the guts today?" Chang Yue teased with a chuckle. She had a mirthful gleam in her eyes and her eyebrows waggled comically at Zheng Ren.

She was certifiably still sober. Zheng Ren still remembered the day of the drinking competition between her and Su Yun; she had returned barefoot and left a trail as if she had just come out of the showers.

The current Chang Yue was still speaking normally and had her shoes on.

Su Yun stalked over. "Oi! I've been waiting for a rematch. Let's go have a few more rounds."

"Want to lose again?" Chang Yue hummed.

"Beer is not my thing. I'm not scared of you," Su Yun sneered. Chang Yue's words were like a lit match tossed into the pool of whiskey he had just downed.

"You lost before, but sure, I'll give you another chance today." Chang Yue smirked. "Are you sure you want to do this with hard liquor?"

The confidence made Su Yun hesitate.

Chang Yue, this... Was her tolerance really...

Some people could tolerate a mixture of drinks. The more they drank, the more energized they became. The different alcohols fused into a hodgepodge in their stomach.

"Let's go. Yanran, you haven't drank anything right? Take us there." Chang Yue then turned to Su Yun. "I'll make sure you have your fill." With a rare burst of excitement, she dragged Chu Yanran and Chu Yanzhi into the vehicle, sparing nary a glance at Xie Yiren and Zheng Ren.

Just like that, the two were left by the street.

The raucous members of their party had departed for their next destination.

The wind picked up again, but Zheng Ren could vaguely hear Xie Yiren sigh.

"That... Yiren, can I escort you back?" Zheng Ren asked again.

"Sure." There was still some residual shyness in her voice, but she felt much better with the crowd gone.

Her smile blossomed like a flower in spring.

They got into her Volvo XC60. Xie Yiren started the car and put on the turn signal.

Zheng Ren's initial assumption was wrong. Xie Yiren's driving was slow, to the point where walking seemed faster.

The drive was unhurried, as if Xie Yiren was enjoying every second of the journey.

Within the small, confined space of the vehicle, Zheng Ren could smell her faint scent. It made him dizzy.

Words failed him in such a scenario. They were never truly his strong suit.

Was he supposed to follow Su Yun's advice and try to put his arm around Xie Yiren? She was driving, though; what if they got into an accident?

What to say...

Zheng Ren's mind hummed like a broken television. He could almost hear crows cawing around his head.

How awkward...

Was this the tragic fate of a single dog?

"Zheng Ren, your shift is over, right? Where are you staying now? I heard that you stopped renting your place after becoming chief resident," Xie Yiren asked.

The question caught him off guard.

He had absolutely forgotten about his housing arrangement...

Zheng Ren's belongings were sparse. His extra stuff had been left with Little Zhao and whatever he wore had been thrown in with the emergency ward's laundry to be cleaned.

This was going to be awkward.

Was he going to have to spend the night on the streets?

No, Yang Lei was on duty tonight. He could still get into the hospital.

A thousand ideas ran through his mind as he tried to come up with a plan.

"I knew you had forgotten about this." Xie Yiren chuckled. "Sister Yue said you would, but I didn't believe her. Guess she was right."

These girls...

"How about you stay over at my place?" she asked. Her face was as red as an apple.

He instinctively opened his mouth to reject the offer.

Before the words left him, Su Yun's advice boomed like thunder in his ears.

If he rejected it... Zheng Ren ran through multiple possibilities in his mind.

It would be a dumb move.

"Sure," Zheng Ren uttered after some deliberation.

Xie Yiren let out an audible breath.

Were they cohabitating? Zheng Ren's chest burst with joy, accompanied by anxiety.

He chanced a glance at Xie Yiren and saw an expression similar to his. She was also nervous.

"The house was cleaned today. You don't have to worry, housekeeping comes in every day." Xie Yiren kept rambling to disguise her anxiety. "I got a few sets of quilts for you and you can pick whichever you like. I was worried you wouldn't like silk so I got someone to custom-make one with Shandong cotton."

Wait a second, had he misinterpreted something?

[1] 陪酒师 could also be translated as "escort", but the term is loaded and was thus replaced with the more literal "professional drinker".

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Chapter 316: I Like You (Part 4 of 4)

Zheng Ren was not a quick-witted man.

There was a moment of letdown. He did not know what to say to dispel the awkward tension in the car.

Xie Yiren had also picked up on the shift in mood and her voice cut off abruptly after the mention of Shandong cotton sheets.

The car crawled at a steady 20 to 30 miles per hour toward their destination.

Peace would be found once they reached the house.

The ride was not bad, however.

Occasionally, a food delivery rider passed the car and peered in.

They seemed to expect such a pace from a woman driver.

Xie Yiren drove as if they were on a stroll through the nightscape of Sea City. It would be almost serene if not for the food delivery riders zooming by.

Traffic was sparse, so there was a lower risk of an accident happening.

"That..." Zheng Ren made an attempt to break the silence. "Can I know where I will be living? How far is it from the hospital?"

"It's nearby," Xie Yiren said in a whisper.

Zheng Ren steered his thoughts away from cohabitation. He did not want to raise his expectations, only to have them shattered later.

The Volvo XC60 entered a residential area near the hospital with villas and manors. Zheng Ren and Xie Yiren chatted inanely as the car approached the house at a leisurely pace.

He was stunned by his surroundings.

They pulled up to a street that he had once visited.

"You'll be living in this house," Xie Yiren said with her head down. She handed him a set of keys without meeting his gaze.

"Oh." He took them with some disappointment.

Xie Yiren did not kill the engine as she came down from the car.

She took a deep breath of fresh air. There was an instant change in her demeanor.

The enclosed space was truly...

Stifling.

"You'll be staying here, while that one over there is mine. The Chu sisters come over sometimes, usually the one on duty," Xie Yiren said, pointing to the manor next door.

Zheng Ren scanned his surroundings and spotted the emergency department building.

It was less than ten minutes away. If there was an emergency at night, they could easily rush back to the hospital.

"Here, give it a try." Xie Yiren rubbed her face to relax her facial muscles and walked to the gate, explaining, "The keychain can be used to unlock the gate."

Zheng Ren studied the set of keys he had been given and tapped the keychain to the gate, which opened, letting them into the porch.

The exterior of the place was around 100 square feet.

It was different from Xie Yiren's house. There was no greenery here and the building design looked Northeastern.

"Insert the main door key and turn it clockwise," Xie Yiren said as she bounced on her feet.

Zheng Ren did as he was told.

A pair of men-sized house slippers greeted him at the doorway.

"It's a new pair. Sister Yue said to get you the same slippers as the hospital's so that you'd be accustomed to them. Try them on."

He changed into the slippers.

There was only one pair. Was she not also going in to give him a tour?

As the thought crossed Zheng Ren's mind, Xie Yiren piped up, "The bedroom is on the second floor. The bath has hot water 24 hours a day. You will be able to freshen up after a round of surgery.

"Go ahead and check it out. I'm going to head back now." She quickly turned to leave.

"Hey!" Zheng Ren called out before his brain could process what he wanted to say.

Xie Yiren's body jerked to a stop, but she did not turn to face him.

A hotheaded Zheng Ren walked up to her and hugged her from behind.

She had on a form-fitting winter coat that served its purpose without sacrificing aesthetic.

Zheng Ren could feel her body tremble slightly in his arms.

He lowered his head and said into her ear, "Yiren, I like you."

There was a sudden tension in her body, followed by violent trembling. Her nervousness was palpable.

"Mm," Xie Yiren vocalized before breaking from Zheng Ren's embrace and quickly walking out the door.

He was unsure if he had heard her response correctly. Had she even heard what he said?

"Funny..." Xie Yiren let out a shy chuckle. "I'll be heading home. If there's no emergency call, I'll be in first thing in the morning."

With that, she left. The red Volvo sped off while Zheng Ren's mind drew blanks.

The car mosied into the driveway next door.

As the walls blocked his view of Xie Yiren, he shut the front door. Her lingering scent still teased his nose.

He inhaled heavily and went upstairs.

The house had the same floor plan as Xie Yiren's. There was a huge bed in the bedroom with two quilts that Xie Yiren had handpicked for him.

Zheng Ren felt their fabric, then promptly threw the silk one into the closet.

There, he found an array of clothes. Were these for him? Zheng Ren was familiar with the brand; it was the same one that Xie Yiren had gotten him when he was in Imperial Capital.

He went to the bathroom to wash up. When he was done, he texted Xie Yiren.

Their conversations through the screen flowed more easily, with less anxiety and trepidation. Xie Yiren's scent was still with him.

Zheng Ren dozed off into a deep slumber, only waking when the sun rose the next day.

He jerked awake with a start.

Where was he? Was the on-call room so big?

Slowly, his mind pieced the puzzle together and he remembered he was in Xie Yiren's house.

She had too many houses to her name. Having fewer would be better.

Zheng Ren's thoughts went in all directions as he began his morning routine. He texted Xie Yiren his usual morning greeting, asking about breakfast.

They met up for it before leaving for the hospital, both seemingly in silent agreement to put the events of the previous night behind them.

Before the 8.00 am shift change, Zheng Ren went to check the wards.

The patients who had gone home had yet to return. Drips would only be attached after the shift change so there was no point in patients coming in early.

Staying home was much better than waiting in the hospital.

Patients with minor illnesses always preferred to go home.

Old Chief Physician Pan could not do much to change their minds.

Doctors could only try their best to communicate the risks and get the patient to sign a disclaimer.

Old Chief Physician Pan arrived at the emergency ward at 7.55 am, spotting and approaching Zheng Ren. "A former comrade sought me out for a friend of his who has liver cancer. Can you take a look? If surgery is viable, we'll take him in."

Zheng Ren nodded.

Behind the old chief was a man and a woman, both middle-aged. They smiled at Zheng Ren.

"You must be Dr. Zheng. Here are my father's scans. Please take a look," the man said.

Zheng Ren bade them to wait as he had to oversee the shift change.

It was 8.00 am. The shift handover was starting.

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Chapter 317: Fourth-Grade Pain

There had been few incoming patients the day before and those already in the emergency ward had remained stable throughout the night. Hence, the shift handover was brief.

Once the handover and ward rounds were done, Old Chief Physician Pan returned to his office.

Zheng Ren called the two middle-aged visitors over to ask about the patient's history, checking their scans and medical test results.

The patient was a 69-year-old male with no prior medical conditions. A week ago, he had sustained some blunt force trauma and had gone to the local hospital for a check up. An ultrasound scan had revealed space-occupying lesions in the liver; the largest was 6 x 7 cm and suspected to be malignant.

The patient's medical history was simple and clear. The space-occupying lesions had spread throughout the liver and conventional surgery was no longer an option.

Right now, interventional surgery was the best route.

However, Zheng Ren could not tell if the surgery would be effective without a contrast-enhanced 64-slice CT scan.

He informed Chang Yue to admit the patient before heading off with Su Yun to check on the post-surgery patients.

They arrived at the gastroenterology department and were greeted by Department Chief Xia. Her treatment of Zheng Ren had improved significantly; even the other department chiefs did not receive such warmth.

She personally escorted them to the TIPS surgery patient.

His hematemesis had abated and hepatic encephalopathy was no longer an issue. Zheng Ren estimated that the second stent could be removed after one or two days of observation.

The patient's family thanked him profusely, but he was just glad he had managed to save the man from death.

Gratitude from the patient's family was secondary.

The sump syndrome patient was also recovering from her surgery. There were still hints of a fever but it was being managed.

She had a body temperature of 39.5 C pre-surgery, but it now hovered around 38.5 C.

Zheng Ren was confident in his operation. The next most important thing to treat was the patient's sepsis. Once that was under control, she would have won the battle.

After the checks were done, Department Chief Xia escorted them all the way to the entrance of the gastroenterology ward.

The gesture was Department Chief Xia's way of acknowledging Zheng Ren's expertise. She now saw him as a peer, rather than a subordinate.

The two young doctors quickly made their way back to the ICU.

Su Yun showed no symptoms of a hangover, unlike the last time he tried competitive drinking with Chang Yue.

Zheng Ren was perplexed. The amount of Scottish whiskey Su Yun had imbibed yesterday night far outweighed the alcohol content of 11 packs of Snow beer, but the man was totally fine today.

As they walked, Su Yun suddenly asked, "Yesterday, did you get it?"

Get it... Zheng Ren was not sure how to answer the question.

If a hug was being implied, then yes, but Zheng Ren knew Su Yun meant something else.

"Your mood this morning tells me you at least got something. Don't rush; girls don't like a clingy man. One step at a time," Su Yun advised.

Zheng Ren found himself agreeing. He was glad he had managed to hold back yesterday.

Who knew what would have happened if he had given in to his emotions.

The two doctors changed before entering the ICU. Department Chief Qian was discussing a case, a stern expression on his face.

"Little Zheng, you're here," he said upon seeing them.

Sensing that the man had questions, Zheng Ren approached.

"The patient in the fifth ICU bed is struggling. We had thought her breathing tube could be removed today, but when the sedative wore off, her vitals became unstable."

Department Chief Qian's explanation was precise and to-the-point.

This would be the trauma patient who had fallen from a great height. Zheng Ren had performed her surgery.

Was there something he had missed?

Zheng Ren thought about it. She ought to be recovering gradually and was due to visit the orthopedic department in the next few days.

The System's mission, Save People from Misery, was ignored. Zheng Ren was not interested at the moment.

An elective surgery could never be treated like an emergency surgery. There were just too many unpredictable consequences for the patient.

What was going on?

Zheng Ren studied her. The display in the top right corner of his vision was still a mild red.

As expected, her multiple bone fractures had yet to be addressed.

Based on the System's diagnosis, there was nothing amiss...

Mystified by the turn of events, Zheng Ren silently stood aside and listened to the ICU doctors' case discussion.

Su Yun sidled up to him and whispered, "Boss, I have a feeling the patient's adenomyosis is acting up, causing agitation to be observed whenever sedatives wore off."

Zheng Ren thought it over. Without exact measurements, he could not come to a firm conclusion.

He nodded slightly, putting his right hand on his forehead as he ruminated.

"Little Su, what's your opinion?" Department Chief Qian asked.

"Chief Qian, I think the patient should undergo an interventional surgery to treat her adenomyosis. If it does not solve the issue, her uterus will need to be removed." Before anyone could interject, Su Yun continued, "The patient could no longer live with the pain from the adenomyosis and decided to take her life.

"We do not know how much pain she is in, but I believe it must be at fourth grade."

The pain scale commonly seen online ranged between 1 to 12. In medicine, though, pain was sorted into four grades[1, the fourth being the most severe to the point of affecting blood pressure and heart rate.

The ICU doctors were used to Su Yun being right and did not repudiate him.

Although his diagnosis was out of the ordinary, the more they thought about it, the more it made sense.

Department Chief Qian sighed.

"The pain from the fractures can be lessened by remaining still, so I believe the root cause of the patient's agitation is her adenomyosis.

"I suggest we inform the patient's family. If worst comes to worst, we will have to remove the uterus. We shouldn't delay any longer; the patient has been using a breathing tube for nearly 48 hours and we may end up having to perform a tracheostomy soon.

"There will be a risk of lung infections and other sorts of complications, threatening recovery," Su Yun elaborated.

Zheng Ren was unsure if the agitation was truly caused by adenomyosis, but agreed with Su Yun's assessment nonetheless. "We should try."

The patient was no longer in danger of bleeding out. It was worth a shot.

After all, it was a minimally invasive procedure.

Were it not for her fractures, the patient would be able to walk 24 hours after an interventional surgery.

If they had the compression device and other high-end equipment from Imperial Capital at their disposal, her recovery time could be cut short to 4-6 hours.

Department Chief Qian was impressed. Adenomyosis was not a rare disorder, but most women chose to perform a hysterectomy, giving up their reproductive ability.

The disorder was usually found in older women. Department Chief Qian had no experience handling a younger patient, who had yet to give birth, with it.

After some thought, the chief said resolutely, "I'll talk to the family. We can give it a shot."

[1] Non-medical pain scales seem to stretch from 1 to 10 at most. The author could be taking artistic liberties.

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Chapter 318: Precise To A Fault

The next step was confirmed. Department Chief Qian went to speak with the patient's family.

Zheng Ren and Su Yun returned to the emergency department.

As they walked, Zheng Ren was deep in thought.

He did not like to rely on luck. Much like the TIPS surgery, where most doctors had historically relied on chance, Zheng Ren had spent countless hours of training time to increase his probability of success and minimize his dependence on the fickle Lady Luck.

The adenomyosis had been initially viewed as a minor disorder that could be treated once the patient was stable, even though it would leave her without a womb.

There was a low chance the interventional procedure could truly save the woman from pain and misery.

Zheng Ren had made some mental calculations and realized his estimation from a few days ago had been too optimistic. The success rate of the surgery was less than 20%.

He did not like the numbers.

Once he arrived at the emergency wards, Zheng Ren gave out some instructions before quickly heading for the on-call room; there, he laid on the bed and entered the System.

The air in the System was cool and refreshing.

The water in the lake rippled with life.

The fox statue was on its four limbs before the thatched cottage, its eyes gleaming in the light. Zheng Ren felt its gaze follow him wherever he went.

He tried to communicate with the little fox, to no avail.

The System had always been distant and that was not about to change today.

Zheng Ren shrugged. He bought some training time and entered the System's operating room.

Adenomyosis was considered a non-deadly disorder, but in Zheng Ren's eyes, it was comparable to cancer. Both were debilitating diseases that deserved his full attention.

It was especially so when those infirmed were getting younger and younger, affecting women who had yet to have children.

He could spare some time to experiment in the System in hopes of finding an alternative to a hysterectomy.

The training room rose from the ground, a simulation mannequin lying ready on the operating table. Zheng Ren did not rush to the surgery but looked through the patient's presurgical tests and scans.

The scans showed that this case of adenomyosis was confined to the cervix.

With that in mind, Zheng Ren could visualize the path of least resistance to the target site.

It was a path to victory; he was sure of it.

The surgery began.

The System conjured up a string of simulation mannequins with focal adenomyosis at the cervix.

From the System's behavior, Zheng Ren postulated that interventional surgery was not suitable for the diffuse variant of the disorder.

Being in the System's space did not mean Zheng Ren could make just any procedure work.

The cause of adenomyosis was unknown to this day. The general consensus was that the thinning submucosal layer of the uterus triggered endometrial tissue proliferation in the myometrium.

Zheng Ren performed artery superselection and studied the contrast image for any signs of abnormality.

Tissue proliferation would often be accompanied by angiogenesis.

During superselection, contrast agent was administered to color the blood vessels. They appear black against the bright background.

Zheng Ren successfully located the vessels supplying blood to lesions in the uterus.

The subsequent steps were simple. He proceeded with injection of the embolic agent, then follow-up imaging to confirm that the vessel was completely blocked. It was a successful surgery, in Zheng Ren's opinion.

However, the System disagreed. The completion bar was at only 60%!

Barely a pass.

The whole procedure had taken less than 20 minutes.

Barring any life-threatening emergencies, this would have been a straightforward surgery that Zheng Ren could perform with his eyes closed.

Su Yun had implied something similar during the emergency surgery to address the pelvic fracture hemorrhage.

However, Zheng Ren was worried about complications as that patient was not in a stable condition.

Now, he was sure he had made the right choice. What was he missing?

The 60% kept haunting him.

Where was the problem?

Zheng Ren took a break from the surgery and went to sit beside the lake, ruminating on the task at hand.

Just like the TIPS surgery, it was best to sharpen one's axe before chopping wood.

At this stage, he was stuck at 60% completion for surgical treatment of focal adenomyosis.

What would he do next?

Zheng Ren took a trip down memory lane, revisiting books and journals he had read.

Many of them were largely to do with general surgery, especially the liver. There was little that contributed to adenomyosis.

He spent a long time thinking, his mind calm and collected.

Department Chief Qian was handling patient communication and that would need at least half an hour to an hour. This was not a life-or-death surgery like the TIPS surgery had been.

Adenomyosis... problem... surgery...

A question popped into his mind. Could it be the imaging?

Zheng Ren's method of imaging had always been superselective. He would only begin it at the third or fourth branch of artery.

Many doctors did not like this method because superselection was time-consuming and meant prolonged exposure to radiation.

However, it allowed the surgeon to be more accurate.

Why was the surgery still incomplete? Perhaps there was more than one site with adenomyosis.

There were possibly clusters of cells spread across the myometrium that had yet to grow into a pronounced mass.

Like seeds of grass, some clusters were still dormant. The procedure only addressed the fully-grown weeds, not the seeds deep within the soil.

Right!

Zheng Ren smacked his thigh in realization.

The pain was a jolt to his senses.

He regretted his action and swore to keep his excitement at bay in the future.

His precise imaging method could be the cause of the incomplete surgery.

Zheng Ren chuckled as he called forth the operating room again.

This time, he did not overdo superselection.

Once the guide catheter was in the uterine artery, Zheng Ren began imaging.

As expected, a complex network of vessels appeared onscreen.

The more condensed network indicated the initial embolization site while the less concentrated networks were potential problem areas.

Zheng Ren would try to embolize the remaining vascular networks.

The vessels feeding into the adenomyoma were larger than the capillary network that Zheng Ren had treated during the prostate interventional surgery. This would be an easy task.

One by one, Zheng Ren delivered the embolic agent into the feeder arteries. The progress bar at the top right corner of his vision ticked towards 100%.

%... 65%... 70%...

After 2 hours and 12 minutes, the surgery was finally complete.

100%!

A grim smile was on his face when he saw the time.

He had turned a minor procedure into a major one.

Despite the laborious process, Zheng Ren was glad to thoroughly complete treatment of adenomyosis.

Only he could achieve such precision and accuracy.

A Grandmaster rank in interventional surgery was no joke.

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Chapter 319: Unimportant Matters

Zheng Ren exited the System.

The success in the System's operating room had given him great satisfaction.

Although the procedure was not for all forms of the disorder, he was content with it being effective for focal adenomyosis.

His phone rang.

"Chief Qian, hello.

"Alright, we will begin preparations.

"Please bring the family to the emergency ward, I will brief them on the procedure."

The conversation ended.

Zheng Ren left the on-call room and saw Su Yun in the office playing a mobile game, thumbs tapping away furiously at the screen. He was probably gaming and texting at the same time.

"Su Yun, the family has agreed to the surgery. Go ahead and prep," Zheng Ren ordered.

Su Yun made a noise of acknowledgment. He pocketed his phone, a smug grin on his face.

Zheng Ren shook his head. This manwhore; he could smell the pheromones from meters away.

Professor Rudolph was listening intently to Chang Yue's explanation of the local medical scene and did not notice Zheng Ren's arrival.

Sitting at one of the computers, Zheng Ren typed out the consent form.

As this was a rare disorder and the patient was suffering multiple fractures, the informed consent document had to be tailor-made.

Zheng Ren carefully listed down each possible complication. His typing was agonizingly slow.

A moment later, the patient's family was gathered in the room. Zheng Ren vaguely remembered the young man.

He asked the man to take a seat with a gentle smile to soothe the nerves.

The man had received a non-stop barrage of bad news that would have made anyone else crumble.

Zheng Ren began his explanation of the procedure. Rather than recite the document he had just made, he spoke about adenomyosis.

The most important detail to convey to the family was not the potential complications but the special circumstances surrounding the patient. There was no way to determine if the adenomyosis was focal or diffuse.

If surgery found that it was diffuse adenomyosis, they would abandon this course of treatment.

Communication went on smoothly.

The young man had brought the patient to many hospitals, including larger hospitals in Imperial and Sorcery Capital, in hopes for treatment.

He had some basic understanding of the disorder. Between the multiple hospital trips, he had decided that he would accept hysterectomy were there no alternatives.

His choice was clear; between the potential for generating a new life and protecting an existing one, he would choose the latter. It was the patient who could not give up the idea of biological children. She was adamant about bearing a child before going for surgery.

The man had even thought of how to console her after the hysterectomy.

Needless to say, he was shocked when Zheng Ren bring up the possibility of alternative treatment.

Professor Rudolph Wagner turned and said, "Zheng, did I hear you mention adenomyosis?"

"Yes, professor," Zheng Ren confirmed.

"My lord, do you have a sure-fire way to treat focal adenomyosis?" the professor exclaimed, gesticulating wildly.

"It would only work for focal adenomyosis. A hysterectomy remains the only solution for diffuse adenomyosis."

"Staying back was the best decision I made. You surprise me every week," Professor Rudolph Wagner said dramatically.

"I don't think this counts as a surprise, professor. Focal adenomyosis has always been treatable."

"But no surgeon can guarantee success. Zheng, I hear the confidence in your tone and I believe you."

Zheng Ren waved dismissively. He was still in the midst of informing the family.

The young man stared at the foreigner whom Dr. Zheng had called the professor. Was he the expert on this case?

"Professor, sir, do you understand Mandarin?"

"Yes, but I'm a bit slow and I can't understand dialects," the professor replied.

"What is your expertise?" The young man stood and approached the professor, hope sparkling in his eyes.

He had visited hospitals more equipped than Sea City General Hospital and received negative responses from them all, filling with him justifiable doubt. Zheng Ren's suggested procedure was a last ditch effort in his eyes.

"Interventional surgery," the professor said.

The answer prompted the young man to bow before the professor. "Can I request that you operate on my fiancee?"

Professor Rudolph Wagner was taken aback by the man's gesture. His head swiveled to Zheng Ren and back again.

The man noticed the odd expression on the professor's face. Perhaps he had said something wrong.

There was an odd tension in the air.

"Zheng, did I misinterpret your words earlier?" Professor Rudolph Wagner asked quizzically.

"What words?"

"When you said you could treat focal adenomyosis through interventional surgery with confidence."

"No," Zheng Ren said.

"Then, why is this young man asking me to perform the surgery? I will likely have only half your confidence," Professor Rudolph Wagner said in confusion.

The young man was at a loss. He looked between the professor and Zheng Ren but could not decipher the relationship between the two men.

Zheng Ren smiled. He did not blame the poor fellow.

"Young man, I'm from Heidelberg University in Germany. The purpose of my visit is to invite Zheng to Heidelberg for a collaboration, to research new methods and build a new research lab. I believe only Zheng alone can perform this procedure," Professor Rudolph Wagner clarified.

The young man was stunned. When did Sea City have such talent?

Were they pulling his leg?

"If you agree to the terms, sign this. Preparations in the operating room are almost done," Zheng Ren said, tapping the paperwork in his hand.

The surprise remained on the young man's face.

"Relax. If I can't complete the procedure, we still have this German professor here, right?" Zheng Ren said with a smile. It did not matter whose skill was greater as long as it worked to reassure the family.

The young man's eyes glimmered with sincere gratitude. He gave both Professor Rudolph and Zheng Ren a bow of respect before signing the documents.

Zheng Ren received the paperwork and nudged the professor. Together, they departed for the operating room.

"Zheng, do your people not know you have the hands of God? Unbelievable," the professor remarked.

"Recognition is not important to me. As a doctor, my focus is solely on treating patients. That's all," Zheng Ren said, smiling.

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Chapter 320: A Northeastern Slang

On the operating table, the patient's lower body was held in place by a plaster cast, her breathing assisted by a ventilator.

"Why did it take so long? I thought the family was rather compliant." Su Yun was already at the operating table, all set and ready to go.

"The guy spotted the professor and requested he perform the surgery," Zheng Ren replied as he scrubbed his hands.

Su Yun's eyes widened before bursting into laughter.

He entered the operating theater in a sterile surgical gown, but as he was closing the lead door, his phone rang loudly from the inside the control room.

Zheng Ren halted. "Have a look."

Chu Yanran checked the number. "Emergency department," she called out.

It was one of Zheng Ren's fears: having one ongoing surgery while another emergency case required his attention. It was manageable with the added manpower, but still not ideal.

He made his decision. "Su Yun, go check on the emergency."

"Can you handle the surgery alone?" Su Yun asked while taking off his gloves, despite his faith in Zheng Ren.

"Yes."

"Zheng, I can step in as your assistant," Professor Rudolph Wagner interjected abruptly. "This pretty old lass's[1] condition shouldn't be too complex."

"..."

"..."

"..."

Zheng Ren and Su Yun were momentarily baffled.

Old lass? Pretty old lass?

The foreign accent and the Northeastern slang was an odd combination coming from the professor's mouth.

Su Yun held back his laughter as he removed his surgical gown, leaving for the emergency department while pulling on his white coat.

He wanted to ask about the choice of slang but prioritized emergency cases over gossip.

It could be anything from acute appendicitis to a major emergency. It was best to bring his A-game.

Although Old Chief Physician Pan was available, Su Yun did not want to trouble the old man unless it was critical.

In the operating room, Zheng Ren's brows furrowed. "Who taught you that?"

Professor Rudolph Wagner was amused by the question. His words had stunned the young doctors.

"Chang taught me. She said 'old lass' was equivalent to 'little miss' in this district," the professor said.

Chu Yanran pursed her lips to hide her laughter but her shaking shoulders betrayed her.

This joker, Chang Yue, was toying with the foreign professor.

The age gap between the professor and the patient was not wide enough to warrant the title.

"Scrub in." Zheng Ren swept the issue under the carpet. He would speak to Chang Yue later to convince the professor to leave. Although the man's presence had brought an international flair to their department, it was getting on Zheng Ren's nerves.

Professor Rudolph Wagner happily went to put on a lead apron and scrub in.

Zheng Ren began artery cannulation, placed the introducer sheath and inserted the guide wire.

When the professor was done at the sink, Zheng Ren said sternly, "Professor, be quick. I'm switching on radiation."

The professor was taken aback. He struggled to find the words as he said, "Zheng... Boss Zheng, it's too soon to turn on the equipment. The radiation is bad for you. The X-rays may be directed but scientific—"

"The guide wire is already in position. If all you want to do is talk, please stay in the control room," Zheng Ren said, interrupting the professor's lecture.

He had gone off to scrub in and this man had already reached the target site? Professor Rudolph Wagner was filled with disbelief but he quickened his pace to keep up.

Chu Yanzhi laced up his sterile surgical gown and sent him back inside. The lead door shut tight. Without waiting for the professor, Zheng Ren commenced imaging.

[Another international surgery... Can we request some neurosurgery?]

[Neurosurgery would be a good topic to livestream. It'll definitely benefit us, broaden our horizons.]

[Quiet down. The surgeon is treating an adenomyosis patient. I'm not familiar with this disorder and am looking it up on Moudu[2].]

[You're a doctor but you need to search for a disorder on Moudu? Embarrassing.]

[Adenomyosis is a complex disorder that's hard to cure, according to Moudu.]

Routine banter picked up as the livestream started on Xinglin Garden.

By the time Professor Rudolph was done and ready to assist, Zheng Ren was already analyzing the imaging display.

"Boss Zheng, you didn't perform superselection before imaging. Isn't that too reckless?" the professor commented.

Zheng Ren had once thought Su Yun's snide remarks unbearable, but Professor Rudolph Wagner's incessant commentary was far worse. He found himself wanting Su Yun back if only to remove the professor from the operating room.

He really had to get Chang Yue to make the professor leave.

Right now, he would much rather perform the surgery solo than endure the constant interruptions brought upon by Professor Rudolph.

The sudden change in salutations was definitely Chang Yue's doing as well.

He continued to ignore the professor as he completed imaging of the left uterine artery, where superselection continued; the guide wire ended up in one of its smaller arterial branches.

Ten minutes later, the professor was silent.

The procedure was a novel method in treating adenomyosis!

Accuracy of the superselection could rival that of a robot. Despite using a guide wire one size thicker than what Professor Rudolph was used to, Zheng Ren had managed to select each arterial branch on his first attempt and follow through with embolization. The process was repeated like clockwork.

Two vessels in and Professor Rudolph realized what Zheng Ren's plan was.

The man was using interventional embolization to eliminate all potential clusters that could develop into adenomyoma.

Reckless was the wrong word to describe this man.

Upon his realization, the professor assisted Zheng Ren in silence.

His change in attitude gave Zheng Ren a taste of what it was like to have an extremely adept assistant.

Su Yun was great but lacked knowledge of interventional procedures and methods.

The professor was able to sense what Zheng Ren wanted to do and make the necessary adjustments.

With him as an assistant, the surgery proceeded 30% quicker than usual.

[The surgeon's hands seem faster again. Am I the only one who noticed?]

[Yeah. I feel this surgery might be easier?]

[Hey. It's fine if you're uninformed but there is a line!]

Doctors who could not make sense of the procedure left the Xinglin Garden livestream. Most of the remaining viewers treated the livestream like a chatbox.

The few who actually understood the surgeon's methods turned off commentary and watched the stream in earnest.

A small-town interventional surgeon was off to a corner of his office, also watching on his phone with rapt attention.

The hospital prohibited phone usage during working hours.

Despite the rule, he did not want to pass up the opportunity to learn from an expert.

Adenomyosis!

It had come under his knife a few times, but most had been failures; even the successes remained mysteries to him.

He was curious as to what the surgeon would do.

[1] 老妹儿 is northeastern slang, referring to a youngest sister or a very young girl in general.

[2] A play on Baidu, the search engine.

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