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 321: A Habit of Surgeons - Read The Surgeon's Studio Chapter 321: A Habit of Surgeons Online - All Page - Novel Next

Chapter 321: A Habit of Surgeons

Initially, the interventional doctor could not make sense of anything as the superselective catheterization was not targeted. After reading through the patient's profile, though, he realized that the surgeon had no related imaging for visual reference.

It was a semi-urgent surgery.

Radiography revealed signs of abnormalities in the stratum basalis of the endometrium.

The tissue distribution was not homogeneous; it was thicker in certain areas.

What would he do in that position?

He put himself in the surgeon's shoes. In such a situation, superselection ought to be done to the 4th-grade artery. However, those arteries were extremely thin and challenging, requiring at least half an hour to successfully superselect even one.

I would take at least half a day to supeselect them all by his estimations, even though the arteriography only displayed a single side of the uterine arteries.

Onscreen, a thick and stiff guide wire successfully passed through a vascular curvature.

The interventional doctor fell into deep thought. He just witnessed a minor adjustment to the movement of the guide wire. How had the surgeon managed to do that?

He began twisting motions with his right thumb and index finger as if he was the one standing at the operating table carrying out the surgery.

After a while that seemed anywhere between a moment and an eternity, a lightning bolt shot through his mind and ripped an opening in its dark night sky.

Right! That was it!

Tilting the angle of the guide wire down by 15 degrees by twisting it between the thumb and index finger, with the middle finger as basal support, could ease it through a large curvature!

Despite staring at the screen, his mind was elsewhere.

The joy that had come with the realization that he could improve his skills suddenly dissolved into nothingness.

He watched in shock; the surgeon had completed all superselective catheterizations and embolizations while he had been processing their surgical technique.

There was a tightness in his chest. He knew there was a disparity in skill between himself and the surgeon, but he had not expected the gulf to be so wide...

Despite his sudden enlightenment, the interventional doctor could not see himself catching up with the surgeon; it only made the techniques and methods on display more apparent.

The distance between them grew further apart.

Hmm? This particular superselection seemed rather interesting. The doctor did not have time to sulk and focused on the surgical field.

He had encountered such an artery several days ago during superselection when performing interventional treatment of liver cancer.

No matter how hard he tried, he had been unable to finish the superselective catheterization.

However, this surgeon had made it seem like a walk in the park. The guide wire looked alive, smoothly swimming through the arteries.

From his angle, it ought to be done like this...

The interventional doctor once again moved his fingers accordingly.

In the interventional operating room in Sea City General Hospital, only the low hum of the machine was audible in the enclosed room. With Professor Rudolf Wagner assisting Zheng Ren with each superselection, the entire surgery was smooth sailing.

Each region with basal cell hyperplasia was embolized without any injury to the patient's normal endometrium.

The surgery was performed precisely, with so much detail that it was beyond the professor's current knowledge.

However, it was also done incredibly fast. Even for areas where superselection was more challenging, the professor watched Zheng Ren steadily insert the guide wire without any anticipated complications.

Professor Rudolf Wagner was bewildered. He knew that Zheng Ren was very skillful.

But could a man really be that good?

Within 30 minutes, the left uterine arteriography showed that all of the abnormal branches had been embolized. Even if he were equipped with a high-quality guide wire and conducting the surgery in a Heidelberg operating room, he would require at least an hour to finish everything.

Hmm, at least... maybe an hour and a half.

A few of those areas would have been insurmountable to him, as well.

The difficulty of this surgery was... incredible!

[I am so bored, can someone explain what the surgeon was doing?]

[He embolized the mutated areas of adenomyosis. It's very interesting, each step was absolutely enticing.]

[I can't understand at all cause I'm just a general surgeon.]

Several specialists were already mystified by Zheng Ren's methods of operation, let alone those without specializations.

Despite all of them being doctors, in such an era of sub-specialization, they only had a rough understanding of what had just transpired.

The discoloration of the mutated endometrium was apparent.

One by one, each region was embolized and radiographed by Zheng Ren. There were no longer any discolored mutated tissues on the left region supplied by the uterine arteries.

The surgery was halfway done.

After the guide wire was removed, he performed superselective catheterization on the right side of the uterine artery.

The surgery was successful. After half an hour, all the discolored regions on the right side of the uterine arteries were completely superselected and embolized.

Radiography confirmed that everything had cleared up.

When Zheng Ren removed the guide wire and the guide catheter, the surgery was over.

Professor Rudolf Wagner had been silent the whole time. Not a single word had left him up to the very end.

He had made the right choice staying behind!

Out of habit, Zheng Ren abruptly left the operating table, but noticed the professor doing the exact same thing...

Huh, was this a habit of surgeons?

Who would stop the bleeding if both of them left?

Su Yun was usually the one in charge.

Zheng Ren laughed. Since his clothes were still clean, there was no need for him to scrub in again.

He turned around and applied pressure on the insertion point with sterile bandages.

Only then did Professor Rudolf Wagner remember that he was not in a Heidelberg University operating room and that he was not the surgeon, but an assistant.

He turned around and said in embarrassment, "Mr. Zheng, leave it to me."

Zheng Ren did not hear the man as a chime rang in his ear.

[Emergency Mission: Save People from Misery Completed

[Mission: Treating symptoms but not the root cause is meaningless. Please complete one case of emergency rescue and cure the patient's hidden health condition. Surgery completion 100%, perfect review.

[Mission Rewards: 2,000 skill points, 20,000 experience points.

[Mission Time: 7 days, 2 days 7 hours 14 minutes spent. Remaining time awarded, 4 days 16 hours 46 minutes.]

Mission complete? There were more skill points awarded than usual on top of almost five days of surgery time. It was indeed a fulfilling mission.

Zheng Ren had never paid attention to it, however. In his opinion, the surgery was long-term and could not be treated like an emergency.

Were it not for the patient's continuous agitation, Zheng Ren would never have begun the mission even if it expired.

He felt as if he had returned to Imperial Capital. The abundant rewards aside, he had managed to practice TIPS surgery, and in doing so, earned more skill points.

The Grandmaster rank of 30,000 skill points had once been an unachievable peak to him. Looking back at it, the Legend rank of 100,000 skill points did not seem so impossible now.

Zheng Ren's mind was occupied by thoughts of how much more successful his surgeries would be at Legend rank as he put on the sterile bandages.; he was so zoned out that he completely ignored the professor.

Professor Rudolf Wagner was at a loss. Had he made Zheng Ren angry?

Occasionally, in exasperation, he would carry out tasks outside his responsibility to remind other researchers that he could fire them at any time.

Was Zheng giving the same hint?

...

...

Author's Note:

In one of the chapters, I saw some of you guys discussing the problem of binge writing. I dare not do that, and I won't. No matter the surgery, the first time would be more detailed, but any similar ones after will be summarized and breezed through. That's because I don't want to keep recycling the same old thing. For example, appendectomies have already faded from sight. TIPS surgery will also be relegated to the background soon after. There are many new and refreshing surgeries and cases to write about, so don't worry. The main storyline will focus on interesting and bizarre diseases and surgeries. I won't touch a lot on societal issues, it's too brutal.

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Chapter 322: Emergency

"Zheng... Boss, let me do it," Professor Rudolf Wagner said meekly, like a child who had made a mistake.

It did not matter to Zheng Ren who ought to be pressing on the wound. As he was about to turn down the offer, he remembered that he had an emergency to attend to as well.

"You take over, then," he said.

Only then did the professor proceed to put pressure on the wound to stop the bleeding, relieved. This time, he did not go on about surgical supplies in Heidelberg that could have reduced the time required for hemostasis.

Zheng Ren left the operating table and went to the changing room, keeping on the lead apron until he reached the operating console room.

"What condition is Su Yun dealing with?"

As he said that, Su Yun entered the room. "Hmm? You're finished?"

"What kind of patient was it?"

"Acute appendicitis, laparoscopic appendectomy. I brought along Yang Lei and finished the surgery," Su Yun said as he approached the operating bench, examining the images from the surgery.

"Boss Zheng, your temple is too small for its deity," he teased, "I bet Professor Rudolf hasn't done such chores for several decades."

Through the leaded glass, Zheng Ren glanced at the professor in the operating room diligently applying direct pressure for hemostasis, and felt nothing out of the ordinary.

It was just a normal task that needed to be carried out by hand.

The professor was also human; there was nothing fantastic about him.

More importantly, the professor's skill... there was nothing exceptional.

Fifteen minutes later, the bleeding stopped and some of them transferred the patient carefully onto the stretcher trolley. As his family members held the elevator open, Chu Yanran sat on the trolley and pumped the breathing bag all the way to the ICU.

The patient would be in much less pain after post-surgery acute ischemic necrosis.

Even the pain of ischemic necrosis was incomparable to the fourth-grade agony of adenomyosis.

Zheng Ren was finally relieved, having completed all the surgeries at hand.

From the ICU, he went to the gastroenterology department to check on the TIPS surgery patient, who was recovering well with no hematemesis since the night before. There was only a slight increase in blood ammonia levels but no signs of hepatic encephalopathy.

His condition was promising. Zheng Ren decided to practice another round in the System's operating room before the next scheduled TIPS surgery.

Practice was not affected by luck points, which made it a true reflection of his basics. Successful training surgeries in the System meant that he would perform better in reality.

He returned to the emergency ward. It was as if the whole world had quietened down.

Zheng Ren sat on a chair and recalled the events of the past few days. He did not feel any less busy with flexible shifts.

From this point onward, he would probably be called from "home" to perform surgeries every day.

Such was life.

...

The patients in the ward were all stabilized. Zheng Ren went for lunch and had a 30-minute nap before waking up to read.

At 3.30 p.m., he brought Su Yun to the emergency department to check on the observation unit.

Zheng Ren decided to leave work on time if it was not too busy and there were no misdiagnoses. He was still deciding whether to treat Xie Yiren to dinner or a movie...

Whenever he thought of movies, Su Yun's story resurfaced and haunted him.

New Year's Day was around the corner. There had been an outbreak of influenza over the last few days and the emergency ward was filled with patients.

Zheng Ren heard a doctor from the emergency internal medicine unit complain about running out of Tamiflu.

This was beyond the pay grade of a chief resident. Zheng Ren decided to report it to Old Chief Physician Pan.

Suddenly, the high-pitched ring of the 120 emergency call began to blare, but Zheng Ren did not pay it much heed.

There was a special 120 emergency team with specifically assigned paramedics.

A nurse picked up the phone right as the bell pierced the air.

A few seconds later, a doctor and nurse came running from the office with an emergency toolkit, heading for the side door. There was a 120 ambulance parked outside it at all times like a soldier poised to charge into battle.

Wondering wha patient it would be, Zheng Ren walked to the chief's office.

As he raised his hand to knock on the door, it suddenly opened and Old Chief Physician Pan rushed out with a serious expression on his face, shouting down the corridor, "120 dispatch, hold on!"

Zheng Ren froze.

The 120 ambulance had to adhere to a strict schedule. They had to be dispatched within three minutes of a call.

What was Old Chief Physician Pan trying to do?

"There's an accident in the No. 9 Elementary. They reported someone with serious injuries. The city council called and requested specialists join in with the emergency rescue," Old Chief Physician Pan said sternly, "I was about to, but since you're here, you should go."

"Yes!" Zheng Ren replied immediately.

He turned and sprinted to the side door.

No. 9 Elementary was the ninth elementary school in Sea City. 120 command had contacted the hospital just as Old Chief Physician received orders from the city council.

They had bypassed the hospital's top management to save time. Zheng Ren could feel the tension in the atmosphere.

As for what had happened, Zheng Ren dared not and did not want to guess.

A few years back, there had been brutal assaults in kindergartens and elementary schools in other cities. Zheng Ren despised such people; no one had the right to take revenge on society by attacking those places.

These people were scum, cowards who were too afraid to attack adults and chose to lash out at children instead!

Zheng Ren rushed to the 120 ambulance and jumped in, closing the door behind him and saying in a commanding tone, "Turn on the sirens and drive as fast as you can!"

"Okay!" the driver answered, and the siren began wailing.

"Is the ventilator functioning properly?" Zheng Ren began checking on the ambulance's equipment.

"Yes, we check them daily," a nurse replied.

Ambulances in the city had been standardized a year ago. They were all Mercedes-Benz, equipped with aspirators and oxygen supplies.

"What about the others?"

"There are designated staff to check the endotracheal intubation packages, surgical kits, central venous catheter puncture kits, dextrose and emergency drugs," the nurse answered immediately.

Under normal circumstances, medical staff would usually joke around before receiving patients.

However, the nurse could clearly feel that something was not right.

Old Chief Physician Pan's unnatural orders and Zheng Ren jumping on board were signs of a serious emergency.

Zheng Ren did not slack and continued checking the equipment and supplies.

It was as the nurse had told him: everything was in order, from emergency medication to machines like aspirators and ECG monitors.

The caterwauling siren sent Zheng Ren's heart rate over 100 beats per minute.

After a few minutes, he had checked through everything and finally relaxed a little, sitting down and closing his eyes to conserve energy.

He was like a soldier resting during an intermission, cautiously waiting to return to the front.

Suddenly, the ambulance turned abruptly, causing Zheng Ren to stumble.

He frowned. Could there possibly be traffic obstructions ahead? Every minute, every second was crucial. It would be disastrous if they were held up in such a situation.

He stood up, trying to look out of the small window, but the ambulance made another sharp turn and almost sent him flying.

What was happening?

After altering course twice, the ambulance gradually slowed to a halt.

...

...

[This incident was a mashup of two current events.]

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Chapter 323: Run Over

"What happened?" Zheng Ren yelled, opening the window between the rear compartment and the driver seat.

How could he be calm when the ambulance was not at full speed during an emergency?

"Chief Zheng, there's a vehicle in front of us blocking our path," the driver said helplessly. He had tried to change lanes several times, but a sports car in front of them had continually gotten in their way. It was impossible to outrun it, too.

Furthermore, it was approaching the evening rush hour and traffic was already building up.

Most private cars and taxis were more considerate and would usually move aside for the ambulance when they heard its siren.

This was a life and death situation. Most people understood its urgency; reaching home slightly later or having a late dinner were nothing in comparison. If they were able to, they made way for the paramedics.

However, this sports car was blatantly obstructing them. They could even hear its roaring engine from inside the ambulance even though it was not accelerating.

In fact, the car was actually slowing to a crawl of 30 to 40 miles per hour.

Normally, they would simply overtake it by changing lanes.

No matter how they tried to, however, it immediately moved to cut them off.

Sh*t! Zheng Ren was fuming in anger.

That bastard had to be drunk driving!

Since it was not dinner time yet, the driver had probably not sobered up from lunch drinks. Otherwise, no one in their right mind would publicly provoke an ambulance.

This was not the first time Zheng Ren had encountered such a situation, but right now, they were on the way to an emergency rescue in No. 9 Elementary school!

After several attempts to change lanes, the ambulance was still beholden to the more agile sports car. A few other drivers were also outraged on their behalf and honked their horns, those with shorter tempers even winding down their windows to shout at the offending driver.

The ambulance driver was frustrated. Their stretcher-bearer in the passenger seat had already called the police.

However... doing so would not help in such a situation.

If they waited for traffic officers to resolve this, it would be too late for No. 9 Elementary School.

Every second was crucial in an emergency rescue! Why was this happening to them?

Surprisingly, traffic officers reached them quickly. A police car was there within a minute.

Its siren began wailing as it pulled up next to the sports car.

By loudspeaker, the officers instructed the sports car to pull over, but its driver continued to ignore them and kept idling.

The ambulance driver swore. "Damn it!"

Zheng Ren knew that verbal abuse would not solve the problem, despite being so furious that his jaws were clenched together like a vice, his teeth gnashing audibly.

He was normally a mellow person, but this was one of the rare times his anger was stoked.

"Pull over and let me take the wheel," Zheng Ren said, his expression wrathful.

His tone surprised the ambulance driver, who knew the chief resident to have a good temper and unfaltering smile. The security guard, Fan Yianshui had praised Chief Zheng for performing a surgery on him for free and even followed it up with a job offer.

Was this the spark that had finally set off such a well-mannered man?

Was he planning to drive? Would he be able to overtake the car in front of them? Impossible! The ambulance driver was himself a trained professional, not a standard car owner.

The ambulance was a mid-sized vehicle. Despite being a Mercedes-Benz, it was more known for its stability and interior equipment, while its other performance metrics were incomparable to that of a sports car.

Was Chief Zheng losing his mind in desperation... the ambulance driver felt helpless. He wanted nothing more than to run over the sports car, but the thought of it costing as much as his annual salary if he so much as made a scratch stayed his hand.

"Stop the vehicle! I'll drive!" Zheng Ren roared again as the ambulance driver hesitated.

Left with no choice, the driver obeyed.

In front of them was a Porsche 911, its black frame glistening under the rays of sunset.

Its first impression on those who saw it was how expensive it was. A second look only drove the point even further.

The car seemed satisfied as the ambulance stopped, coasting slowly alongside the police with nary a care in the world for doctors nor traffic officers.

Another order came through the loudspeaker on the police car demanding the driver pull over, but the only response it got was a window rolling down, followed by a rude gesture.

How arrogant!

How ridiculous!

However, the driver had not expected Zheng Ren; the man did not care for the cost of the Porsche 911 before him or the financial background needed to afford such a grandiose car in the first place. To him, these things were meaningless.

Zheng Ren quickly slid into the driver's seat and told the nurse to fasten her seatbelt before ramming on the accelerator. The ambulance began to charge like a beast baying for blood.

Its engine revved and kicked its massive bulk into gear.

The wind was howling!

The ambulance was roaring!

Its driver was screaming!

The ambulance bellowed and thundered forward!

The driver of the Porsche 911 was stunned by the sight of the ambulance charging at him in the rearview mirror.

Both vehicles were very close to each other, but although Zheng Ren owned a driving license, he had no actual experience and the ambulance did not pick up immediately when he floored it.

Nevertheless, it was like a giant in comparison to the sports car.

The police were also shocked by his move, immediately braking to avoid colliding into the other two vehicles.

Bang! There was a thunderous crash, but the ambulance only rocked a little with no serious damage.

Since the Porsche 911 had a mid-engine, rear-wheel-drive layout with its trunk in front, it had no buffer for the impact. Its driver scrambled to control his car after the collision, but the engine died.

Zheng Ren braked, backed up and stepped on the accelerator again. The ambulance charged at the Porsche 911 once more and rammed it off the street completely, sparks flying as the two vehicles ground against each other.

The driver of the Porsche was already stupefied; he could only raise his hands and stare blankly at the ambulance grating against his car with a piercing screech.

After running over the Porsche 911, Zheng Ren pulled over.

"Back to you," he said calmly, no sign of anger on his expression.

The ambulance driver was still in shock from the decimation of car before them, which cost anywhere between one to two million yuan

Chief Zheng's composed demeanour, like someone who had done such a thing before, sealed his lips. He returned to the driver's seat and pumped the siren to maximum volume.

Zheng Ren alighted from the ambulance and turned to see two traffic officers in front of him.

"Dr. Zheng?" they said at the same time.

He frowned. The two seemed familiar, but he had forgotten where he met them.

"Dr. Zheng, where are you heading to?" the older officer asked.

"No. 9 Elementary."

"I'll handle this; you escort them and clear a path for Dr. Zheng," the older one informed his compatriot.

The latter officer ran back to his car and began to maneuver into traffic.

Without another word, Zheng Ren jumped right back into the ambulance.

The ambulance driver followed, his foot unrelenting on the accelerator.

Police and ambulance sirens blared together, tearing apart Sea City's peaceful evening.

As they sped by, every other vehicle made way for them. No one had seen a police car escorting an ambulance before, their wailing sirens bearing a grim banner.

Something major had to have happened!

If not, they would not have both their sirens on at the same time!

With their path clear, they reached No. 9 Elementary School of Sea City within minutes.

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Chapter 324: Blood Runs Cold

Sea City's winter fog was thick and oppressive.

Beyond several meters, visibility was reduced to layers of white mist.

In the field of the No. 9 Elementary School, children were trembling in fear. Their crying and shouting could be heard through the fog like shrieks of demons.

There was a pool of blood on the path between the teaching building and the main entrance.

Only ten minutes ago, a man in his forties armed with a sharp blade had appeared like an evil spirit just as students finished their classes.

Their happy chatter dissipated instantly, leaving only horrifying reality.

A class teacher, Yang Lili, had been 24 this year. She had just graduated from a teacher's university with a heart full of aspirations and passion.

She had the habit of seeing the children off at the main gate. The smiles on their faces kept her dreams happy and positive.

It was foggy as usual, but the man's sudden presence had broken the normal routine.

Yang Lili responded quickly, almost instinctively.

She yelled at the top of her lungs when the attacker appeared, throwing the books in her hand like weapons to attract his attention.

However, it was a futile attempt. He did not dare face an adult; his only targets were harmless children who could not fight back.

Despite being terrified as well, the children's screams instantly pushed her fears aside.

She faced the attacker head-on and was stabbed twice in the chest as she used her body as a shield.

As life faded from her in agony, she remained determined to continue fighting, using her last breath to wrap herself around the attacker's knife hand and blocking his way with her body.

She had then been stabbed multiple times in the abdomen.

The young woman had been powerless to fight back, but she had given it her all.

As if by ritual sacrifice, Yang Lili had given her life in exchange for the safety of the children.

The attacker had been scared off by other teachers arriving. His knife lay abandoned in the snowy ground nearby, covered in blood.

It had turned cold, the blood on it frozen to ice.

In the face of such a bloody scene, the male teachers were also shocked and paralyzed. After calling 110 and 120, they notified the principal.

They did not know how to deal with the situation. Yang Lili's face was pale like white paper smudged with red ink.

Her youth pooled underneath her, leaving her a cooling husk.

They dared not move her body for fear that it would worsen the injuries.

A female teacher close to Yang Lili knelt beside her, frantically trying to stop the bleeding. Both her hands were covered in fresh blood.

However, there was nothing she could do.

A male teacher gathered the courage to tear some fabric from his shirt and tried his best to put pressure on Yang Lili's wound to stop the bleeding.

Alas, it was pointless.

Soon, the cloth was soaked in blood that flowed like a winding stream and froze solid not far away.

Some of the children she had saved were still dazed and confused. A few were wailing loudly while others were catatonic. They were like a helpless flock of sheep.

Ten minutes later, police and ambulance sirens began to approach.

They pierced through thick layers of fog like a beam of light, bringing them a glimpse of hope and the future.

The ambulance skidded to a halt near Yang Lili's body.

Zheng Ren leapt out with a first-aid kit in hand before the vehicle had even come to a stop.

"Move aside!" he roared at the crowd, shooing them away so that he could reach Yang Lili.

The System's monitor at the upper right corner of his vision was blinking with a glaring red.

Hemorrhagic shock, punctured lungs and mediastinal, traumatic hemopneumothorax, punctured superior mesenteric artery, punctured intestines and over ten other diagnoses were flashing a ghastly red like a devil's grin.

Zheng Ren's ears rang with the chime of a System mission.

[Sudden Mission: Hope in Darkness.

[Mission: Save teacher Yang Lili who had been brutally injured protecting her students.

[Mission Rewards: 500 skill points, 100,000 experience points.

[Mission Time: 6 hours.

There will always be darkness in the world, but no matter when and where it appears, there will be hope, of which you are its light.]

It did not register. His mind was working at full capacity to process the patient's situation.

With more than ten injuries present, they naturally differed in urgency and significance.

Since time was running out, any misjudgment would result in a delay in rescue and cost the patient her life.

"Load her up; prepare the surgical tray, suture kit and infusion set," Zheng Ren said hurriedly.

Already waiting for Zheng Ren's orders, the stretcher-bearer lifted Yang Lili onto the stretcher.

The nurse did not know what Zheng Ren was planning but followed standard procedure and efficiently prepared the things he would need.

"Open a bottle of saline!" Zheng Ren hastened his instruction when he saw Yang Lili's already weakened breathing starting to accelerate.

The stretcher-bearer loaded Yang Lili onto the ambulance and folded up the stretcher before shutting the door.

The ambulance whizzed away, leaving only a bloody floor and a crowd of ashen-faced, terrified people.

Unable to detect any blood pressure, the first thing the nurse did was to cut open Yang Lili's clothes, exposing the surgical field for Zheng Ren to prepare for subclavian vein catheterization.

When Zheng Ren got into the ambulance, he ignored the catheterization set the nurse passed to him and instead ripped open the first layer of the suture set, pouring its contents into a surgical tray.

"Iodophor," he said as he put on sterile gloves.

The nurse opened the jar of iodophor cotton balls for Zheng Ren.

He pinched the cotton balls between his fingers and began disinfecting the right section of Yang Lili's chest.

It was the second intercostal space along the midclavicular line.

After disinfection he picked up a surgical blade. He did not have the time to attach it to its handle and simply made an incision with the bare blade between his fingers.

There was no blood. It was currently all over the school grounds.

Zheng Ren then used the blade to cut open the infusion set and grabbed the infusion tube.

"Saline."

After blunt dissection, he used hemostatic clamps to insert the tube into Yang Lili's chest cavity through the incision he had made.

The other end of the tube was connected to the bag of saline.

The saline gurgled, and fresh blood began to flow.

Zheng Ren unpacked the suture set, used the needle holder to secure the reverse cutting needle and started stitching the infusion tube in place.

"Disinfect the subclavian artery," he said as he did so.

He was slightly disappointed that it was not Xie Yiren beside him. There would be no need for words if she were.

In less than twenty seconds, he completed the suture and secured the infusion tube in its position. Then, he opened the central venous catheterization set and changed into a new pair of gloves before performing the procedure.

He punctured the subclavian vein and hooked the patient up to low molecular weight dextran. The nurse also added a pressured infusion set to increase the rate of infusion into the patient's circulation, hoping to buy them more time.

The young police officer escorting them was aware of the urgency of the situation, speeding up and anxiously ordering traffic to make way for them via loudspeaker, fighting for as much time as he could for the ambulance.

Every second mattered.

...

...

Chapter 325

An ambulance was just a mobile emergency treatment facility.

The procedures that could be performed in it were limited.

Zheng Ren had set up a simplified version of a closed chest drainage system to ensure the patient's breathing was unobstructed and that she would not die of pneumothorax. He then used the suction tube to remove blood from her upper airway to prevent it from clotting, which would result in blockage of her airway.

On top of that, he applied pressure onto Yang Lili's stab wounds on her abdomen to reduce bleeding.

Faster! Faster!

Zheng Ren kept urging the ambulance driver on.

Sea City General Hospital and No. 9 Elementary School were not that far apart, but the thick metallic scent of blood heightened Zheng Ren's anxiety.

The ambulance would normally be unable to drive at such speed even with its sirens at maximum volume.

However, with a police car clearing its path, the combination of both sirens cut through the traffic between Sea City General Hospital and No. 9 Elementary. No one knew what happened but all gave way to the two vehicles.

Even at traffic lights, cars stopped to let the police car and ambulance by.

Inside the ambulance, Zheng Ren tried to calm himself despite the terrifying vitals on the monitor and the undetectable blood pressure.

He removed his blood-covered gloves and picked up his cellphone.

"I'm Zheng Ren. Prepare for emergency surgery.

"Yes, pre-operative procedures are not done yet.

"There's a blood sample, send someone to take the sample and prepare for transfusion.

"Notify the thoracic surgeon to meet me at the operating table. We'll be operating together.

"Ask Yanran to prepare the double-lumen endotracheal tube."

Upon hanging up, Zheng Ren frowned deeply. Yang Lili's breathing was very weak, with deep breaths taken at intervals.

Such breaths were commonly referred to as "gasping" for air on one's deathbed.

Her condition was very bad. He flushed the dextrose but there were no changes in blood pressure, which remained undetectable.

The police car and the ambulance sped all the way to the emergency department of Sea City General Hospital.

Because the attack had happened in a school, the city council informed Sea City General Hospital that they would be overseeing it closely. Director Xiao was already rushing over with his group. Old Chief Physician Pan stood beside the emergency lane with his hands behind his back, waiting for the ambulance. He did not chat with the hospital's management as his mind was focused on the emergency rescue plan.

Even though Zheng Ren was on the case, Old Chief Physician Pan was not slacking.

If he managed to develop a more comprehensive rescue plan, he could identify possibly overlooked details more easily, allowing him to pull off the emergency rescue.

Finally, the police car and ambulance arrived.

The high-pitched piercing of the police siren sent Old Chief Physician Pan's blood pressure skyrocketing and disrupted his thoughts.

Why were they being escorted by a police car? Why was there damage on the front and side of the ambulance? Old Chief Physician Pan was puzzled but had no time to think about it.

The police car moved aside for the ambulance to come to a halt and park steadily in the emergency lane.

The back door of the ambulance opened as a stretcher trolley reached it. They transferred Yang Lili onto the trolley and Zheng Ren ran towards the operating room with her.

Since this was a high-profile case, many from hospital management were there.

A few of them crowded over to make their presence known.

Zheng Ren pushed them aside as they were blocking the way, not caring who they were.

There was someone standing by at the lift. A dark red trail of blood dripping across the marble floor of the emergency building of Sea City General Hospital like a path of blooming flowers.

The nurse from the 120 ambulance passed several tubes of blood to a doctor who made for the blood bank. Their remaining blood samples would be sent to the lab in the emergency department.

Even though it was an urgent emergency rescue, they still had to go through standard protocol including testing for HIV and syphilis.

Two years ago, National Taiwan University Hospital had missed out on one point during an emergency and infected all their organ transplant patients with HIV.

Some procedures had to be completed, but they would omit steps that were unnecessary.

Zheng Ren ran all the way to the operating room on the third floor with the stretcher trolley.

Su Yun, Yang Lei, Xie Yiren, Chu Yanran, Chu Yanzhi and the operating room nurse were all already on standby. The operating room door was also wide open.

There was complete silence but for the faint sound of the stretcher trolley's wheels rolling against the marble floor.

Zheng Ren handed the trolley over to be delivered to the operating theater while he went straight to the changing room to prepare for emergency surgery.

This was very different from the emergency they had had in Imperial Capital.

When Fang Lin had been injured, he received treatment immediately. This time, however, the golden window for emergency rescue had been lost during the journey to the hospital.

Zheng Ren was not confident that he could save the patient.

Still, regardless of how he felt, he had to save her!

She had used her body to protect the children.

He needed to protect her in return at all costs.

After changing as fast as he could, he strode to the operating room while putting on his surgical cap and mask.

When Zheng Ren arrived, the patient was already on the table.

She was positioned slightly lower. Su Yun had considered the possibility of two concurrent surgeries.

He was in the midst of setting up the closed chest drainage system and did not choose the second intercostal space along the midclavicular line, instead inserting the tube between the sixth and seventh intercostal space along the midaxillary line.

The former option could remove trapped gases, but the latter could allow the drainage of blood. In the ambulance, Zheng Ren had been wary of draining a lot of blood, if the patient lost too much, it would lower her intrathoracic pressure and lead to even more hemorrhaging.

Things were different in an operating room.

"Where should we start?" Su Yun asked.

"Where's the thoracic surgeon?" Zheng Ren frowned and started scrubbing in.

"Almost here."

"Thoracoabdominal incision at... raise her right side by 45 degrees," Zheng Ren said.

General surgery required the patient be in the supine position, but thoracic surgery needed the patient to be in the lateral position.

Since both surgeries would be performed simultaneously, they had to compromise and choose between the two. Even though their surgical view would be restricted by doing so, it would be worth the time they could save.

Su Yun did not speak, moving the patient into the instructed position after completing the suture to secure the closed chest drainage tube.

"Double-lumen endotracheal tube." Zheng Ren walked to the operating table after scrubbing in.

"Got it," Chu Yanzhi said.

Chu Yanran also had no time to talk, being busy setting up endotracheal intubation and adjusting the parameters of the ventilator.

Xie Yiren passed him the oval forceps and kidney dish. Zheng Ren picked up several iodophor balls and began disinfecting.

After that, he scrubbed his hands again and put on a sterile surgical gown. As he did so, the thoracic surgeon and other directors of the hospital arrived.

"How's the patient?" Old Chief Physician Pan asked from behind Zheng Ren

"Not good." The latter reached out and the handle of the scalpel was put in his hand.

"Does she require a joined incision?"

"Punctured lung, most likely with vein ruptures that need to be treated. Intestinal punctures in the abdominal cavity while the superior mesenteric artery is also ruptured. I'm not sure the extent of the intestines we'll have to remove." After the incision, he had direct access to the peritoneum without the need for blunt dissection.

He opened its protective layer and removed the slightly colder, dark red blood via suction.

Seeing the continuous flow of blood, Old Chief Physician Pan immediately called to rush the blood bank.

Right then, a continual supply of fresh blood seemed to be the patient's only hope for survival.

"How's the situation in her chest? Is there a CT scan of her chest region?" the department chief of the thoracic department asked at the operating table.

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Chapter 326: Spare No Effort

"No." Zheng Ren handed suction over to Su Yun before opening the peritoneum and performing protective procedures.

The department of thoracic surgery chief's surname was Zhang. He was rather short and stout, an unpleasant sight even in a face mask.

In the hospital, he was well-known to be stingy and petty. People rarely interacted with him unless it was important.

Chief Zhang felt somewhat awkward in front of the operating table, hesitating.

When Old Chief Physician Pan returned from his call to the blood bank, he saw Chief Zhang standing unmoving and glared at the man.

He did not blame Zhang for lacking the courage to start operating, though, since Yang Lili's blood pressure was still undetectable. The chances of her surviving both a thoracotomy and laparotomy were very slim.

"Let's perform a thoracotomy with exploration," Old Chief Physician Pan said as he watched Chief Zhang mull it over.

Were there fewer directors present in the operating room, Chief Zhang would have rejected the surgery.

He wanted to ask why they were putting in so much effort to save someone who was already dead.

Blood pressure was still not showing up on the monitor. The patient's heart rate was also extremely high and she had already been tachycardic for a while.

He watched the surgeon perform emergency general surgery at lightning speed. Within only several minutes, the surgeon had already found the ruptured superior mesenteric artery and started a suture.

Chief Zhang let out a sigh and said, "I'll try my best."

"Su Yun, help Chief Zhang," Zheng Ren said without lifting his head. He reached out and received a saline-soaked bandage, which he used to cover the intestines while searching for both necrotization and stab wounds.

Hmm? Chief Zhang was stunned. He glanced at Old Chief Physician Pan out of the corner of his eye, noticing no opposition to Zheng Ren. Many questions arose in his mind.

He was aware that the emergency department had "taken over" emergency general surgeries. Were they going to absorb emergency thoracic surgery as well?

There were few people in the emergency department, but they were definitely ambitious.

Without looking at Chief Zhang, Su Yun turned and left the operating table. He began to disinfect the area for thoracic incision, proceeded to scrub in again and changed into a new surgical gown.

Chief Zhang felt helpless. What the f*ck was happening?

Nonetheless, he could not lash out in front of so many superiors. More importantly, Old Chief Physician Pan was a figure he dared not offend.

If he did... Liu Tianxing was still hospitalized and word was that his depression was so severe his liver was affected.

One had to surrender to fate when the time came. Chief Zhang started by asking the emergency department operating room matron for permission to use a sterile bag from the thoracic department surgery theater.

Su Yun ignored him and started to lay out sheets after scrubbing in and disinfecting the area. He stood beside Zheng Ren and both surgeries commenced.

Xie Yiren became even busier.

For such an unconventional surgery, mutual understanding without verbal communication was impractical.

Zheng Ren and Su Yun continually asked for different tools and Xie Yiren was barely keeping up.

After Chief Zhang had finished briefing the operating room matron about his department's sterile bag and ordered his own chief resident to retrieve it, he turned to see Su Yun making an incision on the patient's chest and was instantly angered.

"Stop playing around! You're going to operate rashly without a retractor? This is a thoracic surgery, not your usual emergency surgery!"

He was right; for the ribs in the chest, special tools were required to retract the chest walls and expose the surgical field. General surgery had self-retaining retractors, but thoracic surgery was different.

Only two decades ago, thoracic surgery required the removal of one rib to expand the surgical field.

Even though his worries were reasonable, every minute and second in an emergency rescue was more precious than gold.

Su Yun was focused entirely on the thoracotomy. He had the confidence and pride of a rising star in cardiothoracic surgery. Why would he bother with complaints from a department chief of Sea City General Hospital?

No one else acknowledged Chief Zhang. Zheng Ren and Su Yun were busy with their respective surgeries. Behind the former stood Director Xiao and Old Chief Physician Pan, fully focused on the surgery and paying no heed to Chief Zhang's words.

He had no choice but to scrub in. Perhaps he had spoken out of turn.

The operating table was unable to accommodate the usual number of people for both surgeries. In the thoracic surgery department, at least three people were usually required at the table for a thoracotomy. At the moment, only Chief Zhang and Su Yun could fit.

Yang Lei then became the busiest person there as the first assistant.

He had to hold on to the retractor while passing the surgeons their tools.

Zheng Ren was also multitasking, glancing over to Su Yun to check how the man was doing.

Su Yun was executing his part skillfully just like a trained thoracic surgeon, even better than those specializing in general surgery.

Zheng Ren had told Su Yun to assist Chief Zhang due to his experience in heart transplants in Imperial Capital.

Would any emergency case be a challenge to someone who had performed one of the most difficult surgeries?

No way!

To support Su Yun, Zheng Ren selected a Master level skill book without hesitation and added it to the cardiothoracic surgery branch of the skill tree.

Yang Lili had been stabbed twice in her chest when clinging on to the attacker's arm out of desperation to stop him. After breaking free, he had stabbed her in the torso multiple times.

Fortunately, her liver and spleen were uninjured, but there were between seven to eight perforations in her intestines with some sections pierced right through.

The extent of contamination in her abdominal cavity was critical.

After repeated rinsing and suction with warm saline, he stitched up part of the mesenteric artery and they finally had a clear surgical field.

Repairing the perforated intestines was not a problem. Zheng Ren rapidly performed the suture and managed to fix it in no time.

The main threat was that the patient's punctured mesenteric artery could lead to mesenteric ischemia and necrosis. After the artery was sutured, the intestines relying on blood supply from the sealed portion would inevitably end up necrotizing.

Cutting and suture of the intestines was now their main task in the abdominal cavity.

Zheng Ren would have preferred an assistant, but he could handle it himself if necessary.

Soon, Yang Lei was helping Su Yun perform other tasks. For Zheng Ren, he only needed to adjust the retractor to help expose the surgical field.

Zheng Ren tied the knot and cut the excess thread on his own. The scissors magically vanished and reappeared at intervals without interrupting his hand movements.

There was about 60 cm of necrotized intestine, which was within an acceptable range. Any more would risk other postoperative complications such as short bowel syndrome.

15 minutes into the laparotomy, Zheng Ren had already removed the necrotized intestine and sutured the healthy parts together.

Right then, fresh frozen red blood cells and plasma finally reached the theater.

"Each of you, take one." Old Chief Physician Pan began warming a bag of red blood cells by hand.

Director Xiao watched the surgery with a deep frown.

Noticing the arrival of the blood bags, he got Office Director Ding to pass him one.

With the director of the hospital taking the lead, who dared decline?

A phone rang and the emergency room matron answered it. "The blood bank is empty."

"Office Director Ding, contact the city's central blood bank," Director Xiao said, "At least 20 units of red blood cells."

"Platelets and fibrinogen too." Su Yun was still perceptive of his surroundings even during a surgery.

Director Xiao was also from clinical surgery; he knew that even if the patient was fit to leave the operating table at that moment, she would face multi-organ ischemia-reperfusion injury and disseminated intravascular coagulation complications.

He nodded.

Officer Director Ding ran out to make the call.

Soon, he returned and whispered into Director Xiao's ear, "Director, the reserves of B-positive blood in the central blood bank are running low."

The entire city's supply depended on the city's central blood bank. Rarer blood types or those used more often were hard to maintain.

"Contact the blood bank and hospital; get them to find people with the corresponding blood type to donate blood. Hurry up!" Director Xiao continued to watch the surgery, his face grim.

"Yes." Office Director Ding immediately sprinted out of the operating room to fulfil his duties.

Under normal circumstances, even with an appropriate donor, the central blood bank had a cumbersome list of standard protocols that took up the entire day before any blood could be donated.

However, words from the director of the city's largest hospital carried some weight.

Zheng Ren felt relieved hearing them.

With the hospital's support, they did not need to worry about shortages of platelets and fibrinogen.

These two things were essential for the patient's survival, but it was very difficult to get them nowadays, especially fibrinogen.

Because of the lack of fibrinogen, many porto-azygos disconnection surgeries could not be performed.

After suturing the patient's intestines, they covered it with bandages soaked in warm saline for five minutes while Zheng Ren checked the abdominal cavity for any unattended injuries. After removing the bandages, he found some light bleeding on the anastomosis.

That was proof that there was no more necrotized tissue and that the anastomosis would not be a problem after surgery.

After several rinses of the abdominal cavity, they began to close it.

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Chapter 327: Stockholm Syndrome

Wash and close.

Zheng Ren operated skillfully. Even though every step was in order, each was so fast that it became a blur to observers.

Chief Sun had arrived and watched with wide eyes. He was aware that Zheng Ren was superior to him in surgery. However, Zheng Ren seemed a little rushed today and was going at full speed.

He had already given up trying to compete with these two from the emergency department, but when he saw Su Yun and Chief Zhang working on thoracic surgery together, he could not resist being a spectator.

Chief Zhang was an idiot, a poser. He had no idea what he was going up against this time.

Even though Chief Sun from the second general surgery department was unaware of both Su Yun's past and Zheng Ren's use of a Master level skill book, all that had happened thus far were as obvious a hint as morning bells.

He was perceptive enough to know that there would be quite a show today.

"Where are you at?" Zheng Ren closed the abdomen with his head lowered. The light of the surgical lamps was slightly dimmer than usual as one had been adjusted to illuminate the surgical field on the chest.

"I've sutured the punctured lungs and bronchial artery, currently checking other regions," Su Yun said, "Boss, come take a look when you're done. Something's not right with the mediastinum."

Zheng Ren acknowledged him.

They successfully closed the abdominal cavity. All procedures were completed under an hour.

"Dr. Zheng has exceptional skill," Director Xiao said, "Old Chief Physician Pan, you have a strong team."

"It's all from Zheng Ren. I didn't teach him much," Old Chief Physician Pan said seriously.

By then, the external surgeries on the abdomen had already been dealt with, but the chest surgery was still in progress and he was not yet in the mood for casual banter.

Blood began leaking slowly from the stab wounds on the abdominal wall.

Zheng Ren recognized it as a sign of increased blood volume due to heavy blood and fluid infusions.

He let Yang Lei suture the skin and a few other stab wounds before going to Su Yun.

Zheng Ren was unfamiliar with thoracic surgery. When he was an intern, he had only helped with the retractor while his teacher performed the operation proper.

Even though he had achieved the Master level in thoracic surgery, he was still cautious.

The patient had only a single functioning lung; her right lung tissues were like a deflated balloon, collapsed into a ball of mass.

Its middle and lower lobe had two punctures.

They had finished repairing the wounds and the chest cavity was filled with warm saline.

Chu Yanran turned on single lung ventilation and increased pressure to inflate the lung tissues, allowing them to check for any missed punctures that would lead to gas leakage.

Repair of the lungs was similar to that of the intestines. The skill it required was... basic.

Zheng Ren was very confident that Su Yun could complete it alone without Chief Zhang.

How would he call himself the rising star of cardiothoracic surgery if he could not do this?

"Boss, how long was the attacker's knife?" Su Yun asked.

"Approximately 30 cm," Zheng Ren said, his mind taking him back to the glaring red pool on a snowy ground.

"There's a slight possibility that her mediastinum was injured," Su Yun said immediately.

"Suction, with cover." Zheng Ren reached out a hand and an aspirator was placed in it.

"That should be it." Chief Zhang saw only a little red in the rinsing solution with no air bubbles and assumed the surgery was complete. "The punctured lung was successfully repaired. We can close up."

"We still need to check," Su Yun said.

"Who's the one doing the surgery!" Chief Zhang said in a low voice, "The longer the patient is under anesthesia, the less likely she will recover."

"I'm the one who'll be taking care of her in the ICU after surgery," Su Yun said nonchalantly, "Would you like to take over that, Chief Zhang?"

That was f*cking arrogant.

Chief Zhang was furious.

Nevertheless... he could not start a fight with Su Yun on the operating table, could he?

Winning the argument was one thing. Even if he did, did he really want to go to the ICU for the patient's postoperative care?

He knew that Su Yun excelled in intensive care medicine. Him, not so much.

Chief Zhang lifted his head angrily and looked at Director Xiao.

Director Xiao was also curious. What had given Su Yun the confidence to question the decision of a department chief during a surgery?

Under normal circumstances, they would close the chest even without absolute certainty.

"Let them try." Old Chief Physician Pan settled the matter.

Chief Zhang was fuming. He slammed the hemostatic clamps he had been holding onto the sterile sheets, turned around and left.

"You go over," Zheng Ren said.

Su Yun nodded. He raised his hands to chest level and walked around the operating table to stand where Chief Zhang did.

"Single lung ventilation," Zheng Ren said.

Chu Yanran followed the order immediately and the patient's right lung instantly deflated.

The two of them searched carefully around the pleura. A few minutes later, they found an open wound smaller than 1 cm on it, right beside the mediastinum.

The wound was small, almost like a scratch, a non-issue.

Had they not been careful enough, they would not even have noticed it.

Su Yun groaned. Zheng Ren saw the diagnosis on the System monitor on the upper right corner of his vision blinking red—esophageal rupture.

This wound was clearly much deeper than it looked. After the lung had been punctured, the knife had pierced through the mediastinal pleura and injured the esophagus.

"Time to open up and check on it." Zheng Ren reached out and received a scalpel.

Whether in general or thoracic surgery, Xie Yiren could gently pass the tools Zheng Ren needed into his hand.

This,

Maybe,

Was life.

No drinking or flirting, no obsession over money, no sweet-talking, no overflowing passions.

She knew what he needed right away when he opened his palm.

A life like this would be great.

There was no joy in Zheng Ren's heart. He was paying full attention to the patient.

The blade glided along the wound on the mediastinal pleura and opened it up.

Chief Sun's eyes lit up. He had a hunch that they were about to reach the highlight of the day.

Zheng Ren was truly remarkable. The man was dabbling even in thoracic surgery and was still so confident in such a situation.

Did monsters really exist?

He had never believed in such things. Anything could be improved through practice, and even an average person could perform surgery after practicing a hundred times.

However, since meeting Zheng Ren, he had begun to believe.

Both the first and second division of the general surgery department would never live down how emergency general surgeries had been "taken over" in this hospital.

Chief Sun was used to being careful throughout his entire career. Before this, he had been suffering under the oppression of Chief Liu, but only to a tolerable extent.

It looked like it was the thoracic surgery department's turn today.

Under the face mask, Chief Sun's mouth curled into a smirk. He was thrilled to see how the snobbish Chief Zhang would embarrass himself.

As long as there was company, even the most embarrassing thing was bearable.

He was not only the one who had failed to compete with the whelp, not out of incompetence, but because the whelp was a true monster.

The thoughts did not leave his lips.

He was more confident in Zheng Ren than in Old Chief Physician Pan.

Perhaps this was a different embodiment of Stockholm Syndrome.

Zheng Ren was unaware of Chief Sun's thoughts, having already entered the System to practice thoracic surgery in bulk.

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Chapter 328: A Successful Surgery

Since Zheng Ren was still in the middle of a surgery, he dared not waste any more time. He entered the System and bought a few surgery training hours.

The System's operating room emerged from the ground, bearing a simulation mannequin with a condition thoughtfully similar to Yang Lili's.

In that moment, Zheng Ren appreciated the System more than ever.

It showed him a clear purpose and he could get the training he wanted.

That was enough.

Zheng Ren did not get much surgery time as he only needed to do reparative surgery of the esophagus and mediastinal pleura. Five hours would be more than sufficient.

Esophageal repair differed from an esophagectomy. It was not a major surgery, unlike the removal of the upper esophagus.

The only skill required was suturing. No special techniques needed.

Zheng Ren was simply being careful by practicing for a few hours in the System's operating room. He was eternally afraid of slipping up and making a mistake, compromising the patient's recovery and even causing death.

If that happened, he would regret it forever.

Within five hours, Zheng Ren performed over 30 surgeries, all simple procedures to repair the mediastinal pleura and esophagus.

When his time was up, he exited the System.

He was still holding the scalpel in his hand. Su Yun asked, puzzled, "Boss, what are you thinking?"

"I think we may need to leave the gastric tube in for a few more days," Zheng Ren said, making up an excuse.

He made a longer-than-usual incision along the wound on the patient's mediastinal pleura, performed blunt dissection and found the esophageal wall.

As predicted, it had a lesion smaller than 0.5 cm.

Su Yun probed and pushed the hemostatic clamp through the esophageal wall. Had they not discovered it, the patient's digestive fluid would not have allowed the wound to heal, possibly leading to tracheo-oesophageal or bronchopleural fistulas.

Nevertheless, they had found it, and there was nothing further to worry about.

Old Chief Physician Pan's expression relaxed instantly and his chest rose even further.

Even without looking directly at Chief Zhang Linyou of thoracic surgery, his intentions were clear—you are inferior in diagnosis and surgery to even my subordinate!

Chief Sun was thrilled.

His confidence had not been misplaced, after all. Once discovered, an injury on the esophageal wall was but a small problem and could be resolved by leaving the gastric tube in for a few extra days.

Even without a suture, it would not pose any threat.

However, missing it would be a huge blunder.

Chief Zhang Linyou, today was finally your turn.

Chief Sun happily anticipated Chief Zhang Linyou's astonished expression, but looking around, the man was nowhere to be found.

"Where's Chief Zhang?" he chuckled.

"He just left," Chu Yanzhi replied instantly. She was having a hard time not speaking, but there were so many people around today and she could not be her usual lively self.

Although protocol called for as few people as possible in the operating room, this patient had been directly designated by the city council. Even the hospital director was present; any department chief who sat this one out would likely face a rocky road ahead.

The effect of their commotion on patients... was the least of their concerns.

Those present were used to and fully aware of such situations.

There had once been an old minister who had returned on a visit to his hometown, a rural village near Sea City. His journey had been challenging due to his tight schedule and he caught a cold.

There was no specific medication in the small hospital in his hometown. They had never even heard of specialized drugs for influenza such as Tamiflu and Peramivir.

He was prescribed three days of dexamethasone, but his symptoms improved significantly and he was so pleased that he heaped endless praise on the medical ability of rural hospitals.

When the old minister arrived at Sea City, everyone in Sea City General Hospital panicked.

How would they handle the case?

Treatment was normally followed by two to three days of recovery which would occasionally still present mild flu symptoms.

What would their betters think?

That Sea City General Hospital was inferior to rural health centers?

Was that not a ridiculous supposition?

Hence, Sea City General Hospital prescribed two days of dexamethasone to relieve his symptoms in addition to regular treatment.

After that... did all ministers not return to Imperial Capital? The doctors there were all experts and had plenty of tricks up their sleeve. [1]

It was strange, just like stories from unofficial history records describing how an emperor could not drink fresh tea, only old tea, as no one dared to speak otherwise...

As they said, a grasp of mundane affairs was genuine knowledge, and the understanding of worldly wisdom was true learning.

Today's situation was exactly the same: a bunch of people cramming themselves into the operating room as if afraid of being called out for their absence when an important patient was being rescued.

If they were accused of disrespect by someone with malicious intent... they would be f*cked.

Who would notice if somebody left in such a crowd? Only Chu Yanzhi, the girl with inexhaustible energy could notice that Chief Zhang Linyou had left after the lesion on the esophagus was discovered.

Su Yun smiled gently upon seeing the lesion. He reached out his hand but received nothing.

Zheng Ren was already ahead with a needle holder attached to a thin needle and thread.

Stunned, Su Yun clocked that Zheng Ren seemed rather familiar with the procedure. This could not be the man's first thoracic surgery.

He fell into a daze. What could this guy not do?

Zheng Ren's detailed sutures on the esophagus were also flawless. Were it Su Yun... he would still be better than Zheng Ren, but this was a fine job.

After stitching up the esophagus and mediastinal pleura, they washed the area and closed up the chest after observing no further blood in the flush.

"Boss, you seem rather familiar with thoracic surgery," Su Yun said.

"I'm just scratching the surface," Zheng Ren said.

Su Yun recalled how Old Chief Wang's jaw had almost dropped to the floor back in Imperial Capital.

The same tactic would not work on Su Yun a second time. Out of habit, he blew at his fringe, but the gust of warm breath was stayed by his sterile mask.

He shook his head.

Chest closure was slightly more complicated than that of the abdomen.

However, they had worked together for some time and complemented each other exceptionally, what more with Xie Yiren assisting. Suture, knot, cut; four hands flew about and between five to six minutes later, they had managed to close the chest.

On the other hand, Yang Lei was still in his own world of skin suture.

"This surgery is a success," Old Chief Physician Pan said after a look at the ECG monitor.

"Mm," Director Xiao said with his hands behind his back, "Pay strict attention to perioperative care. If there are any problems, just contact the medical administration and office. We have to ensure this emergency rescue is successful no matter what."

After his command, Director Xiao turned to leave the operating room.

Before he could complete his rotation, though, a panicked Ding Zhongtai rushed in and whispered, "Director, the ambulance rear-ended a Porsche on their journey. The driver is arguing with the police now."

"Hmm?" Director Xiao had not seen the scratches on the front of the ambulance and had no idea of the matter. He stared at Ding Zhongtai, confused.

Old Chief Physician Pan scoffed coldly and said, "The ambulance dashboard camera has all the footage. How dare he make a scene?"

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Chapter 329: Lil Fugui

"Little Zheng, what happened?" Ding Zhongtai asked.

"The car was blocking the way, so I knocked him aside," Zheng Ren answered nonchalantly.

Su Yun was taking off his surgical gown, but upon hearing his words, turned around and gave him a thumbs-up without a word as there were still a lot of people in the operating room.

"You can't just crash into him like that!" Ding Zhongtai exclaimed in horror, "Little Zheng, you're too... impulsive."

"Check the record on the dashcam." Zheng Ren was unbothered. He was on the side of reason this time, and with Old Chief Physician Pan backing him, he was not afraid of whatever came next.

"Also, did they take blood samples to test for drunk driving?" Zheng Ren added.

"Drunk driving?" Ding Zhongtai was confused.

"Yes, I suspect that he drank at noon and he's still not sober yet. His blood alcohol level should be enough to charge him with drunk driving."

At that, Old Chief Physician Pan took out his phone and made a phone call.

Zheng Ren and Su Yun transferred the patient from the operating table to a stretcher trolley bound for the ICU, with Chu Yanran pumping the breathing bag as usual.

As they left the operating room, Old Chief Physician Pan stopped Zheng Ren.

Su Yun was there to follow up on subsequent procedures. Zheng Ren's presence was unnecessary.

There was sufficient manpower at the scene, but even if there were not, the various department chiefs were not just there for display. It would not hurt for them to do some work.

Old Chief Physician Pan pulled him aside and quietly asked, "Zheng Ren, what happened?"

Despite looking a bit haggard—his hair was drenched in sweat—his expression was calm, and his tone even more so. He told the old chief what had transpired.

"Outrageous!" Old Chief Physician Pan bellowed.

Zheng Ren was shocked. He had never done such an adrenaline-pumping thing before and still bore some guilt; his initial impression was that Old Chief Physician Pan was rebuking him, but on second thought, he realized such a thing was unlikely.

"I made a call and the video recording is now in my office," Old Chief Physician Pan said coldly, "If someone tries to twist the truth, I will fight it to the f*cking highest court!"

Zheng Ren laughed and tried to calm the old man down. It was not worth it for such a person.

"What year does he think it is?" Old Chief Physician Pan slowly regained his composure. "I heard the guy was throwing a hissy fit in front of the traffic officers. Were it ten years ago, he could get away with doing this, but now? Hmph!"

Zheng Ren had heard of the incident before.

A drunk driver in the emergency department had resisted attempts to obtain a blood sample and threatened to self-harm.

Unwilling to escalate the situation, the traffic officers had no choice but to relent.

The incident had gone under the radar after a while.

However, Zheng Ren had heard through other doctors that drivers resisting blood alcohol tests would receive a warning. Three strikes resulted in an automatic drunk driving charge.

"You go ahead with your business. I'll take a look at the video and see who's this arrogant bastard." Old Chief Physician Pan left quickly.

Zheng Ren let out a long sigh. Although he had not done anything wrong, he was afraid of being sold out by people like Ding Zhongtai were it not for Old Chief Physician Pan's presence.

He would not be able to stand up for himself.

Such things happened all the time. Zheng Ren knew as much.

However, with Old Chief Physician Pan around, there ought not to be a problem. As for everything else, he would take them one at a time.

Why should he be afraid if he had evidence and reason?

What a joke!

Zheng Ren felt a little tired, not from the surgery, but from the incident with the ambulance.

He did not regret his actions. Even if it meant a permanent record, he would never regret what he had done.

The ambulance had been delayed for at least three minutes.

With those extra minutes, the patient would not have bled as much and her recovery could have been shortened by three days.

Had he not acted on his "impulse", she could have been dead by the time they reached No. 9 Elementary.

They would be pretending to perform CPR on the patient for ten to twenty minutes out in the snow in order to comfort the teachers and students of No. 9 Elementary.

The lowlife who had blocked their ambulance would not get the punishment he deserved and would continue living his lavish lifestyle.

Even if that outcome was not controversial, a true hero would be lying in the snow, quietly embracing her inevitable death.

Justice?

What justice!

...

...

In the emergency ward office, Professor Rudolf Wagner approached the clearly exhausted Zheng Ren. "Mr. Zheng, what emergency was it?"

He could sense the professor's Mandarin getting more fluent. The man was truly a savant at languages.

Nonetheless, Zheng Ren was surprised that the professor was still present outside office hours.

"The patient had been stabbed, sustaining thoracoabdominal injuries. Why haven't you left?"

"Chang said that I would need to follow local customs if I really wanted to blend in. Although I don't agree with the idea that only bad doctors leave work on time, doing so often myself, I stayed in case a patient needed interventional surgery."

"Go home, there's no need for that." Zheng Ren waved his hand weakly.

Professor Rudolf Wagner was all smiles. He seemed sincere.

As they spoke, Ding Zhongtai rushed in.

"Little Zheng, there might be some trouble this time," he said seriously.

Zheng Ren had mentally prepared himself. He refused to believe that he would lose.

Old Chief Physician Pan was right; things were not as they were ten years ago.

To Ding Zhongtai, Zheng Ren's poker face looked insufferably unaware of the severity of the situation, so he began to explain everything with a frown.

"Lil Fugui, is Chief Zheng back?" Chang Yue called from the corridor.

"He's back, Chang," Professor Rudolf Wagner replied.

Lil Fugui? What was that about?

Both Ding Zhongtai and Zheng Ren were dumbfounded.

"Mr. Zheng, I asked Chang Yue to name me.

"I thought I would need a Chinese name if I really wanted to be part of the local culture. Something everyone would like, something that sounds joyful. Even if I don't agree with it, I really like the word "fu gui"," the professor said with a chuckle.

Zheng Ren was speechless.

Ding Zhongtai had not noticed that professor's presence. He thought for a moment and said softly, "Let's go somewhere else to talk."

"Don't worry," Zheng Ren said with a smile and hand gesture, "There's nothing I'm afraid of letting others in on, so please proceed."

"The car was seriously damaged and the driver had minor injuries," Ding Zhongtai said sternly when Zheng Ren did not oblige him, "He's from a wealthy family in Imperial Capital, like his lawyers, who have already touched down at the airport and are currently heading right to traffic police command."

"Oh," Zheng Ren said casually, still unperturbed.

Ding Zhongtai let out a suppressed sigh at Zheng Ren's reaction. "Little Zheng, I don't want to judge you, but this concerns the hospital, you..."

As he spoke, Zheng Ren's phone rang.

It was from Chief Kong.

Zheng Ren accepted the call.

"Hello, Chief Kong.

"Ah, yes, I went to an elementary school in the afternoon for an emergency rescue, but the ambulance was obstructed. I was in a hurry, so I just ran the offender over.

"Okay, sure, thanks for your trouble."

He hung up.

Chapter 330

Ding Zhongtai's face scrunched up when he heard that it was Department Chief Kong from Imperial Capital calling. His ears perked up, trying to listen in on the phone conversation.

Zheng Ren's phone volume was too low for eavesdroppers, however.

"Little Zheng, how did Department Chief Kong find out?" Ding Zhongtai asked directly.

Communication with doctors on the ground was straightforward, in stark contrast to the guessing games that often happened within hospital bureaucracy. Ding Zhongtai paid close attention to Zheng Ren's eyes as if they could provide him his answers.

"Chief Kong only asked about the situation. I don't know how he found out," Zheng Ren replied. "He wanted to know if there was anything he could do to help. It's probably just a courtesy call, with him being so far away."

Ding Zhongtai scrutinized Zheng Ren's blank expression. Perhaps it was truly a greeting call... but how had he heard the news?

Ideas in his heads bounced about. Finally, a revelation struck him.

Without raising his voice, he said to Zheng Ren, "Little Zheng, while what you did was not wrong, we're under the scrutiny of the urban district for this high-profile case. You should be more wary next time."

"Next time..." Zheng Ren mumbled then smiled. "If I ever encounter this again, I'll just run them over without hesitation."

Ding Zhongtai cursed the young doctor internally. Zheng Ren was as stubborn as a rock. Did he think he was invincible just because he had a direct line to a department chief from Imperial Capital?

"Rest assured, the hospital will come to your defense. It's just... it's quite an expensive car." Ding Zhongtai was irked by the whole situation but maintained his mask. "Now that everything has settled down, you'll need to go to the traffic police."

"Sure." Zheng Ren stood and asked, "Where's the station?"

Zheng Ren had a driver's license but had never owned a car. Hence, he had had little to no interaction with traffic police.

"Oh. You go get changed and I'll take you there," Ding Zhongtai said.

"Boss Zheng, what is happening?" The professor had been in on their conversation, but they had been vague and he was not confident in his comprehension. Still, he gathered that Zheng Ren had run into some trouble.

"It's nothing. And please, Professor Rudolph, don't call me Boss Zheng," Zheng Ren said.

"Call me Ru Fugui, or Lil Fugui," Professor Rudolph said earnestly.

Zheng Ren ignored the man. His mind was elsewhere.

On the way to change his clothes, he rang up Su Yun to ask about the ICU patient.

She was stable, although her blood pressure was on the low end.

Her bleeding was under control now. With another 1000 or 2000ccs of blood transfusion, her blood pressure ought to return to normal.

Zheng Ren did not inquire about kidney and brain function. Such critical care information was beyond his expertise and for Su Yun to monitor.

Before leaving with Office Director Ding, Zheng Ren left a few instructions with Chang Yue.

They got into a car and made their way to the police station. Zheng Ren had no regrets.

If life gave him a second shot, he would do what he did again without hesitation.

It did not matter whether the car was a Porsche or Ferrari.

They were nothing compared to a human life.

Zheng Ren and Ding Zhongtai arrived at the station and made their way upstairs to the incident management center.

Old Chief Physician Pan was sitting with an old, stern-faced police officer. The rank badge on the officer's shoulder meant nothing to Zheng Ren but he concluded that the man held some authority in the station.

On the other side of the table sat a middle-aged man in a business suit. Behind him stood two young professionals, a man and a woman, taking note of the ongoing conversation in their books.

"The dashboard camera is evidence," the officer said as he leaned forward, the national emblem on his uniform gleaming.

"We'll have to authenticate the evidence, and I've yet to speak to witnesses. We can't have only one side of the story, yes?" the man in the suit said with utmost decorum, a polite smile on his face.

"Lawyer Ge, you're a big name in Imperial Capital. The suspect—"

"I'm sorry, Inspector. Let's not call my client that unless we're willing to call the driver of the 120 ambulance a murder suspect as well," Lawyer Ge interjected, the smile on his face unwavering.

Murder?

The bushy white eyebrows on Old Chief Physician Pan's face furrowed.

Old Chief Physician Pan and Zheng Ren were men of science, medicine and surgery. They were not well-versed in semantics and the black-and-white of the law.

Even the chief inspector was no match for the lawyer in this department.

After all, it was a lawyer's bread and butter.

At this moment, moral accusations carried little weight. There had been many cases over the years with blood-soaked evidence.

An example would be the shocking news reported by an established news agency in the south about an assistant maternity doctor who had wrongly sutured a woman's anus post-delivery.

The story was instantly sensationalized by the media and the truth was quickly drowned out by public outcry.

If that happened today, there would be individuals selling the news online and inseminating false information within social media groups to garner attention. The story would then be twisted by the public and immortalized in an unrecognizable form on the Internet.

Logic played no role in the modern world.

Resources would determine the last one standing.

The owner of the Porsche had managed to get a big-shot lawyer from Imperial Capital to travel all the way to Sea City within the span of a surgery.

It demonstrated the man's wealth, prestige and power.

All of these went unnoticed by Zheng Ren, whose worldview was as thin as his wallet.

Old Chief Physician Pan wanted nothing more than to slap the infuriating smile off the lawyer's face.

However, such an action would not help their case. He swallowed his anger.

"That is conjecture," Old Chief Physician Pan said, "The hospital's legal representative is on his way. It would be best if you spoke with him instead."

"The hospital's what?" Lawyer Ge's static smile revealed no change in emotion as he spoke. "To be frank, in the legal sector, most winning lawyers would start their own firm. Of those who can't win in court, only the dumbest go into consultancy."

The smile had a devious edge now.

"At least, that's the case in Imperial Capital. Sea City... Heh." Lawyer Ge did not bother to elaborate.

"I take it that this is the doctor who took over the ambulance?" Lawyer Ge had noticed Zheng Ren's appearance but had wanted to deliver his speech before acknowledging the young doctor.

"Your actions have been escalated to a criminal court, I will—" Halfway through Lawyer Ge's words, the female assistant's phone rang.

...

...

Chapter 331: Thick-Skinned And Unscrupulous

Lawyer Ge was not happy. His smile turned ugly as his mood darkened.

"It's for you," the female assistant spoke carefully, her smile forced. She could feel the displeasure radiating from Lawyer Ge.

"We're on a case. Personal calls are prohibited," Lawyer Ge stated.

"It's Chairwoman Lin," the assistant clarified.

Lawyer Ge's hands froze, then he relaxed and said to the room, "Pardon me, I have to take this call."

His hand reached out for the phone.

"Chairwoman Lin?

"Yes, we're at the police station. The suspect had caused intentional harm through his driving."

Despite having excused himself, he remained seated in place as he took the call.

It was a tactic employed to pressure a suspect.

Lawyers were unscrupulous and not above using dirty tactics.

A moment later, the lawyer's hands visibly clenched.

The smile on his face became a grimace.

He fell silent as the caller went on.

After half a minute, Lawyer Ge opened his mouth to speak.

"But—"

Shouting from the other end of the phone cut through the lawyer's retort. Zheng Ren could hear the anger reverberating through the speaker.

"Yes. Yes, I will handle it.

"Yes, you are right. We have to maintain a zero tolerance policy on this."

Lawyer Ge finally hung up.

The room was silent as all eyes fell on him.

From the tone of his conversation, there were some changes to be made. What did the future hold for this case?

"Dr. Zheng, my employer has informed me that I am to be your legal counsel for this case," Lawyer Ge announced seriously.

There was no hint of hesitation in his tone. Truly, he was a man of many faces.

He could change sides as easily as a coin flip.

It was a room-shaking revelation.

Zheng Ren took a moment to think and remembered Department Chief Kong's call. "Are you Sister Lin's lawyer?"

Sister... Lin...

It was rare to hear someone address Lin Jiaojiao so casually.

His eyes narrowed into pinpoints as he stared at Zheng Ren.

Without much fanfare, Lawyer Ge schooled his features and put on his characteristic smile.

The courts had been around for centuries.

During the Ming Dynasty, the Huizhou merchants were renowned for their economic prowess. Everyday lives of the people were simple and largely governed by the teachings of their ancestors. Larger expenses could be split into three categories: concubines, harlots and disputes.

As such, someone who could hire a personal attorney could also throw entire fortunes into the Qinhuai River.

A good attorney was hard to find, especially one who could play both offense and defense. Having a thick skin and no scruples were essential to the trade.

Lawyer Ge was exemplary in his work, and that excellence extended to his ability to switch sides at a moment's notice.

Why else would Lin Jiaojiao hire him as the group's legal attorney?

Why else would he be willing to come to Sea City at the drop of a hat?

Why else would he be smiling as he spoke to Zheng Ren now?

The dark aura surrounding Lawyer Ge dissipated.

"Dr. Zheng, Chairwoman Lin is the chairperson. I'm from the legal department and have little contact with her. You are her..." Lawyer Ge said.

"I'm not that familiar with her, either," Zheng Ren answered honestly.

Old Chief Physician Pan sighed. At times, Zheng Ren was too oblivious.

Although they had morals and logic on their side, having a professional lawyer would not hurt their case.

"I performed an emergency surgery on her back in Imperial Capital. Was that Sister Lin?" Zheng Ren explained, smiling humbly.

Lawyer Ge was responsible for legal processing and had read up on the incident during his flight to Sea City.

He had gotten the gist of it before arriving at the police station.

"Zhou Bai is one of Chairwoman Lin's partners in the franchising business. His family is wealthy. When Chairwoman Lin announced that she wanted a direct branch office in Sea City, he quickly packed up and headed over."

Zheng Ren listened to the lawyer talk but was getting bored by the second. He wanted to return to the emergency department. Even with no surgeries scheduled, he could read his book in peace in his office.

Despite his eagerness to leave, he knew he had to settle this incident.

"He wishes to gain a small position of power in the Lin empire. With Chairwoman Lin's blessing, I have full authority over the legal case and will proceed with a public disturbance charge."

Lawyer Ge knew little of Zheng Ren's character, so he studied the young doctor's face as he spoke.

Zheng Ren was daydreaming. He found the lawyer to be most uninteresting. Sure, the whole incident could be considered a form of public disturbance.

He wished he was back in the hospital, reading.

From Zheng Ren's inscrutable expression, Lawyer Ge could not gain any insight into the young doctor's mind. He gritted his teeth, money from the Zhou family long forgotten.

"If Dr. Zheng feels that it is insufficient, we can bump it up to a public endangerment charge. It'll be a sentence of three, suspended sentencing of one.[1]"

Sentence of three, suspended sentencing of one? What did that mean?

Zheng Ren did not understand what Lawyer Ge was saying.

He was exhausted after the emergency surgery, to the point where he was missing the faint minty smell of an energy elixir.

Lawyer Ge took in Zheng Ren's silence.

The kind face of the young doctor belied his cruel demeanor.

Public endangerment was a harsh charge for a criminal case and a three-one sentencing was quite a heavy punishment.

Was he still not satisfied?

Lawyer Ge felt a chill creep into his heart. Pleasing a vengeful client was the hardest part of a lawyer's job.

The fact that he had just threatened Zheng Ren made all this even more complicated. He could feel a guillotine hanging over his neck; one misstep and his head would roll.

"Understood. I will try my hardest!" Lawyer Ge did not know how far Zheng Ren was willing to drag the case but there was no need to show all his cards. A vague answer was best.

Suddenly, another phone rang. It was the traffic police chief's.

He checked the caller ID and left the room.

Lawyer Ge truly believed Zheng Ren was a difficult client to handle. "I have read through the accident report and will proceed with Chairwoman Lin's instructions. If I require any assistance from Dr. Zheng, I will personally pay you a visit."

"Is that all, then?" Zheng Ren asked.

"Yes, we're good for now. Zhou Bai will likely call for other lawyers but do not worry, I am an expert in court cases."

Lawyer Ge desperately wanted to emphasize his importance in the case. At that moment, the traffic police chief entered the room.

"Overtime tonight," the chief said.

He was addressing his subordinate.

An officer transcribing the conversation in his notebook stopped. Had there been a major accident that required them to work overtime?

"The Provincial Government Department wants to drop in," the chief continued.

[1] suspended sentencing (缓刑, also translated as a sentence "with reprieve"): sentencing does not immediately follow the guilty verdict, but is instead determined after a period of probation.

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Chapter 332: Unnecessary Tests?

The traffic police chief escorted Zheng Ren's group out of the police station.

The involvement of the Provincial Government Department meant that a criminal charge was imminent.

Old Chief Physician Pan knew his worries were for naught.

Intentionally obstructing an ambulance responding to an emergency was a heinous act, but it was most certainly not the first of its kind.

This time, however...

Old Chief Physician Pan said nothing more for fear of distracting Zheng Ren from his work. He parted ways with the young doctor and went home to further understand the situation.

Ding Zhongtai had had a shocked expression ever since Lawyer Ge renounced his loyalty and came to their side.

Yet again, he realized he had underestimated Zheng Ren.

He recalled his interaction with Zheng Ren in the emergency department. Had he sounded rude or offensive? Perhaps he had been a tad agitated, but he was glad he had not berated Zheng Ren.

He ought to be safe.

Office Director Ding absent-mindedly drove Zheng Ren back to the hospital.

He tried to invite the young doctor over for a meal but was unceremoniously turned down. Zheng Ren wanted to check on the patients in the emergency ward.

It was an ironclad reason. Ding Zhongtai let Zheng Ren go and went to report to Director Xiao.

...

After disembarking, Zheng Ren took a few breaths of fresh air to clear his mind.

Crowded places were a source of frustration for Zheng Ren.

Being back at the hospital rejuvenated him.

He headed for the emergency department. Its chaotic environment brought him peace.

There were a few patients who were in for surgery, mostly for internal diseases such as gastritis and influenza.

Snowfall had fled the Northeast for the Southern region.

Heavier snow had catalyzed the spread of influenza, which started as a mild fever on the first day and worsened into a 40-degree Celsius fever within 24 hours.

The queue for consultation stretched throughout the corridor. Community clinics were able to handle the common cold, but influenza patients were quickly directed to Class Three Grade A Hospitals.

Nurses were running left and right, replenishing IV drips and administering medicine. It was a hectic scene.

Zheng Ren walked down the busy corridors. While turning a corner, he overheard the sounds of an argument. A frown creased his forehead. 'What's happening?'

In the emergency medicine area, he found a doctor engaged in heated conversation with a patient's family.

A security guard was moderating the commotion. It was Fan Tianshui. The man's appearance suggested he had been taking good care of his body.

He met Zheng Ren's gaze and smiled as the latter approached.

When the emergency medicine doctor saw Zheng Ren, still dressed in casual wear, his eyes sparkled as if his savior had appeared. "Chief Zheng, I was going to call you."

"What's going on?" Zheng Ren asked.

The family members present side-eyed Zheng Ren uncomfortably.

"The patient is a 52-year-old female who experienced pain around the navel and vomiting this morning. There were no signs of external injuries or other notable symptoms. Physical examination indicated point tenderness at the abdomen but no rebound tenderness or muscle guarding. Her blood test came back with slightly elevated white cell count," the doctor explained.

Zheng Ren studied the patient as the doctor talked.

The patient on the hospital bed was overweight. Her hands clutched at her abdomen and her face was twisted in agony.

"I suggested a peritoneal dialysis or abdominal CT scan to rule out intestinal obstruction but the patient refuses radiological methods for fear of radiation. It could be acute gastroenteritis, but I have other suspicions," the doctor said, frustrated.

"It's not a serious problem. Why should we consent to a CT scan? CT has radiation, what if it gives her cancer? Who'll be responsible then?" one of the family members shouted.

Zheng Ren could not sympathize with the family's worries.

The patient had been admitted to the hospital, but her family was accusing them of suggesting unnecessary tests. The patient was also at fault here; a few radiology exams would not deteriorate a normal person's health.

If the myth was true, interventional surgeons would be the first to succumb to disease.

"Let's all keep a cool head and focus on treating the patient," Zheng Ren advised.

"Who are you?" one of the family members squinted at Zheng Ren.

Zheng Ren replied with a non-sequitur. "The patient has an intestinal obstruction due to intussusception. The affected parts of the intestines have yet to necrotize. She will require emergency surgery to address the intussusception. If you guys delay it any longer, we will have to remove the whole segment."

The emergency medicine doctor was as shocked as the family. Zheng Ren's face betrayed no emotion and the doctor reminded himself to praise the chief resident's acting skills later.

Such a massive white lie was a bit over-the-top.

At Zheng Ren's words, the family members paled.

"Did they sign the refusal of consent form in the morning?" Zheng Ren asked the doctor under his breath.

Refusal of a recommended test required proper documentation. It made explaining themselves easier in the future.

An emergency department doctor who had to handle all sorts of patients had to abide by standard procedure. The risk of being sued was always there, and having evidence to back up one's word was essential.

"Yes," the emergency doctor said brusquely, "They refused a CT scan and peritoneal dialysis and are willing to bear the consequences. The patient signed the form herself and I have it filed and locked."

Zheng Ren was relieved to hear the doctor's answer. A misdiagnosis would be a hassle. He could handle the surgery from here on out. "Call for an abdominal CT. I'll take the patient for the scan."

The family's anger dissipated when they heard the exchange between the two doctors.

Unnecessary tests did not occur in a Class Three Grade A Hospital. The many tests reflected the many patients they had, to the point where a rare disease was common.

Especially in times where patients doubted their doctors every step of the way, a misstep could lead to a life-ruining lawsuit.

The doctor quickly issued an abdominal CT scan ticket which Zheng Ren took and handed to the family. "Make your payment, then head to the CT room. I'll drop by to view the scans once I'm changed."

"Doctor, she's going to be alright, right?" Their attitude towards the hospital's doctor's had softened.

"I've already said that she has an intestinal obstruction due to intussusception and needs surgery. She's lacking blood flow in the intestines and if we don't hurry, the tissue will necrotize. Do you think I'm joking?" Zheng Ren snapped at them.

The emergency medicine doctor's eyes went wide. Was Chief Resident Zheng not joking?

He could feel cold sweat on his back.

Acute intussusception intestinal obstruction and necrosis?

It was no longer a small matter.

The family members did not argue. One went to pay for the scan while others helped transport the patient to the CT scan room.

"Chief Zheng, was what you said true?" The doctor was still convinced that this was a ruse by Zheng Ren. The patient's symptoms were... not conclusive.

"Yes. Did you ask about the patient's diet?" Zheng Ren questioned.

"Er..." The doctor was too shocked for words.

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Chapter 333: A Male Version of Fukuhara Ai

It was 9:00 p.m. Zheng Ren was once again caught up in a whirlwind of cases. The surgery would likely drag on until midnight.

Zheng Ren grimaced but figured a surgery was better than dealing with the many-faced Lawyer Ge.

What kind of food could cause bowel obstruction? Especially to the point of intussusception? A sticky bean bun?

Zheng Ren turned to the emergency medicine doctor. "It probably wouldn't have clarified much but if she's back a second time, we should cover all bases. Don't be too occupied by arguing with the family."

After that, he left to change into his work clothes.

The emergency ward was quiet with most of the patients having gone home for the night. Its few remaining patients were in postsurgical care. The hospital had no television and slow Wi-fi. Without any entertainment, patients had no reason to stay awake.

The office lights were still on when Zheng Ren entered the room. Chang Yue was patiently typing out a patient's record while Professor Rudolph Wagner was reading through a Mandarin coursebook.

Zheng Ren's arrival was met with a curious look from Chang Yue.

"Chief Zheng, why are you still here? Are you so much of a workaholic that you want to take my shift?" she said, expression deadpan.

It was clearly a joke, though; who wanted to spend the night in the emergency department on-call room?

The men's on-call room was unkempt and dirty. Their hectic schedules meant that no one was willing to perform housekeeping.

Some of the nurses did help out occasionally, although they could not be blamed for simply letting the room rot.

How was it even comparable to a villa with its own bathtub?

"I went to the emergency department and noticed a patient with bowel obstruction due to intussusception. She'll need emergency surgery. I'm taking the patient for a scan, so help me prepare the admission papers and the patient record."

"Admitting patients so soon after your return. You're a weird one, Chief Zheng," Chang Yue said impassively.

Grumble as she might, there was still work to be done.

Zheng Ren quickly left to change into his work clothes. On his return, he passed the office and said into the room, "The patient and family have low medical compliance, take caution."

"Understood," Chang Yue said. "Lil Fugui, why don't you go help Chief Zheng?"

Professor Rudolph was already one step behind Zheng Ren. "Enna[1]."

Zheng Ren was speechless.

The professor had only been in town a few days and had already changed his name to Ru Fugui. Now, he was even speaking in a Northeastern accent.

Zheng Ren appreciated the professor's willingness to adapt to his new surroundings. The distance between them felt smaller with the change in his manner of speaking.

"Boss Zheng—"

"Don't use that, call me Dr. Zheng or Chief Zheng," Zheng Ren interjected.

Zheng Ren was self-aware enough to feel undeserving of being called a boss. The title made him uneasy.

Su Yun was the only person whom he could tolerate using it.

"Enna," the professor carried on in his Northeastern twang, "What's the problem? You're back in so late. I would have been resting in my hotel had you not come."

"There's a surgery. Are you up for it?" Zheng Ren asked.

"Chief Zheng, the working hours here are truly inhumane." The professor had taken a Chinese name and picked up the local slang, but was still a Westerner through and through.

"Are up for surgery, I said? If you can't, I'll get someone else," Zheng Ren said dismissively and picked up his pace toward the CT scan room.

"I'll join the imaging. Don't you think it's against the law to allow an interventional surgeon to perform a surgery outside of his—"

"Understood." Zheng Ren took out his phone and dialled a number.

"How's the patient?

"Sounds a bit complicated. Thank you for your dedication.

"Nothing. There's a patient with bowel obstruction, but I think I can handle it alone.

"Really... Alright, preparations here are almost done. You can drop in soon."

With that, Zheng Ren ended the call.

Su Yun was watching over Yang Lili, whose injuries were severe and her condition still unstable.

Monitoring organ blood flow was a difficult task.

At times, the human body was resilient. Zheng Ren had seen car accident victims, whose bloody bodies had to be dragged out of wreckages, recover in mere days.

However, the human body could sometimes also be tricky to handle. They had to monitor blood circulation throughout the body as prolonged inadequate blood supply could lead to loss of organ function.

Even with modern medicine, not all patients could be saved.

The ICU was akin to the gates of hell. Some patients could leave, but some never did.

Yang Lili's surgery had been a success but Zheng Ren could not guarantee her survival. He had no power over the afterlife.

Soon, he and the professor arrived at the CT scan room.

There were few patients who needed an emergency scan at night. The bowel obstruction patient was already inside undergoing her CT scan.

The family members said nothing when they saw Zheng Ren in his white coat, followed by a blond-haired, blue-eyed foreigner.

Perhaps there were some perks of having the professor around, Zheng Ren thought.

The professor seemed to make people speechless. He was quite good-looking and gave off a scholarly vibe.

Zheng Ren greeted the doctor in the CT scan room and watched him operate the machine.

Zheng Ren's presence hinted at the patient's condition. The CT room doctor made haste as he scanned and processed the images.

The images loaded, slice by slice, on the display. Zheng Ren located the telescoping intestine within the scan.

There were two encircling layers at the target site. The affected part of the intestines were bulging and swollen. The machine differentiated the low-density adipose tissues from the high-density muscles of the intestines.

The damaged blood vessels of the telescoping intestine were dark pools on the image.

"Fecalith intestinal obstruction?" Professor Rudolph offered, pointing at the scan.

"It might not be fecalith. I'm guessing it's food residue," Zheng Ren said.

The CT room doctor did not understand the difference between fecaliths and food residue. Were they not different names for the same thing?

Professor Rudolph looked doubtful. "Chief Zheng, when is the surgery? I want to have a look. My hypothesis is that this was caused by fecaliths and not undigested food."

The CT room doctor was shocked by the fluent Northeastern Mandarin leaving the foreigner's mouth, his mouth agape as he stared at the blond-haired man.

Anyone who spoke Northeastern Mandarin was regarded as family, be they a national or a foreigner.

Like Fukuhara Ai... Unfortunately, Professor Rudolph was not as cute. He had an intense look about him.

"Chief Zheng, will you need the prints?"

"Yes. Pass it to the family later, please. As for the report, I'll tell them to collect it tomorrow," Zheng Ren instructed before leaving the control room to deliver the news to the family.

Upon meeting them, he asked, "Can I speak to the patient's spouse?"

A man in his fifties stepped forward hesitantly. Worry was etched into the lines of his face as he approached Zheng Ren.

Zheng Ren's earlier diagnosis had shocked him to his core. He had been fearing the worst throughout the CT examination, praying that his wife would not need surgery.

However, noticing the young doctor's grave expression, he braced himself for the bad news.

The aggression from earlier had given way to resignation and concern. Logic had kicked in after hearing the doctor's diagnosis.

"Doctor, I am her husband. Is she okay?"

"The CT scan confirmed the intussusception which led to the intestinal obstruction. We'll have to perform an emergency surgery. If there are no objections, follow me to the emergency wards to sign the admission papers and we can proceed with the procedure," Zheng Ren said in a no-nonsense tone.

The man nearly fainted at the news.

Zheng Ren managed to catch him in time and guided him to a bench by the CT scan room.

"Sorry. I have high blood pressure." There was no more fight in him, only regret and shame. "She was fine yesterday. How did it end up like this?"

"What food did she have yesterday?"

"We were at a gathering yesterday, ate steamboat for dinner, then went to a karaoke bar. It was regular food, nothing special," the husband mumbled as he tried to recall the events.

The human memory was unreliable.

"Whatever it is, we'll find out after the surgery.

"Although the intussusception was mild, the situation is now critical as we lost precious time in the morning. Any further delay would likely lead to necrosis and resection would be unavoidable," Zheng Ren said truthfully, not trying to frighten the family.

However, the truth was itself horrifying.

The family obediently followed his instructions. One person stayed back to wait for the physical scans while the others helped transfer the patient to the emergency ward with Zheng Ren.

[1] 嗯呐 – Northeastern slang for 'yes'.

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Chapter 334: Offer Up Your Face For A Slap

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

With Zheng Ren's reassurance, the patient's family quickly agreed to the surgery.

The patient was pushed to the emergency ward to settle the paperwork and undergo preoperative preparations.

Zheng Ren made a call to Xie Yiren and the group. The thought of getting to share a car home with Xie Yiren later put a smile on his face.

Being inexperienced, he was happy with even the slightest opportunity to spend time with Xie Yiren.

Once he was done giving orders, Professor Rudolph asked, "Boss... Chief Zheng, why do you think it's food residue?"

"Density," Zheng Ren replied.

Was there a difference in density? The professor thought back to the scans. The density of food residue ought to be lower than that of fecaliths, especially after digestion.

Zheng Ren had to have misjudged it. Professor Rudolph abandoned the thought of heading back to his hotel to rest.

He wanted to watch the surgery. Even a small victory against Zheng Ren would be meaningful.

Professor Rudolph Wagner held his tongue, though. He would wait for the truth to unfold.

Although Zheng Ren had the hands of god, there were many aspects to medicine. Perhaps he was not proficient in interpreting radiological images and could not differentiate between a fecalith and undigested material.

An expert could identify the problem from scans but anything more in-depth was beyond their expertise. The professor was sure 95% of the doctors in the world were in such a group.

However!

Professor Rudolph was at the forefront of this field.

He was sure that he would win this argument, already imagining himself going back to his hotel room and popping some champagne in celebration.

Chang Yue's presence expedited admission as she skillfully handled all the paperwork.

This brought Zheng Ren relief.

Trivial matters could be left to Chang Yue while he communicated with the patient's family and focused on getting their consent.

He did not bother to call Su Yun. The man's work in the ICU was more important.

Zheng Ren sincerely hoped for Yang Lili's survival.

A brave and responsible person like her deserved to enjoy the good things the world had to offer. Her existence ought not be limited to the memories of the living.

Half an hour later, preoperative preparations were complete. The family had signed the informed consent document. Zheng Ren brought the patient to the operating room.

Along the way, he called Su Yun.

Professor Rudolph trailed behind Zheng Ren excitedly. The professor had no doubt the surgery would be a success.

However, that was not his focus.

He wanted to know who had interpreted the scan correctly.

Zheng Ren changed into a sterile surgical gown and entered the operating room.

It had been a while since he had to start a surgery. Su Yun was usually the one who handled the beginning.

There was an ordered bustle in the operating room.

Xie Yiren was in a dark green sterile scrub. She inquired about the procedure and proceeded to prepare the necessary tools.

Chu Yanran was finalizing anesthesia when Su Yun arrived.

Zheng Ren was in the midst of disinfecting the skin. The surgical drapes were already in place.

"Boss, you're too fast." Su Yun scrubbed his hands and put on a sterile surgical gown.

Zheng Ren was a man of few words while Su Yun was the opposite.

The operating room was silent, as if a terrible thing had happened.

"It's normal for me." Zheng Ren reached out for a scalpel, which he used to part the skin.

"What's the procedure?" Su Yun asked.

"Patient has intussusception. Bowel obstruction surgery."

"Why have there been so many cases of intussusception in adults recently?" Chu Yanran questioned as she knotted Su Yun's surgical gown. Once she was done, Su Yun stepped up to the operating table, picking up the sterile gauze by the patient's legs.

"Coincidence, perhaps, but this patient is a bit special. You'll see soon," Zheng Ren said.

"Oh?" Su Yun eyed Zheng Ren suspiciously. "I wonder sometimes if you have X-ray vision."

"Don't believe such nonsense. You've been reading too many novels. Was one called The Widowed Doctor with X-ray Vision?"

"Then how would you know?"

"Years of clinical experience."

"I've never met someone as cocky as you!"

The two doctors bantered as they operated on the patient, parting the peritoneum to gain access to the peritoneal cavity.

As Zheng Ren had expected, the intestines were in a twist.

He used warm saline gauze to line the surrounding organs before cutting into the intestine.

Professor Rudolph's eyes were as wide as saucers as he watched with anticipation.

Su Yun felt a tingling sensation and looked up. "Lil Fugui, why haven't you gone home?"

Hm... How did Su Yun know?

"You know the professor's Chinese name?" Zheng Ren asked.

"Don't you read the group chat? Chang Yue was asking for opinions. I was the one who proposed that name. Not bad, right?"

"..."

"Prior to surgery, the patient had an abdominal CT scan. I believed it was fecalith causing the obstruction but Chief Zheng says it's food residue. I wanted to see for myself." The professor's eyes did not leave the organ in Zheng Ren's hand.

Su Yun instantly predicted the outcome. "Oh? Lil Fugui is offering up his face for a slap?"

"Huh? What do you mean?" The professor was confused.

"You believe Zheng Ren's judgment to be wrong and want to witness the truth with your own eyes, right? You'll probably smile in response and say it doesn't matter but your heart will be aflutter," Su Yun elaborated dramatically.

"Yes, why, that is accurate." Professor Rudolph Wagner said excitedly, "Su, you are a master of descriptions. The Mandarin language is so intricate; two characters can mean so many things."

Zheng Ren wanted to scream.

These two clowns were performing a ballad over a body.

He ignored them and requested a scalpel from Xie Yiren, making a 1cm incision on the obstructed bowel.

A moment passed and an entire almond was squeezed out of the incision.

The almond clattered onto the surgical tray with a thud, cutting through Su Yun and the professor's conversation.

The professor was stunned... It was not a fecalith, but a whole almond...

Was Zheng Ren playing a trick on him?

Su Yun frowned. "And you say you don't have X-ray vision."

"The patient's husband said they had a steamboat dinner and went for a karaoke session," Zheng Ren stated as he squeezed out nut after nut from the patient's intestine. The surgical tray was filling up quickly.

"And?"

"Between today's symptoms and the karaoke session, what's the likeliest snack they had? Almonds."

"Your explanation makes absolutely no sense," Su Yun whispered.

Professor Rudolph Wagner watched in astonishment as the almonds were removed from the patient's gut, some whole, some partially digested.

As per Su Yun's description, this was him being slapped in the face.

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Chapter 335: Overindulged in Almonds

"Chief Zheng, what do you think?" Professor Rudolph asked curiously.

"Slow intestinal strangulation is likely caused by accumulation of food. Fecaliths can also cause intestinal strangulation but that would be rapid. In line with the patient's food consumption last night, I hypothesized it was likely due to insufficient chewing of solid foods that gave rise to intussusception," Zheng Ren said.

Su Yun made a noise. He could not come up with something sarcastic to say to Zheng Ren.

"If the patient had agreed to an abdominal CT scan in the morning, we would probably not have had to resort to surgery," Zheng Ren muttered.

Su Yun wondered for a moment. "How would you prevent the intussusception?"

"By drinking cola," Zheng Ren said without missing a beat. "Large gulps of cola; if she had let the carbon dioxide bloat her intestines, it's likely this surgery could have been avoided. Unfortunately, the patient made light of her situation and refused the CT scan."

Su Yun was silent.

The professor was lost in thought.

Zheng Ren removed over 20 almonds from the patient's intestines. He probed the organ and found no more foreign solids, then reoriented the telescoping intestines and used warm saline gauze to cover it.

The root cause of this one's intussusception differed from that of their previous patient.

Strangulation and necrosis were not as severe in this case. There was a high probability that no resection would be required.

As for the cola treatment method, Zheng Ren had read about it in a scientific report.

He had no idea if it actually worked in practice.

All in all, the surgery had proven his hypothesis accurate. Su Yun was right; it was a slap to the professor's face.

Zheng Ren cared little about Professor Rudolph's pride, though.

Ten minutes later, he removed the gauze.

The organ was red and alive with its blood supply restored.

They stitched up the intestines and rinsed the peritoneal cavity. A final check was performed to ensure no foreign objects or bleeding had been missed before they began stitching the patient back up.

The surgery had not taken long. There had been no System mission, so Zheng Ren surmised that it had considered the surgery easy.

That was good. The patient would recover swiftly and be out of the hospital in no time.

"How is Yang Lili?" Zheng Ren asked as he closed the abdomen.

"So-so. She's showing signs of disseminated intravascular coagulation; we've started her on medication."

"Urine output?"

The kidneys and brain were the two major organs impacted by severe blood loss.

If there was kidney damage, the patient would have zero to reduced urine output. At that point, a thorough check would be required to mitigate the problem.

If the problem persisted, it would be an uphill battle for the patient.

No urine was often a bad sign.

"Low urine output, around 10ml per hour," Su Yun said.

"That's reassuring."

"We'll have to monitor her for longer." Su Yun's voice sounded strained.

"Thank you for your dedication."

"It's my duty."

Five minutes later, the final stitch was made. The anesthetic slowly wore off and the patient stirred.

They moved her onto a stretcher trolley. Su Yun and the professor prepared the patient for transport while Zheng Ren showed the family the contents of the surgical tray.

The family was waiting outside the operating room, their earlier hostility lost.

Patients like this were simply naive, stirring up trouble not out of malice but from ignorance. Many other patients and families were similar.

When they saw the almonds in the surgical tray, they were shocked into silence.

"I take it there were almonds served yesterday? She probably overindulged," Zheng Ren said.

"Yes... We drank during dinner before going for karaoke. I didn't notice she ate so many almonds," the patient's husband muttered.

If he had known this would happen... Ah, there was no way he could have.

Zheng Ren watched each individual expression. They would probably experience lingering trauma from karaoke.

As they talked, Su Yun wheeled the patient out of the operating room.

Zheng Ren and Chu Yanran took over and pushed the patient back to the wards while Su Yun left for the ICU to resume his post.

The surgery had been a respite for him.

In the war, the patient was hooked up to a vital signs monitor, her condition stable. She began conversing normally as the anesthetic wore off.

Zheng Ren was certain they had stepped in in time to save her.

He went to log his surgery record and left the other paperwork to Chang Yue.

Communicating with patients' families was Chang Yue's expertise. Despite the rewards and skills given to him by the System, he still found himself behind her in that regard.

She was indeed incredible.

The professor had left the hospital in resignation. His imagined victory remained so: a distant dream. He had been slapped in the face by the truth, a personal experience to associate with the Chinese term.

Zheng Ren made his rounds and found nothing that needed his attention. He texted Xie Yiren.

Seconds later, a reply came.

[Done? Zone D.]

His heart fluttered in his chest. He had gotten used to the bachelor's life—toiling day and night without anyone asking about him. This was a good change.

He bid Chang Yue goodbye before heading down to the basement to find Xie Yiren, humming a tune as he walked.

It was late at night but there was still a significant number of vehicles in the car park.

The Northeastern winter was cold and many employees did not own garages. Instead, they left their cars in the hospital's warm basement parking.

Zheng Ren searched around the area.

He was hopeless at recognizing faces, and that weakness apparently extended to cars as well.

Zone D... Red car... Zheng Ren repeated the words in his head. There were not many red cars and Zone D was a small area to cover.

Zheng Ren searched and searched again but could not find the sleek and robust Volvo XC60.

Odd. Where was the car?

Zheng Ren sent a text.

[Where are you? Can't find your car.]

[Look up. I'm looking right at you.]

The reply was instant.

The basement parking was quiet and devoid of life. Cars lined the pathway, cold and unmoving.

Goosebumps crawled up his skin when his phone lit up, startling him.

He looked up and saw Xie Yiren smiling at him. She was less than five meters away.

Zheng Ren was speechless at himself.

What had he been searching for just now? She was literally five meters away.

He resigned himself to his fate of being forever a victim of face blindness.

Pocketing his phone, he jogged toward the car, opened the door and got in.

"What were you looking for just now?" Xie Yiren asked.

"I couldn't find you." Zheng Ren was frustrated at himself.

"Are you hungry? Want to get a quick bite?"

Zheng Ren had spent the afternoon rescuing Yang Lili at No. 9 Elementary School. After that, he had gone to the police station and returned to find another surgery waiting for him.

It had been a busy but productive day.

He had not even noticed his hunger until Xie Yiren asked him about food.

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Chapter 336: Female Chef

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

When he had been in the first general surgery department, he would take a cab home after being paged for surgery in the middle of the night. Occasionally, he would cook himself a packet of instant noodles before going to bed.

Zheng Ren recalled that cold, lonely period in his life, smiling when he realized that there was someone that would think of him now.

"Instant noodles," he blurted directly from his mind, unintentionally.

He regretted it the moment the words left his mouth.

The story Su Yun told him was like a crow, persistently circling his head.

Xie Yiren was surprised for a moment, then smiled and said, "Sure; I can assure you that I'm an expert at cooking instant noodles."

Hmm? Zheng Ren was bewildered.

It actually worked?

Xie Yiren kicked the engine into gear and the car slowly left the basement parking lot of Sea City General Hospital.

Within three minutes, they had reached her mansion.

Xie Yiren drove into the garage, where they alighted and entered the house from a side door.

Zheng Ren had not known about a direct link between the garage and house.

"What flavor would you like?" Xie Yiren asked, hanging her coat up with a smile. She was already poised to run towards the kitchen.

Zheng Ren was a little caught off guard. He had always eaten the same flavor of noodles, or rather, he had only tried one before—braised beef noodles.

It was not the only one, but he seldom visited the mall, choosing instead to order them from a convenience store downstairs.

He knew about other flavors but could not name them to save his life.

Zheng Ren's silence and blank expression prompted Xie Yiren to leave for the kitchen while humming a lively tune.

"Have a seat. There's water in the fridge, so please help yourself," Xie Yiren said, "Is there any food you avoid?"

Zheng Ren nearly stuttered when he saw Xie Yiren's alluring back. "No, I eat everything."

"Okay, I'll whip up something then." Xie Yiren put on an apron, instantly becoming a female chef. She then opened up the fridge and started searching for ingredients.

In a few moments, she had retrieved a whole bunch of food and put them aside.

Seaweed, eggs, sausages, condiments, and a few pickled vegetables.

Zheng Ren had not known that instant noodles required so many extra ingredients. Simple man that he was, he sometimes even forgot to add the packet of seasoning.

There was a small fridge beside the sofa.

Opening it, Zheng Ren took out a bottle of distilled water and gulped down a mouthful.

He had not eaten or drunk anything in almost eight hours. After relaxing for a while, the thirst and hunger had started to set in.

Half a bottle of water later, he felt much better.

He offered to help Xie Yiren in the kitchen but she laughed and pushed him out, just like in the operating room.

The feeling of being treated like a master... was unpleasant. He felt anxious.

About ten minutes later, a savory aroma from the kitchen filled the air. It was not very strong but it made Zheng Ren's stomach growl.

So fragrant!

So hungry.

Another few minutes later, Xie Yiren came out with a huge bowl and called him over to eat.

On the dining table lay a white porcelain bowl filled with instant noodles, barely recognizable under all kinds of side dishes.

"These are red sausages from Harbin. I don't fat-free like sausages because they lack texture," Xie Yiren said.

"Aren't you eating?"

"I've already eaten. I was worried that you were hungry, so I asked if you wanted to eat."

"What did you have?" Zheng Ren asked as he picked up a piece of red sausage with his chopsticks and put it in his mouth.

True enough, it had an amazing texture.

"I went to eat at Xiao Long Kan with Sister Yanran. They have a newly open branch here. We tried it today and their taste was quite authentic, but their dipping sauces were nothing to shout about. However, we were just glad to be able to have it so near our house."

Upon recollection, he estimated that they had probably gone during his meeting with the traffic officers.

"Also, we looked for you, but Chang Yue said that you had gone to meet with traffic police. Sister Yanran said that you could be in trouble, so she made a few phone calls and asked her family to help you sort it out," Xie Yiren said. She had a satisfied smile on her face when she saw Zheng Ren happily enjoying his meal.

Oh? So it was Chu Yanran who pulled the relevant strings.

Zheng Ren thought about it for a while, but decided to put it aside as he had no information to work with. It would be more straightforward to ask her tomorrow when they met face-to-face.

"Eat slowly, it's hot," Xie Yiren said as she watched him slurp down mouthfuls of noodles.

It was an ordinary meal, simple even, but Zheng Ren felt the taste of home.

When he finished, Xie Yiren quickly took the bowl and chopsticks away and started cleaning before he had the chance to.

He was slightly embarrassed... He had no idea that it would be so troublesome to make a bowl of instant noodles.

"Zheng Ren, you should head back and rest for the night. You have to work tomorrow," Xie Yiren called from the kitchen.

He hesitated.

Simply leaving after filling his stomach made him feel callous.

However, Xie Yiren was busy cleaning up. It would be worse to bother her.

What ought he say?

Zheng Ren panicked. A sheen of sweat formed on his forehead and temples.

This was just... too difficult.

When Xie Yiren did not hear Zheng Ren's response, she leaned back gracefully.

"Hey, what happened? Did you fall asleep?"

"No... I was thinking, if I should... if I should help you," Zheng Ren stuttered.

By then, Xie Yiren had already finished washing up as there was not much to begin with.

She pulled off her pink gloves and walked out with a smile, approaching Zheng Ren and lowering herself so that her face was on the same level as his.

The proximity was setting off his nerves. Zheng Ren's mind went blank.

"Be a darling and go back to rest." Xie Yiren seemed a little embarrassed, either due to the distance between them or the things on her mind. "After such a busy day, you should take a bath before you sleep."

Her face flushed red after saying that and she immediately ran off to get Zheng Ren's coat.

Zheng Ren was reluctant to stay any longer. He accepted his coat from her and went to the porch, repeatedly stopping to turn around.

He still felt unwilling to leave after putting on his shoes.

Why would he go home when he had the chance to embrace this stunning girl?

"Hey," Xie Yiren said from behind him.

Zheng Ren's heart shook violently. He began to turn but was rushed by an elegant figure before he could.

"You hugged me like this yesterday, so I'm taking it back today," Xie Yiren said shyly, burying her head into Zheng Ren's back.

This felt... really good.

It was too bad that everything was happening so fast.

Zheng Ren's brain shut down for heaven only knew how long before Xie Yiren pushed him out of the house.

The sensation seemed like it would remain with him for a lifetime.

Zheng Ren went back to his place in a daze. His mind was still blank, a far cry from the steady and experienced surgeon he was in the operating room. The sweet feeling of nervousness was all so strange to Zheng Ren.

A text came in from Xie Yiren. [Sleep earlier tonight, remember to take a bath.]

[Okay, you rest earlier too. I'm going to bathe now.:)]

Zheng Ren remained immersed in the short but sweet moment, not wanting to forget it.

...

Chapter 337: She Must Love Him Very Much

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Zheng Ren obediently took a bath and had a good night's sleep.

It felt great not to have to work night shifts.

Xie Yiren woke up very early and left a message for Zheng Ren, telling him to wash up and come over for breakfast.

He felt like the owner of a thousand buildings and hectares of farmland, having to go through two mansions just to have breakfast...

There were fried eggs, bread and milk. Zheng Ren ate, tasting nothing but sweetness.

Hmm... sweetness, like Xie Yiren's fragrance leaving an indelible imprint in his mind.

They both hurried to the hospital after breakfast.

There was still some time before ward rounds, but Zheng Ren went regardless.

The patient who had received surgery the night before had regained consciousness. Her pain was not severe, but she could not eat solid food yet as she had not passed any gas.

She was still embarrassed by the almond incident. Apparently, she had drunk a little too much and downed her food without chewing it thoroughly.

The other patients in the ward were in a stable condition as well.

Zheng Ren called Su Yun to ask about Yang Lili's situation.

The latter was fine, with no serious fluctuations.

No changes also meant no complications.

It was the best news he had received this far.

Zheng Ren believed the human body had excellent mechanisms to heal its own traumatic injuries.

At 7.55 a.m., like clockwork, Professor Rudolf arrived at the department on time and greeted Zheng Ren with a little more enthusiasm than usual.

At 8 a.m., Old Chief Physician Pan performed the handover of shifts and ward rounds.

After the rounds, Zheng Ren had little left to do. Other routine tasks were dealt with by a few residents. He picked up a book and began reading, hoping to add to his skill points.

Even though he had reached the Master rank, Zheng Ren was a man with aspirations. One specialization remained in mind—he hoped to achieve Grandmaster level in general surgery one day, possibly even the Prime level that he had caught the barest glimpse of.

Although skill points accumulated from reading were slow, they still added up.

The patient that Old Chief Physician Pan had referred was currently undergoing a 64-slice CT scan with three-dimensional image reconstruction and was thus not in the ward. Chang Yue had already contacted the CT room and Zheng Ren would be allowed to perform the reconstruction during their afternoon break.

After that, they would assess the man's condition and decide whether or not to opt for surgery, as well as resolve other matters such as scheduling.

The department phone rang after some time.

Cheng Yue picked it up and said a few words before looking at Zheng Ren. "It's for you."

Zheng Ren took the receiver.

"Hello.

"Oh, oh, I am.

"Okay, I'll go look at the patient's scans.

"Oh, sure. I'll wait in the department."

He hung up.

"Why is orthopedics looking for you?" Chang Yue was curious.

There had not been an emergency orthopedics surgery in the emergency department before. Why were they looking for Zheng Ren? Did they have a pelvic fracture case with bleeding?

"They have a patient with bone metastasis and are planning a corpectomy, and so want to prepare for preoperative interventional procedures," Zheng Ren said, already imagining the surgery requested by the orthopedic surgeon.

Suddenly, Professor Rudolf Wagner piped up, "Boss, if you're going to remove the vertebra, will you perform the embolization in the lumbar artery?"

Zheng Ren nodded. "I think so."

The professor was likely well-versed in this method to bring it up so casually.

"Professor Rudolf, I've told you not to call me boss. You can call me Dr. Zheng or Chief Zheng if you'd prefer," he said stiffly.

"Oh, no!" Professor Rudolf Wagner shrugged. "I heard from Chang that you allow your assistant to address you as boss. Since I'm trying to be your assistant, let's start with your name. Everyone does this in my lab, too."

This...

Forget it. It was the man's prerogative.

Zheng Ren had no issues with it. He closed his book and inched closer to the professor. "Professor Rudolf, I'm going to do a 64-slice CT scan with three-dimensional image reconstruction later. Would you like to accompany me?"

"Dear Zhen. Do you prefer this instead? Or would you prefer I call you boss?" Professor Rudolf Wagner asked seriously.

Zheng Ren could not stand the idea of being called "dear" by a blonde-haired, blue-eyed, burly German.

It was uncomfortable.

"Call me boss," Zheng Ren said without hesitation.

"Then please call me Lil Fugui too," Professor Rudolf Wagner said.

Zheng Ren truly had no idea why this man was insisting on a Chinese name, let alone "fu gui".

In the past, these two characters were reserved for indentured servants.

They were now used to name pets.

Chang Yue and the others were clearly pulling this man's leg.

Even though he knew it was just a joke, explaining it would waste too much time and effort.

Zheng Ren was not keen on doing so.

After some consideration, Zheng Ren decided to give up and let the professor use any salutation he pleased.

Grimly, he said, "Lil Fugui, I'm going to do a 64-slice CT scan with three-dimensional image reconstruction later. Would you like to come with me?"

"Yes, please." Professor Rudolf gladly accepted. "Are you doing the scans to prepare for surgery?"

"I'm sure that it will be an interventional surgery for liver cancer. I need the scans to decide whether a patient with the embolized lumbar artery requires reconstruction," Zheng Ren said.

As they talked, a woman in her mid-thirties knocked on the office door.

"May I know if Chief Zheng is around?" she asked.

"That's me. Are you the family member of the patient under Dr. Zhou from orthopedics?"

The woman was slender and haggard; she had dark circles under her eyes, withered, yellow hair and a bad mood. In her hands was a big bag of what looked like five kilograms of scans.

At Zheng Ren's question, she nodded.

"Let's take a look at the scans first." Zheng Ren took the bag, put it on a table in front of a radiographic film viewer and started checking for dates.

"Chief Zheng, do you want to see the more recent ones or the earliest batch?"

Since the patient's cancer had metastasized to the vertebra, older scans were obsolete.

"The latest three months," Zheng Ren said.

"On the 15th of September, he had a CT scan on his lumbar vertebrae. This one," the woman said unhesitatingly.

Rifling through the scans without referring to their date stamps, she counted out an envelope and passed it to Zheng Ren.

He felt a twinge of melancholy.

Such attentive family of patients were rare throughout his many years as a doctor. Most did not bring their previous scans and some even forgot where they had been left.

Lacking previous information would not pose a problem for most doctors, but it would be better to have something as comparison.

For a family member of a patient to be so thorough was extraordinary.

A few years ago, Zheng Ren had met a man in his mid-thirties who had bound his father's health reports from over a decade into a book. The progression of his father's condition from its very beginning unfolded itself clearly.

This woman in front of him was exactly the same.

She had to love the patient very much to remember his scans so well.

It was truly a shame that he had late-stage cancer and bone metastasis.

One could not bear all of the joys and sorrows on this earth. All Zheng Ren could do was relieve the patient of some pain.

Such were the extent of mortal hands.

Zheng Ren retrieved the lumbar vertebrae CT scan from the envelope, placed it on the viewer and started to analyze it.

Professor Rudolf rushed over to join him.

The patient was in a bad way. His renal cancer had metastasized to his vertebra, which was uncommon for a form of indolent cancer.

Luck had not been on the man's side.

The scans from three months ago revealed that cancer cells had invaded the bone and were approaching nervous tissue.

He had gone for two more consultations, the most recent being the 64-slice CT scan with 3D image reconstruction from two days ago. It seemed like the orthopedic surgeon wanted to have a clearer image of the surgical path.

The patient's condition was regressing extremely quickly. Although the malignant tumor originating from the kidneys had been indolent, the cancer cells had multiplied faster as his immunity deteriorated during the later stage.

Zheng Ren hummed softly.

The tumor would have an abundant blood supply due to angiogenesis. Zheng Ren believed that he would discover more blood vessels if he personally performed the reconstruction.

Orthopedics wanted to embolize the lumbar artery to reduce the extent of bleeding during surgery. That, he could do.

The woman waited patiently and did not push Zheng Ren.

Twenty minutes later, Zheng Ren said, "They can proceed with embolization. I will do my best to reduce the bleeding so that he will have a better quality of life after surgery."

"Thank you." She looked as if she had accepted fate. Zheng Ren's words were all that she wanted to hear.

Putting the scans back into her bag, she bowed deeply before leaving.

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Chapter 338: Unpredictable Heart

The CT room was packed every day as Sea City General Hospital only owned one 64-slice CT scanner. Zheng Ren could not disrupt other patients' scans scheduled during working hours, so he only had the afternoon break to use the machine.

His morning was fairly uneventful, which was the usual routine in the emergency department.

Traffic normally climbed in the evening and gradually slowed down between 3 to 4 a.m.

Sometime after nine, Zheng Ren noticed more people outside than usual from the noise.

It was normally very quiet in this hour, when patients were all on a drip and there was no major rescue to attend to.

"Chang Yue, what's happening outside?" he asked.

"3-8's family is here to visit," Chang Yue replied indifferently.

Having just had a night shift, she was supposed to be off-duty but had yet to finish paperwork for the emergency rescue yesterday

With things as they were, it was unclear if she would be able to go home before noon.

The patient in ward 3-8 was Old Chief Physician Pan's referral with liver carcinoma, who had just returned from his checkup.

Since he had only recently been admitted to the hospital, there were many people coming to visit him.

Today had more well-wishers than usual.

Zheng Ren looked out, saw the ward as busy as a fair, and shook his head.

"Chief Zheng, you might not be able to perform this surgery," Chang Yue said, suddenly turning around.

"Why?" Zheng Ren was a little confused.

"Because of the family's attitude, but it's just my personal opinion. I wouldn't count on it."

Zheng Ren hummed softly as he recalled the patient's family members.

The patient was in his sixties, skinny, and had a dark complexion like the majority of liver disease patients.

He had two children, one male and one female.

Zheng Ren's inability to recognize faces made him give up trying to remember anything else. Memorising their gender was already hard enough.

Had there been any subtle differences he had missed? Zheng Ren thought about it for a moment before halting his search for truth.

If they wanted it, they could have the surgery, and if they did not, they would not have to.

As doctors, only certain emergency cases would require them to rush to treat patients, unless they were from Putian hospitals or Quanjian (Tianjin) Tumor Hospital.

He was somewhat rushed for time with two 3D reconstructions in the afternoon.

From his schedule, Zheng Ren concluded that he would not be able to make it for lunch.

At 10.45 a.m., Zheng Ren and Professor Rudolf Wagner went to the CT room to wait so that they could start right after the technicians left for their break.

The professor was unsure why Zheng Ren had wanted to personally come down to the CT room. In his opinion, a general surgeon required already excellent skill to even understand a CT scan.

After greeting the deputy senior consultant of the CT room, Sister Zhao, Zheng Ren began operating the machine as the other staff departed for lunch.

The professor personally disagreed with Zheng Ren's habit of skipping lunch, but had likely been brainwashed by Chang Yue into thinking that it was the Chinese spirit and the reason Zheng Ren refused to follow him to Heidelberg University.

Therefore, despite being famished and irritable, he remained silent and sat behind Zheng Ren, observing the man closely.

Ever since Zheng Ren's first 3D-reconstructed 64-slice CT scan on Zheng Yunxia, he had gained a good grasp of the technique.

His skill had especially improved after the reconstruction of a prostate capillary network.

This scan of a liver was much easier in comparison to all that he had done before.

Watching Zheng Ren operate the scanner and perform the reconstruction, Professor Rudolf's initial dissatisfaction and confusion turned into a growing realization.

It was the same thing done during the prostate interventional surgery!

Zheng Ren's proficiency and intricacy during the surgery in Imperial Capital aside, the professor could not comprehend how the man had managed to map out so many capillary networks.

Watching Zheng Ren perform 3D reconstruction of a 64-slice CT scan in person finally answered the burning question.

This was how he had done it!

Since Professor Rudolf Wagner had a background in medical imaging science and interventional surgery, he understood how the reconstruction worked.

He was a world-class physician inside and out.

After a little over ten minutes, he already had several questions in mind.

Zheng Ren had no intention of withholding any information and answered all the professor's queries unreservedly.

Half an hour later, the professor could discuss operational details with Zheng Ren and had his own opinions on the retrograde reconstruction of the tumor blood supply vessels.

Both of them differed in opinion and method as they had had very different upbringings.

Zheng Ren had been groomed by the System while the professor had the experience of thousands of cases.

The latter had a richer well of direct involvement to draw from while the former was stronger in terms of thought process and integration capability.

They listened to each other and occasionally had a heated debate during their discussion. Zheng Ren gained a lot from their conversation.

One and a half hours later, 3D reconstruction of 64-slice CT scans for both patients was complete.

Zheng Ren already had the initial framework for the surgeries tomorrow in his mind.

The insertion point, the choice of artery for embolization, routes to enter to prevent embolization of normal arteries; he had it all planned out.

It was an amazing feeling.

Suddenly, Zheng Ren thought of the nodular hepatocellular carcinoma surgery he had performed in Imperial Capital. This time around, he ought to be able to finish it more quickly.

He could complete ten of these surgeries in a day.

The professor had completely forgotten about missing lunch and working overtime. On his way back, he continued to discuss details of the scan and reconstruction with Zheng Ren.

This was the first time Zheng Ren had shared his thoughts with a world-renowned professor from an academic standpoint. The professor had many ideas worth considering and his input could only help Zheng Ren further refine his skill.

They headed back to the ward, but before they could enter, Zheng Ren heard a commotion down the corridor.

Was it a medical dispute?

Zheng Ren's heart fell.

Doctors would rather face major emergency rescues than medical disputes.

Some people dared to take off all their clothes and sit naked in the corridor as they wailed to imply that doctors had done something abominable.

However, it was strange how doctors with questionable ethics seldom got into trouble. More often, it was the well-mannered and skilled who got embroiled in controversy.

Going after a soft target was easier, after all.

Zheng Ren's hands were tied.

Perhaps it was true that "bad money drives out good", according to Gresham's law. After enough time, perpetrators would be left with mediocre doctors that could end up misdiagnosing them. What would happen then?

Despite his anxiety, he still had to handle the situation.

He entered the emergency ward and saw a middle-aged man swearing in the corridor.

Beside him was a woman trying to calm him down.

Zheng Ren could not recognize him from appearance, but remembered them as family members of the patient in ward 3-8, who had just gotten a 64-slice CT scan with 3D image reconstruction.

What was happening?

The man was not berating doctors and nurses, but rather going on about how the hospital was not providing the necessary medical care, including something about no IV drip being provided even two to three days post-admission.

Zheng Ren was puzzled, but ignored the man and went into his office.

Chang Yue was typing furiously on her computer.

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Chapter 339: A Long Sigh

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

"What's happening?" Zheng Ren asked.

"They're doing a double act." Chang Yue's tone suggested she was unpleased.

The professor was stunned. "A double act?"

Even though he was a savant at languages, he had yet to master all the terms during his short stay.

However, neither Zheng Ren nor Chang Yue was in the mood to explain it to the professor.

Zheng Ren had just finished a 64-slice CT scan with 3D image reconstruction for the patient in the ward 3-8, whose condition was assuredly under control based on the data shown.

However, both his children were playing good cop, bad cop, and Zheng Ren could not understand why.

Seeing Zheng Ren's confusion, Chang Yue explained nonchalantly, "The admission was a setup."

It was ridiculous.

"They did it as a display of filial piety toward their family friends. When their father became sick, they didn't bring him to a rural health center and instead, chose to go straight to Sea City's best hospital." Chang Yue's tone was becoming so harsh that Zheng Ren could feel the biting cold behind it.

"After all their family friends came to visit, they started to request a self-discharge."

"I tried to talk to them and asked them to wait for you to return after the 64-slice CT scan to decide the treatment's success rate. However, it was then that the patient's son started to make a scene."

With just a few simple sentences, she had painted the complete picture.

Few were willing to spend money on old folks. They would only splurge on funerals after their seniors passed away.

Everything was designed to show off to the living and uphold their reputation.

Zheng Ren understood that.

And because he understood it, he knew he was boxed into a corner.

The patient's condition could still be stabilized. Although liver cancer was commonly called the emperor of all maladies, Zheng Ren predicted that the patient could live for at least another three to five years without the need for any costly, targeted drugs if he visited the hospital every two months for surgeries and follow-ups.

However...

This was frustrating.

"What are you doing?" Zheng Ren asked.

"I'm drafting the self-discharge consent form." Chang Yue turned to say as she continued typing.

Zheng Ren had no choice. He could not pin the old man to the operating table and perform the surgery, could he?

The office was very quiet. Professor Rudolf Wagner had many things he wanted to discuss with Zheng Ren but was forced to hold it in as he felt the tension within the room.

It felt as if he were being choked.

Soon, Chang Yue was at the office desk and calling for the family of the patient in ward 3-8.

Instead of the man who had been swearing uncontrollably, the woman who had held him back came in.

Immediately, she said in embarrassment, "Doctor, I'm so sorry. My brother has a bad temper."

If Chang Yue had not explained the situation to Zheng Ren earlier, he would have believed her.

It took incredibly acting to successfully lie to an experienced clinical doctor. Her expression was delicate and sincere, filled with sorrow and helplessness.

Nevertheless, after Chang Yue's briefing, Zheng Ren saw right through her.

"Sign here." Chang Yue did not put on her usual smile for communicating with patients' families. She was as cold as a statue.

"Oh, okay." The woman nodded repeatedly as she reached for the pen.

"Write here that you're aware that the patient is diagnosed with liver cancer and that it's treatable with surgery. However, due to financial and personal reasons, his immediate family have decided against having surgery after discussion and are forcefully requesting a self-discharge. You will be solely responsible for any consequences resulting from the discharge." Chang Yue's explanation was cruder than usual.

Zheng Ren could feel the anger radiating from her.

The patient's daughter was shocked.

"Don't worry, no one will see this agreement," Chang Yue said. "It's just to prove that I've briefed you on this. If Old Chief Physician Pan asks, I will have something to show him."

At the mention of Old Chief Physician Pan's name, the patient's daughter squirmed.

She signed the form and wrote the words Chang Yue had said without hesitation.

Zheng Ren felt an indescribable feeling as he watched the woman finish the paperwork.

It was mostly pity.

Even if the patient received only one surgery, he would be able to live for at least another six months to a year.

If he left now, his disease would kill him within three to six months.

Zheng Ren let out a long sigh.

The patient's daughter completed the documentation quickly and asked a few questions on the discharge time.

Chang Yue impatiently answered them and left to proceed with other work.

The patient's daughter were going through a mixture of complicated feelings, but Zheng Ren had no interest in digging deeper. Recognizing that she was exactly as Chang Yue had described, he lost interest in her and continued to read the Fundamentals of General Surgery.

The professor found all of this very new and strange. He blinked, seemingly lost in thought.

The patient's daughter hurriedly left the office. Within half an hour, she had packed up and left with the patient.

Such were the difficulties of being a clinical doctor.

The human heart was unpredictable. One could hurt themselves if they were not careful.

This time around, the patient's family members had stopped requesting a self-discharge and avoided berating Chang Yue and Zheng Ren due to Old Chief Physician Pan being around.

Were they anyone else, there would have been a big fuss.

After Chang Yue finished the patient's discharge process, she tossed the case file onto the nurse's station. She then went to change and irritatedly notified Zheng Ren that she was leaving.

Zheng Ren did not dare to step on her toes. It was something not even Su Yun had the guts to do.

The weather was not ideal, the afternoon sun was weak and chilly.

Zheng Ren continued reading, aware that the usual warmth from the sun was absent.

While he read, he texted Xie Yiren via WeChat. Time flew when he chatted with Xie Yiren. In the blink of an eye, it was already time for his evening shift.

...

At that moment in one of the Class Two Grade A Hospital in Horqin Right Middle Banner of Inner Mongolia [1].

An interventional doctor was participating in a multidisciplinary case conference review.

In the ICU, there was a patient being presented with lower gastrointestinal tract bleeding. The entire hospital did not know what to do.

At the beginning, the patient was going to be abandoned. However, after watching the hybrid surgery from Xinglin Garden, the interventional doctor got inspired and joined the conference.

He understood clearly why the hospital had decided to hold a multidisciplinary case conference review.

It was because they were unable to treat his disease.

The purpose of the conference was just to show that the hospital had paid attention to his case. They could not treat him simply because they were unable to, not because of malpractice.

This would have been impossible in the past.

Now, the interventional doctor thought that the patient had a fighting chance.

The deputy chief of the medical administration division had chaired the multidisciplinary case conference review. Each department chief spoke in turn.

All of them thought that the patient was too old, and the complication risks after surgery... No, not risks. The patient would definitely die in surgery.

If they chose the conventional treatment, he had a 1% survival chance.

It would be totally up to fate.

The interventional doctor did not judge them as they were just restricted by current medical limitations.

More than a century ago, pulmonary tuberculosis was untreatable, but times had changed.

Since the interventional department was the last department on the list to speak, the interventional doctor sat at the far corner and waited a long time for his turn to speak.

After they had all finished speaking, the medical administration division's deputy chief had started to pack up before dismissing the conference. He asked one last routine question, "Does anyone else want to share their opinion?"

"I have something to say."

...

Author's note:

One of my patients was the head of the food bureau of Horqin Right Middle Banner of Inner Mongolia. He had retired for a few decades. I've always remembered the name of this place because it sounded interesting.

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Chapter 340: Boundless Merits

All the doctors were stunned.

It was obvious that the deputy chief of the medical administration division had simply planned to dismiss the meeting with that question.

How could someone be so dense?

Also...

Who was he!

There were more than a thousand people in the hospital. The interventional doctor was not a sociable person. More than half of the doctors present did not know what his specialization was, while the other half knew that he was into interventional surgery but did not know what his skills were like.

It startled the medical administration division's deputy chief, and he put down the things in his hand in discontentment.

"We can find the source of bleeding in the lower gastrointestinal tract and resect that portion of the intestine," the interventional doctor said confidently.

If he had only read the surgical procedure from a magazine or a book, he would not be this confident.

However, the surgery kept replaying in his mind, and he could clearly remember every single detail.

Medicine was an empirical science.

After watching the surgery, the only thing he could think was that if he had the skills to perform it, it would be the beginning of a new treatment method.

The patient would not need to lie on the ICU bed awaiting death.

At least his chance of survival would amplify by a few times.

"Hmm?" The medical administrative division's deputy chief and the department chief of general surgery were stunned.

They have never heard before that this disease was treatable!

The interventional doctor stood up. Even though he was at the far corner, his confidence-filled voice sounded throughout the office.

"A few days ago, there was a live surgery broadcast on the Xinglin Garden's professional forum that was similar to this case." The interventional doctor's voice was so firm and confident. "We can use interventional methods to locate the source of bleeding..."

The general surgery chief interrupted him. "It's pointless, we did try that. After the laparotomy, the source of bleeding was unrecognizable."

"No!" the interventional doctor said. "After locating the source of bleeding, we can perform embolization to block a portion of the blood supply from the mesenteric artery."

"That would lead to necrosis of the intestines!" The chief of general surgery's voice sounded a little sharp and angry.

This was ridiculous!

The necrotic intestines would be seen as an iatrogenic disease. This would be typical medical malpractice. Was this guy trying to ruin himself?

That had to be!

If he wanted to ruin his career, he should be doing it alone without dragging him into this mess.

"Yes! That's my intention." The interventional doctor once again recalled the live surgery broadcast in Xinglin Garden and continued, "About half an hour to an hour after the embolization, the necrotic intestines will show significant changes that are comparable to normal intestines. If we remove the necrotic portion of the intestine and connect the healthy intestines together, the source of bleeding would be removed."

It was fairly simple. Just like a trick, it was worthless after being revealed.

Before the secrets were exposed, it was like an unsolvable math problem.

His assertive voice inspired the crowd to think. Indeed, this method could work according to his description.

Even though it was risky, it was still a feasible method.

The general surgery chief was a little lost. He had never done a destructive operation before...

What if something happened? What then?

He glanced at the medical administrative division's deputy chief.

No chief could decide on the surgery. It would have been best if the hospital could bear all responsibility.

The deputy chief was also a clinical physician, but he was sick and tired of night shifts and decided to join the administrative division.

He considered what the interventional doctor had said and thought that it was worth a shot.

As a clinician himself, treating patients was a natural instinct.

If there was somebody to bear the responsibility, there was no harm in trying.

There was a vast difference between a 1% and 50% chance of survival.

Even if the patient had a 50% survival rate, there was the other 50% of death. This was an incredibly high-risk surgery.

He picked up the phone immediately to contact the chief of the medical administrative division and the executive deputy director who was the head of clinical operations.

He filled them in on the current situation and emphasized the surgical method's novelty.

A few hours later, the hospital contacted the family members and acquired their consent.

Like that, a "new" surgical method began in Class Two Grade A Hospital in Horqin Right Middle Banner of Inner Mongolia.

The interventional doctor was so excited, his hands were shaking.

Nevertheless, he quickly calmed himself and operated the micro-guide wire with simple instruments, superselection, radiography, and embolization.

He completed the series of procedures in a single sitting without any hesitation.

The surgery from the broadcasting room had been replaying in his mind countless times.

All of the procedures were "branded" into his mind.

The only thing that disappointed him was that the recording function in the live surgery broadcasting room was canceled. Otherwise, he could have replayed the recording to his colleagues in general surgery, allowing them to better understand the subsequent surgical process and thus minimizing its risks.

He was not prepared beforehand and did not think to pre-recorde the surgery. The next time, he needed to record the live surgery broadcast.

Even though he regretted it, he still had to proceed with the surgery.

Of course, there was one more thing—the embolization surgery took 1 hour and 6 minutes, which was much longer than the surgeon from the broadcasting room.

Nonetheless, the interventional doctor was not affected by it. It was normal to have a gap between him and the world's top professor, right?

It would be weird if they had the same level of skill.

After completing the embolization, the general surgeon went to the operating table.

He performed a laparotomy, searched for the intestines, and covered them with gauze soaked in warm saline.

The surgery proceeded with much difficulty under constant instructions from the interventional doctor.

Half an hour later, the intestines showed defined boundaries after changing the warm saline gauze several times.

The necrotic intestine was around 40cm. They removed the necrotic parts and stitched them back together. After ensuring that there was no more bleeding, they closed up the stomach too.

The patient's vitals were stable and the surgery was a success.

Even the chief of general surgery who completed the surgery was a bit surprised. He had encountered more than a hundred cases like this over the past few decades as a doctor.

Most patients died quickly, even those with family members who strongly pushed for surgery. There was almost...no one who managed to survive at the operating table, much less recover.

However, the chief of general surgery was quite certain that this patient would be able to survive if there were no serious postoperative complications in the ICU!

This...

He heard from the interventional doctor that the Xinglin Garden broadcasting room would have a live surgery broadcast at irregular times, presumably performed by a top surgeon from the Montreal Medical Center in Canada.

He did not know about Xinglin Garden. There were not many users on this kind of professional website. Most of them gravitated toward first-tier cities such as Imperial Capital, Sorcery Capital, and Shenzhen.

If the remaining users were averaged across the country, it would be lucky if there were one person per city to follow Xinglin Garden all year round.

A thought struck him; he would ask one of his residents to download the app for him after he got out of the operating theatre. He also wanted to watch world-class surgeries.

There were times that a simple thought could decide the fate of someone's life.

Canada was the homeland of Dwight L. Moody. To be able to organize live surgery broadcasts regularly, how great did their medical skills have to be?

The patient was transferred to the ICU. The interventional doctor was still drenched in sweat.

Even though he was physically exhausted, he was still riding on an adrenaline high.

The surgery succeeded! This meant that the surgery he observed in the Xinglin Garden broadcasting room was replicable!

This also meant that more patients could receive such treatment!

The interventional doctor was touched. The broadcasting room's merits really held no bounds. At the very least, the patient who had just received surgery just now would have died if not for the broadcasting room.

...

Zheng Ren was unaware of what was happening in Horqin. He probably did not know where Horqin was.

His afternoon was filled with reading and texting Xie Yiren.

Sometime past 3 o'clock in the afternoon, his office phone rang.

He answered the call, it was from the orthopedic department.

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Chapter 341: Go All Out

A feminine voice could be heard from the other end of the phone call. "Chief Zheng, I'm Old Zhou from ortho."

Dr. Zhou in orthopedic was a good man but spoke in a feminine manner.

His voice was too distinct, so Zheng Ren was able to recognize him immediately.

"Brother Zhou, what is it?"

"Are you busy? There's this interventional surgery on a patient who needs vertebral column resection surgery..." The voice over the phone hesitated, "Can you perform the surgery later?"

Hmm? Why was he in such a hurry?

"I have some free time. Has the patient finished fasting?" Zheng Ren asked nonchalantly.

"Yes! Yes!" Dr. Zhou replied instantly. "We actually invited a professor from the Imperial Capital to perform this surgery, but the professor had an emergency and could only fly in tomorrow morning or he would need to delay the surgery for another 3 to 5 days." Dr. Zhou explained hurriedly.

It was almost time to leave work. Zheng Ren's agreement to do this surgery would depend on his personal ties with him.

"The patient is in a lot of pain, requiring plenty of pain meds to suppress the pain. I'm thinking that if we could do the surgery earlier, the patient wouldn't have to suffer as much."

"No worries, Brother Zhou. I don't have any emergency surgeries here at the moment. If it's convenient, you can ask the family members to sign the consent and just send the patient over to me," Zheng Ren said while chuckling.

"Oh, okay," Dr. Zhou hastily agreed. "I'll refer you to the family members now."

He hung up right after.

Zheng Ren immediately started writing the pre-operative briefing. Since this was the first time they would be attempting this new method, Zheng Ren was figuring out the possible complications that could arise and noted them down.

The professor saw Zheng Ren start working and approached him. "Boss Zheng, are you going into surgery now?"

"Uhm," Zheng Ren replied.

"You guys work all day and night." As the stereotypical German, the professor had opinions on him going into surgery right when they were about to leave work.

The time after working hours was personal. The professor was not accustomed to such an unbalanced work-life schedule.

They were not living, simply enslaved to the hospital.

Nevertheless, the professor was unwilling to leave and even if he did, Zheng Ren would not stop him.

The 64-slice CT scan with three-dimensional image reconstruction from this afternoon opened new doors for the professor, allowing him to take a peek of a whole new world.

He could probably catch a glimpse of the new world from this surgery.

The professor only wavered for a second before he decided to stay.

Zheng Ren was totally unaware of the drama happening inside the professor's mind as he was busy assessing the preoperative checklist. When the young lady arrived, Zheng Ren was still deep in thoughts about the possible complications.

He wrote down those that he could think of so that he would be able to brief the family members.

The young lady was not affected by it. In her words, this was the time for family members to give their best support to the patient and leave the rest to the doctors.

She was also mentally prepared if the patient would not come off from the operating table alive so that she would be less burdened.

She willingly signed the preoperative forms that Zheng Ren drafted. She then went back and brought over the patient to the emergency ward to prepare for surgery.

Zheng Ren called the operating room to prepare for surgery, bringing the professor to the operating room without notifying Su Yun.

The professor, who had been waiting for Zheng Ren to be free, kept bombarding him with questions about the 64-slice CT scan with three-dimensional image reconstruction.

Zheng Ren did not pay much attention to the professor's questions. He kept his head lowered and changed, occasionally replying the professor.

His mind was filled with questions related to the lumbar artery embolization.

He needed to go to the System's operation room to practice. He figured he would have sufficient experience after ten to twenty surgeries.

Now that Zheng Ren was rich in resources, he had decided to splurge on ten to twenty trials on this new surgical method without even thinking.

He was also not concerned about the surgical time required per trial.

In the past, he would definitely not do this.

It was easy to go down the slippery slope of luxury.

After he finished changing, Zheng Ren told Professor Rudolf to prepare the preoperative measures. He then entered the smoking-room and lit up a cigarette before entering the System.

He bought some surgical training time. The System's operating room emerged from the ground and the simulation mannequin appeared right in front of Zheng Ren.

The lumbar arteries were parallel with the intercostals. There were usually four of them, two each arising from the front and back of the intervertebral foramen.

The arteries in front passed through the transverse process, which continued along the intertransverse ligament. They then pierced through the posterior aponeurosis of the transversus abdominis and were carried forward between this muscle and the obliquus internus to supply blood to the posterior abdominal wall.

The arteries at the back passed through a finer intervertebral foramen into the spinal canal to provide blood supply to the anterior spinal dura mater and the posterior vertebral column.

At the same location, the posterior branch then continued behind to supply the lumbar plexus.

Not only did he need to perform embolization on the posterior branch, but he also had to embolize the abnormal growth of blood vessels from the main branches and the tumor.

He had already confirmed this in the afternoon when he did the 64-slice CT scan with three-dimensional image reconstruction.

Since the patient had an advanced tumor, this was also considered to be a palliative surgery to improve the patient's quality of life post-surgery. Therefore, they had to try their best to block the abnormal arteries supplying to the spine and avoid introducing complications at the same time.

A simple destructive operation would not be this difficult. Without the embolization of the lumbar arteries in the past, the bleeding volume during surgery would be around 3 to 5 liters.

This was a terrifying number.

If they embolized the lumbar arteries, the bleeding could be controlled under an acceptable range of 1.5 to 2 liters.

Zheng Ren used almost 3 hours to complete his first surgical training.

Zheng Ren decided that he was not only going to embolize the posterior branch even though that method would be much easier and satisfy the requirements of an orthopedic surgeon from Imperial Capital.

However, losing 1.5 liters of blood would significantly affect the patient's life.

In order to increase the patient's quality of life in their last remaining days, they needed to minimize the bleeding.

He needed to embolize the intercostal arteries on both sides, the lumbar arteries, and the surrounding capillaries in order to reduce blood loss during surgery.

In reality, there was no need for Zheng Ren to do that.

However, as a doctor, one would always give their best to improve the patient's recovery if the situation allowed. If there was no chance of recovery, they would always try to improve their quality of life.

The blood supply to the spinal cord was very rich. Other than the need to avoid the Adamkiewicz artery, Zheng Ren would need to carefully scan the other arteries and check if they were connected to other organs or the spinal cord. It was only then that he would cut off the arteries that supplied blood only to the tumor.

The surgery progressed very slowly. Zheng Ren gradually got a grasp on the embolization techniques.

It was not easy to be at the Grandmaster level.

Even after completing 10 surgical training, Zheng Ren could only complete the lumbar artery embolization surgery within two hours.

Just to qualify under Zheng Ren's standards, this surgery was much more difficult than prostate interventional surgery.

This was because even if he embolized the wrong capillaries in the prostate, it would not cost the patient's life.

Similar to the patient treated by Professor Rudolf Wagner whose superior vesical artery got embolized, the patient only had urinary incontinence which could be solved by a urinary catheter.

This time, he was going to embolize arteries from the spinal cord's blood supply.

One mistake would paralyze the patient's lower body and even cause respiratory arrest and lead to the patient's death.

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Chapter 342: Working the Professor Like A Servant

Zheng Ren took a drag on his cigarette after exiting the System's operating room. He then crushed the butt and placed the second half of the cigarette back into the box.

Chang Yue used to tease him about this.

However, it became a habit that he found difficult to change. Besides, there was no need to change it either.

When he arrived at the operating room, the patient was positioned accordingly. Dr. Zhou greeted Zheng Ren from the operating console room.

"Brother Zhou, you're here." Zheng Ren began to scrub in.

"I'm troubling you at such a late hour. It wouldn't be right if I didn't accompany you," Dr. Zhou said with a smile.

"Right, who's the guy inside?" Dr. Zhou asked, pouting.

"Oh, he's a professor from Germany. He's here to observe," Zheng Ren answered briefly.

"..." Dr. Zhou was at a loss for words.

A German professor here to observe? More like he was gracing them with his presence. Instead, you use him like a servant and made him do all the work while you stand outside chatting happily like a department chief.

Even though Dr. Zhou had questions, he only gave him a smile and kept quiet.

He asked a neutral question. "Which university is the professor from?"

"He's Professor Rudolf Wagner from Heidelberg University," Zheng Ren answered. He saw that the professor had completed the preoperative work and notified Dr. Zhou before entering the operating theatre.

Professor Rudolf Wagner, Heidelberg, why did that all sound so familiar?

The surgery had begun.

People were waiting excitedly for the live surgery broadcast in Xinglin Garden.

The interventional doctor from the Class Two Grade A Hospital in Horqin Right Middle Banner of Inner Mongolia had set a unique ringtone on his phone. Once he heard it, he would spring up like Pavlov's dogs and switched on his phone at the speed of light.

The interventional doctor and the chief of general surgery were exchanging formalities over a meal after the surgery. The chief was not very pleased when he saw him suddenly whip out his phone at the table.

"It's the live broadcast in Xinglin Garden," the interventional doctor explained.

The general surgery chief's face lit up. He logged into the broadcasting room of Xinglin Garden with his subordinates' help.

The general surgery chief was disappointed when he saw the diagnosis.

It was not a general surgery. Embolization on the lumbar arteries?

From an anatomical perspective, the lumbar arteries supplied blood to the abdomen. There would be serious consequences after the embolization.

Medical care in Canada was really so advanced if they were able to perform surgeries like these.

"Too bad Chief Han from ortho is not here. He'd be very interested in this." The interventional doctor's eyes were fixed on the screen. The general surgery chief thought about it and dialed Chief Han's number.

The hospital was not very big. Even though they had over a thousand employees, most of them were office staff and at least 20% of them usually skipped work.

The department chiefs were very familiar with one another.

The live surgery broadcast was just an excuse for them to gather and drink. It was also for them to brag about the surgery they performed today.

In Xinglin Garden, half of the viewers were shocked after reading the diagnosis.

Embolization of the lumbar artery?

Why did it sound so far-fetched?

[Why would they embolize the lumbar artery. Thoughts, anyone?]

[Yeah, the patient has an advanced tumor. What's the point of lumbar artery embolization?]

[Thanks for the invitation. Let me explain to you guys briefly from an orthopedics surgeon's perspective.

To remove the spinal cord tumor, it would involve complicated operations to resect the vertebra. In order to reduce the amount of blood loss that could lead to death, the patients should undergo embolization on the tumor arteries, with selective sectioning radiography on the chest and spine 24 or 48 hours before the surgery.]

[Uhm, not too long ago, our hospital did the first spinal cord tumor resection. We did not perform embolization and the patient lost 6 liters of blood. Blood was flowing out even under constant transfusion. The orthopedic surgeon almost peed his pants.]

[You guys can do it even without an interventional doctor. It's quite easy to do the lumbar artery embolization with a Gelfoam sponge.]

[if it was that easy, would the professor be doing this? Why do I feel that besides the appendectomy that I missed, the surgeon's broadcasts are becoming less frequent but with an improvement to surgery quality over time? All of his surgeries are extremely difficult to pull off.]

Before the surgery had begun, everyone was happily exchanging their views and opinions.

In the hybrid operating room, Professor Rudolf had inserted the catheter in the femoral artery and fixed the arterial sheath in place, waiting to assist Zheng Ren in surgery.

The professor had gone down a rabbit hole with no end.

Only a few days ago, Professor Rudolf Wagner was the world's top surgeon. He had probably not done any preoperative work for at least a decade long.

However, he had accepted his fate in such a short period of time and became an "excellent" assistant.

Zheng Ren was used to Su Yun inserting the arterial sheath beforehand so that he could start the surgery immediately. However, he was not bothered by whether it was Su Yun or Professor Rudolf doing the preop.

He went on the operating stage and inserted the micro-guide wire. The surgery had now officially started.

When Zheng Ren intentionally avoided the lumbar artery and started the embolization on other smaller branches, many experienced orthopedic surgeons went berserk.

[What surgical method is this surgeon applying? Isn't the surgery over after inserting the Gelfoam sponge into the lumbar artery? The main event is the vertebral resection.]

[Ya, why is the surgeon performing embolization on the branches?]

[That's so strange.]

Everybody was baffled on why he was trying to complicate such a "simple" surgery.

Indeed, more artery embolization would significantly reduce blood loss but at the same time, it would amplify the overall risks.

It was not worth it.

Time passed as Zheng Ren embolized one artery after another with the assistance of Professor Rudolf Wagner.

Even the professor could not understand his methods at the beginning.

However, he was still the world's top interventional surgeon. He understood Zheng Ren's intention 5 minutes into the embolization.

Professor Rudolf could sense Zheng Ren's ambition to "complicate" this surgery.

What was supposed to be a simple surgery had turned into a complicated operation.

Was this the reason why Zheng Ren brought him along to the 64-slice CT scan with three-dimensional image reconstruction? Was he trying to show him something?

Once again, Professor Rudolf was overthinking and got all excited.

Based on his professional judgment, Professor Rudolf had guessed that Zheng Ren also did a 64-slice CT scan with three-dimensional image reconstruction prior to performing the prostate interventional surgery.

Zheng Ren must be trying to teach him the embolization techniques through this surgery.

What a selfless young man, Professor Rudolf Wagner thought.

The professor paid full attention since it was related to the prostate embolization surgery, which was his main concern.

Dr. Zhou was totally lost in the middle of watching Zheng Ren and the German Professor from the operating console room.

He did not know much about interventional surgery, but the surgeons from Imperial Capital told him that it would only take around twenty minutes.

How long had it been?

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Chapter 343: A Surgery That Will Leave Female Doctors In Tears and Male Doctors Speechless

It seemed like Dr. Zheng was not up to their standards, Dr. Zhou judged silently.

It was fine as long as he could get the job done because he did not know how to perform the surgery himself.

Dr. Zhou had a kind personality. Even though he had never done any research on interventional surgery, he did not complain when Zheng Ren took longer than expected. Instead, he thought of how tough it must be for Zheng Ren.

In a third-tier or fourth-city like Sea City... It was considered lucky to have someone who knew how to perform interventional surgery. If Zheng Ren was not here, they might not have been able to invite the professor from Imperial Capital.

Who would want to risk having their patient bleed out 5 to 6 liters of blood after surgery?

He took his phone and started communicating with Professor Tian from Imperial Capital.

Dr. Zhou described the situation to him, saying that the surgery had been going on for more than an hour.

The professor from Imperial Capital told him not to worry. For a rural area to be able to handle interventional surgery, it meant that they were coping very well.

Suddenly, a thought emerged in Dr. Zhou's mind. This professor from Imperial Capital was his mentor while he was pursuing his further studies. He vaguely remembered hearing him mention of Heidelberg University.

He hesitated for a moment before sending out a text.

[Professor Tian, I remember that you told me that you studied in Germany before?]

[Yes, I have a PhD from Heidelberg University.]

Professor Tian from Imperial Capital replied.

Dr. Zhou shuddered internally. No wonder Heidelberg University sounded so familiar to him. Professor Tian had graduated from there.

No wonder.

Another question came to his mind. It was not his intention to embarrass Zheng Ren but merely out of curiosity.

[Professor Tian, do you know Professor Rudolf Wagner from Heidelberg University?]

He messaged him without hoping for an answer.

A world-class university would have countless professors. Professor Tian was just a postgraduate student, so how many professors would he have gotten to know then?

However, he got a reply shortly after sending the text out.

[Of course I know him. He's the world's top interventional professor. I even studied interventional surgery under him for a period of time. Lumbar artery embolization may seem easy on the surface but is very technical.]

Dr. Zhou was completely stunned...

Could it be? The name that Chief Zheng had mentioned... Had he heard wrongly?

It was definitely impossible. Why would a professor from Heidelberg University who had taught Professor Tian surgery come all the way to Sea City?

Dr. Zhou mocked his own ridiculous imagination.

[Professor Rudolf Wagner only needs 5 minutes to perform a lumbar artery embolization. He works at an incredibly fast pace.]

Professor Tian replied to Dr. Zhou with another text.

Dr. Zhou chuckled. He must have heard the name wrongly. An hour and a half had passed and the surgery was still not finished.

Dr. Zhou kept his phone after arranging to pick up the professor from the airport tomorrow morning.

The broadcasting room in Xinglin Garden was very quiet. All the orthopedic surgeons were in a daze, and even the interventional doctors were dumbfounded.

The surgery was extremely intricate.

In comparison to the surgeon's operation, the lumbar artery embolization performed by the orthopedics surgeon...was rubbish.

Could theirs even be considered surgery?

Look at how he was doing it!

The orthopedics surgeon watched the usual arteries and new ones get embolization one after the other. They put themselves into the surgeon's shoes and were surprised by the magnitude of blood loss that could be prevented.

Of course, those who managed to come up with this conclusion were all skilled surgeons.

For instance, doctors like Dr. Zhou, who could only rely on inviting other professors to perform the vertebral resection, had no idea what Zheng Ren was doing.

All the interventional doctors were in awe. Looking at the hair-like arteries and capillaries being embolized one after another, there was only a single thought in their minds—this surgeon was truly amazing.

The ones who failed to understand did not know how to comment, while the ones who did were so shocked that they were at a loss for words.

There was rare silence in the Xinglin Garden's broadcasting room.

Another half an hour had passed and the surgery was finally completed. A stream of comments like bullets started filling the screen for almost 10 minutes after the broadcast had ended.

[My goodness... That was f*cking incredible!]

[That was the best partner an orthopedic surgeon could get. If our hospital has an interventional doctor like him, I'm up for resectioning any part of the vertebra!]

[I estimate that the bleeding would be less than 1 liter. This is a figure that no one has dared to hope for. It's a miracle.]

[1 liter? Are you joking? How bad are your skills? I think it would be capped at 600 mL.]

[This is a surgery that'll leave female doctors in tears and male doctors speechless. I'm really jealous. I think our hospital is offering a fellowship in Canada. I must fight for it this time.]

[Host, please send my regards to the surgeon. I'm looking forward to seeing you in the broadcasting room.]

[Stop dreaming, do you think you can get onto the live surgery broadcast as an exchange student? Have you seen the surgeon's assistant? Regardless of general surgery or interventional surgery, all his assistants have shining credentials.]

[You make me feel hopeless...]

Comments rained on like bullets. The interventional doctor from Horqin Right Middle Banner remained silent.

All enthusiasm and excitement from succeeding in the mesenteric artery embolization surgery was gone.

What he had just witnessed was the vast distance between him and the surgeon, devastating his pride.

However... What else could he do? The surgeon had the skills of a world-class physician! It was understandable that he could not compare.

Chief Han from the orthopedic department also had no idea what was going on in the live surgery broadcast. He gave a few glances and proceeded to start a drinking competition with the general surgery chief.

The interventional doctor was disappointed as they did not know how to appreciate the top-class surgery presented right in front of them.

He felt so depressed, it was as if all the air had been sucked out of his lungs. This was not the way of becoming a doctor!

Nevertheless, he seemed so out of place in an environment like this.

He had no one to blame if he got sidelined and bullied.

Should he spend all his time at social events to entertain others? If he did, would he have any time left to study?

The interventional doctor was lost in his dilemma.

...

In the emergency operating room of Sea City General Hospital, Zheng Ren removed his sterile gown and kept his lead vest into the System before entering the operating console room.

"Brother Zhou, the surgery is done."

"Thanks for the trouble."

"No worries. There shouldn't be much bleeding tomorrow," Zheng Ren said confidently.

"Hmm?" Dr. Zhou was a little surprised. "I've prepared 20 units of red blood cells and plasma."

"Just hold on to it. There's no hurry to retrieve them. I was thinking that if the professor from Imperial Capital has the skills that I expected from him, the patient would only lose around 500 mL of blood and might not even need a transfusion," Zheng Ren said.

"..." Dr. Zhou noticed that Chief Zheng was really good at being boastful.

The global standard for the bleeding volume of a vertebral resection was under 2 liters. It was already remarkable if one could keep it under the standard volume.

Did he just say 500 mL?

Was he out of his mind?

However, Dr. Zhou had always been very feminine and gentle, so the smile on his face never faltered.

He just smiled politely after hearing Zheng Ren's "boasts".

After all, Zheng Ren had willingly stayed behind to help him with the surgery.

He could not look down on him due to his gloating post-surgery.

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Chapter 344: A Movie Date

Zheng Ren glanced at his watch. Fifteen minutes had passed. Professor Rudolf Wagner was still applying pressure to stop the bleeding. He seemed to have lost track of time.

"Lil Fugui!" Zheng Ren called out.

"What's the matter?" The professor was startled for a while before he regained his composure and answered the call.

Dr. Zhou shuddered. A country-like Fugui was appalling enough.

When the professor spoke in a pure Northeastern dialect that was rarely heard even in the Northeastern region, it was the last straw that finally broke Dr. Zhou.

What in the...

"It's time, wrap it with compression bandages and hand over the patient to Brother Zhou." When Zheng Ren finished saying that, Xie Yiren had appeared in front of the professor with the compression bandages in her hands.

"Brother Zhou, I'm not following the patient back," Zheng Ren said with a smile. "As usual, just remove the compression bandages after 24 hours. However, since you guys are performing the vertebral resectioning, you should listen to the Imperial Capital professor."

Dr. Zhou was still immersed in the Northeastern slang that Professor Rudolf had just used.

He nodded his head in a daze after hearing what Zheng Ren had said.

"Right, Chief Zheng. I'll be picking up Professor Tian tomorrow. After the surgery and postoperative care, I'll take you out for a meal," Dr. Zhou said. "Thanks for the favor."

"No problem," Zheng Ren said before chuckling.

After transferring the patient onto the stretcher trolley, Dr. Zhou waved his hand at him before pushing the patient out together with another orthopedic doctor.

The operating room finally quieted down.

"Lil Fugui, you should head back to the hotel and rest," Zheng Ren said to Professor Rudolf when he was finished with work.

"Boss, remember to page me if you have an emergency interventional surgery tonight," the professor said, reluctant to leave.

If the doctors from the Xinglin Garden were in shock, it seemed that the professor was the one who had truly become enlightened by the crux of the surgery.

Professor Rudolf felt as if he were back in his internship days. His entire body was energized and emergency surgery did not seem so dreadful after all.

"It's after work hours and your personal time, Lil Fugui." Zheng Ren waved his hand.

The name Lil Fugui seemed to roll off the tongue better.

It was a good name.

"No, Boss. F*ck personal time." The professor gave a reassuring gesture and said, "I'm your assistant now. You have to call me if there's an operation."

"Okay." Zheng Ren had been scouting around after sending the patient away. Xie Yiren and the circulating nurse were busy cleaning the surgical waste in the operating room and sterilizing the area. He thought about it several times before making a decision.

Zheng Ren went to the changing room together with the professor. He then chased the professor back home before taking out his phone to text Xie Yiren over WeChat.

[Any suggestions for dinner tonight?]

She should be busy because Zheng Ren did not receive an immediate reply. He gripped his phone tightly and placed it into his coat pocket, using his hand to feel the vibrations as he feared that he would not hear WeChat's notification ringtone.

Zheng Ren quietly sat in the changing room and waited.

Should he ask Xie Yiren out for a movie tonight?

This was a problem.

Since Su Yun had told him about the story, Zheng Ren was fixated on the movie theater scenario as if under a spell.

He had only watched a handful of movies. He could not even remember which way the cinema doors open, not to mention the fact that he was about to watch a movie together with the girl he liked.

Zheng Ren's palms turned clammy at the thought of it.

His mind was blank, like a soldier about to go into battle.

His phone rang and vibrated 3 times, startling Zheng Ren who was entirely focused on waiting for her reply.

He took his phone out of his pocket, both anxious and excited. He was disappointed to find that the message was from Su Yun.

[Boss, Yang Lili's in the diuretic phase. She had more than 100 mL of urine per hour for three consecutive hours.]

Uhm, this was good news. Entering the diuretic phase meant that she had regained a certain level of kidney function after renal reperfusion.

As long as it did not progress to urinary incontinence, the injury would heal over time.

[Is she conscious?]

Zheng Ren replied.

[She can open her eyes but is still in a fuzzy state. You can reduce the dosage of sedative tomorrow, but that's a problem for tomorrow. I'm going back to sleep. If there's any emergency surgery tonight, please don't call me. I can't take it anymore.]

[Go ahead.]

The image of Su Yun sitting in the ICU appeared in Zheng Ren's mind, his messy fringe resting sluggishly on his forehead.

He laughed.

The possibility of the emergency rescue being a success was increasing. Su Yun had done a good job.

While he thinking halfway, Xie Yiren sent a text on WeChat.

[There's a newly open Cantonese restaurant. I heard that the chef is from Shunde. Do you want to try it?]

Zheng Ren had no idea that the most authentic Cantonese cuisine originated from Shunde. To a person who had no desire to eat when he was not hungry, bland and healthy Cantonese cuisine did not sound appetizing at all.

However, if it meant he could have dinner with Little Yiren... He would be happy no matter what.

After a brief moment of hesitation, Zheng Ren had a determined expression on his face.

[Let's go watch a movie after dinner?]

Zheng Ren could feel his heart beating strongly as if it was about to jump out of his mediastinum when he pressed the send button.

Even his ribcage and sternum could not hold back his pumping heart.

The high-energy phosphate bonds of ATP were breaking up, supplying ample energy. Zheng Ren was so pumped up that he could clearly hear voices from the microscopic world.

He was extremely nervous. What if Little Yiren rejected him?

It seemed like she was more interested in eating.

Why did Su Yun not teach him what to say over the course of a meal?

Zheng Ren's mind was filled with a rampage of thoughts. He had yet to receive any reply from Xie Yiren.

Zheng Ren's fear grew over time.

Gaining new feelings and the worry of losing them...

He had never felt something like this when he was...single.

[I've browsed through the showtimes. The earliest showing for the latest film is within an hour. We might not have time to eat. Let's watch the movie first.]

Zheng Ren felt relieved after reading Xie Yiren's reply.

However, there should have been a lot of movies screening at the same time. What would be the newest movie premiering now?

The question flashed across Zheng Ren's mind.

He should do whatever Xie Yiren wanted, why was he thinking so much?

[I'm in the changing room, just tell me when you're ready to leave.]

[You're not doing ward rounds?]

[I completed my rounds before surgery today. Su Yun just texted me that the ICU patient is in the diuretic phase and has regained consciousness.]

[Great, give me 5 minutes.]

[No need to rush.]

Zheng Ren tightly grabbed the phone in his hand, his heart full of affection.

Life was great. He was able to watch a movie with Xie Yiren after successfully completing a surgery.

He had totally forgot about buying movie tickets.

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Chapter 345: The Importance of Experience

Five minutes later, Xie Yiren's message came in, telling Zheng Ren to meet at the usual basement parking spot at Zone D.

The whole emergency department, be it the wards or the operating room, knew about Zheng Ren and Xie Yiren's budding relationship. However, Little Yiren was still hiding in her own world, unwilling to face the truth.

Zheng Ren happily went down to the basement parking.

He made sure his eyes were wide open as he searched for the curvaceous Volvo XC60.

"Weyh! Here!" Xie Yiren wound down her car window and called out.

It was 20 meters away and he failed to spot it. Sweat dripped from his forehead.

'I will succeed next time, next time!' Zheng Ren thought to himself.

"Yiren, where are you looking at?" Zheng Ren asked.

Xie Yiren drove out of the car park. "There's only one nearby."

Zheng Ren was puzzled and Xie Yiren continued, explaining, "The IMAX, of course."

Oh, so that was what she meant.

Did it mean that 2D and 3D cinemas were nothing in Xie Yiren's eyes?

"The surround sound and cinematic effects are amazing. Back when IMAX was not available in Sea City, I would drive to Provincial Capital to watch movies," Xie Yiren told Zheng Ren as she drove.

The country's first IMAX theater opened in Sorcery Capital when Xie Yiren was still in school. She fell in love with its atmosphere and effects. When Sea City got their first IMAX theater, she was ecstatic.

A third-tier city like Sea City only had one IMAX theater and Xie Yiren quickly became its loyal patron.

Zheng Ren listened attentively to her. Time passed them by gently.

Once they reached the cinema, Zheng Ren felt his anxiety work its way up.

Xie Yiren scanned the barcode to retrieve their tickets. She went downstairs and got them two ice cream cones.

"It's half price for the second cone. Every time I come to the movies alone, I would get two despite not being able to finish the second one. It's a bit of a waste." Xie Yiren chuckled. She handed Zheng Ren a cone and began nibbling at her own.

Zheng Ren did not know what ice cream flavor it was. The scene was playing out in a different fashion from what he had imagined. Life was not his to control.

He had thought to arrive at the cinema late so they could walk into the theater while it was dark.

He should have spent more time making the rounds, perhaps checking up on the ICU as well. That would have taken up some time.

He would take this as a lesson for the next time they came to the movies.

The ice cream was mediocre when compared to the faint smell of perfume on Xie Yiren's body, and Zheng Ren soon found himself intoxicated.

"Let's go!" Xie Yiren suddenly stood up.

"It's starting?"

"Yes."

Zheng Ren trailed behind Xie Yiren, his mind in a daze. She was wearing a white cap with two pom-poms that wiggled as she walked. She was adorable.

They entered the theater. The room was brightly lit, a stark contrast to what he had imagined.

Xie Yiren led them down the aisle, a youthful spring in every step.

Row 7, seat number 17 and 18. They took their seats.

Zheng Ren noted the armrest between the two seats and sighed.

This would be a learning experience for him. He would summarize all the learnings today and make sure history did not repeat itself.

Xie Yiren's ice cream was gone. She had her cap in her lap and was toying with the two pom-poms.

How Zheng Ren wished he could be the pom-poms in her hands.

The lights in the theater dimmed as the movie started.

Zheng Ren did not pay attention to the movie. Instead, he was surreptitiously moving his arm. He wanted to rest his arm around Xie Yiren's shoulders and pull her into his embrace.

At that moment, he realized the importance of the advice Su Yun had given.

Hypothetically speaking...

If he moved his arm over and Xie Yiren did not pull away, the biggest barrier between them would be the armrest.

Should he then remove the armrest?

Would that be too eager?

The gentle and unrushed atmosphere would be broken by that abrupt action.

At that moment, Zheng Ren had a measure of respect for the experienced Su Yun.

That guy ought to have gone through a lot of relationships to be able to distill such knowledge.

When Yang Lili's condition was better, Zheng Ren would have to consult Su Yun on the matter.

These thoughts occupied his mind as the movie played onscreen. He was oblivious to its plot.

He had abandoned the desire to get Xie Yiren into his arms. Instead, he focused on breathing the air that carried Little Yiren's scent. It calmed his wildly beating heart.

Unfortunately, fate had scheduled an interruption.

Less than an hour into the movie, Zheng Ren's phone buzzed in his pocket, snapping him out of his daze.

The number was from the emergency department. He answered the call.

The movie was at its climax and the booming sound effects effectively muted the caller.

He nudged Xie Yiren and signaled that he was going out to answer the call. He ducked down as he hurriedly made his exit.

"What's happening?"

"Oh, okay. I'll be back as soon as possible. Get gynecology to consult."

He ended the call.

He turned and found Little Yiren closing the theater door.

"An emergency case?" Xie Yiren asked.

"Yes, a 17-year-old girl with lower abdominal pain. A B-scan ultrasonography was inconclusive and they're asking for me to have a look," Zheng Ren said apologetically.

Xie Yiren gave him a sweet smile and put on her cap. She shook her head and the two pom-poms bounced in response.

"Come on, let's make haste."

Zheng Ren put aside his earlier musings and focused on his job.

They jogged to the car and quickly strapped themselves in.

This time, Xie Yiren's driving was no longer the slow crawl that Zheng Ren had gotten accustomed to. He felt the car's acceleration push him deeper into his seat.

Like a feral dog unleashed, the Volvo XC60 tore down the streets as it made its way to Sea City General Hospital.

Zheng Ren headed straight to the emergency department, forgoing a change of clothes.

Meanwhile, Xie Yiren went to the operating room and waited for Zheng Ren's call.

In the emergency rescue room, a young, pale-faced girl was clutching her abdomen in pain.

The gynecology department chief resident, whom Zheng Ren knew, was present.

There was no time for pleasantries. Zheng Ren asked, "What's your diagnosis?"

"Could be an ectopic pregnancy but the family and the patient denied any form of sexual contact," the gynecology chief resident whispered.

Zheng Ren questioned the sonographer. "What did the ultrasound show?"

"The blood vessels don't seem to be branching from the ovaries, though the pain is radiating from that area. I don't think it's a gynecological problem."

There was a disagreement between the two departments. Zheng Ren got the patient to lie flat on her back. The patient's pants were pushed down to reveal her lower abdomen. He applied the ultrasonic couplant and personally performed the ultrasound.

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Chapter 346: Accessory Spleen?

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

As the family and the patient had denied any past sexual contact, Zheng Ren could not suggest a transvaginal ultrasound and instead, settled for an abdominal ultrasound.

Although it was not as suitable, Zheng Ren had the System on his side.

Zheng Ren had trouble believing the System's diagnosis was true.

An accessory spleen torsion...

This diagnosis... If the patient was experiencing upper abdominal pain, Zheng Ren would take the System's word for it. However, the patient was hurting in the lower abdomen. Therefore, he decided to perform the ultrasound.

The uterus and the two ovaries showed no abnormalities. There was a lump next to the left ovary, approximately 5cm wide.

The doctors' disagreements lied there.

Zheng Ren held the ultrasound scanner in his right hand while his left hand depressed the patient's abdomen.

When he exerted pressure, he noticed the lump moved away from the ovary and the area between the two masses showed large blood vessels.

Zheng Ren was leaning toward the sonographer's diagnosis but understood why the chief resident suspected an ectopic pregnancy.

"Where's the family?" Zheng Ren asked.

An anxious, middle-aged woman approached him. "Doctor, how is my daughter?"

"We'll have to perform a surgical procedure to find out the tumor's roots." Despite having the System's diagnosis, Zheng Ren spoke in rather general terms to avoid trouble. "Let's begin the admission and surgery prep."

Sweat dripped from the middle-aged woman's forehead.

Most people were not keen on surgery.

Jokes of appendectomy patients dying post-surgery were constantly on people's minds. The probability of it happening was low but was still present.

"Chief Zheng, ring me when you start the surgery. I want to have a look," the gynecology chief resident said. She was excited to have encountered a tricky case.

She was confident in her diagnosis but the sonographer's observation made sense. Hence, she wanted to have a closer look.

In general, doctors hated exploratory laparotomies.

There were too many unknowns as no one knew what laid inside the patient's body.

It required a doctor with sufficient clinical and surgical experience to solve the unknown as a misstep could be fatal.

The gynecology chief resident was fine with the exploratory laparotomy. If a gynecological problem was identified, they could fix it there and then.

There was another reason she was keeping tabs on the case. She was worried Zheng Ren had never done an ectopic pregnancy surgery.

Zheng Ren's reputation in the gynecology department had been on the rise ever since he had successfully handled the medical dispute. While the chief resident did not agree with some of Zheng Ren's views, she refrained from challenging him outright.

Zheng Ren did not mind the extra pair of eyes. He nodded at the chief resident.

Zhong Min was on duty today. Zheng Ren made a call to Yang Lei and then Chu Yanzhi to inform them of the surgery.

To be honest, Zheng Ren was not sure how the twins had split their duties but either one was enough.

He brought the patient to the emergency ward for the presurgical preparation.

Zhong Min was responsible for getting the patient settled and documenting all their details and history. While she busied herself with the patient, Zheng Ren took the time to explain the procedure to the family.

Regardless of which diagnosis was correct, time was of the essence.

The patient's mother was wiping tears from her eyes as she signed the informed consent documents.

The gastric catheter and urinary catheter were all set up as soon as the signing was complete.

Yang Lei stayed a distance away from the hospital, so Zheng Ren wheeled the patient to the operating room with her family's assistance.

Once inside, Chu Yanzhi had arrived. A few staff worked together to move the patient onto the operating table while Zheng Ren went off to change.

There would be approximately ten minutes before Zheng Ren would be needed inside. The anesthesia for this case was tricky so he took his time.

Accessory spleen? Zheng Ren mulled over the System's diagnosis.

Based on tissue biology, the existence of the accessory spleen was due to the failed fusion of the original spleen buds located in the dorsal mesangial membrane of the stomach during the fifth week of embryo development.

It was hard to diagnose in practice.

In CT scans, the accessory spleen was a mass less than 2cm in diameter with a smooth outline and even contrast. An MRI would show a feeder artery that branched from the splenic artery to supply nutrients to the accessory spleen.

A B-scan ultrasonography was rudimentary. It could not clearly visualize the branching of arteries in the abdomen.

As the patient came in through the emergency department, there was no time to arrange for the various scans. An exploratory laparotomy was the only solution.

Once changed, Zheng Ren called for a pathologist's consult.

If the accessory spleen was in the upper abdomen, Zheng Ren would not have worried.

However, it was in the pelvic cavity. There was a chance of it being cancerous.

In order to rule out cancer, a histological sample would be required.

Zheng Ren had informed the patient's mother on the particulars.

Due to this possibility, Zheng Ren opted for a laparotomy instead of a laparoscopy.

The small incisions made in a laparoscopic procedure were too small to retrieve the accessory spleen. If the mass was damaged during retrieval and happened to be cancerous, metastasis could occur en masse, leading to late-stage cancer.

The surgical procedure was decided after a thorough risk assessment. Zheng Ren informed the gynecology chief resident of the surgery, then proceeded to scrub in.

Chu Yanzhi was bouncing on her feet while the patient lay sedated. She was chatting with Xie Yiren.

Well, chatting was not the right term. It was more like Chu Yanzhi was talking at Xie Yiren as she prepared the surgical tools. Xie Yiren's replies came in the form of affirmative noises.

Chu Yanzhi was asking about Xie Yiren's absence at home. She did not notice the awkward silence from Xie Yiren and Zheng Ren.

The total opposite from her sister, Chu Yanzhi spoke in a direct manner, oblivious of the room's mood.

Chu Yanran had gotten all the tact and attentiveness.

Yang Lei was still nowhere to be found. Unwilling to wait, Zheng Ren began the disinfection process and laid down the surgical drapes.

A solo surgery was nothing new to him.

The surgical lamp illuminated the area before him. He studied the surgical site. The patient was young and to minimize scarring, he made an 8cm incision down the left flank of the rectus abdominis.

The incision was long as he had to investigate the blood supply's source.

If the incision was too small, he would have to extend the cut midway through surgery.

The layers beneath the skin were parted carefully.

The young patient had less adipose tissue which made the surgery easier.

At this point, the gynecology department's chief resident arrived.

She saw Zheng Ren alone at the operating table and asked, "Chief Zheng, do you need my assistance?"

"No, Yang Lei should be here soon." Zheng Ren gently manipulated the peritoneum and accessed the cavity.

Seeing the exposed abdominal cavity, the chief resident stopped talking and paid close attention to the ongoing surgery.

A retractor held the skin and muscles of the lower abdomen at bay. Zheng Ren and the gynecology chief resident saw the culprit—a visible mass sat right beside the ovary.

The redness of the mass was almost black.

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Chapter 347: The Melon That Leads To The Vine

"Chief Zheng, you're amazing," the gynecology chief resident said from behind. She had gotten a glimpse of the necrotic organ and saw that it was not attached to the surrounding tissues of the patient's reproductive system.

She was not a sore loser. The medical field was different from others.

If they had proceeded based on her diagnosis, it would be troublesome.

The surgeon would have to quickly leave the table to inform the family.

A reasonable family would understand and the gynecology surgeon would have to seek a general surgeon to resume the surgery as they would have to change the surgical method.

If the family was unreasonable, then congratulations!

If the unreasonable family had some power or was up the social ladder, then you would have hit the jackpot!

Therefore, the gynecology chief resident was grateful if nothing else. Competitiveness was not an issue here.

"I'm alright." With a clamp and his hand, he carefully separated the accessory spleen from the surrounding organs. He did not want to risk tearing any unseen connections and damage the other organs.

"It's an accessory spleen?" the gynecology chief resident asked.

"We'll know more later. We have to finish up here first." Zheng Ren focused on identifying the connections within the site. The artery supplying blood to the accessory spleen was twisted, leading to organ necrosis. He would want to avoid puncturing the organ as there would have been pus buildup within.

Zheng Ren worked with caution, always keeping in mind that the mass could be cancer.

"Could you check if the pathologist is here?" Zheng Ren asked the chief resident.

"Sure."

[Whoa! That's an accessory spleen!]

The Xinglin Garden livestream was lively.

[Is the accessory spleen so deep within?]

[I've never seen one in real life but it looks like one.]

[We'll see. Maybe it's a malignant tumor.]

While the surgeon in the video had demonstrated countless successful high-difficulty surgeries, the doctors on Xinglin Garden still approached the livestream with their own individualistic thinking. They did not blindly accept the diagnosis given in the livestream.

Supremacy?

Even the mighty made mistakes.

Independent thinking was essential for a doctor.

Hence, the doctors in the audience maintained a respectful disbelief toward the published diagnosis, but no one doubted the surgeon's skills.

Every surgery thus far had been accurate and precise.

The audience believed the surgeon on camera was from an internationally-acclaimed medical facility in Canada.

There were no other major organs attached to the accessory spleen. Zheng Ren carefully wrapped the spleen with a wet gauze, then palpated his way up the feeder artery.

His motions were gentle and cautious. He felt his way up the abdominal structures that he was familiar with, avoiding pressure on the other organs.

Once he had a clearer picture of what was going on, he prepared for ligation and removal.

[How detailed.]

[Is he following the vine to the melon?]

[More like the melon to the vine, then uprooting the whole plant.]

[Judging from this, the probability of a malignant tumor is low.]

[Agreed, but let's see how the surgery ends. To be honest, in my ten years in general surgery, I've never seen an abnormally long pedicle on an accessory spleen.]

[It does look oddly long.]

The mood in the livestream was not as rowdy as before.

This surgery was rather mild and did not showcase any spectacular skills.

Tracking the artery up to the source and removing the accessory spleen were simple procedures that were not flashy.

The only highlight was the accessory spleen's odd location.

[The surgeon seems to be operating solo again.]

[Oh yeah. However, this procedure seems to be doable without assistance. It's just ligating and removing the accessory spleen. There's no point in having two surgeons.]

[Probably not. In previous streams, the surgeon performed surgeries of higher caliber without any help.]

At this moment, Yang Lei hurriedly entered the operating room.

Noticing the surgery was halfway through, he quickly scrubbed in.

With Yang Lei's help, it was easier to maneuver upstream.

Xie Yiren stood near to the patient's lower body and could only pull the retractor in a single direction. In order to follow the feeder artery, he needed someone at the upper body.

Yang Lei got in position and held the retractor. He observed the scene before asking, "Chief Zheng, is this an accessory spleen?"

It was not his first time seeing an accessory spleen, but this one was odd.

"Yes, it is." The blunt scissors and curved forceps made slow but steady progress upward. He was separating the attachments to the feeder artery all the way to the main trunk.

A call came from the gynecology chief resident. "The pathologist is here."

"Okay. The sample will be out in five minutes," Zheng Ren replied confidently.

Yang Lei felt like a small ant in Zheng Ren's presence.

He had rushed over to the hospital only to find out that the surgery was nearing its end.

Frustrated, he looked at Zheng Ren.

The emergency chief resident was wholly-focused on the operating table, his eyes unblinking.

Yang Lei signed in his heart. How did his appendectomy partner from a few months ago become such a powerhouse?

Clank! The sound of metal on metal echoed. The appendix retractor he held made contact with the forceps.

The retractor in Yang Lei's hand trembled slightly. He lowered his head and cleared his mind.

If something similar had happened with Department Chief Liu, a surgical tool would be striking his head at this moment and he would be barred from surgery for at least a month minimum.

Yang Lei gathered his thoughts and followed Zheng Ren's hands. He retracted a part of the tissue to expand the surgical site.

The feeder artery was long and the minor tissues attached were not heavy. They spotted the torsion at the duodenum.

Zheng Ren did not intend to untangle the knot. Doing so would restore the blood flow through the accessory spleen and allow the accumulated pus to enter the circulatory system.

[Look! That's the twist.]

[What a long artery. From the looks of it, the twist happened not too long ago. It can only be an accessory spleen. Their diagnosis is incredibly accurate.]

[Yeah, but a histology is needed to confirm this.]

Soon, the surgeon reached the hilum of the spleen.

The feeder artery originated from the hilum.

Zheng Ren reached out and a pair of hemostatic forceps was placed into his hand.

As the incision was short, the retractor was needed to gain access to the target site. Once the retractor was in place, Yang Lei was under to observe the surgery from his angle.

The gynecology chief resident was bent at an angle to watch Zheng Ren's maneuvering.

"Chief Zheng, there's insufficient exposure. Maybe you should widen the incision?" No matter which angle she observed from, it was impossible to see the spleen.

"It's alright," Zheng Ren said with a smile.

Zheng Ren was confident he could remove the organ as long as he could reach it. The first System training on appendectomy taught him that.

Another surgeon would not be able to perform such a feat.

No surgeon would have the opportunity to practice a procedure numerous times on simulation mannequins.

The gynecology chief resident was silent. She did not understand why Zheng Ren refused to widen the incision. Without visual inspection, how could he ascertain what was going on inside?

Just as she was doubting him, Zheng Ren had a hemostatic clamp in his hand.

He asked for a scalpel then got to work. A length of artery was pulled out from the abdominal cavity.

As the separation was clean, he was able to retrieve the elongated vessel along with the necrotized accessory spleen. The organ was then tossed into the surgical tray.

"Send it for frozen section biopsy."

[The real surgery is starting. Is the surgeon not worried something might go wrong?]

[You must be new here.]

[It must be. If one has watched The Night of Appendectomies, one would not be surprised by the surgeon's actions.]

[To be frank, I disagree with the surgeon's methods to this date. Although he is very capable, it is best to err on the side of caution.]

The circulating nurse studied the operating table. Seeing that there were no other instruments needed, she put her gloves on and bagged the surgical and its contents. It was to be sent to the pathology lab.

Zheng Ren reached for a long-handle needle holder with sutures.

He performed the stitching within the small, confined space. The gynecology chief resident and Yang Lei watched him in astonishment.

Their view of the surgical site was obstructed. All they saw was Zheng Ren's hands moving about.

Chu Yanzhi adjusted the surgical lamp to deliver a direct light beam from behind Zheng Ren. The light illuminated the surgical site to give him a better view of the insides.

Suture, knot, snip.

Zheng Ren took the warm saline gauze and covered the surgical site.

The surgery had come to a pause as they waited for the pathology results.

If all was well, Zheng Ren would perform a rinse and some stitching to close up the abdomen.

If the results showed malignancy, the cleanup afterward would be unimaginable.

"Chief Zheng, are you sure the stitching will hold?" the gynecology chief resident asked worriedly.

Her concerns were viable as the angle and space Zheng Ren operated in was extremely small.

"No worries," Zheng Ren replied in an easygoing tone. He gave her a confident smile.

"Signs of malignancy?" Yang Lei asked.

"I don't think so. The surface was smooth and there were minimal attachments to the surrounding tissues. If it was a malignant mass attached to the spleen hilum, metastasis would have occurred," Zheng Ren said.

Although Zheng Ren was sure it was not a malignant tumor, he had to follow the standard operating procedure and wait for the frozen section biopsy results.

There was a one in a million chance the System was wrong.

[This half-blind surgery is going well.]

[Guys, how do you think the surgery is being filmed? Where is the camera?]

[We were able to look into the surgical site. It's probably on the surgical lamp?]

[I don't think it's on the surgical lights. If so, there must be multiple cameras. Just now when the lamp moved, we only saw the lighting change but there was no sign of people in the operating room.]

Messages started to fill the screen as they waited for the pathology report.

This was a break in the livestream, allowing the audience to interact with each other. Other times, the surgery carried on without pause.

Whether it was in the operating room or the surgery livestream, the 40 minutes passed with laughter and banter.

A call came from the pathology lab, negative for cancer.

The abdomen was stitched back up and the surgery came to an end.

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Chapter 348: Amigo Veterinary Hospital

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

The patient roused from total anesthesia and was wheeled out of the operating room.

Zheng Ren changed and headed for the wards. He wanted to check on the patient and give some instructions to the on-call doctor.

Once Little Yiren cleared up the operating room, they could go home. Zheng Ren smiled at that thought.

Suddenly, he remembered they had not eaten dinner.

He reached the patient. She had woken from the anesthesia and was in a stable condition. The numbers on the vital sign monitor proved that Zheng Ren was dependable even when operating blind.

A text came from Xie Yiren. Zheng Ren happily went down to the basement parking lot.

He got into the red Volvo. Before his mind could come up with a conversation topic, his ringtone blared.

The ringing phone suggested a possible emergency surgery. Zheng Ren's heart rate picked up.

He flipped over his phone and checked the caller ID. It was Su Yun.

Zheng Ren's chest tightened. Had something happen to Yang Lili? It was the only reason Su Yun would be calling him at this hour.

In a flash, Zheng Ren's mind went through every step he made in yesterday's emergency surgery.

He could not find any mistake.

The scene replayed in his mind as he picked up the call.

"Boss, what are you doing?" Su Yun's lazy voice sounded through the phone. He sounded more disgruntled than usual.

"Just wrapped up a surgery. We removed an accessory spleen," Zheng Ren replied.

"Oh! That's rare." A pause. "Are you in Xie Yiren's car?"

Zheng Ren's face flushed.

"Lot 14 on Weier Road. Come quickly," Su Yun said.

"Eh? Did you dial the wrong number?" Zheng Ren asked.

What was this? Su Yun expected him to just go to the address?

"It's Amigo. I'm hanging up. Wait, who assisted in the surgery?"

Zheng Ren was speechless.

Amigo; it sounded like a community veterinary hospital.

Was Su Yun going to operate on animals?

"Chu Yanzhi," Zheng Ren answered.

"Bring Yiren over. If Yiren's not there, get a cab here. Okay, I'm hanging up, I need to speak with Yanzhi."

Su Yun hung up the call before Zheng Ren could ask any more questions.

"What's wrong?" Xie Yiren asked inquisitively.

"Su Yun called to tell me to go to a veterinary hospital called Amigo?" Zheng Ren said, annoyed. It was late and he was not interested in visiting a veterinary hospital.

"The one on Weier Road?" Xie Yiren drove over a bump at full speed. If it were not for the safety belt, Zheng Ren would have hit the car's roof. Xie Yiren continued speaking, "Great, let's go."

Zheng Ren was troubled.

"I've always wanted a dog. A husky, to be exact. However, I don't have the time to take it for walks and can't hire a nanny for the dog every day, so I gave up on the idea," Xie Yiren said as she drove. "I'm glad we get to visit a veterinary hospital."

"It should be for a surgery." Zheng Ren recalled Su Yun's insistent tone on the phone. He wanted the whole emergency department to head down to the veterinary hospital at this hour.

Soon, the car rolled onto Weier Road.

The place was behind the city's busiest commercial street, a highly sought-after real estate area.

Zheng Ren glanced at the central business districts a distance away. He figured some of those might be Xie Yiren's.

Getting a rich girlfriend was quite troublesome.

He did not know if Xie Yiren's parents were nice people to talk to.

He did not know what expectations they had for the daughter's partner.

He did not know...

Zheng Ren's attention drifted.

The car came to a halt. Su Yun stood beside the car and gestured dramatically to welcome them.

The veterinary hospital had a trite name, but the building was beyond Zheng Ren's expectations. The hospital was huge and looked new. Zheng Ren believed a dog shower here would cost no less than 50 yuan.

It actually cost 300 yuan for a long coat dog.

"Boss, name your price," Su Yun said.

Zheng Ren frowned at Su Yun's teasing.

"If you have no request, let's get started. I got called over during my nap. I still have to go to the ICU tomorrow, so a good night's sleep is essential," Su Yun ranted as they walked into the veterinary hospital.

"Brother Yun, this is..." a young woman asked with a warm, sincere smile.

"This is my boss, Zheng Ren. That's his girlfriend and also his scrub nurse, Xie Yiren," Su Yun said.

Xie Yiren's footsteps faltered. Her face turned red.

However, she did not deny or reject the statements made. She lowered her head and trailed behind Zheng Ren.

The introduction also took Zheng Ren by surprise but before he could say anything, the young woman offered her hand and said, "Boss Zheng, nice to meet you. I'm the boss of this veterinary hospital, Shen Xiaoou. You guys can just call me Little Shen."

Zheng Ren took her hand and shook it. Su Yun smirked and said, "Hurry up, the anesthesia has set in. We're just waiting for you."

They reached the third floor. There was a middle-aged man standing outside the operating room. Their arrival elicited no response. The man's eyes were filled with tears.

"Mr. Qin, this is the doctor we've invited. Rest assured, we will do our very best," Shen Xiaoou said.

The middle-aged man bowed multiple times. His sincerity was many times deeper than the families Zheng Ren had met in the hospital.

Zheng Ren could sense the difference. It was staggering.

"Boss, hurry. Once it's done, we can go home," Su Yun urged.

Zheng Ren walked into the operating room in silence. Su Yun said to him, "You can feel the difference, right?"

"Yes," Zheng Ren admitted.

"When I was in Imperial Capital, I did some work in a veterinary hospital. For the six years I was there, I've never witnessed a single medical dispute. You don't even need to write the patient's history. A surgery costs... Little Ou, how much is the fee?" Su Yun said.

"10.5 thousand," Shen Xiaoou whispered. "This golden retriever has been with the owner for ten years. Grew up with his daughter. The dog is old now but the owner is still willing to pay for the best surgeon."

Zheng Ren was speechless...

The emergency surgery that he had just completed had probably only cost 400-500 yuan. The same procedure in a southern private hospital would not even cost more than 10000 yuan.

The huge difference in surgical fees was another blow to Zheng Ren.

"Ah, you poor thing." Xie Yiren ran to the operating table which held a golden retriever who had long since passed its golden years. Its fur was no longer golden and shiny. It panted heavily as its eyes zoned out of focus. Tears rolled down from its eyes.

"Chu Yanzhi? Why isn't she here? Usually she's the fastest to respond," Su Yun grumbled.

"Didn't you say the anesthesia has already been done?"

"It was a lie to get you moving," Su Yun retorted.

"What's wrong with the poor dog?" Xie Yiren asked as she stroked the dog's head.

"It ate a sock. If the dog was a few years younger, I would have done it myself. At this age, I'd prefer Boss to handle it for better results."

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Chapter 349: The Golden Retriever Who Grew Up With His Daughter

The golden retriever's condition was not ideal. It was suffering from the human equivalent of a bowel obstruction.

The key factor was time and they were slightly behind. Chu Yanzhi got to the scene and quickly started the anesthesia.

Amigo Veterinary Hospital had the simplest of respiratory machines.

The veterinary hospital was large and boasted all types of facilities. However, it was still lacking when compared to a rural human hospital.

Zheng Ren had a suspicion the sterility of the equipment could be called into question.

An intravenous catheter was set up. Chu Yanzhi started to calculate the anesthetic dose, scribbling messy numbers on a piece of paper.

"Boss, what are you thinking? Have you made your considerations?" Su Yun mumbled tiredly.

"I'm still considering," Zheng Ren replied. "There's an upcoming surgery that requires traveling. Are you coming?"

"Where?" Su Yun's ears perked up.

"Imperial Capital. Chief Kong says they have about a dozen or so liver cancer patients ready."

"Of course I'll go. It's a large-scale clinical research trial. Once you have 100 cases—it probably won't take too long—you can live on the money they pay you for annual conferences," Su Yun said.

Su Yun stopped. He realized Zheng Ren was just bragging to him.

This bastard.

"Do you know why I came to this veterinary hospital?" Su Yun asked.

"Huh? Wasn't it because of Shen Xiaoou?" Zheng Ren raised an eyebrow at Su Yun.

"Hehe," Su Yun let out a dry chuckle that was filled with mirth.

Zheng Ren was sure he was right about the reason. If Su Yun was more reckless... Even if Su Yun was uptight, girls would still flock to him like bees to honey.

In this aspect, Su Yun was a Grandmaster. No, a Legend.

"Are you familiar with ringworms on dogs?" Su Yun asked abruptly.

"I'm not a vet, so no. I don't think I've heard you mention it earlier either."

"Simply put, when a dog has ringworm, its fur will start to come off in circular patches. The end result is a dog with ugly, patchy fur. Many people abandon their dogs because of this condition," Su Yun said.

"And?"

"As a side note, ignore the fact that this surgery costs 10,500 yuan and this family is willing to pay up. They're likely a well-off family. There are many owners who just abandon their pets. Have you seen people abandoning people? There probably are some, but it's rare."

"I see. So you have to seize the opportunity, I know." There was no expression on Zheng Ren's face. He figured sleep deprivation was making Su Yun talk more than usual.

This talkative Su Yun was getting on Zheng Ren's nerves.

"To treat ringworms, there is an animal-specific ivermectin. An injected dose costs less than one yuan and even after some middleman profiting, the price is about one to two yuan." A sneer appeared on Su Yun's face. "Most veterinary hospitals look nice but just like some human hospitals, their intentions are not pure."

"Oh? Intentional misdiagnosis?"

"Of course, what do you think? There are a bunch of divine doctors and cancer experts out there, don't you know?" Su Yun rambled uncharacteristically. The mention of divine doctors was a trigger point.

"I know," Zheng Ren answered exasperatedly.

"They're all scams! Capitalizing on people's despair. Most veterinary hospitals act the same way," Su Yun scolded, then brought the conversation back on topic. "Honestly, I like to treat animals. There are less problems to deal with and the families are very civil, much better compared to human patients."

"You can earn a good amount too."

"I was the rising star of the cardiothoracic department, do you think money is an issue for me?" Su Yun said.

Zheng Ren knew that was true.

He himself was just a budding surgeon but within a short period of time, Department Chief Kong had involved him in research work in Imperial Capital. Money was no longer a worry.

Money was never an issue when one was at the top in their line of work, no matter how niche it was.

Medicine was definitely not a niche job. Needless to say, their financial support was not lacking.

"Back to the topic, I believe any veterinary hospital that administers ivermectin is good and sincere. When I visited, the attitudes of the vets here were average, but the medication they prescribed was on-point. So occasionally, I would come by to perform surgery," Su Yun explained.

"Out of the goodness of your heart?"

"Hours in the hospital watching people live or die can make a man's heart grow cold. Looking after these old dogs, you'd find that they're sometimes more human than us," Su Yun said with a laugh. "I saw Chang Yue's rant in the group. That old man with liver cancer whom Old Chief Physician Pan referred to the hospital, his children are joking around in the hospital."

Zheng Ren thought about his words before sighing.

The anesthesia was complete. Xie Yiren had the surgical tools ready. There were fewer tools here but she spent an equal amount of time making sure everything was perfect.

Zheng Ren and Su Yun scrubbed in.

The old golden retriever was lying on the operating table, anesthetized. The room was sparse, much like a clinic in the rural area.

The surgery was simple. After opening the abdomen, an obstructed intestine appeared before them.

The necessary organ protection was done before a 4cm incision was made at the bulge of the intestine. An undigested sock was pulled out.

Then, an aspirator was used to remove the fecal matter and digestive fluids.

The open intestine was stitched up. The abdominal cavity was rinsed before they sutured the layers back together. The whole surgery took less than 20 minutes.

Zheng Ren and Su Yun removed their gloves and stepped away from the operating table.

Xie Yiren instinctively went to clear the surgical tools but was stopped by Shen Xiaoou with a courteous smile.

The surgery was beyond the veterinary hospital's capabilities but cleaning up after a surgery was not.

They exited the operating room and found the middle-aged man still waiting in the corridor.

"Doctor, did you help him?"

"Huh?" Zheng Ren's mind could not formulate a response in time.

"Hush," Su Yun interjected expertly. "The surgery is complete. In a moment, Director Ou will show you the sock. The sutures can be removed after ten days, depending on the recovery rate. Please be more vigilant next time."

The middle-aged man was shocked.

He had driven to multiple veterinary hospitals around the city and every single one of them had turned him down.

It was all done behind his daughter's back. He had lied to her, saying that he was just taking the dog out to play.

They got the golden retriever when his daughter was born and the two of them had grown up together. He was worried his daughter would be overly saddened by the dog's passing.

The man was willing to pay for the best surgeon to work on him.

However, the surgery was quicker than he expected.

Just a blink of an eye and it was over already?

As they talked, Shen Xiaoou walked out with a plastic bag, the undigested sock within.

"I think you lost a sock," Shen Xiaoou joked.

"Yes, yes." The man's eyes brightened.

"The surgery was successful but Harry will need to be hospitalized for a few days. When he's stable, you can bring your daughter over to visit." Shen Xiaoou added a caution note, "Please be careful next time."

"Thank you, thank you." The middle-aged man bowed deeply.

Zheng Ren thought of the children who treated their father's illness as a joke... Humans were such odd creatures.

"Okay, it's time to go home." Su Yun's eyes were nearly shut as he scrolled through his phone.

"Yeah, I'm leaving soon." Zheng Ren was waiting for Xie Yiren.

"Boss Zheng, come have a look." Su Yun waved his phone at Zheng Ren. It was a snapshot of a lab report.

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Chapter 350: Boss, Did You Get It?

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

"What's up?" Zheng Ren asked.

"Yang Lili's medical report shows improvement," Su Yun replied with a smile.

Finally, a sincere smile graced Su Yun's face.

Zheng Ren immediately reached for Su Yun's phone. Xie Yiren noticed he was attending to some business and went back into the operating room. She wanted to spend more time with the golden retriever named Harry.

Zheng Ren magnified the test report and read through the details.

The kidney function had returned to normal, and the blood urea nitrogen and creatinine were only slightly above the normal range.

The transaminase levels in the liver had also fallen to 100 units per liter. Her recovery from acute liver damage was impressive.

Most importantly, the coagulation factors in the body were functioning normally.

The blood gas analysis and other test results indicated Yang Lili was on her way to a full recovery.

"Amazing!" Zheng Ren patted Su Yun's shoulder.

It had been two long and tiring days for Su Yun, working tirelessly like a dog. Dogs nowadays probably had a better life, sock-eating aside.

Finally, Yang Lili was no longer in danger.

"Of course. It has to be perfect," Su Yun said with a smile.

"Shall we try to get the breathing tube out tomorrow?" Zheng Ren asked.

"Yes, we can try. The Acinetobacter baumannii in the ICU are vicious. The earlier we remove the tracheostomy tube, the better."

"Head on home and rest then. The days have been rough on you."

Suddenly, the weariness on Su Yun's face was replaced with a suggestive look.

"Boss, did you get it?" Su Yun whispered.

Zheng Ren wanted to yell at the man.

"Holding hands count." Su Yun's voice was full of hope.

"..."

Su Yun studied Zheng Ren's face and let out a resigned sigh. "Never mind, I know that you're going to be as slow as a tortoise."

"I've moved into her house," Zheng Ren declared.

A wide-eyed expression could be seen from Su Yun.

"But it's in another building."

"Ah..."

"Don't blame me, okay. We went to the movies today but an emergency case interrupted the date," Zheng Ren said, annoyance in his tone.

Hand-holding.

"Take it slow. Don't let a girl this good slip between your fingers." Su Yun let out a yawn before continuing, "I'm gonna head home now."

"We'll drop you off?"

"The traffic is light at this hour. I'll drive slow, don't worry." Su Yun shuffled away. Zheng Ren kept an eye on the retreating figure, worried he might just collapse and pass out in the corridor.

"Oh right, the money for this surgery. I'll give it to you when we're free," Su Yun said as he waved his hand without turning back. He exited the building and disappeared into the night.

"Boss Zheng, you did an amazing job!" Shen Xiaoou said beside him with a smile.

Zheng Ren did not know how to respond. He had only just met this woman.

"Brother Yun's recommendation is truly reliable. Harry had been to all the vets in Provincial Capital but everyone said there was nothing that could be done. Some said the surgery's death rate was as high as 90%."

"Oh, veterinarians don't know how to perform surgery, I guess." Zheng Ren's reckless statement had earned him glares from multiple people.

It was absolutely reckless, given he was in a veterinary hospital.

Shen Xiaoou explained, "This type of surgery is not common for veterinary surgeons. There's little reference for aftercare as well. Veterinary is a new field, so we're all just figuring it out as we go."

Zheng Ren looked uninterested.

"Can you provide your contact details?" Shen Xiaoou tried her luck.

"No need. If the hospital needs me, you can reach me through Su Yun." The rejection was firm, his disinterest fortified.

The smile on She Xiaoou's face froze.

What a merciless rejection.

Zheng Ren went to get Xie Yiren and Chu Yanzhi. It had been a long day.

Before going home, the group grabbed some supper at a restaurant.

Then, the two cars made their way to Xie Yiren's houses.

Chu Yanzhi's presence dashed away any hopes Zheng Ren had of receiving a hug from Xie Yiren. Unlike most girls of this decade, she was a shy person.

They bid each other goodbye. Once inside, Zheng Ren ran a bath as instructed by Xie Yiren.

They texted for nearly an hour before sleep took over.

...

The sun rose the next day, as it did every day.

A new day was before them.

Zheng Ren ran through the tasks he had to do today: ward rounds, patient consultations, and all the essentials.

A trip to the ICU to visit Yang Lili. Her survival was a miracle to behold.

The gastroenterology department patient who underwent the TIPS surgery would be needing a second surgery to remove parts of the stent soon if their blood ammonia level remained low and there were no signs of hepatic encephalopathy.

The removal would smoothen the passage of fluids and widen the lumen. He would also need to check if there was bleeding from the gastric varices.

Zheng Ren would not have the free time to watch the vertebral column resection surgery. He had some interest in orthopedics but his plate was full. He could not just abandon his responsibilities to entertain his interests.

He ate his breakfast before setting out to the hospital.

Old Chief Physician Pan was asking about patients who left the hospital last night. He cursed under his breath, then began assigning tasks to the staff. They did their rounds in the emergency wards.

Once that was done, Zheng Ren left for the gastroenterology department.

Department Chief Xia spotted Zheng Ren and quickly brought a junior doctor to the critical care room.

The junior doctor reported the patient's latest developments. The hematemesis and hepatic encephalopathy had abated. With an elevated but acceptable blood ammonia level, the patient's recovery was on track.

Zheng Ren evaluated the patient's condition and decided a second surgery could be scheduled soon.

Department Chief Xia agreed with Zheng Ren's judgment, and they arranged for the surgery to begin tomorrow morning.

As they exited the patient's room, Department Chief Xia said, "Little Zheng, you did well with the TIPS surgery."

The straightforward compliment caught Zheng Ren off guard.

"I asked a colleague who's a professor in Imperial Capital. He was shocked to hear you performed an emergency TIPS surgery. He said the difficulty of the surgery was well beyond that of an elective TIPS." Department Xia chucked, then continued speaking, "I was wondering if you could have a look at one of our patients who has refractory ascites. If it's fine with you, we can operate tomorrow. It's quite severe and I'm worried the patient will not last the month if we put off surgery."

Zheng Ren cared not for the professor's praise.

Instead, he was interested to hear more about the refractory ascites.

If he wished to further develop his interventional surgery skill, elementary embolization surgeries was not the way to go. It would take a lifetime to make any significant progress.

He had to perform high-difficulty procedures like the TIPS surgery.

They arrived at the patient's room. Zheng Ren saw a thin figure with a bulging belly on the bed.

The large-volume ascites hindered the patient's breathing.

With every laborious breath taken, the man's clavicles and sternum sank deep into his body.

Zheng Ren knew it was not the three-concave sign. The ascites was pushing against the diaphragm and restricting the expansion of the lungs, hence the breathing difficulties.

The System's diagnosis blinked at the right corner of his vision.

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Chapter 351: Postoperative Mental Disorder?

Decompensated cirrhosis, portal hypertension, hypoalbuminemia, electrolyte imbalance, ascites, hydrothorax...

The list of diagnoses was long and blurry.

It looked like this patient had a hepatitis B infection that had progressed to hepatic cirrhosis, splenomegaly, and portal hypertension. This had then led to refractory ascites.

The earlier diagnosis was similar to a disease progression of hepatitis.

Decompensated cirrhosis would lead to two fatal complications—hematemesis and ascites.

When the ascites developed into refractory ascites, the usual diuretic treatment would not work. The ascites would result in hypoalbuminemia, leading to the leakage of fluids, worsening the ascites, and further lowering the albumin levels.

It became a vicious cycle.

The clinical treatment of ascites and hypoalbuminemia were diuretics and an intravenous infusion of human albumin.

With the presence of refractory ascites, it did not matter how much human albumin was transfused as it would just leak out as ascites.

This complication was different from hematemesis. Even though hematemesis seemed more urgent than refractory ascites, hematemesis caused by portal hypertension was treatable with general surgery.

Before the emergence of TIPS surgery, patients with refractory ascites could only sit and wait to die. Even now, TIPS surgery was extremely difficult to execute, and only Class Three Grade A Hospitals in cities as big as provincial capitals were equipped enough to perform it.

Without TIPS surgery, patients diagnosed with this disease were pretty much getting sentenced to their deaths.

The patient would be in excruciating pain, suffering slowly while life ran its course.

Zheng Ren performed a simple checkup and questioned the patient about his condition when the labs were back.

The resident beside Chief Xia answered the questions in an orderly manner. The diagnosis by gastroenterology and the System's monitor was similar.

There were no specific contraindications, so the patient was cleared for surgery.

Zheng Ren said, "Chief Xia, the patient did a liver DW-MRI. I've submitted the request for surgery tomorrow."

"DW-MRI?" Chief Xia was stunned.

DW-MRI, diffusion-weighted magnetic resonance imaging in full.

DW-MRI differed from the usual MRI. DW-MRI utilized diffusion of water molecules to generate contrast by mapping the movements of water molecules in biological tissues, such as the brain, to provide clinical information.

It was mostly used for neurological treatment.

It could diagnose acute brain ischemia at a 94% sensitivity rate and 100% specificity. It could also reliably differentiate between an arachnoid cyst and epidermoid cyst, subdural empyema and subdural hygroma, and necrotic abscess and tumor.

Why did Zheng Ren order a DW-MRI for a TIPS surgery?

Chief Xia heard of how the experts from Imperial Capital and Sorcery Capital used DW-MRI to visualize the tumor. However, this patient was suffering from refractory ascites as a result of liver cirrhosis progression, not a tumor.

Little Zheng...

Chief Xia hummed softly.

Zheng Ren did not explain his decision further to Chief Xia. This was a preoperative assessment for TIPS surgery that he devised in the System's operating room after countless practices. He had used it to locate the position of the portal vein and hepatic vein so that his catheterization had a higher rate of success.

If he were to explain from the very beginning, he would not be able to finish telling him the reasons why even after several days.

Zheng Ren was also too lazy to deal with other things.

After briefing Chief Xia about the patient, Zheng Ren took his leave and headed to the ICU.

He changed and entered the ICU ward. The ward had a strong, depressing atmosphere.

The chief of the medical administration division was sitting in the ward with deep, furrowed brows.

Su Yun was seated beside Yang Lili's bed, his fringe swaying in front of his forehead while his head was buried in lab reports.

"What happened?" Zheng Ren approached Su Yun and asked softly.

"Boss, there's something wrong," Su Yun said. "We stopped the sedatives this morning but the patient started showing symptoms of mental disorders."

Mental disorders?

Zheng Ren was stunned.

There was no mental disorder shown on the diagnosis on the System's monitor.

"The routine blood work was mostly normal. The surgery's aseptic environment was maintained well with no obvious signs of infection. Biochemistry analysis: 15.49 mmol/L of glucose, 134 mmol/L of sodium, and 4.15 mmol/L of potassium. Blood gas analysis: pH 7.46, 61 mmHg partial pressure of oxygen, 38 mmol/L of bicarbonate, 3 mmol/L base excess, and keto acids: ." Su Yun dictated the entire emergency lab report from this morning without even looking at the papers in his hand.

"How was Yang Lili's mental state?" Zheng Ren asked with a frown.

"Extreme, intense fear, like phobia," Su Yun said. "It was as if she had seen a ghost. She had an intense episode of emergency agitation and the hand straps couldn't hold her down. Her heart rate shot up from 95 to 156 beats per min after we stopped administering sedatives."

"That's strange." Zheng Ren recalled the lab results that Su Yun had just told him. The overall results seemed fine. It only had a slight increase in blood glucose, urine glucose, and keto acids. He considered that this was the body's acute stress reaction in response to a traumatic injury.

Bloody h*ll...

This would not be easy to explain.

Could the intense shock from the incident have left her with psychological trauma?

It was possible. Nonetheless, psychological treatment was still a new branch of science in the country. Zheng Ren did not know any experts in the field.

More importantly, the psychiatrist would not be able to give Yang Lili counseling in her condition.

They were going to do a thoracotomy in a few days. If the complications of lung infection began to...

Zheng Ren had no choice.

No wonder the ICU's atmosphere was so depressing. A patient with seemingly fine test results had manifested such strange complications.

Especially when this patient was someone highly regarded in the city. They had to report directly to the health bureau director and the deputy mayor who oversaw the cultural education and health of the patient's condition every day.

What should they report today? Should they say that she saw ghosts after they stopped her sedatives?

Zheng Ren frowned deeply while he went through each and every diagnosis shown on the System's monitor.

They had started her on sedatives again but Yang Lili's heartbeat remained high.

Postoperative infection? The patient's temperature was slightly elevated, most likely due to postoperative fever. The C-reactive protein had no apparent abnormality, which meant it was unlikely to be an infection.

Pulmonary embolism? Chest pains and respiratory distress that led to an increased heart rate?

Zheng Ren listened to Yang Lili's breathing sounds on both sides with a stethoscope. It was not pulmonary embolism...

Zheng Ren was certain about it without the need to perform CT angiography on the pulmonary artery.

He should be able to derive a conclusion based on the combinatorial results from the body examination and the System's diagnosis.

Could it be cardiac insufficiency due to the large volume of postoperative fluid replacement? Zheng Ren pondered. He then asked, "What was her input volume?"

Su Yun shook his head. Obviously, he had already thought of this.

"The postoperative fluid output was significantly lesser than the fluid input. On the first day post-surgery, the difference between fluid input-output had decreased. They reached the same volume as of yesterday."

They administered a larger volume of fluid replacement because Yang Lili had lost a significant amount of blood.

Besides Yang Lili's young and healthy body, she was able to recover just 2 days after surgery because of Su Yun and the ICU medical staff's hard work.

Furthermore, Yang Lili had no family history of cardiovascular disease, so he eliminated the possibility of cardiac insufficiency.

Besides this... What else could it be?

The last possibility was diabetic ketoacidosis.

Since Yang Lili presented an increase of blood glucose, ketone in urine, acidosis, and normal levels of β-hydroxybutyrate, the ICU doctor administered a low dose of insulin.

It was not ketoacidosis either.

Could it really be a mental disorder... Zheng Ren was stuck.

After going through each diagnosis on the System's monitor, Zheng Ren's eyes suddenly lit up!

Could it be that?

Chapter 352: Beriberi Is Not A Disease

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

"Have you checked her vitamin levels?" Zheng Ren asked.

"Vitamin?" Su Yun was stunned.

Their usual routine for emergency rescue in the ICU did not include vitamin tests unless the patient had a specific disease.

External injuries did not qualify as a specific disease.

"I'm thinking that it might be vitamin B1 deficiency," Zheng Ren said. "Stop the patient's sedatives."

"..." Su Yun was still in a daze.

"I want to see if the patient is presenting symptoms of oculomotor nerve palsy during agitation."

Paralysis of the extraocular muscle resulting from oculomotor nerve palsy would lead to misalignment of eyes and a loss of pupillary light reflex.

Right before Su Yun was about to argue, he suddenly recalled the constant trembling of Yang Lili's eyes while she was conscious. That was also why Su Yun felt as if she had seen a ghost.

He hummed softly for several minutes before abruptly lifting his head, his eyes brightening with realization. "Boss, I think you're right."

Chief Qian and the other consulting chiefs were baffled.

Were these two young lads joking?

The city council was still waiting for their morning report, yet they...

If it was not for the exceptional emergency rescue abilities that Zheng Ren had demonstrated in the ICU prior to this or his impeccable surgical skills showed in past emergency surgeries, he would be ridiculed and scoffed at.

Vitamin B1 deficiency?

What a joke.

"Little Zheng, Little Su, stop joking around," Chief Qian said in a deep voice to indicate his dissatisfaction.

"We're not joking, Chief Qian." Su Yun chuckled.

Zheng Ren's words unveiled the fog and the sky was clear now.

There were times that a seemingly unsolvable problem could be easily resolved with a simple push.

"How are the patient's symptoms related to vitamin B1 deficiency!" The medical administration division chief roared. "Beriberi? What nonsense is this!"

"We all studied pathophysiology before, right?" Su Yun looked around, a sneer hanging on the corners of his mouth. "The common disease of vitamin B1 deficiency is called beriberi, there isn't anything wrong with that."

While he spoke, his smirk grew larger, attracting many pairs of glistening eyes from the ICU nurses.

"Vitamin B1, also known as thiamine, is absorbed by the intestine and phosphorylated into thiamine diphosphate.

"Thiamine diphosphate is an important coenzyme in the decarboxylation of pyruvate and α-Ketoglutaric acid, as well as the coenzyme of erythrocyte transketolase."

The people present were struck with a string of scientific jargon that seemed to appear out of nowhere like thunder and lightning.

Chief Qian hummed softly. What Little Su said made sense.

The medical administration division chief had an awkward expression because...he could not understand a single thing.

His position was quite important, as it required integrating each emergency rescue segment, ensuring the hospital's medical quality was up to standard, and handling medical disputes.

He had left clinical practice for a long time and lost touch with things like pathophysiology.

Su Yun could not be bothered about their concerns and continued speaking, "The brain and cardiac tissues have a high metabolic rate. They require sufficient vitamin B in glycolysis to breakdown glucose into pyruvate or otherwise, the lack of thiamine diphosphate will prevent the keto acids from entering the tricarboxylic acid cycle.

"Accumulation of keto acids in the blood results in the dilation of surrounding arteries due to the decrease in peripheral resistance. The increased blood flow would then subsequently raise the cardiac output and cardiac workload."

Hmm? Finally something about the right ventricle output and cardiac preload?

The medical administration division chief pretended to be in deep thought. He could not risk letting anyone discover his inability to comprehend anything.

Anyway... This rascal, could he just explain it in simpler terms?

"Therefore, I..." Su Yun halted midspeech. "My boss said that Yang Lili's agitation and mental distress should be the complications from a vitamin B1 deficiency."

Su Yun glanced at Zheng Ren after he finished speaking.

"Am I right, Boss?"

"That's about it," Zheng Ren said straightforwardly. "I suggest giving her a 100 mg shot of vitamin B1. However, intramuscular injections tend to have a lower rate of absorption. We can try simultaneously injecting 20 mL of saline with 50 mg of vitamin B1 intravenously."

"It should be fine to administer a higher dosage on the first day," Zheng Ren said.

The department chiefs and the medical administration division chief stared at each other blankly. They could see the confusion in each other's eyes.

Even though not everybody agreed with what Zheng Ren and Su Yun were saying, they could not come up with a reasonable rebuttal.

They had explained their speculations clearly, with detailed elaborations on the biochemical processes.

Even when the people around them could not follow, their reasoning sounded very professional.

So?

What else could they do?

"Let's try that out since we have no other choices," Chief Qian said.

He had known Su Yun for the longest time and was well acquainted with him. Usually, if Su Yun had that obnoxious expression on his face, it usually meant he was right.

They should not argue with him, even if they were a department chief. If not, they might have gotten a slap on the face even when if they backed it up with medical reasoning.

Moreover, a few milligrams of vitamin B1 would not cause any harm to Yang Lili's condition.

"Stop the sedatives after half an hour," Zheng Ren said as he stood up, giving the final order.

"Sure, boss," Su Yun noted down the doctor's order.

Chief Qian got sentimental as he watched Zheng Ren leaving.

The young cub had matured into an adult.

Some of the older department chiefs did not even have the strong presence that Zheng Ren exuded.

Who dared to speak in such conclusively without knowing the medical treatment's guaranteed outcome? If they just spoke without careful consideration, they would be given hell toward the end of it.

Chief Qian only encountered a handful of professors from the Imperial Capital and Sorcery Capital with a similar aura, but he had never seen someone like this in the...Sea City General Hospital.

After Su Yun conveyed the doctor's order, the little nurse hurriedly carried out the orders and gave an intravenous injection of vitamin B1 before injecting another dose intramuscularly.

Su Yun glanced at the time before sitting down beside Yang Lili's bed, his eyes fixated on her.

There was no problem with the half hour cut-off time that Zheng Ren had mentioned earlier. If they stop the sedatives then, it would take another 2 hours for Yang Lili's body to metabolize the drug.

If the oculomotor nerve and cardiovascular symptoms were a result of vitamin B1 deficiency, the patient would then be relieved of those symptoms afterward.

What an interesting diagnosis.

...

At the same time, the vertebral resection surgery was ongoing in the major general surgery operating room.

"Little Zhou, were the embolizations from yesterday done precisely?" Professor Tian from the orthopedics department asked while making an incision.

Dr. Zhou said, "The embolization took longer than usual because we only have one interventional doctor. I can't really tell if it was successful, but he performed embolizations on a patient with peritoneal hematoma after a pelvic fracture and it went really well."

"Uhm, interventional doctors are quite rare. You're lucky to have one." Professor Tian started a blunt dissection to separate the muscles, carefully avoiding a location that was richer in capillaries.

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