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 385: The Troubles That Come With The Younger Generation - Read The Surgeon's Studio Chapter 385: The Troubles That Come With The Younger Generation Online - All Page - Novel Next

Chapter 385: The Troubles That Come With The Younger Generation

When Zheng Ren entered the operating room, the first patient was ready for the procedure.

Feng Xuhui wheeled a silver suitcase into the control room.

An assortment of surgical equipment and materials for the TIPS procedure was in the case.

Zheng Ren studied the operating room. The facilities in the Secondary Hospital interventional operating room were older than the ones in the hybrid operating room in Sea City General Hospital. The cost of replacing a double C-arm machine was beyond what the Secondary Hospital could afford.

It would have to do.

At least it was better than the usual gastrointestinal imaging machine.

Zheng Ren pinned the patient's scan to the viewer in the operating room and studied it with his arms folded. He visualized the process in his mind, from start to end.

In the operating room, the professor was busy fussing over the instruments while Zheng Ren studied the scan. The observers in the control room were silent.

The interventional surgery department chief, Cheng Lixue, pursed his lips. "He thinks he's a bigshot just because he has a foreigner in tow."

Feng Xuhui, who was standing in the corner of the room, smirked.

'This is the guy who dies within three episodes in dramas. He didn't even read up on who that foreigner acting as Chief Zheng's assistant is,' Feng Xuhui thought.

Director Zhang responded to the department chief's comment. "What we want is a successful TIPS surgery. This will be a major milestone in the history of the Secondary Hospital. Department Chief Cheng, please learn from them. I hope to see one of our own successfully perform a TIPS surgery in the future."

Cheng Lixue held back any further comments. He did not want to overstep and offend the deputy director.

Although Cheng Lixue and Director Zhang were once doctors of the same rank, the man was now the deputy director of the hospital! He could easily make life a living hell for Cheng Lixue.

The department chief knew better than to provoke the sleeping lion when his hands were tied.

Recently the hospital administration board decided to make some organizational changes. The interventional department was split into two, with the deputy chief taking some of the manpower away.

Who would be happy with a split department? It meant the department chief's authority was slashed by half.

The change meant everyone had to buck up and work harder to increase their department's surgery volume. With his department cut in half, Cheng Lixue would have a hard time presenting a satisfactory report at the end of year.

Meanwhile, the vultures were circling him. A stagnant surgery volume could spell a career death.

This change was the root cause of Cheng Lixue's misery. Those free and easy days were long gone for the interventional department chief.

Now, Director Zhang invited a young chief resident from Sea City General Hospital to perform a TIPS surgery! The interventional department deputy chief was in Provincial Capital, learning the TIPS procedure.

The arrival of the young chief resident was good news for Cheng Lixue, but he doubted the chief resident's abilities. The TIPS procedure was one of the hardest procedures. Cheng Lixue did not believe Sea City General Hospital had them outclassed by this much.

When it came to hepatic disorder treatments, whether it be interventional or general surgery, the Secondary Hospital had always outranked Sea City General Hospital.

They were a specialized hospital after all.

Director Zhang must have been blinded. Cheng Lixue cursed internally but he maintained a calm composure and kept his criticisms to himself.

"Director Ren is rushing back from Provincial Capital as we speak. We only have one goal. Old Cheng, you need to see the big picture," Director Zhang lectured.

'Big picture, my *ss!' Cheng Lixue swore in his mind.

An emergency department chief resident of this age could perform a TIPS procedure?

If the man could really perform the procedure without major complications, Department Chief Cheng would be fearful of the younger generation.

He had a few younger subordinates in his department, including the deputy chief and some attending surgeons. They had always shown him adequate respect, but he wondered if they had ever spoken badly of him to Director Ren.

Cheng Lixue had managed his department for a good 20 years. He did not expect to be ordered to relinquish half of it before he entered retirement.

It was all bullsh*t!

Cheng Lixue was only a department chief who could not contribute to the hospital's vision. Hence, all his anger was directed at Zheng Ren, as if the chief resident was here to personally sabotage his career.

Professor Rudolf Wagner completed the disinfection process and began the cannulation.

Zheng Ren went to put on his lead apron and began scrubbing in.

"Director Zhang, the foreigner will be doing the surgery right?" Cheng Lixue asked as he watched Professor Rudolf insert the guide wire into the cannula.

"No. I've witnessed it with my own eyes in the general hospital; that foreign professor is just Chief Zheng's assistant."

Cheng Lixue made a sound of disapproval.

'He took the foreign professor as an assistant? Does this guy have a low IQ or low EQ?' Cheng Lixue thought.

The local professors in Provincial Capital had trouble getting foreign professors to do as they say, what more in Sea City General Hospital.

The plump man who delivered the scans to Sea City General Hospital knew why Cheng Lixue was in a bad mood. He spoke up in support of the deputy director's words. "Chief Zheng is a remarkable surgeon. While I was sending over the scans, there was an emergency patient suffering from a cardiac tamponade."

Director Zhang's interest was piqued. "And?"

"I saw Chief Zheng perform an emergency pericardiotomy to relieve the pressure. He did an open heart massage to restart the patient's heart. There were blood splatters all over the room, even the ceiling," the plump man said with a look of admiration.

"And the patient?"

"His heartbeat was restored and he was immediately sent to the operating room."

"Emergency rescue vastly differs from TIPS surgery," Department Chief Cheng pointed out.

"Old Cheng," Director Zhang warned.

They were old friends, so Director Zhang did not say more. The invitation was extended to Zheng Ren with Director Ren's approval. Cheng Lixue had to accept the circumstances.

Director Zhang felt the department chief was being juvenile.

Cheng Lixue frowned. Then, he turned and left.

He walked to the changing room and grabbed his phone.

He would not be surprised if the foreign professor played a major role in the TIPS procedure. However, a successful TIPS surgery was still a win for Zheng Ren, and that did not sit well with Cheng Lixue.

As for the emergency rescue, it was unlikely the foreign professor could assist in such procedures.

Cheng Lixue had to confirm the authenticity of the story. He dialed a number on his phone.

He did not believe a procedure like a pericardiotomy and open-heart massage were effective in saving lives.

These procedures had a slim chance of success... The young chief resident was too ballsy.

As he pondered the necessity of such emergency procedures, his call was picked up.

Cheng Lixue greeted, "Old Qian, this is Old Cheng."

"Oh, what's going on, Old Cheng?" the other speaker asked.

Cheng Lixue had called up the ICU Chief in Sea City General Hospital.

"I heard from a colleague of mine that your hospital had a patient with cardiac tamponade yesterday?"

"Yes, we had. Did the attacker's family reach out to you to get information? Tell them to not worry; the patient just left the ICU," Department Chief Qian said with a chuckle.

'See, the patient died. What's there to boast now? A pericardiotomy followed by an open-heart massage was a suicidal rescue plan,' Cheng Lixue thought.

"I see. I will convey the death to the family so they can mentally prepare."

"Death? No one died, Old Cheng. You misunderstood; the patient was discharged from the ICU. The emergency rescue and follow-up surgery was successful. He's stable now.""

Cheng Lixue froze.

A cardiac tamponade patient was stable the second day after surgery?

What...

Chapter 386: A Sham of A Surgery

After the phone call ended, Cheng Lixue lit a cigarette.

He took a deep drag to clear his head.

Cheng Lixue was not from the cardiothoracic department. but as a doctor, one had to be familiar with the basics of emergency rescue.

Any experienced doctor would know the criticality of a cardiac tamponade. There had been cases where the patient was successfully rescued, but ended up in a vegetative state.

Was Old Qian trying to prank him?

He sat in the chair in the changing room and took a drag of the cigarette. The smoke lingered in the room.

Cheng Lixue could not wrap his mind around the whole thing.

He glanced at the clock and found that it was close to 9:00 a.m. He had been away for almost 20 minutes. The surgery would have started already. Regardless, he should be present when Director Ren shows up.

As he stepped out of the changing room, Cheng Lixue saw a nurse calling for the next patient.

"Why are you rushing the patient?" Cheng Lixue growled. "The surgery will still take a few hours, there's no point calling the patient in." He glared at the nurse for emphasis.

The fact that Zheng Ren requested eight surgeries to be performed in a day annoyed him and he sought the opportunity to express his dissatisfaction.

"Chief Cheng..."

Cheng Lixue went on the offensive and did not give the nurse a chance to explain herself.

"Did you learn the correct procedure? The patient is elderly and has ascites, and yet you want him to wait out there for hours? Have you no shame?"

The harsh words brought tears to the young nurse's eyes.

Cheng Lixue was a superior who tended to alternate between hot and cold when it came to dealing with his subordinates. As Cheng Lixue was about to speak some gentler words of encouragement, he was rudely interrupted.

The plump man came out of the room.

"What's going on, Chief Cheng? This..." the plump man asked.

"Who allowed the patient to be transported before their turn?" Cheng Lixue asked coldly.

The plump man rolled his eyes and said sharply, "The first surgery's over. He's the second patient." Cheng Lixue's constant bone-picking with Zheng Ren was starting to get irritating. "Chief Cheng, why don't you go celebrate with the first patient while we begin the second surgery? After all, it's the hospital's first successful TIPS surgery. We don't want to keep this elderly patient waiting, right?"

There were hidden barbs in his words. Although the plump man showed Zheng Ren only kindness and hospitality, he was not a pushover.

"Uh..." Cheng Lixue was rooted to the spot.

Completed? Impossible!

'We're talking about a TIPS procedure–a surgery that only the best interventional surgeons could master–and this chief resident completed it within the span of a smoke break?'

"What did you say?" Cheng Lixue asked.

"We're moving on to the next patient and you're in the way. Do you have something against the hospital's decision to invite an external surgeon?" The plump man's tone was curt and his words were merciless.

There were other patients in the process of changing shoes outside the operating room, so they had to keep their volume down.

A low volume did not mean the sting hurt less.

Cheng Lixue was speechless.

'It was really done? He managed to complete a TIPS procedure in 30 minutes?'

Impossible... It was impossible!

A year ago, Director Ren brought the team on an international trip to gain insights on the procedure. Department Chief Cheng observed a few surgeries, but his passion for learning had long since died out.

It was a highly risky procedure, certainly not one he would attempt.

Cheng Lixue would rather keep his shoes dry and wait for his retirement. He doubted he would be able to master the new procedure anyways.

He treated the whole trip to Europe as an all-expense-paid trip from the company and opted out on most of the conferences and demonstrations.

Although he spent most of the trip on leisure activities, he still attended the TIPS demonstration. Even the most skilled surgeon in Europe required two to three hours to complete the procedure.

It must be a botched surgery!

The operating room opened and the first patient was wheeled out. The nurse shot a glare at Cheng Lixue before leaving with the second patient.

The department chief ignored the jab by the plump man and headed straight for the control room. He wanted to review the recording.

The cannula was set up. Then, the puncture was successful on the first attempt and a shunt was left in place... A second shunt was added? Zheng Ren had punctured the portal vein on the first try and had time to leave two shunts?

The speed at which the surgeon completed the surgery was extraordinary.

Cheng Lixue did not believe the young chief resident was responsible for this surgery.

A silhouette caught him by surprise.

"Director Ren, welcome back."

"Director, you must be tired. Please, have a seat."

A string of pleasantries were uttered following Cheng Lixue's queue. The director had made it back from Provincial Capital.

The surgery had proceeded at a breakneck speed. When he had heard Sea City General Hospital wanted eight patients, he wondered how long the surgeon planned to stay in the Secondary Hospital. Forcing the patients to fast for days was against ethical code.

It was inhumane.

However, he was forced to change his mind now. At the rate Zheng Ren was going, eight TIPS procedures would not be a problem.

Damn!

"Professor?" Director Ren asked in a low voice, surprise laced in the question.

'What professor?' Cheng Lixue was trying to figure out who the director was referring to.

There a shuffling of feet as Director Ren parted the crowd to reach the door for the operating room.

"Professor Rudolf, it really is you?" Director Ren said in amazement.

Professor Rudolf Wagner turned his head to the door. "It's me; what's up?"

The thick Northeastern accent shocked Director Ren to his core.

This was the esteemed professor from Heidelberg University. He was rumored to be a stern and aloof professor with great skills.

The professor was disinfecting the skin as he asked, "Yes?"

Director Ren composed himself and bowed at the professor as if he was a pupil. "I brought my team to Heidelberg University in April last year to watch you perform the TIPS surgery."

Professor Rudolf started to place the surgical drapes over the patient. "That was nothing. What a sham of a surgery that was."

"..."

The straightforward statement made Director Ren clutch at his chest. He took a deep breath.

The words hammered straight into the director's heart.

Without a doubt, this was Professor Rudolf Wagner from Heidelberg University. Director Ren could recognize the blond professor. He had a good memory for faces, unlike Zheng Ren.

The professor's mention of TIPS surgery back in April also substantiated Director Ren's guess.

Was the professor tricked into assisting the operation? The director was unsure what had happened.

Tricked into having to be exposed to X-rays?

"Professor, why are you disinfecting the patient yourself?" Director Ren glared at the people around him and instructed, "Go get someone to assist. Zhang Guangzhi, how can you let the professor perform the surgery alone? Why didn't you scrub in? Cheng Lixue?"

The sudden attention on him caught Director Zheng off guard. He could feel sweat starting to form on his forehead.

The plump man waddled up to Director Ren and said with a smile, "Director Ren, we did not invite this professor. We invited the surgeon from Sea City General Hospital. The professor, he..."

Director Ren was suspicious. "The professor?"

"The professor is here as Chief Zheng's assistant."

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Chapter 387: An Up-And-Coming Revolutionist

"What did you say?" Director Ren's expression darkened as he asked.

The plump man noticed the sudden change in Director Ren's expression. Before he could clarify, Professor Rudolf Wagner muttered unhappily, "There's too many people in here. Are you new to the concept of sterility?"

The professor laid the surgical drapes over the patient then turned to Zheng Ren and said, "Boss, I'll begin the cannulation."

"Alright." Zheng Ren was wholly-focused on the patient's diffusion-weighted MRI scan as he needed to visualize the procedure in his mind. The appearance of the crowd in the operating room went unnoticed by the occupied chief resident.

"Lil Fugui, remind me to angle the needle 15 degrees later when we're performing the puncture," Zheng Ren ordered before walking away. He was going to scrub in.

"Alrighty," Professor Rudolf Wagner answered before glaring at Director Ren and the others.

The professor held a cannula sheath as he stared down the intruding group. The unflinching look on his face made Director Ren back down, who sheepishly smiled.

Lil Fugui... What a name for the great Professor Rudolf Wagner. Director Ren left the operating room amused.

He was surprised to find Professor Rudolf Wagner performing a TIPS procedure here. He recalled Zhang Guangzhi's explanation: the person they invited over to the Secondary Hospital was a doctor from Sea City General Hospital.

Why was the professor here then? The young doctor in the operating room had the air of a professor studying the scan on the viewer, while Professor Rudolf acted like the junior doctor, fussing over the disinfectant and surgical drapes.

Director Ren watched the scene in disbelief. He was confused at the role reversal.

The professor's serious tone and expression reminded him of time he spent in the operating room of Heidelberg University. Professor Rudolf was not a person who made jokes.

Random scenarios ran through Director Ren's mind.

"Director, when I was observing the surgery in Sea City General Hospital, Dr. Zheng was the lead surgeon while the professor assisted," Director Zhang whispered in Director Ren's ear.

"..."

Director Ren was speechless. The truth was hard to digest when he had such a high opinion of Professor Rudolf Wagner.

"The first TIPS surgery in Secondary Hospital was also successfully completed by Dr. Zheng. He managed to puncture the portal vein on the first attempt with the professor assisting."

"..."

Director Ren's silence continued.

The second TIPS surgery was ongoing now. Cheng Lixue muscled his way to the front of the crowd to get a good view of the screen.

The cannula was in position and the guide wire was fed into the jugular vein. It was the usual procedure to gain central venous access.

Everything was moving smoothly thus far.

The key highlight of the TIPS procedure was the puncture of the hepatic vein to the portal vein, as it was a literal stab in the dark. There was a low rate of success due to the lack of visual guidance.

Cheng Lixue kept his full attention on the screen. He was curious about the young doctor's methods.

What was he going to do?

The puncture kit was delivered to the two surgeons inside.

Cheng Lixue's eyes were wide as he stared unblinking at the screen. Zheng Ren was probably just lucky the first surgery went so smoothly.

It would not happen a second time.

Cheng Lixue had always been a principled doctor, but he found himself wishing for the surgery to encounter some complications.

Perhaps it was the organizational change in the hospital that incited the professor's irrational anger toward young doctors.

He used to be able to say young doctors these days were daring and full of energy, but lacked the skills and experience; yet here he was witnessing a young doctor from Sea City General Hospital, who did not look over 30, perform a TIPS surgery: a procedure Cheng Lixue himself could not execute.

It was a blow to his pride.

Should he step down and let the young take over?

No, that was not an option.

The whole control room was unusually quiet. Anyone who knew the procedure was paying close attention to the screen, waiting for the most important step. The others, who only knew the procedure's name, kept their mouths shut in the presence of Director Ren and Director Zhang.

No one dared to interrupt the tense silence in the control room. Anyone who spoke up unnecessarily was likely to earn Director Ren's ire, as he was captivated by the ongoing surgery.

Through the radiation shielding glass, they could see Zheng Ren and Professor Rudolf were in the middle of a discussion. The puncture needle shifted slightly, then was held in position.

'Seems like they aren't proficient either,' Cheng Lixue thought to himself, grinning as if he had won the battle.

If they had it down to a T, they would not be having a discussion partway through the surgery.

His victory lasted less than 20 seconds. On the screen, the shunt was inserted via the wire guide.

A success?

With Cheng Lixue's level of understanding, he could not make out what had happened. His interventional skills were limited to liver cancer treatments such as radiofrequency ablation. He did not bother to expand his skillset and the TIPS surgery was undoubtedly beyond his capabilities.

'No way... No way...' Cheng Lixue chanted in his mind.

He was going to be disappointed.

The shunt reached the target site and was deployed, connecting the hepatic vein and the portal vein.

Cheng Lixue had witnessed this surgery from start to end.

Despite that, he had no idea how Zheng Ren succeeded. even Director Ren was at a loss.

At this point, Director Ren realized age was catching up to him.

The world belonged to the next generation, to doctors like this young chief resident from Sea City General Hospital.

The TIPS procedure was viewed as one of the most difficult surgeries, and yet he successfully performed the puncture on the first attempt. No wonder the Heidelberg University professor flew all the way to China to be his assistant.

In modern day speech, this was known as an intellectual exchange. In the past, it would be said the professor was learning a trade.

Whether it was Lil Fugui or a random doctor, they would be considered a world-class surgeon after learning this skill.

This young doctor... He was an up-and-coming revolutionist.

While Director Ren was caught up in his thoughts, the second shunt was set in place.

Once he got over his surprise, Director Ren turned to Director Zhang. "Old Zhang, is this second shunt to prevent hepatic encephalopathy?"

"Uh, yes, Director Ren. Usually a second shunt isn't placed as during the removal process, it could potentially cause a major bleed."

Director Zhang got straight to the point. There was no point speaking in riddles with the director; it would only irritate him.

"At Sea City General Hospital, Chief Zheng performed two TIPS procedures. One of them was an emergency case to stop the bleeding. In both surgeries, they set removable shunts. They already successfully removed one of the shunts and the patient was discharged today."

"Amazing!" Director Ren exclaimed.

"Yes. Hence why I was so adamant that we invite him over to perform the surgery. We might never get another chance if he becomes a bigshot."

"How much does one surgery cost?"

"5,000 yuan. For the financially needy, the hospital will cover 3,000 yuan," Director Zhang said.

Director Ren frowned and turned to stare at the busy pair in the operating room. "Nonsense! That price is a slap to the professor's face and ours!"

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Chapter 388: You Can Brag But Don't Exaggerate

"Director, we were considering the patient's financial background when we settled for 5,000 yuan—," Zhang Guangzhi said.

His words were cut off.

Director Ren asked as he watched the screen, "What does Dr. Zheng think of the offer?"

The second removable shunt overlapped with the first shunt graft perfectly. The surgery was coming to an end.

"Chief Zheng agreed to the offer. His only request was for us to get eight to ten patients within the month."

"Oh?" Director Ren made a surprised sound.

"I believe Chief Zheng and Professor Rudolf Wagner are developing a new method and require sufficient cases to back them," Director Zhang whispered his suspicion to Director Ren.

Director Zhang knew the implications of such a project.

Director Ren thought for a moment, then said, "The volume is insufficient. We need at least 30 samples. Money is not an issue; the hospital will provide a discount."

"Then..."

"Get Dr. Zheng to train someone from our hospital. Most of the patients who require TIPS surgery are definitely from our hospital. Let him know he will have his supply of patients."

"Understood."

It was at this point of the conversation Zheng Ren exited the operating room. Professor Rudolf Wagner had taken over the procedure.

Director Ren still could not wrap his mind around the situation. He wondered if he had missed any signs that this was a prank.

"Chief Zheng, you're terribly familiar with the TIPS procedure." Director Zhang approached Zheng Ren with a big smile on his face.

"I'm alright."

"Where did you learn the method?" Director Zhang asked.

Where indeed? Even the world's best hospital would have trouble completing the TIPS surgery in such a short time.

"My first TIPS procedure was because of Chief Xia's emergency patient. It was a forced, rushed job, but the procedure was less difficult than I'd thought. Then, with the professor's help, we did a few days of research and developed this new approach," Zheng Ren said with a chuckle as he searched around for the third patient's scan.

Director Zhang rushed to Zheng Ren's aid and the words made him trip, nearly hitting his head on the table's corner.

The plump man managed to get a hold of Director Zhang before he fell.

Forced to perform an emergency TIPS surgery?

Was this an exaggeration?

The TIPS surgery was the pinnacle of interventional surgery and anyone who could perform it was highly skilled. Zheng Ren was undoubtedly an exceptional surgeon, but there was no need to tell a tall tale.

"We can bring in the next patient. Director Zhang, can we assign your best team to monitor their post-surgery condition?"

"I'll make the arrangements. Don't worry," Director Zhang promised.

Zheng Ren had proven himself to be an exceptional surgeon despite his young age. In Director Zhang's mind, Zheng Ren was of equivalent standing to an Imperial Capital professor, hence he minded his words when speaking.

With Professor Rudolf Wagner on his team, Zheng Ren was making a bigger splash in the medical field.

The world-renowned interventional surgeon was currently stemming the blood flow from the surgical wound under Zheng Ren's instructions. A deputy director of a prefecture-level hospital was nothing compared to them.

"Thank you," Zheng Ren said before picking up the third patient's scan and moving toward the heavy door. His departure was interrupted when Director Ren spoke up.

"This is Dr. Zheng?"

Director Zhang froze. He had forgotten to introduce the director.

It was quite a mistake.

He blamed his forgetfulness on Zheng Ren's emergency TIPS surgery story. It had taken him by surprise and reset his brain.

He immediately pulled Zheng Ren over and said, "Chief Zheng, why don't you introduce yourself?"

Zheng Ren turned his head to look at Director Zhang.

"This here is Director Ren, and this is the chief resident of the emergency department in Sea City General Hospital, Zheng Ren," Director Zhang said with an awkward smile.

"Chief Zheng, nice to meet you," Director Ren said reservedly. He smiled at Zheng Ren.

He was waiting for Zheng Ren to initiate the handshake.

Scans in hand, Zheng Ren returned the smile and said, "Nice to meet you too, Director Ren."

Then, he turned and headed for the operating room.

Zheng Ren was in the zone. He and Professor Rudolf Wagner had conflicting opinions over the second patient's scans when they were reviewing it in Sea City General Hospital. Their discussion went on for a long time, but they were interrupted by the emergency case with the heart laceration.

After the emergency rescue, Zheng Ren was still mulling over the patient's scans.

Today, with the patient before them, Zheng Ren felt enlightened.

The current surgery they had completed was not perfect. Although it was a success, the puncture needle had to be angled slightly, and if it were not for Zheng Ren's 8 to luck, it would have been a failed puncture.

This was the part that required experience. Zheng Ren's theory and hypothesis had to be proven once with the help of the System's attributes, then he could repeat the procedure to form a conclusion.

At the moment, Zheng Ren's mind was fully occupied with the third patient's MRI scan. The two directors were the least of his concerns.

The air in the control became freezing.

Even Director Ren was surprised by Zheng Ren's disrespect.

This young man...

Then, Director Ren realized his mistake.

Although this young man held the position of a chief resident in Sea City General Hospital, he doubted anyone in the hospital actually treated him as such.

The director glanced at the professor in the operating room who was closing up the wound. Instead of getting angry, Director Ren felt cold sweat drip down his back.

"Chief Zheng, it's really good to meet you personally. I'm the director of the Secondary Hospital," Director Ren said with a genial smile. He reached out with two hands and clasped Zheng Ren's free hand.

"Uh huh, Director Ren. Good to see you too." The sudden warmth from the man surprised Zheng Ren.

"I won't hold you any longer. Please proceed with the surgery. We'll have dinner once everything's wrapped up," Director Ren said.

"Sure, sure." Zheng Ren let out a relieved sigh; the ideas in his head were still intact.

Director Ren released their clasped hands and Zheng Ren made a beeline for the operating room. They watched as he clipped the scan onto the viewer and started studying the scan.

Silence fell over the control room.

Those doctors who were used to the bureaucratic ways of the hospital were stunned at the exchange.

The interaction between Director Ren and Zheng Ren was beyond their comprehension.

In the operating room, Zheng Ren stared at the scan.

The whole world faded away as his focus honed in.

Suddenly, Zheng Ren called out, "Lil Fugui!"

Professor Rudolf Wagner startled. "Yes? I'm here."

"Here!" Zheng Ren tapped on the scan.

Professor Rudolf had noted the same position and said, "I think for this position, we'll have to angle the needle 25 degree to the left, then advance from the right."

"No, 18 degree then a straight puncture," Zheng Ren corrected.

The observers in the control room watched the argument unfold. Words like gravitational field, thermal equilibrium, density, altitude, Boltzmann distribution, and a bunch of scientific jargon sounded from the operating room. No one understood a thing.

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Chapter 389: I Have A Dream

The surgery resumed.

TIPS surgery was supposed to be full of challenges, but in the hands of Zheng Ren and Professor Rudolf Wagner, the surgery progressed so smoothly, it was a boring affair for the observers.

For each surgery, they managed to establish the connection between the hepatic vein and portal vein in their first attempt.

The TIPS procedure appeared to be as simple as treating an ultrasound-diagnosed hepatorenal cyst. Zheng Ren's movements were so methodical, it gave people the impression that he was not even performing surgery.

It took 30 minutes to complete one surgery. Zheng Ren operated like a machine, in spite of the different patient conditions and tweaks in the methods. The time management was impeccable.

Director Ren, Director Zhang and the others in the control room watched on impassively.

There was a vast difference between the skill level of the doctors in the control room and the ones in the operating room.

As the final surgery of the day ended, the System display notified that nine out of ten surgeries were completed for the main mission.

He only needed one more surgery and was impressed by his progress. He was looking forward to completing the mission and getting the reward.

Radiofrequency ablation was very effective in treating liver cancer–a reason why Zheng Ren wished to accomplish the mission.

It was a shame he was one surgery away from completion.

Zheng Ren went to the changing room and took off the lead vest. He stored the lead vest in the System's space before entering the control room.

A dozen pairs of eyes fell on Zheng Ren as he entered. The plump man's feet shuffled, but he stayed where he was.

A deafening silence filled the room.

Zheng Ren felt the tension in the room and wondered, 'Why is no one speaking?'

After a few seconds, Director Ren gave him his sincere praise. "Chief Zheng, remarkable!"

Director Ren's words broke the silence. Like the warmth of the Pacific Ocean spreading across the Arctic Ocean, the huge iceberg in the room melted and the room broke out in an uproarious standing ovation.

"It's alright; it's really nothing," Zheng Ren responded with a humble smile.

"Chief Zheng, what do you like to eat?" the plump man approached Zheng Ren and whispered in his ear.

"I'm fine with anything," Zheng Ren said.

Director Ren had said they would have dinner together, but Zheng Ren was not particularly interested in social gatherings. However, he knew better than to reject an invitation from the director.

Especially when the Secondary Hospital had invited him over to perform the surgery.

Each patient displayed indications for operative treatment and had conditions that were not so severe as to serve as contraindications.

Zheng Ren interpreted this as the Secondary Hospital being invested in the TIPS collaboration as the patients were carefully cultivated.

Although the Secondary Hospital invited him to leave a mark in their history books, Zheng Ren was equally grateful for the sourcing of patients.

"Chief Zheng, you put us old men to shame. To be able to perform a perfect TIPS procedure at your age," Director Ren said amicably.

Zheng Ren gave a short reply, "It's all coincidence."

He had no clue as to how he should respond to the compliment, so he made generic responses in hopes to appease Director Ren.

From his previous interactions with Zheng Ren, Director Zhang knew the chief resident's social skills were the opposite of his surgical skills. With that in mind, Director Zhang stepped up to relieve Zheng Ren.

Director Zhang masterfully managed the atmosphere in the control room. If half of his social skills were allotted to surgery, the Secondary Hospital would already have a TIPS demonstrative surgery.

When Professor Rudolf exited the operating room, there was another round of applause.

The reservation was set by the plump man, but Zheng Ren was adamant about paying a visit to the wards to check on all the patients.

It was a habit.

It was better to identify any issues early on.

As they were all doctors, no one objected to Zheng Ren's practice.

It would be embarrassing and unbecoming to criticize a doctor who put their patients first. No one wanted to work with a big-talking doctor who only cared about the surgery, not the patient.

Zheng Ren would have a clearer picture of the patient's post-surgery condition with the System's help.

As the patients had the second removable shunt in place, the blood flow in the liver was better controlled; this reduced the chances of hepatic encephalopathy.

Each patient was given an intravenous administration of ornithine aspartate to prevent hepatic encephalopathy.

The visit to the ward allowed Zheng Ren to assess the capability of the Secondary Hospital staff. Once he was satisfied, the group made their way to the restaurant.

They arrived at a farmhouse restaurant that advertised a wide range of dishes, including the exotic sorts.

Deer meat, swan meat, and wild goose meat were available in different styles of preparation.

Zheng Ren stared at the table full of food, then looked around. Everyone around him was raising their glass; even the foreign professor was enjoying the alcohol. Zheng Ren felt very lonely at that moment.

The noisier the crowd got, the lonelier Zheng Ren felt.

If only Little Yiren was there... If she was there, she would not be socializing, but wolfing down the numerous dishes that were laid on the table. Zheng Ren would be happy just watching her eat.

They had held hands. Did this mean he could pick food for her?

Zheng Ren let his mind wander into the clouds; his imagination was much more appealing than reality at the moment.

Director Zhang appeared before Zheng Ren with a glass in hand. "Chief Zheng, can we ask a favor from you?"

A reluctant expression crossed Zheng Ren's face. Were they going to force him to drink?

He was a lousy drinker. One glass was enough to make him want to puke.

The change in expression clued Director Zhang in on Zheng Ren's thoughts. The deputy director laughed and said, "You're a good man to not have this vice. Drinking excessively can make your hands shake; definitely not good for a surgeon. I respect your discipline. No wonder you've achieved this much at such a young age."

At the admission, Zheng Ren felt relieved.

"You're too kind, Director Zhang. What do you need?" Zheng Ren asked.

"Your TIPS procedure was exceptional." Director Zhang did a fist pump that made Zheng Ren slightly embarrassed.

"Hahaha, you're younger than me, but I hope you won't feel awkward if an old man like me calls you brother," Director Zhang said as he wrapped an arm around Zheng Ren's shoulders as if they were actual brothers.

"Oh... I'm good, I'm good." Cold sweat was breaking out on Zheng Ren's forehead.

"Brother, your surgical skills are incredible. Everyone was speechless. Brother, I've always wanted to perform a TIPS procedure, but at this age, it's not possible anymore. Regardless, I have a dream: to have someone from the Secondary Hospital successfully perform a TIPS surgery," Director Zhang said.

'I have a dream'. Zheng Ren recalled the African-American man's iconic speech [1] and cringed.

"Brother, you gotta help me with this." Director Zhang had a tight grip and Zheng Ren was starting to feel pressured.

"Sure, sure. It's very easy. So long as the person has some foundation, they'll be able to pick it up. But..." Zheng Ren rambled.

Director Zhang was slightly tipsy as he hollered, "No worries, just tell me what you need."

"The person has to be a good listener. I have a busy schedule, so I can't give lessons for too long."

"Sure. I'll get you someone. If they misbehave, just hit them."

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Chapter 390: A Heartfelt Thank You

Zheng Ren was exhausted after the dinner.

His soul was tired. He had to promise Director Zhang he would pass on the TIPS method to one of the doctors at the Secondary Hospital.

As a human being, Zheng Ren knew he had to participate in these social events despite how much he hated them.

They were the bane of his existence.

Feng Xuhui served as their waiter, running errands and refilling glasses; hence, he remained sober all through the night. Occasionally, he had to drop a line here and there to keep the mood alive.

After attending multiple events, Feng Xuhui had graduated from wallflower to a professional at addressing the crowd.

He was tired, but excitement buzzed through his body.

Every hospital was a castle and he had successfully penetrated the defenses of one. With the Secondary Hospital sourcing supplies from them, the company's business report would show a significant boost in sales. Feng Xuhui looked forward to the hefty bonus at the end of the year.

These pleasant thoughts occupied his mind as he served the crowd.

Feng Xuhui recalled the words of that restaurant owner in Imperial Capital. He was told to hold on tight to Chief Zheng; the man was a rising star.

Feng Xuhui did not know what a TIPS procedure was, but he could tell the doctors from the Secondary Hospital were impressed by Zheng Ren's performance.

As the night ended, Feng Xuhui escorted Zheng Ren and Professor Rudolf home.

"Chief Zheng, shall I drop you or the professor off first?"

The professor had one too many and was snoring soundly in the back seat.

"Drop the professor off at Shangri-La first." Zheng Ren wound down the window and lit a Ziyun cigarette. He took a drag and let the menthol in the tobacco linger in his mouth. The cold Northeastern air blew into the car, clearing Zheng Ren's mind. "You help him up. I'll wait downstairs."

"Okay." Feng Xuhui could sense that Zheng Ren wanted some silence. He kept his focus on driving.

After Professor Rudolf Wagner was dropped off at the hotel, Feng Xuhui asked Zheng Ren about their next destination.

When he heard Zheng Ren mention the neighborhood, Feng Xuhui's eyes widened.

No wonder Zheng Ren was able to wholly focus on surgery; money was not a worry for him. He lived in one of the fanciest neighborhoods.

Only the rich could abandon the usual worries in life and truly pursue what they loved.

Surgery was a hobby to Chief Zheng.

In that instance, Feng Xuhui's impression of Zheng Ren strayed further and further from the truth.

Zheng Ren was texting Xie Yiren on his phone.

He wanted to go to Xie Yiren's place and bid her goodnight with a hug.

If he could do that, the night would be perfect like the TIPS surgeries he had done that day.

However, Chu Yanzhi was at Xie Yiren's house today as she was working on-call.

Given Xie Yiren's personality, with the presence of another human being... Zheng Ren sighed and gave up on his idea.

It was late and he had things to attend to tomorrow.

Zheng Yunxia's 64-slice CT scan required his attention. He needed to evaluate the efficacy of the second embolization treatment.

He needed to visit the patients in the wards, and there was still the old man who was faking ill.

Never mind... He would go home and wash up. An early rest would do him good as he would be required to replace Su Yun in the emergency department. The man had been working for two days straight.

With Zheng Ren's guidance, they arrived at Xie Yiren's manor.

Feng Xuhui watched as Zheng Ren entered the house. He was still shocked to find out how loaded the man was.

Zheng Ren was a man of many surprises. He had never flaunted his wealth. His attire was ordinary and his taste in food was nothing unusual, but the manor he lived in was spectacular.

The image of Zheng Ren as a rich person was surprising.

Feng Xuhui gathered his thoughts and quickly drove off.

He still had a lot of work to do when he got home. He had to assess today's surgeries and evaluate future business between Changfeng and the Secondary Hospital.

Although these were usually done by the company's data analysts, Feng Xuhui felt he had a better feel of the ground and could provide a more accurate and realistic number.

He patted himself on the shoulder. He drove off with thoughts of one day living in a manor like Zheng Ren.

Self-motivation was important in his line of work.

...

The next morning, Zheng Ren was invited by Xie Yiren to breakfast.

Chu Yanzhi was interested in his visit to the Secondary Hospital and asked a bunch of questions. Xie Yiren ate her breakfast quietly, occasionally glancing at Zheng Ren.

After breakfast, Zheng Ren went to the emergency department wards and asked about the patients.

Unexpectedly, Su Yun had had two rather free and easy days at the hospital.

"You must have neglected to worship the Night Shift God," Su Yun laughed at Zheng Ren.

'This lucky bastard,' Zheng Ren cursed in his mind.

At 7:55 a.m, Professor Rudolf Wagner walked into the emergency wards. At the sight of Zheng Ren, the professor immediately got his attention. He wanted to share the reflections he had about the TIPS procedures they did yesterday.

However, Zheng Ren rejected his advances.

Zheng Ren had to oversee the handover, make the rounds and check on some patients. He had no time to entertain the professor.

This was not Heidelberg University. Sea City General Hospital had limited medical personnel on duty.

The medical staff were jaded from the many years of service at the hospital. They were no longer excited about their jobs and the toil was slowly grinding away at their souls.

Even with insufficient staff, the hospital took in patients and the staff cared for them at the expense of sleep. Medical research was far from their minds. They would rather have more time with their family than be roped into some research project.

After the rounds, Old Chief Physician Pan went back to his office while Chang Yue dragged the professor off to help with something. Zheng Ren was not sure what she needed help with, but refrained from asking.

Zheng Ren and Su Yun started to check on the patients whom they had operated on. They made note of each patient's condition: what was the blood oxygen level of the TIPS surgery patient, when could they remove the extra shunt, how was the ICU patient doing? It was a lot of work.

Once they were done, they exited the emergency ward. Zheng Ren was shocked to find a crowd in front of the emergency ward.

There were a bunch of elementary school kids and two adults. The adults looked prim and proper.

Which of their patients was a teacher? Teachers were held in high regard these days. A sick teacher often beckoned worried parents to the hospital.

Zheng Ren had heard complaints from coworkers who regretted joining their children's class chat group. After joining the group, they realized the group's content consisted of only two things: the teacher berating the parents and the parents trying to impress the teacher.

Zheng Ren rifled through his memory, but found no sick teacher in his list of patients.

The children were quite young. Could it be...

As Zheng Ren was lost in his thoughts, the child who looked the eldest in the group held up a newspaper. The child was comparing Zheng Ren to a photo in the newspaper.

"Uncle, are you Dr. Zheng?" The child had an angelic voice, which Zheng Ren found cute.

"Yes, I am." Zheng Ren studied the situation. The newspaper in the child's hand was the Sea City Metropolis Daily. He could not see the publication date, but he saw the front page headline photo; it was him.

"Good day, Uncle. We are students from No. 9 Elementary School. Our class teacher is Miss Yang Lili," the child who was leading the group said. "We're here to visit Miss Yang and to thank you."

Zheng Ren chuckled at the child's serious tone. He ruffled the child's head and said, "You're welcome. It's my job to save people."

The adults of the group approached Zheng Ren and bowed. "Dr. Zheng, the children were insistent on coming over to express their gratitude. Really sorry if we're interrupting your work."

Zheng Ren panicked at the sudden show of gratitude. "Thank you, thank you."

Social encounters were not Zheng Ren's forte.

Su Yun stood behind Zheng Ren, a playful grin on his face as he watched the scene play out.

"Students from Second Year Class One, Miss Yang's condition is improving. We can come back in a few days to visit her. This is Dr. Zheng, the doctor who saved Miss Yang's life. How do we show our gratitude?"

The first child who interacted with Zheng Ren must have been the class monitor, as she quickly turned to face the other students and said, "Class, attention!"

All the children stood up straight, shoulder to shoulder.

The class monitor turned to face Zheng Ren. Her expression was as serious as an adult's.

"Dr. Zheng, we of Second Year Class One from No. 9 Elementary School sincerely thank you." The class monitor raised her right hand and led a Young Pioneer's salute.

The 30 or so children followed her gesture.

It was not a neat salute, but the effort was enough to impress the adults.

Zheng Ren felt his heart swell.

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Chapter 391: Good And Evil

Zheng Ren was fumbling with his hands. How should he react to the pure hearts of innocent children?

The teacher from No. 9 Elementary seemed to notice his struggle. He stepped out immediately and yelled, "Attention!"

The children put down their hands and stared at Zheng Ren with their innocent gazes.

"About-turn! Teacher Sun, can you bring the kids to the bus? I need to speak to Dr. Zheng," he said.

Another teacher nodded and guided the children away from them.

The crowd instinctively cleared a path for them. Many of them were stirred by the commotion but had no idea what was going on. However, they could feel a tug in their worn hearts.

"Who is that? Why are the children here?"

"Didn't you hear on the news about the assault at No. 9 Elementary School? This is the doctor who saved the wounded teacher."

"I heard that the teacher is still in the ICU."

"She's lucky to have survived after being stabbed more than a dozen times. I heard that they couldn't even get her blood pressure reading when she arrived at the hospital."

"They were able to rescue her? That doctor's incredible!"

"Of course. A few days ago, a patient with a heart injury was sent in while I was having a drip in the emergency department. I took my drip and followed them, only to see this doctor opening the patient's chest right there with blood shooting out to the ceiling."

"My goodness... Is that person still alive?"

"Of course, he's fine. I heard that they transferred him to a normal ward. This doctor is amazing. He almost made me cry. If I could experience that once, I'd die without any regrets."

There was a soft murmur from the crowd as they gossiped about them. The teacher from No. 9 Elementary walked toward Zheng Ren and extended his hand for a handshake.

"Dr. Zheng, I know it came as a bit of a shock but it was what the children wanted. I tried to talk them out of it, but I ended up changing my mind in the end. We have to show our gratitude. It's the right thing to do and it'll help set a good example for the kids," the teacher told Zheng Ren with a smile.

"Thank you, Dr. Zheng."

"You're welcome. I'm just doing my job," Zheng Ren said.

"I was there at the scene. If not for you, I'm sure she wouldn't have survived," the teacher said. "Yang Lili can thank you personally when she's transferred back to the emergency ward. I'm here to represent the teachers from No. 9 Elementary in expressing our sincere gratitude for your help."

After saying that, he released Zheng Ren's hand and bowed deeply.

Zheng Ren was speechless as all of his words coursed through his heart.

"You must be busy this morning. I won't take up any more of your time." The teacher stood up and smilingly said, "We'll talk more if we meet again."

"Sure, of course," Zheng Ren replied.

After that, the teacher bid farewell before turning around to leave. Zheng Ren accompanied him downstairs.

There were a few school buses filled with children in front of the emergency building's entrance of the Sea City General Hospital.

When the children saw Zheng Ren, they rushed to the windows and waved at him.

What a sight.

Zheng Ren waved back and said goodbye to the kids from No. 9 Elementary, feeling bittersweet.

This was the greatest satisfaction from his successful emergency rescue.

"Boss, are you crying?" Su Yun whispered in Zheng Ren's ear once the school buses left.

"No." In that instant, Zheng Ren felt a strong resentment against him.

Why did he always interrupt him when he opened up his heart to these touching moments?

"It's time for ward rounds. Yang Lili's in good condition. She's fully awake after disconnecting from the ventilator. We can even remove her chest tube today," Su Yun said.

"Can she be transferred out the day after tomorrow?"

"I hope so," Su Yun said. "If she's like any other patient, she would have been transferred out already but since the Ministry of Education and the deputy mayor instructed us that this is a high profile case and Director Xiao has been visiting her every day, we have to leave her in the ICU for a few more days."

Zheng Ren had no choice but to follow these formalities.

"A little bird told me that you did eight TIPS procedures at the Secondary Hospital?" Su Yun changed the topic shockingly fast.

"Mm." Zheng Ren frowned as he stared far ahead.

"Boss, your surgical talents will make others envious," Su Yun said.

"It's no big deal. There's nothing to be jealous of." Zheng Ren brushed it off as his frown deepened.

"That's because you're blessed with a gift," Su Yun said smilingly.

Back in Imperial Capital, many envied Su Yun's talents too.

It was just that he had met a greater monster in Sea City.

Zheng Ren remained silent and watched the crowd from a distance.

Su Yun quickly noticed that something was wrong. He asked lazily, "Boss, what are you thinking of? Are you still overwhelmed by the children's gratitude?"

"No, call Fan Tianshui and check if he's in the hospital. If he's not, tell him to hurry over." Zheng Ren sounded anxious.

Su Yun was at a loss for words.

What was going on?

Zheng Ren was fixated on a bearded man carrying an infant. He seemed to be in a hurry while he glanced around sheepishly.

Su Yun could not see that the System's monitor in Zheng Ren's upper right vision was displaying an ashen white screen.

There was no diagnosis on the screen, just a ghostly white color like years of thick frost accumulating in the cold chambers of a morgue.

If it was several days ago, Zheng Ren might have been startled by this because he had not experienced something like this since he first attained the System.

However, after the heart stabbing incident where the cardiac tamponade patient's heart stopped beating, Zheng Ren understood what was going on.

The System's monitor would show a plain white color if the person was dead.

White: A ghastly color.

Just like the infant in the bearded man's arms.

What was happening?

Zheng Ren felt suspicious.

The System's monitor was green for the man, indicating that he was perfectly healthy without any neurological disorders.

If he was sane then why was he carrying a dead child to the hospital?

Zheng Ren felt a chill run down his spine.

"Old Fan, are you working today?

"Boss is asking for you. Please come immediately. Oh, we're at the emergency building's main entrance.

"Okay, I'll talk to you when you're here."

Su Yun then hung up.

"Boss, did something trigger you?"

"Su Yun, go look for Old Chief Physician Pan." Zheng Ren's voice was firm and irrefutable.

Su Yun was confused. He looked around but did not find anything unusual.

Nevertheless, as the perfect assistant, he did not question Zheng Ren's decision and turned around instantly.

"Chief Zheng, what's the matter?" Fan Tianshui asked from behind with an honest smile.

At that moment, the middle-aged man carrying an infant brushed against Zheng Ren.

He glanced at Zheng Ren briefly and tightened his grip on the blanket around the infant before rushing into the emergency building.

Zheng Ren turned around. "There might be some conflict later. Try not to hurt anyone if possible. We can always call the police."

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Chapter 392: Blackmail

There was a shift in Fan Tianshui. He did not ask why and squinted his eyes. He then followed behind Zheng Ren into the emergency building.

Zheng Ren walked slowly, unsure of the man's intention.

Was he here to get a death certificate or something?

Medical disputes were rarely seen in Sea City General Hospital with the help of Little Six, so Zheng Ren did not take this into consideration.

However, Zheng Ren chose to play it safe.

He calmly followed the man to the emergency department, putting around a 20-meter distance between them.

The man disappeared into the pediatric emergency department.

Zheng Ren leaned against the door and listened.

"Doctor, my child is having a fever, please prescribe some medication," the man said.

The crowd in the emergency department was not too busy early in the morning.

If the patients did not have any urgent symptoms, they would usually let the sick children be treated first.

The country currently had a shortage of pediatricians.

Sea City General Hospital fought hard to transfer two pediatricians to the emergency department. They only worked day shifts so if there were any patients at night, they would be directed to the inpatient department.

If they lost more pediatricians, the hospital would need to close the pediatric inpatient department.

Zheng Ren curiously stood in the corridor while carefully listening to the conversation in the consultation room.

"Let me examine your child," the doctor said.

"Doctor, there's no need for that. My baby is soaked in sweat. What if my kid catches a cold?" The man sounded agitated, his tone no longer polite.

"How can I simply prescribe medicine without examining your child?" The pediatrician insisted, but there was fear in her voice.

There were numerous occasions where pediatric doctors and nurses got hit and scolded by rude parents. Was it finally her turn today?

"You want me to spend more money! I just want some medicine for my child!" The man roared. "Can't you treat people without doing a checkup?"

Zheng Ren frowned deeply.

This man was obviously no ordinary visitor. He casually interchanged the concepts of physical examinations and a body checkup.

Although physicians could clearly distinguish these two different diagnostic methods, patients usually could not.

He raised his voice to attract the attention of others so that he could pressure the pediatrician.

Threatening the pediatrician with a dead infant...

Zheng Ren's heart sank.

"Zheng Ren, you asked for me?" Old Chief Physician Pan called out to him when he saw Zheng Ren standing in front of the pediatric consultation room after walking out of his office.

"Chief Pan, someone's trying to make a scene. It's going to be a big one," Zheng Ren said.

Su Yun clicked his tongue but did not tease Zheng Ren in front of Old Chief Physician Pan.

"Hmm?" Old Chief Physician Pan strode into the pediatric consultation room when he heard them fighting.

"What's going on? Why are you guys fighting in the morning?" Old Chief Physician Pan stood upright like a huge mountain.

The man was forcing the pediatrician to prescribe medication. He was startled when he saw Old Chief Physician Pan enter the room together with Fan Tianshui behind him.

"I just wanted some medicine. It's fine if you don't want to give me the prescription. I'll just go to the pharmacy." The man turned around to leave with the infant still in his hands. When he was about to leave, he mumbled, "You guys are all doing this for the money, not giving a shit about saving lives."

Old Chief Physician Pan's face dropped but he did not say a word.

When the man was about to walk out of the consultation room, he was blocked by Zheng Ren.

"You're just going to leave without getting treatment?" Zheng Ren asked. "I'll examine your child for free."

The man was immediately flustered by his words.

"You evil doctors!" He yelled out of sheer panic, trying to get the attention of the patients in the corridor.

"You don't have to pay a single cent. Understand?" Zheng Ren did not back down and raised his voice as well.

Old Chief Physician Pan and Su Yun were surprised by Zheng Ren's out-of-character response.

The man glared at Zheng Ren furiously with his fist clenched.

Fan Tianshui stepped forward and stood behind Zheng Ren with an intimidating look.

He was giving off murderous vibes. At most, the man was a local pariah compared to Fan Tianshui. He was definitely no match for him.

The man instantly backed down when he sensed Fan Tianshui's presence.

"I don't want to anymore, okay?" The man muttered. He did not even bother to pretend under Fan Tianshui's pressure.

"No!" Zheng Ren moved sideways to block the man's path. He then said sternly, "You said that a hospital is a place where we save lives. I have to bear that responsibility. Please let me see your child."

This did not turn out the way the man had expected.

Even Old Chief Physician Pan and Su Yun were puzzled.

Was Zheng Ren looking for trouble?

The man felt hopeless. Who was this idiot in front of him? Why was he stopping him from leaving?

This was his first time encountering something like this after going through so many hospitals.

Out of a sudden, he threw the infant toward Zheng Ren and escaped.

Zheng Ren caught the infant and shouted, "Fan Tianshui, stop him!"

Fan Tianshui executed his orders obediently. He treated Zheng Ren as his savior and squad leader.

He would follow whatever his squad leader ordered him to do and carry out the mission without question!

Fan Tianshui knocked the man with his shoulders, causing him to lose balance and fall onto the ground.

Zheng Ren was unaffected by what was happening behind him. He opened the blanket and saw a young face with ashen skin.

Old Chief Physician Pan asked, "Dead?"

Su Yun pressed the infant's cheek with his finger to check its temperature and rigidity. He then said, "He's been dead for at least 12 hours."

The few of them were furious!

This was what the hospital was most afraid of一blackmail.

For instance, if their child was almost dying, they would switch to another hospital and start to make a scene if the child died there.

Another scenario would be patients who discovered cancerous tumors during checkup and would jump off the roof while family members recorded it on tape for blackmail.

The hospital was like their personal bank to cash out whenever they wanted. They could not care less about the psychological trauma they brought upon the consulting doctors and the fact that some doctors gave up practicing medicine afterward.

It was obvious that the man was trying to leave a digital footprint by asking the doctor for a prescription.

If the pediatrician had not resisted or that Zheng Ren had not noticed, he would come back with the infant a few hours later to complain that his child had died from the prescribed medication.

Old Chief Physician Pan, Zheng Ren, and Su Yun were all aware of his motive.

The heartless bastard!

"They're hitting me! They killed my son and hit me! Come and take a look!" The man barked in the hallway.

Zheng Ren placed the infant on the bed and walked out of the consultation room with an ice-cold expression.

He then kicked the man in the face so hard that blood splattered out.

"Motherf*cker!"

Chapter 393: Organized Crime Group

"Zheng Ren!" Old Chief Physician Pan yelled.

He was shocked by Zheng Ren's uncharacteristic outburst.

"Chief Pan, call the police!" Zheng Ren said calmly. He kicked the man to stop him from fighting back.

After that, Zheng Ren kicked the man again between his chest and abdomen.

The fierce expression on his face disappeared as he choked and gasped for air, curling his body like a prawn as he seized up in pain.

Zheng Ren knew he was no longer a threat.

It was not because of him, but due to Fan Tianshui.

No matter how aggressive the man was, he was just a normal person and could not cause much damage.

"This..." Old Chief Physician Pan was stunned by Zheng Ren's overreaction.

"I suspect that the child is not his!" Zheng Ren gave the man on the floor a death stare.

Old Chief Physician Pan was startled after hearing what he said. Su Yun also quickly realized what was happening. Zheng Ren might be right!

The logic behind it was actually rather simple but no one noticed sooner because it had all happened so suddenly.

The man clutched the blanket around the infant so tightly, hiding it from others, and even resisted a body checkup when the doctor requested to do so. All these signs suggested that he knew the infant was dead.

When Zheng Ren forced the issue, he threw the infant toward Zheng Ren. His actions proved that the child was just a pawn in his scheme.

Su Yun immediately dialed 110 to report the incident to the police. He also informed the medical administration division to let Chief Zhou handle this.

There was a police department in Sea City General Hospital but it was for the sake of deterring crime by instilling fear amongst the local gangsters.

The medical administration division had to step in if there was a need to notify the police's upper management.

Chief Zhou was a little rusty as a doctor, thanks to the never-ending medical disputes he had to deal with over the years.

He was in charge of the toughest and dirtiest job in the hospital. Even the janitor from the general surgery department could not be compared with him.

To quote Chief Zhou directly, 'There's an active volcano under my ass, and I don't know when it will erupt. Other people can run for their lives but not only can I not escape from it, I will also have to extinguish the flames.'

After picking up the phone, Chief Zhou sprung from his seat when he heard Su Yun explain the entire incident. "Bang!" His knee bumped against the arm of the chair but he failed to notice it in his shock.

This was an incident with malicious intent. However, he could not really assess how bad the situation was at the moment.

This was only the tip of an iceberg. Fortunately, they had managed to expose them, otherwise... Chief Zhou shuddered at the thought.

He called the police chief as he rushed over to the emergency department together with his assistant.

He met Old Chief Physician Pan in the hallway and asked a few questions about the incident.

When he saw livor mortis on the infant's body, he broke out in a cold sweat.

Thank goodness for these vigilant lads from the emergency department. Several years ago, something like this would seriously damage the hospital's reputation.

Back then, if they cooperated with professional medical dispute profiteers, there would be banners hanging in front of the hospital's main entrance. They would even bring children to throw tantrums and disrupt the hospital's entire operation.

Nowadays, an incident like this would go viral on WeChat and Weibo and spread like wildfire. No one could predict how far it would reach.

'Motherf*cker! How dare he extorts a dead child for money!'

Chief Zhou glared at the man on the floor. Fan Tianshui was standing beside them in a seemingly relaxed manner but was on high-alert to stop him from escaping at any moment.

As the hospital's security guard, Fan Tianshui did not have the right to arrest someone. In fact, he had broken a few rules by keeping the man there.

However, no one cared about that.

It might have been due to their empathy toward the child or their disgust for the middle-aged man. Regardless, no one paid attention to him overstepping a few rules.

The police arrived shortly after and closed off the scene. After that, they arrested the guy and took him away, restoring peace and quiet in the emergency department.

Zheng Ren was furious, but he suppressed his emotions and reacted calmly.

From his decision to expose the man until the attempt to stop him, Zheng Ren had an exceptionally firm stance, which was unlike his usual kind chief resident persona.

"Boss, you're the man." Su Yun dragged Zheng Ren and left through the side door. They stood beside the bin with an ashtray. He then took out a cigarette from Zheng Ren's pocket, lighted it, and passed it to him.

Zheng Ren remained silent and took a deep drag, feeling the burn of the tobacco in his lungs before puffing out thick, white smoke.

Su Yun patted Zheng Ren's shoulders to comfort him. He then lighted another cigarette and twirled the lighter between his fingers sensually. After a few puffs, he said, "Boss, these cigarettes make you look cheap."

"I'm used to it," Zheng Ren said.

"You have to change some of these old habits. You need to get used to better things. Let the past go."

"Uhm."

"How did you know?" Su Yun asked.

Zheng Ren shook his head without answering his question. Instead, he asked, "What do you think about this?"

"This was definitely not his first attempt," Su Yun said with the cigarette in his mouth, his black fringe swaying attractively.

"Let me ask around." Zheng Ren took out his phone and dialed a number.

"Brother Six, it's me.

"Uhm, I need a favor. There's a man who came to our hospital with a dead child trying to scam us. I don't think he's related to the child, so he might be a child trafficker.

"Yes, can you help me to find out about this? Thank you.

"Sure, I'll treat you to skewers the next time we meet."

Zheng Ren hung up after that.

"You're suspecting..." Su Yun asked.

"From the state of livor mortis on the child, the time of death should be around midnight," Zheng Ren said. "The way he carried the child around to ask for medication was suspiciously calm as if he had a clear goal. This means he's done this quite frequently and is not the only one behind this scheme."

"Wow, Boss. I didn't know you solve crimes," Su Yun teased him as usual.

"When I was in school, I worked as an assistant for my pathology teacher. My teacher was also working part-time as the city's forensic pathologist. I was able to earn 100 yuan for each body I dissected. That amount was quite substantial to me as a student," Zheng Ren said.

Su Yun reminisced on his school days. "I invested in stocks when I studied."

"My main concern is that the man belongs to an organized crime group and there are more children involved," Zheng Ren said.

Su Yun tensed up instantly, a serious expression on his face.

"Why didn't you tell Chief Pan?"

"I think the police's intervention would suffice. They are all experienced officers so I'm sure they'll think of it too. Besides that, I can find out other things with Little Six's help."

Both of them stopped talking.

They finished their cigarette and extinguished the buds before turning around to leave.

In that moment, Zheng Ren's phone rang.

"Hi, Brother Six.

"Uhm, hm. Okay, sure.

"Thank you."

Right after Zheng Ren hung up, Su Yun asked, "What did he find?"

"Those despicable medical dispute profiteers," Zheng Ren said. "The one who came here today came from another city. The ones from Sea City still dare not come here."

"Another city?"

"Uhm, they took the child to the Women and Children hospital and scammed them for 20,000 yuan," Zheng Ren said.

Zheng Ren stared at the cloudy sky as he spoke. He then paused for a few seconds before saying, "The child was still alive. Little Six verified with the doctors from the Women and Children Hospital."

"Was he planning to come here for one last job and disappear after making a big one?"

"Hmm, Little Six said that the local medical dispute profiteers received a job offer but they didn't take it."

"These guys..." Su Yun let out a sigh.

"Uhm, let's report this to Chief Pan. It's beyond our reach now." Zheng Ren's expression gradually calmed down.

"Let's go and visit Yang Lili."

"Yang Lili's fine. I think she'll be transferred out of the ICU after one or two days," Su Yun said. "The ICU's not the safest place these days. The influenza is getting worse. Many old folks get transferred into the ICU with heart and lung failure due to influenza."

"Even the South is snowing this time of the year."

"Oh, Chief Sun was looking for you before this. He wanted you to observe a peritoneal loose body resection today."

"What's there to observe?"

"Right? I said the same thing. I already rejected him on your behalf. But boss, I still think that Chief Sun gave in too quickly and there's something unsatisfying about that."

"Only you find pleasure from somebody like Chief Sun," Zheng Ren rebutted immediately as he was not in a good mood.

...

...

Author's note: My classmate from the South told me about this case. This group of people bought an infant with a congenital heart defect. They only attack once in a city. They won't make a huge scene and only demand money. It's revolting...

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Chapter 394: Transition Strategy Of Medical Dispute Profiteer

The municipal police dismantled the organized crime group who kidnapped babies to scam hospitals in record time.

The entire process took less than 24 hours.

One night, a group of people gathered in a deserted house near the city's outskirts to eat and drink.

One of them was a medical dispute profiteer who heckled at Sea City General Hospital before. His name was Goldteeth.

He cracked open a bottle of Qingdao beer with his teeth and chugged half the bottle, beer foam streaming down the corners of his mouth.

"Tsk... Ahh..." He made a sound of satisfaction.

"Brother, thank goodness you stopped us," a simple-looking man beside him said.

"Of course, you guys get tempted too easily. You're just digging your own graves." Goldteeth was a sucker for flattery. "Let me tell you guys, stay away from Sea City General Hospital. Or else, you guys will definitely be arrested. Do you want that?"

"But Sea City General Hospital has the most opportunities. We lose half the jobs without it," another shifty-eyed guy said in frustration. "It's all my fault. When I heard the amount they were offering with an upfront of 10,000 yuan, I just..."

"I told you guys before that Brother Six warned us not to go there anymore. Not only will you get beaten up, but he would also've broken my leg too." Goldteeth then grinned and said, "If you're not street smart, you'll be dead in no time. Those guys got buried alive in Sea City General Hospital."

"Brother, it's a little weird. They came all the way from the South, conned so many hospitals, and got away with it. Why did they get caught in Sea City General Hospital?"

"I've asked around. You guys will be shocked by the truth." Goldteeth downed the last mouthful of beer, his face glimmering with an oily sheen.

His few followers hovered over and started buttering him up, except for the simple-looking man who just laughed and waited for Goldteeth to reveal what had happened.

"Do you guys know who is Old Chief Physician Pan from Sea City General Hospital's emergency department?" Goldteeth asked suspensefully.

"Isn't he an old military doctor? I knew that a few years back, all the advertisements on utility poles were about an old military doctor's branded medications. Is he somebody?"

"A few years back, hehe." Goldteeth opened another bottle of beer and spat the bottle cap to the side. "Let me put it this way, if we were to make a scene in Sea City General Hospital a decade ago, Old Chief Physician Pan could call over a truck of soldiers and beat the hell out of us." [1]

All of them were dumbfounded. They had no idea of the risks involved by pulling a stunt like that in Sea City General Hospital. However, they never experienced any radical actions taken by that old chief.

The last time they were there, they only had to take turns holding up a flag until the young masters were satisfied.

"We're lucky that's all in the past," Goldteeth said as he let out a sigh. "It'll get tougher in the future, so we need to find another way to earn money."

"I see that they're doing quite well," one of them said. "Brother, they get a few hundred thousand for each job. That's much more than what we ask for. I'm thinking..."

"Slap!" Goldteeth hit the back of the man's head, almost knocking him down to the table.

"A*shole, how can we do such an evil deed? Are you blinded by money?" Goldteeth was about to hit him again but the others stopped him.

"Not many people dare to kidnap or buy sick children and use them as pawns to blackmail hospitals," Goldteeth said emotionally. He pointed at the young man and said, "Do you wish to have a deformed son next time? Our job is to help people voice out their injustice! What those people did was immoral and wicked!"

Goldteeth berated him for several minutes.

He was aware that it was not convincing for him to claim the moral high ground.

However, their schemes paled in comparison to those organized crime groups who blackmailed and scammed their way across the country.

These guys had the audacity to buy children with birth defects from villagers at a minimal price and bring them to scam hospitals in big cities.

Nowadays, the reputation of hospitals was already depicted in a bad light.

Wherever they went, they would conspire with the local medical dispute profiteers to exaggerate the situation and gain attention.

They could not care less even if the child had died.

Moreover, a dead child was worth more to them since they could ask for more money.

They rarely stayed in one place. They would carry out their scheme once or twice and leave for the next location.

They would also contain the situation so that it would not attract too much public attention. If the hospital was willing to pay, they would settle peacefully.

It was no good for them if the incident blew up as they had to pull the same stunt across the country.

Their trick would fail if other hospitals were aware of them.

This was a great deal, just that it was too f*cking evil.

In this circle, only a handful of people were willing to do it. They were either sadistic punks or just desperate for money.

No wonder Goldteeth's followers were tempted by the fast cash.

They never expected to get caught in such a deserted place like Sea City.

Goldteeth pointed to the young man with his chopsticks and said, "I pulled a few strings with a security company and found us a job in a hospital at Provincial Capital."

"Brother, what's so nice about being a security guard?" One of his followers said unhappily. "How's the pay?"

"There's no salary. Brother Six said we don't have to come up with a single cent."

All of them were speechless.

Why should they work if there was no salary? From what Goldteeth told them, it seemed like they even had to pay to secure the job.

What on earth was he thinking!

"Idiots!" Goldteeth exclaimed. "Stop thinking that Sea City is the entire world. It's such a small place that everyone knows each other. People can always get referred to a doctor when they're sick. However, in a bigger city like Provincial Capital, we can sell a couple of hundred for a ticket in the specialist outpatient department."

Those young men's eyes lit up.

"Brother, you meant we're going to sell specialist appointments?"

"If we get to make a few acquaintances, we can always claim that we're bringing our family members from our hometown for an appointment. Those specialists wouldn't mind taking one or two more patients. We can earn money with a clear conscience," Goldteeth said. "We won't be able to sustain our current jobs. We have to... Yes, we're transforming!"

"Brother, let's go to Imperial Capital. They can sell up to several thousand for an appointment," one of the young men said.

"Dumb*ss!" Goldteeth kicked him under the table and scolded him. "Can't you use that tiny brain of yours? The hospitals in Imperial Capital are all under contracts with large security corporations. If you tried to compete with those security firms, I can guarantee that you wouldn't even survive a day."

...

Author's note:

When I was working in Weihai from 2009 to 2010, the Chief of Medical Affairs was the warden for senior military officials. The hospital was relatively new and there were people collecting fees in the developmental zone. When they came to the hospital, the chief contacted a few trucks of soldiers and almost fought with them. I've also heard other legends from the local doctors and I haven't seen the chief in person but I really respected him a lot.

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Chapter 395: Solving The Root Of The Problem

Zheng Ren was a little depressed for the rest of the day.

He was upset whenever he thought about the dead child with livor mortis being used as a pawn in their cruel scheme.

The child's lips were rather dark, which led to Zheng Ren's suspicion of it having congenital heart defects.

Maybe this was the reason the family sold the child to the crime group.

Zheng Ren felt dizzy when he returned to the ward. He then went to observe Chief Sun's surgery on peritoneal loose body resection.

The loose body was removed and dissected. The interior structure looked exactly like a goose egg as Zheng Ren had mentioned earlier.

Chief Sun complimented him but his mind was elsewhere.

The gynecology department then called to inform him that the girl who had pulmonary embolism had gone through the dilation and curettage (DC) procedure. The filter could be removed after a few days.

That girl? Zheng Ren's lips curved upwards when he recalled the interaction between her father and boyfriend.

Life was more than just darkness, there was family and love.

In the afternoon, Chang Yue dragged him to the CT room to do a 64-slice CT scan with 3D-image reconstruction for Zheng Yunxia.

Zheng Yunxia had received two interventional embolization surgeries. Her liver tumor had shrunk to approximately 4 cm due to the interventional surgery's positive effects.

The left lobe of her liver was removed, but her caudate lobe was growing like a weed.

The liver had a strong ability to regenerate. Zheng Yunxia's regenerated caudate lobe managed to restore her liver function to a state before she had the disease.

All of this was undoubtedly good news.

Chang Yue looked at the scans with a smile on her face.

Zheng Ren was in deep thought.

The effect of interventional embolization surgery worked best when the tumor size was large. If the tumor was small, the blood supplying vessels were thinner and not all of them could be successfully embolized.

This was different from prostate interventional surgery. He only needed to embolize most of the arteries as the other parts of hyperplasia would slowly die off, improving the symptoms such as frequent micturition, urgent micturition, and urodynia.

Furthermore, considering the patient's age, he might be dead before the hyperplasia recurred.

However, if there were any remaining blood supply to the malignant tumor, it would multiply indefinitely and grow in an uncontrolled manner, resulting in cancer recurrence.

Zheng Yunxia's malignant hepatic tumor had been successfully contained. The best option was to complete the embolization surgery and proceed with radiofrequency ablation.

Zheng Ren gave a low hum while he stared at the scans on the film viewer. He did not start with the 64-slice CT scan with 3D-image reconstruction.

Chang Yue was puzzled. Initially, she tried to be polite and refrained from asking. However, after seeing Zheng Ren in silence for quite some time, she could not help but ask anxiously, "Chief Zheng, didn't Sister Zheng's condition get...better? You..."

"Uhm, she's doing very well," Zheng Ren said. "I'm just thinking about how to remove it entirely from the roots."

Removing it from the roots...

Chang Yue felt that Zheng Ren was joking. If it was Su Yun who said it, she would have teased him right away.

However, Zheng Ren rarely joked.

Given his personality, he would crack a joke so bad that it makes others feel despair.

Could it be true?

"Zheng Ren, the king of liver cancer..." Chang Yue said with hesitation.

"Uhm, you can see that the tumor has shrunk to one-tenth of its original size. We need a new method to tackle it. We can remove the tumor but to uproot it entirely... That depends on the individual's genetics but our current technology doesn't allow us to identify the tumor's source," Zheng Ren said.

"Boss, are you suggesting radiofrequency ablation?" Professor Rudolf Wagner asked while flipping his golden locks. "I'm really good at this. In fact, most of the mainstream interventional doctors are gradually moving away from interventional embolization surgery as it requires the surgeon to be exposed under X-rays. I've already begun to use radiofrequency ablation as the surgery's main procedure."

"Uhm, we're going to do radiofrequency ablation," Zheng Ren said.

"Let's do it then. It's just a simple surgery, there's no need to overthink it," Professor Rudolf Wagner said.

Suddenly, Zheng Ren realized that he might be forgetting something.

The rewards for the second stage of The Crown Jewel included not only 3,000 cases of radiofrequency ablation experience, but also an interventional surgery success rate 2.

What could that possibly mean?

The thought planted itself in Zheng Ren's mind and spread like wildfire.

"Boss, what are you thinking?" The professor asked in confusion when he saw Zheng Ren fall into a daze.

Zheng Ren did not bother about the professor and took his phone out to call Feng Xuhui.

"Hello, Manager Feng.

"Uhm, we're preparing to do a radiofrequency ablation on a liver cancer patient a few days from now.

"Okay, thank you. Right, this patient was the first patient who received the interventional embolization treatment for liver cancer. She comes from a low-income household so I'm hoping you can discuss this with Chairman Ma.

"Sure, thank you so much. Please try to expedite the process, we're going to have the surgery in the next 2 to 3 days."

Zheng Ren then hung up.

Chang Yue was perplexed.

She anticipated that he would perform the surgery tomorrow after completing the 64-slice CT scan with 3D-image reconstruction today.

After all, Zheng Yunxia had to return to work as soon as possible in order to sustain her living expenses. The surgery and the recovery process would take time. She had been facing a life full of misery alone but now she had help from the people of Sea City General Hospital.

The earlier they got the surgery done, the more time Zheng Yunxia would have.

Why did Zheng Ren decide to delay the surgery?

While Chang Yu was still pondering, Zheng Ren made the second phone call.

"Director Zhang, how was the patient from yesterday?

"What about the blood ammonia level?

"Okay, thanks. If that's the case, monitor the patient for a day. I'll go back and take the removable stent out the day after tomorrow.

"Oh right, Director Zhang, if possible, can you arrange a few more TIPS surgery so that I can do them all one after the other?

"Sure, there's no hurry for payment. You can pass it to me when I'm there."

Zheng Ren hung up after that.

"Boss, you're doing more TIPS surgery?" The professor asked excitedly.

"Uhm," Zheng Ren answered.

Professor Rudolf Wagner approached Zheng Ren with a huge grin and said, "Boss, I've recently been learning about your culture一"

"Hmm?" Zheng Ren noticed something was not right. He glanced at the professor and cut him off mid-sentence. "Cut to the chase please."

"My God, thank you for your kindness." The professor expressed his emotional changes in a way he was most familiar with. "I have a friend whose relative has some problems with his prostate. He wanted you to treat him surgically because of his age."

Prostate?

Zheng Ren knew that the reason Professor Rudolf Wagner stayed behind in Sea CIty was to learn prostate interventional surgery.

The fact that he waited so long to make this request was rather impressive.

"Sure, but I don't think I have time to fly to Germany," Zheng Ren said.

"No worries, I can arrange for them to come over as soon as possible by train." The professor turned around and left enthusiastically to tend to his other patients.

...

...

Chapter 396: The Emergency Department Is Not For The Faint-hearted

Zheng Ren's phone rang while he was in mid-thought.

When he saw that it was from the emergency ward instead of the emergency department, he answered the call with a frown.

"Chief Zheng, please hurry over. Something's wrong!" Lu Tianran exclaimed.

Ugh... When would this stop?

Even though Zheng Ren was mentally prepared for these situations to happen in the emergency department, his mind was occupied with the treatment plan to completely remove Zheng Yunxia's hepatocellular carcinoma.

He dashed toward the ward right after he picked up the phone call.

"What happened?"

"The old man who smoked and faked being sick got beaten up and now his bones are fractured," Lu Tianran explained in a rush.

Zheng Ren was stunned.

His worries came true. He transferred the old man to the emergency ward because he was afraid he might get into trouble in the emergency consultation room.

F*ck... How did he get bone fractures in the emergency ward?

He was hit? Who was that reckless?

Zheng Ren hung up the call and picked up his pace.

Professor Rudolf Wagner was contacting his patients to arrange for them to come over to Sea City for surgery. When he saw Zheng Ren running past him, he asked in surprise, "Boss, is it another emergency?"

Zheng Ren did not bother to answer the professor. He had to find out what was going on and nip it in the bud to prevent the situation from worsening.

He reached the ward in just after one minute when it usually took five.

The hallway was crowded with people. Zheng Ren had to push his way through to get to the old man's ward.

He was dumbfounded by the scenario in front of him.

A wrinkly, hunched old woman was standing there, pointing at the old man with her walking stick while berating him in a dialect that Zheng Ren could not decipher.

"What's going on?" Zheng Ren softly asked Lu Tianran who was standing to one side.

Lu Tianran was hiding in a corner, debating whether to interfere or stay out of it. He was relieved when Zheng Ren arrived. He told him in a lowered voice, "After Old Chief Physician Pan and Chang Yue discussed with his family members for three consecutive days, the old man finally admitted that he's not sick and requested for a discharge."

Was it not good news?

"We already completed the paperwork. His family members were packing his things and he was supposed to be discharged today. After that, his wife came." Lu Tianran gave a weird-looking expression as if he was about to laugh and cry at the same time. "His wife asked him why he refused to go home and if he has a mistress."

Zheng Ren was speechless.

Why would she worry at their age? The old man seemed healthy enough but was already over eighty years old.

His body might not be able to cope even if he wanted to.

"The old man argued back but I didn't understand what he said. Anyway, the old lady raised her walking stick and fractured his forearm."

Zheng Ren glanced at the old man and saw his left radius was fractured.

What the hell were they thinking!

The old man finally had a reason to be admitted to the hospital but he would be sent to the orthopedic inpatient department instead of the emergency ward.

At his age, it would be difficult to have surgery.

Most likely, he would need to wear a cast and let it heal over time.

Poor thing... Zheng Ren sighed and asked, "Was the patient dismissed from monitoring?"

Lu Tianran was not very familiar with the terms used by the emergency department because he had been working in the inpatient department. The old man was supposed to be monitored in the emergency consultation room. Technically, it was not considered as an admission because the patient's diagnosis was not serious enough.

Zheng Ren brought him upstairs to the emergency ward because he was worried that the old man would not be able to get a good rest from all the disturbance in the consultation room.

In this case, the patient would be considered as leaving monitoring instead of discharge.

"Uhm, yeah, he was dismissed."

This difference was crucial to both Sea City General Hospital and the patient.

If the patient was not dismissed when he got the fracture, Sea City General Hospital would be responsible for his injury. Things could get messy if legal action was taken.

If the patient was unreasonable, the case could go on for 3 to 5 years.

Even though the medical administration division had their own lawyers, the doctors would crumble under pressure if the case dragged on for years.

If the incident happened when the patient was not under the hospital's monitoring, the family members would not be able to blame the hospital. Since it was a fight between husband and wife, it could be categorized as a civil or criminal case but Zheng Ren was not too certain about that.

However, Sea City General Hospital was still partly responsible since it happened in the ward. However, they had sufficient reasons to plead the case.

"Who's the family representative?" Zheng Ren looked around and asked.

The old lady threw a side glance and asked, "I am, what's wrong?"

Zheng Ren shuddered.

He imagined himself in the old man's place many years later if he failed to stop smoking after Xie Yiren told him to...

Zheng Ren shuddered at the thought.

He shook his head to disperse those thoughts and put on a smile before saying, "Aunty, please don't get angry. You need to take care of your health."

"This useless piece of sh*t learned how to fake being ill!" The old lady roared while glaring at the old man who was sitting on the bed holding his left arm, too afraid to cry out in pain.

She was full of energy, unlike a typical woman in her eighties.

Zheng Ren dare not step on anyone's toes. Although the old lady seemed fine and could even fracture the old man's arm, she would risk having a stroke or even cerebral hemorrhage if she got too emotional...

"Aunty, look at you. I've told you not to get too worked up." Chang Yue emerged behind Zheng Ren. The incident had happened during lunchtime when Chang Yue was not around. After she heard what happened, she immediately rushed back.

Zheng Ren felt much relieved when he saw Chang Yue appear.

The old lady was calmer when she saw Chang Yue. She said, "Dear girl, this bugger decided to go to the hospital and fake being sick instead of taking care of his great-grandchildren at home!"

Chang Yue comforted the old lady while escorting her out of the ward.

Zheng Ren took the patient's sons to file a case in the emergency department to examine the old man before sending him to the orthopedic department.

The old man's children were worried when they heard their father got his arm fractured after the beating.

The children were placed in a difficult position as this was a fight between their parents. It was not easy to deal with such a fierce mother.

Luckily, this family was rather reasonable. Zheng Ren felt relieved and contacted the orthopedic department.

He comforted the family members and told them that the old man would not need to undergo surgery. He just needed time to recover.

There was nothing else that could be done other than reassuring them that the old man would be fine.

It was over when Old Chief Physician Pan arrived, still out of breath after rushing over.

When the old lady heard that she fractured the old man's arm, she backed down instantly. Even though she was still nagging him, there was fear in her expression.

People rarely intervened in a fight between couples, so this was an exception as it got quite physical and both parties involved were elderly.

Zheng Ren finally relaxed after sending the old man to the orthopedic department and reporting to the medical administration division.

The emergency department was certainly not a place for the faint-hearted.

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Chapter 397: Who The Hell Are You?

After wrapping up, Zheng Ren sat down for a rest. Before he got the chance to catch a breath, there was someone knocking on the door. The person looked familiar but he could not remember who he was.

The person was holding a bag of films.

Maybe they were one of the patient's family members. Had they met before?

"You're..." Zheng Ren asked.

"Hi, Chief Zheng. I'm Cheng Lixue from the Secondary Hospital," He said carefully while walking toward Zheng Ren in a humble manner.

"Hmm? Chief Cheng?" Zheng Ren finally remembered.

Cheng Lixue was rather bitter.

To be ignored by a young doctor... It was apparent that he was a nobody to him. He could not even recognize him even though they had met before and shared a meal together.

It was not surprising since the young doctor in front of him was an expert in the interventional surgery field and specialized in TIPS surgery.

Although he had yet to gain fame, it was just a matter of time for him to receive the recognition he deserved with the skills he had.

Cheng Lixue quickly set himself straight and bowed deeply even though he was much older than Zheng Ren.

His action startled Zheng Ren. He was wearing a black suit and had a serious expression on his face. With a white flower pinned on, it looked as if he was paying respects to a deceased person.

Only then did Zheng Ren noticed that he was still sitting on down in his chair.

The person in front of him was a department chief from the Secondary Hospital who was much older than him. It was not polite of him to remain seated.

He hurriedly stood on his feet and said smilingly, "Chief Cheng, please excuse me. I just came back after dealing with some matters and I'm not thinking straight, do forgive me."

It was unsure when Zheng Ren had started addressing him as an equal rather than using honorifics.

The only consolation Cheng Lixue had was that Zheng Ren's attitude remained well.

"Chief Zheng, I watched your TIPS surgery. It's a world-class performance." Cheng Lixue explained his intentions of visiting him. "I applied to the Secondary Hospital and they sent me here to learn TIPS surgery from you."

Zheng Ren stared blankly at Cheng Lixue who was already in his fifties, not knowing how to respond.

He initially thought that the Secondary Hospital would send a doctor in their thirties, or at least below forty to learn TIPS surgery from him. He did not expect them to send their department chief.

The main worry was that even if he was willing to teach everything he knew, would the man be able to cope?

Chief Cheng Lixue was different from Professor Rudolf Wagner. The professor was a pioneer in interventional surgery. After sharing his idea on liver DW-MRI, the professor was able to provide suggestions and open up more possibilities.

Zheng Ren was certain that Professor Rudolf Wagner had fully grasped the new diagnostic and surgical methods of TIPS surgery.

However, the professor was still not up to his level because unlike him, the professor did not have help from the System.

Could Chief Cheng be up for it?

There was a peculiar expression on Zheng Ren's face, but Cheng Lixue understood his reaction.

He would never have come to learn TIPS surgery in Sea City General Hospital if it was not for the high-pressure working environment in the Secondary Hospital.

Cheng Lixue had to pay quite a price to compete for the chance to learn.

However, it was just a matter of time of facing the realities in order to acquire new skills.

A forty-year-old deputy chief in his department was promoted and took half the staff with him. The interventional department was separated into two and he was only left with administrative authority. He had no say in clinical matters.

He had no choice but to put his pride aside and come to Sea City General Hospital to learn TIPS surgery.

Cheng Lixue's general surgical skills had been deteriorating since long ago. 'Time and tide wait for no man,' was a cold and hard truth for general surgeons, and even more so for interventional doctors.

Nevertheless, he was unwilling to succumb to fate.

Before coming over, he mentally prepared himself to accept the role of a student and learn as much as he could, leaving behind the department chief attitude.

However, the reaction he received was not what he had expected.

Chief Zheng really needed to work on his emotional intelligence.

Cheng Lixue felt frustrated but had to suppress his emotions.

"Boss, I'm done with the 64-slice CT scan with 3D-image reconstruction." Professor Rudolf Wagner walked in at this moment, breaking the awkwardness between them.

Cheng Lixue stood up subconsciously and made eye contact with the professor.

A few years ago, he went to Heidelberg University for an exchange program. When he first saw the professor, he was wearing a white lab coat and his golden locks swayed in the air. The way he commanded others left a strong impression on Cheng Lixue.

However, the professor was not aware of his presence. He walked straight up to Zheng Ren and said, "Boss, please take a look at the scan and comment on my work."

"Uhm." Zheng Ren clicked on the 64-slice CT scan with 3D-image reconstruction on Zheng Yunxia that the professor had done and slowly went through them slide after slide.

64-slice CT scan with 3D-image reconstruction? By himself?

Cheng Lixue had just arrived moments ago, but he was already learning new things.

These scans were usually done by the CT room technicians with the software. Why did he do them himself?

Judging from the professor's enthusiasm, Cheng Lixue guessed that he probably learned how to do it recently. The way he presented it to Zheng Ren was like a primary school student showing off his homework to his teachers and parents.

Zheng Ren gave an indifferent response. His 'uhm' sounded quite blasé.

Cheng Lixue quickly composed himself. If a top surgeon like Professor Rudolf Wagner could stay behind in Sea City to learn from someone younger than him, who was he to complain!

He inched closer to Zheng Ren and tried to find an angle to look at the computer screen behind the professor's giant figure.

The 64-slice CT scan with 3D-image reconstruction was not new to Cheng Lixue as it was related to radiography.

However, the images he saw were beyond his knowledge.

He was entirely perplexed by the images of intricate arterial networks.

They were images of hepatocellular carcinoma with lipiodol deposition. It should be from a patient who had received multiple surgeries.

After glancing through the images, Zheng Ren extracted one of the earlier ones and compared it with the current scan.

Cheng Lixue's eyes instantly widened.

He had yet to learn about TIPS surgery but he had fifteen years of experience in the treatment of lung cancer using interventional surgery. He certainly understood what those images were indicating.

The tumor was approximately 10cm in the older scans accompanied by vascularization to supply blood, indicating late-stage carcinoma.

Cheng Lixue was not aware of the patient's current condition.

Judging from the scans, the patient would be incredibly lucky to survive for 6 months.

However...

Did all these scans belong to a single patient?

"Chief... Chief Zheng, you performed the surgeries on this patient?" Cheng Lixue felt a little insecure.

He excelled not only in TIPS surgery but also in liver cancer interventional surgery.

"Uhm, the first treatment was 2 months ago, followed up with consolidation therapy. This is the third surgery. The patient should be able to fully recover," Zheng Ren briefly explained to him while he continued to compare the scans.

Fully recover...

Was he being serious or joking?

"Chief Zheng, it's possible to...recover?" Cheng Lixue asked cautiously.

"Who the hell are you?" Professor Rudolf Wagner glared at Cheng Lixue and asked in a strong accent. He hated being interrupted by others when he was in the middle of a discussion about the patient's scans with Zheng Ren.

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Chapter 398: He Could Do It With His Eyes Closed

"You're as irritating as my second aunt," Professor Rudolf Wagner said disdainfully. "Is it so difficult to treat primary liver cancer?"

Cheng Lixue was at a loss for words.

How could he not know?

Also, what was this about his second aunt?

After being an interventional doctor for a few decades, Cheng Lixue had done more than a thousand interventional surgeries on liver cancer. He also had a few dozens of patients who recovered from primary liver cancer.

Even though there were not many, Cheng Lixue was rather experienced in this area.

However, the size of this patient's tumor was enormous... His thought was that it was far too late for the patient to stand a chance of recovering. He could only try his best to prolong the patient's survival.

"Chief Zheng, what do you plan to do after this?" Cheng Lixue was not bothered by the professor's criticism. To him, it was normal to be lectured by one of the top professors in the world.

"We'll use radiofrequency ablation to burn it off," Zheng Ren replied.

"You will need to insert 3 to 4 needles then," Cheng Lixue estimated.

"Uhm, 3 should suffice. Lil Fugui, note down the points of insertion," Zheng Ren said. "The 10th intercostal space on the right, 4 o'clock. 1.5 cm to the right on the midclavicular line in the upper right quadrant of the abdomen. 15 degrees clockwise for the angle of insertion."

"What about the third one?" Professor Rudolf Wagner paid full attention to Zheng Ren and wrote down the points of entry in German.

The professor was considered a linguistical genius considering that he was able to converse in Mandarin within such a short time frame, but he still needed more time to master the written language.

"I still need to calculate the last position," Zheng Ren said.

The truth was that Zheng Ren thought of going to the Secondary Hospital to perform more TIPS surgery to complete the second stage of The Crown Jewel so that he could get the 3000 cases of radiofrequency ablation experience and the Interventional Surgery Success Rate 2 passive skill.

This would only delay Zheng Yunxia's surgery for a few days but if Zheng Ren could complete the mission, she would gain much more from the surgery.

He decided to wait.

"Chief Cheng, what are those scans you're holding?" Zheng Ren asked after seeing Cheng Lixue was still in a daze after he finished examining Zheng Yunxia's scans. Zheng Ren had to remind him that he was carrying a bag full of scans.

"Uhm..." Cheng Lixue regained his senses and remembered the reason he came here.

"These are the scans and information of patients that meet the requirements for TIPS surgery. Please have a look, Chief Zheng." Cheng Lixue placed them on the table.

Cheng Lixue felt a soreness in his arm as he had carried the bag for a little over half an hour.

Before he had the chance to stretch his sore arms, Zheng Ren already took out the first envelope to view the patient's information.

The professor took the envelope from Zheng Ren and extracted the DW-MRI of the patient's liver and inserted them onto the radiographic film viewer.

Finally, it was his turn. Cheng Lixue quickly gathered himself together and adjusted his position to have a clear view of the scan.

"The patient's condition looks fine," Zheng Ren said in a relaxed manner as he browsed through the diagnosis.

"Boss, this is a typical tumor. We can insert the needle at a 25-degree angle of depression," Professor Rudolf Wagner said.

"Between 24 to 28 degrees should be fine. This way, we can increase the fault tolerance. One thing to note down, align the needle to the left posterior wall of the liver during insertion. Do you have anything else to add on, Lil Fugui?"

Professor Rudolf Wagner quickly wrote down what Zheng Ren mentioned.

When he heard Zheng Ren's question, he answered without lifting his head. "No, boss. This patient has a typical tumor, I think that I can succeed in the first attempt with my eyes closed."

"Uhm, it's quite simple but you shouldn't be too careless," Zheng Ren said. "Let's move on to the next patient."

Hmm? That was all? Cheng Lixue was stunned when he saw the professor start to collect the scans, the patient's information, and his notes before keeping them in the envelope.

What did they say?

It all happened so fast as if they had not mentioned anything at all.

No!

They said...that the needle insertion could be done in the first attempt.

A week ago, if someone told Cheng Lixue that they could succeed in the insertion for TIPS surgery on their first attempt, he would have given them a tough slap to wake him up.

However, Zheng Ren managed to accomplish all that in the TIPS surgery he performed in Secondary Hospital.

Cheng Lixue had no choice but to believe what he saw.

However... What did he learn from this? Nothing!

What should he do?

Cheng Lixue reached out to hold Professor Rudolf Wagner's arm in a panic and said, "Professor, wait."

"What the hell do you think you're doing?" The professor glared at him angrily, causing him to shudder in fear.

Zheng Ren laughed and said, "Lil Fugui, take the scans out."

Professor Rudolf Wagner scowled at Cheng Lixue again before saying, "Boss, this is just a waste of time."

"You didn't say that three days ago," Zheng Ren said smilingly.

"Okay, you're right, Boss." The professor shook his head and continued, "Soon you'll know that you're wrong."

"You're referring to his inexperience on the fundamentals and that he won't be able to learn quickly?" Zheng Ren said.

"Of course, I think there are probably 3 people at most in this world who could master the imageries of MRI scans in one sitting, excluding myself." Professor Rudolf Wagner announced proudly.

Cheng Lixue broke out in a cold sweat.

Why would he start learning TIPS surgery with imaging? This was entirely different from what he had expected.

Should he not start with the basic surgery operation instead of imaging? Furthermore, DW-MRI was never used in interventional surgeries...

Cheng Lixue was completely dumbfounded.

"Chief Cheng, how much do you know about DW-MRI? Zheng Ren asked while he stared into Cheng Lixue's eyes.

"Diffusion-weighted imaging utilizes the Brownian movement of water molecules..." Cheng Lixue stuttered for a bit and failed to elaborate further.

Interventional doctors were more specialized in X-rays.

For instance, interventional embolization surgery was performed under X-rays. After radiofrequency ablation gained popularity in the recent decade, many doctors started to dabble into CT scans but MRI, more specifically DW-MRI, was still...

Cheng Lixue had no clue about it.

"Let's see, what can you infer from this position?" Zheng Ren put up the DW-MRI scan of the first patient on the film viewer and pointed at a specific position while asking his question.

Cheng Lixue was lost.

"The gradient pulse with the same length, amplitude, and position is applied to both sides of the 180b pulse in the spin-echo (SE) sequence. Try subtracting one of the sequence pulses and think along that direction." Zheng Ren tried his best to explain in layman terms.

Nonetheless, Cheng Lixue's expression sold him out.

The Secondary Hospital's interventional department chief was completely lost.

"What about..." Zheng Ren thought for a while before saying regretfully, "Chief Cheng, why not you spend a few days in the CT room to learn?"

"..."

Zheng Ren sighed.

Professor Rudolf Wagner was able to grasp the idea and keep up and even Su Yun did as well, but they were both exceptionally gifted. Cheng Lixue was no match for them.

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Chapter 399: A Surgeon's Focus

Zheng Ren and Professor Rudolf Wagner went through all the scans for 8 patients within an hour.

Cheng Lixue was still in a blur. He had no clue what Zheng Ren and the Professor were talking about.

After arranging the scans, Zheng Ren asked with a smile, "Chief Cheng, how are the patients' post-operative conditions?"

"They're doing fine. There were no symptoms of hepatic encephalopathy," Cheng Lixue answered blankly. "When we checked the blood ammonia levels this morning, there was only one patient with slightly elevated level but his physical and oral examination did not show signs of hepatic encephalopathy."

"That's great. We can extract the removable stent 3 days after surgery when the patient's body has adapted to it," Zheng Ren said.

"Oh," Cheng Lixue's mind was filled with the DW-MRI imagery.

He felt hurt.

He was totally clueless.

As a medical professional who specialized in imaging and the interventional surgery department chief who majored in liver disease, he could not even understand the scans.

Where should he begin?

Cheng Lixue stood in the office dejectedly.

Zheng Ren was slightly annoyed as he was not in a mood to accommodate Cheng Lixue's inner turmoil.

He sat in his chair and took out his phone to discuss with Xie Yiren about their dinner plans after work.

Zheng Ren was not hungry even though he had skipped lunch. He also did not want to share with Xie Yiren about his day.

Little Yiren seemed to notice Zheng Ren was feeling slightly down. She suggested walking around and just finding something to eat along the way when they felt like it.

Zheng Ren was a little worried when he recalled that his dates with Xie Yiren in the past had always been interrupted by emergency cases from the emergency ward, even when they were in the middle of a movie.

He decided to notify Su Yun beforehand by sending him a WeChat message.

[Do you have anything on tonight?]

[Hmm? Are you treating me to dinner or are you planning to go on a date with Little Yiren? Let me guess, you're rather moody today. Surely you're going to meet Little Yiren.]

Zheng Ren was speechless. He could sense Su Yun's mockery through the screen.

[Hey boss, let me tell you a valuable lesson in life. You should never express your negative emotions in front of your girlfriend.]

Zheng Ren thought for a moment before replying to Su Yun.

[Do you have any word of advice?]

[Advice? Why are you still asking for advice? Little Yiren will be yours in no time if you use 10 percent of the focus you have during surgery.]

Ugh... His words were pointless.

[So are you free tonight?]

[Go enjoy your date. Don't worry about the department. Good luck!]

Su Yun did not beat around the bush and simply dismissed him.

Finally, it was time to leave work. Zheng Ren went straight to the basement parking to D zone where he always parked his red Volvo.

This time, Xie Yiren had learned her lesson and met up with Zheng Ren much earlier.

She was wearing a white down jacket but her figure remained slender while still showcasing her beautiful curves. She jumped up and waved to Zheng Ren adorably when she saw him.

Zheng Ren's negative emotions started to rattle and melt away the moment he saw Xie Yiren.

At this moment, life felt good.

When they reached the city center, Xie Yiren started introducing Zheng Ren to different eateries.

The way Xie Yiren described the dishes gave Zheng Ren the impression that she was truly enjoying it.

Even though he was not too enthusiastic about food, Xie Yiren was able to infect him with her happiness.

After parking the car, they both got out.

It was snowing outside. This year, the snowfall was much lighter. It was supposed to be snowing heavily this time of the year, but they could hardly see snow anywhere. Even the weather was warmer than in the past years. There was even a rumor that the influenza outbreak was related to the abnormal weather change.

Zheng Ren would not simply believe baseless speculations without any scientific evidence.

"Zheng Ren, that shop has really good egg tarts, especially when they're fresh out of the oven. You can smell the milky deliciousness along the street," Xie Yiren said while pointing at a bakery not far from them.

Zheng Ren did not look at the bakery as he was too focused on Xie Yiren's hand.

Su Yun mentioned that he needed to use 10 percent of his usual focus on Xie Yiren, then they would...

Zheng Ren decided to make an attempt.

Xie Yiren had no idea that something was approaching her.

She put her hand down gleefully and started walking toward the bakery. When she took the first step, her hand was met with a much larger one mid-air.

She subconsciously tried to free her hand but the other hand was so firm and strong. She felt as if her hand was a small boat, parked safely in a port. She struggled for a moment before slipping her hand into his, holding it gently.

"The other side has a milk tea shop." Xie Yiren's face was reddened due to the chilly winds. She pretended as if nothing had happened and raised her other hand to point to the other shop and said, "That shop has a wide variety of flavors and toppings for their milk tea. It's amazing."

"Hmm? Isn't it just milk tea?" Zheng Ren was lost.

He used his surgical precision and observation skills to track the motion of Xie Yiren's arm so that he could meet her hand halfway to hold hers. That alone had exhausted his emotional and intelligence reserve, so his mind had regressed into a pile of gooey mess.

"Let's try it out," Xie Yiren said excitedly.

It might have been the fact that Xie Yiren tried to hide her awkwardness and embarrassment, or that she was truly happy. She dragged Zheng Ren to the milk tea shop happily.

To Zheng Ren, milk tea was just a normal dessert. The only special thing was the addition of pearls, nata de coco, and grass jelly.

When they entered the shop, Zheng Ren was surprised to see an entire menu of assorted flavors and toppings.

There was barley, oats, taro, red bean, pearls, nata de coco, papaya, almonds, brown sugar...

Xie Yiren chose the ordinary papaya almond milk tea with additional taro paste.

She was quite shy, lowering her sleeves to try her best to cover their linked hands as if the world would not know that they were holding hands if she did that.

"Sir, may I know your preferred choice?" The server asked Zheng Ren after noting down Xie Yiren's order.

"I'll try all of them." Zheng Ren's mind was still in a mess and he had lost all ability to comprehend at that moment.

His entire focus was on the tiny hand wrapped in his palm.

The server was stunned for a moment before asking, "Sir, you want all of the..."

"Uhm, I want to try them," Zheng Ren said.

The server confirmed his order once again with a distracted Zheng Ren before entering the order in with a weird expression.

"I heard that there's a dispute in the emergency department today?" Xie Yiren tried to start a conversation after the server left.

Otherwise, it would be weird for them to stare at each other in silence with their hands linked together.

"No worries, it's just a small matter," Zheng Ren said briefly. "Chief Pan already resolved the issue."

"Oh."

Both their heartbeats were racing at a pace that was dangerously close to atrial fibrillation. They gave their best efforts to continue the conversation and the awkwardness gradually dissipated in the warmth between their fingers.

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Chapter 400: Everything Was Going Well

It was dinner time when they visited the bubble tea shop, which explained the minimal crowd.

Zheng Ren was grateful for that.

As he held Xie Yiren's hand, time passed by in a blur.

A few minutes later, a waitress walked toward their table with two cups of bubble tea.

"Here are your drinks." The waitress placed the drinks on the table and stood behind Zheng Ren, curious as to how Zheng Ren would react.

Zheng Ren removed the cup's cover and looked down. A confused look crossed his face.

His bubble tea looked as if it had all the toppings in the world. It reminded him of an eight treasure porridge.

Half the cup was filled with all sorts of topping. The liquid was so viscous that it did not resemble bubble tea. Zheng Ren tried to taste the beverage with the wide-bore bubble tea straw but his attempts were futile.

The waitress asked awkwardly with a smile, "Sir, d-do you need anything else?"

"Uh... How about another straw?" Zheng Ren sighed.

A smile lit up on Xie Yiren's face. Her fingers stroked Zheng Ren's palm as she chuckled.

The waitress quickly came back with another bubble tea straw and handed it to Zheng Ren. She retreated quietly to the side while keeping an eye on Zheng Ren.

She did not understand why the man had ordered such a concoction.

Even with two straws, there was no way he could drink the cup of eight treasure porridge. There were far too much solids in the milk tea.

Zheng Ren held the two straws like a pair of chopsticks and started to eat the toppings.

The waitress was surprised by his actions.

Seeing the shock on the waitress's face, Xie Yiren pinched Zheng Ren's hand and smiled. "I'll get the bill."

"I'll pay for this."

"You focus on your eight treasure porridge but remember, we still have dinner. What do you want to eat?"

As Xie Yiren scanned the code to make the payment, Zheng Ren's phone started ringing.

The call did not worry Zheng Ren. His heart remained calm.

Su Yun was a dependable doctor. It was unlikely that Zheng Ren would have to rush back to the hospital.

He checked his phone and it was Su Yun calling.

Zheng Ren wondered if he had jinxed himself.

Everything was going well until the mafia had shown up.

"Hello?" Zheng Ren answered the call.

"Boss, sorry for calling." An apologetic Su Yun was a rare creature to behold.

"What's wrong?" Zheng Ren was confused. If there was a mass emergency, Su Yun would get straight to the point without apologizing.

Odd.

"There's an emergency patient ready to be sent to the cardiothoracic department. Multiple rib fractures and trauma-induced pulmonary edema but there's something about the case that I can't quite put my finger on," Su Yun said.

"What's that?"

"The cardiothoracic department's diagnosis is not wrong but I suspect there's something wrong with the patient and an emergency exploratory thoracotomy is required." It was rare to hear Su Yun having doubts.

Was this a case beyond his expertise? He would say so if it was.

Even during the diagnosis of Yang Lili's rare vitamin B1 deficiency, Su Yun sounded much more confident than now.

Zheng Ren remembered how Su Yun was back in the ICU. He could argue all day long about the biochemistry and pathology of a disease, to the point of shutting everyone up.

Where did he turn soft?

"Alright, I'll go back and have a look," Zheng Ren said as he shot Xie Yiren an apologetic look. Her fingers rubbed against his palm gently.

What a shame, another beautiful night was interrupted.

Any night with Xie Yiren without interruption was a beautiful night.

Although he was reluctant for their date to end, Zheng Ren would not abandon his responsibilities.

They held hands while walking to the car.

Zheng Ren's mind was in a daze as he followed Xie Yiren to the driver's side.

Xie YIren chuckled at him. She shook her hand free and pushed him to the passenger's side.

They got into the car and headed for Sea City General Hospital.

...

Along the way, Zheng Ren's mind got to thinking.

Something did not add up.

Su Yun would never call him unless it was a last resort.

The last call for help he made to Zheng Ren had been the Amigo Veterinary Hospital case. Zheng Ren knew Su Yun had just been pulling his leg about not being able to operate on an old dog.

'What's the catch?' Zheng Ren wondered.

Zheng Ren called Su Yun to ask about the case.

The patient had been walking home when a vase fell from a few floors up. The patient was lucky to avoid the falling vase but unfortunately, it did not save him entirely.

The vase fell onto a rebar behind him.

This caused the rebar to bounce upward and hit him in the back.

It resulted in fractures on ribs 2 to 9 and signs of pulmonary edema.

From the CT scan, the patient did not show signs of hemopneumothorax.

The patient's blood pressure was low but there were no signs of bleeding. This was what confused Su Yun.

The diagnosis from the cardiothoracic department was not wrong but Su Yun had his doubts.

He had gone through the scans multiple times to identify the cause for concern.

However, despite his reputation as the rising star of the cardiothoracic department in Imperial Capital, he could not produce sufficient evidence to refute the diagnosis.

His instincts warned him there was something unusual about the patient but the specifics eluded him.

Su Yun could only wait for Zheng Ren's return.

Somewhere along the line, just like everyone else, Su Yun had developed unwavering confidence in Zheng Ren's ability to solve all medical problems. Although cardiology was his strong suit, Su Yun could put aside his pride and ask Zheng Ren for help.

Zheng Ren appreciated the gesture.

Despite being the occasional narcissist, Su Yun had the sense to not let his ego interfere with his professionalism.

Su Yun's instincts that had been honed from his many years of bedside care were tingling but up to this point, the test results yielded no clues. It was an odd case and Su Yun was sure of that!

Soon, Xie Yiren's Volvo arrived at Sea City General Hospital.

Xie Yiren would go to the operating room to standby when Zheng Ren would give her a heads up if surgery was about to proceed. If there was nothing urgent, they would meet back in the basement car park.

Meanwhile, Zheng Ren, who did not bother to grab his white coat from the emergency wards, heading straight to the emergency response room.

Su Yun kept the cardiothoracic department at bay. He was adamant about having Zheng Ren assess the patient before deciding the next steps.

Relinquishing the patient to the cardiothoracic department would take responsibility off the emergency department. Based on the diagnosis, it was unlikely the doctors would perform a night-time emergency surgery.

In this scenario, Su Yun suggested performing an exploratory thoracotomy to have a clearer picture.

He would not be able to have a good night's sleep otherwise.

Zheng Ren arrived in the emergency response room in a hurry. The patient was a man in his mid-twenties. His face was pale and his body was contorted from the pain radiating from his broken ribs.

In the System display at the right corner of his vision, the diagnosis listed: multiple fractures on the right rib cage, trauma-induced pulmonary edema, pleural effusion, and a laceration on the right lung.

The diagnosis was similar to the one given by the cardiothoracic department. Trauma to the lung depended on the size of the laceration. A small injury could heal without surgical intervention.

'Can't you tell me the degree of severity?' Zheng Ren cursed the System in his mind.

Su Yun quickly pulled Zheng Ren to the viewer and pointed at the scan. "Boss, I think there's something wrong."

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Chapter 401: A Bald-Faced Lie

"Go on." Zheng Ren tucked his left hand under his right arm, his right hand massaging his temple. He squinted at the scan clipped to the viewer.

"Here. This is the classic sign of trauma-induced pulmonary edema." Su Yun tapped on a spot on the scan. "But with multiple fractures, the volume of blood loss is up to a few hundred milliliters so pneumothorax is often observed."

"The lack of a hemopneumothorax worries you?"

"Yes," Su Yun said conclusively. Only an optimistic fool would think the lack of a pneumothorax meant good news for the patient.

Su Yun was no such fool.

He spoke his thoughts without sugarcoating them.

"I agree. The patient's blood pressure is low. At his age, the normal blood pressure should be around 120 to 130. The pain from the fractures should see a spike in his blood pressure at around the 150 to 160 zone. Instead, it's in the 90s. It's quite concerning," Zheng Ren concurred.

Low blood pressure typically indicated bleeding.

Whether it was from the laceration or rib fractures, bleeding in the chest cavity would most certainly show up in the CT scan.

However, the patient's CT scan did not show any signs of bleeding.

Even the System did not provide any hint of severe complications. A tear in the lung could be severe or minor.

Under normal circumstances, the patient would be sent to the cardiothoracic department for further observation. They would monitor the patient's progression and decide the course of treatment when they had more information.

Zheng Ren and Su Yun had other thoughts. They were worried that once the problem presented itself, it would have been too late.

A booming voice cut through their discussion. "Su Yun! Why would you consult me on a case like this?"

They turned around and saw the cardiothoracic department's chief resident, Cao Guozhen.

He was a man of great stature. One could say he was built like a bear. He turned heads wherever he went and spoke.

His tone had a hint of exasperation. Su Yun and Zheng Ren figured it was because they stole the limelight during Yang Lili's emergency rescue.

Cao Guozhen glanced at the scan before smirking.

"This is a classic sign of trauma-induced pulmonary edema. Why are you both scratching your heads at this?"

Thousands of possibilities ran through Zheng Ren's mind. Su Yun ignored Cao Guozhen's mockery and continued to mull over the case, a deep-set frown on his face.

"You guys just want to keep the patient in the emergency ward, don't you? Well, you can have him. A piece of advice, dose him with hormones then administer 10mg of dexamethasone daily with nebulizer treatment for the inflammation and phlegm. Muscosolvan can be administered through IV, 100 bottles a day. Ignore what the guidelines[1] say."

His words fell on deaf ears.

"If you follow the guidelines, the patient will exhibit hypostatic pneumonia after the third day. Don't say I didn't warn you," Cao Guozhen continued muttering.

It was sound advice.

Su Yun knew the oral medication—Muscosolvan—was cheap and had no side effects. Back in Imperial Capital, the highest dose he had witnessed was 300 bottles in a day. The solution was pumped intravenously for 24 hours.

The patient had to alternate resting on their sides to prevent hypostatic pneumonia. Most patients could be discharged within a week.

However, Zheng Ren and Su Yun believed the case was not as clear-cut.

Whether in the emergency department or the cardiothoracic department, the first few hours of a patient's arrival was vital...

The patient could die if the wrong rescue protocol was initiated.

It was a slim chance but a chance nonetheless.

Medicine was an experimental field that emphasized empirical data.

Without any supporting evidence, how could one insist on an exploratory thoracotomy? What if the patient died on the operating table?

After a few minutes of thought, Zheng Ren realized why Su Yun had called him back.

Su Yun wanted to perform an exploratory thoracotomy but did not have the qualifications.

Like how Zheng Ren would go to Old Chief Physician Pan to seek protection from any landmines, Su Yun was doing the same.

"We can't follow your advised treatment. We would at least have to perform an emergency fracture internal fixation surgery," Zheng Ren turned to Cao Guozhen and said.

Su Yun was shocked.

Zheng Ren's words were as blunt as a sledgehammer.

The patient's fractures were simple and did not require internal fixation.

Yet, this was the best excuse they could come up with, right?

"Yes. Look here, the dislocation is clear. The fractures might have lacerated the pleural membrane and lung when the patient was moving around, causing a hemopneumothorax," Su Yun said confidently as he pointed to a small fracture on the scan.

In normal situations, a chest CT scan was to visualize the layers of muscle. It was rarely used to determine bone fractures.

To analyze bone fractures, a 64-slice CT scan with 3D reconstruction was needed.

With the chest CT scan's limited view, Su Yun pinpointed a spot and exaggerated the fracture.

Cao Guozhen was confused.

Was the emergency department in dire need of patients that they had to resort to a bald-faced lie?

No wonder the general surgery department never bothered to argue with the emergency department.

The emergency department team was basically giving the other departments an ultimatum.

Cao Guozhen considered his options before saying, "Alright then, let's get the patient to the operating room. I'll perform the surgery."

"You?" Su Yun said disbelievingly, a playful smile on his face. "Can you even handle anything other than the fracture? Ever done a lobectomy? A bronchial sleeve resection?"

"You..." Cao Guozhen wanted to kill Su Yun.

He had been kind with his words, maybe there was some sarcasm mixed in.

How dare Su Yun degrade him like that? Was he a rabid dog?

"Bring over ten rib clamps," Su Yun ordered. He exhaled upward through his mouth to fluff up his fringe.

"What? Why?"

"Do you want to go to the medical administration? Or Old Chief Physician Pan? We don't have time to follow your advice. If we ask Old Chief Physician Pan, he would insist on the emergency department handling the chest treatment. It's just setting up a chest drainage system. Even a nurse can do it and you want to call it a surgery?" Su Yun chuckled.

It was incredibly embarrassing for Cao Guozhen.

However, Cao Guozhen knew what Su Yun said was true. If his department chief found out he lost the chest treatment, he would never be forgiven.

He exhaled deeply before turning to leave.

"Admit the patient. I'll inform Xie Yiren and the others to prepare for surgery," Zheng Ren said.

"Okay." Su Yun nodded. He watched Zheng Ren's retreating figure and called out, "Thank you, boss!"

"It's nothing. I have faith in you." Zheng Ren waved his hand.

[1] This method of Muscosolvan administration was demonstrated by Dr. Chen Houkun 15 years ago. Dr. Chen had used this method to save a few patients who suffered from severe chest trauma, trauma-induced pulmonary edema, and hypostatic pneumonia. I once had a patient, whom even the ICU had given up on, recovering after 26 days of treatment. The patient even came back to visit me once.

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Chapter 402: Crossing The Line

The patient was brought to the emergency ward. There was a series of preparation and documentation before they could start the surgery.

Although an emergency case dictated simpler protocols, everything took around 30 minutes before the patient was wheeled into the operating room.

When the patient was lifted onto the operating table, his systolic pressure was at 90 mmHg.

The decreasing blood pressure suggested that the patient's condition was not as simple as the diagnosis given.

After the anesthesia, Su Yun repositioned the patient's body and placed the first layer of surgical drapes. After that, he went to scrub in. Zheng Ren, who was already gowned, entered and started to set up the second layer of drapes.

The surgery was starting.

A pair of hemostatic clamps and some iodoform gauze were placed into Zheng Ren's open hand.

The clamps were placed beside the patient's lower body. The surgical site was disinfected, then Zheng Ren asked for a scalpel.

A 20 cm incision was made, followed by a blunt dissection of the layers below. Electrocautery was used to stop any major bleeding.

Cao Guozhen was in the operating room, standing behind Zheng Ren and observing the procedure from the surgeon's point of view.

The thoracotomy was done perfectly with minimal bleeding.

He was still bitter about their earlier argument and told himself he would have done an equally good job if he was the lead surgeon.

A thoracotomy differed vastly from an abdominal surgery.

In the past, when electrocautery was not yet common in hospitals, a thoracotomy warranted at least 500 ml of blood loss.

Now, with Zheng Ren and Su Yun at the operating table, there was hardly any blood visible. Some of the larger blood vessels were isolated with the hemostatic clamps and quickly sutured.

The electrocauter was employed after the muscle layer was parted.

The whole surgery was performed so cleanly Cao Guozhen felt fear in his heart.

When did the two devils from the emergency department become so good at thoracic surgery? The idea of them stealing surgeries from the cardiothoracic department no longer seemed far-fetched.

Both Zheng Ren and Su Yun went straight for a thoracotomy instead of a fracture fixation procedure.

The severity of the fractures was an excuse to open up the patient's chest.

They were crossing a line.

If the patient did not recover from the surgery, the family would have the right to sue Zheng Ren and Su Yun.

Of course, the two surgeons had acknowledged the risk when they decided to proceed with the thoracotomy.

A mirthless smile was covered by the surgical mask on Cao Guozhen's face. These guys from the emergency department were brazen.

They were aware of the hospital procedures, right?

The patient did not carry the last name Zheng or Su. Why were they crossing the line?

Had the two surgeons forgotten their own names?

It was viable to perform the internal fixation surgery after checking the thoracic cavity. The patient's family would never know and Cao Guozhen would not tell.

However, he would be wary of what happened in the future.

He watched the two surgeons carry on and wondered when disaster would strike.

They were in the process of opening the rib cage. A self-retaining retractor was placed in Zheng Ren's hands.

The retractor was used to hold the layers apart, giving the surgeon an operative view of approximately 8 cm.

Usually, the operative view was less than 8 cm but due to the patient's bone fractures, they were able to widen the field.

Su Yun found the silence in the operating room unbearable. "My initial foray in cardiothoracic surgery was because I wanted to perform surgeries like this. You get a clear view of the organs and you don't have to touch any intestines and fecal matter. Don't you agree, boss?"

As the gears of the self-retaining retractor turned, the patient's lungs appeared.

The middle and lower lobes of the right lung each had a huge open wound. The edge of the opening was dark red.

Zheng Ren and Su Yun let out a sigh of relief.

Their instincts were right, there was something unusual about the patient.

Zheng Ren cursed the System for not indicating the severity of the injury.

There was a distinct difference between a 0.5 cm laceration and a 10cm by 10cm open wound.

The hemostatic clamps entered the operative view to investigate the injury. The front section of the clamps disappeared into the wound before its depth could be ascertained.

The middle lobe was almost punctured from front to end.

Behind Zheng Ren, Cao Guozhen was shocked.

What was this?

How did the patient not develop a hemopneumothorax with such an injury? It was impossible!

Impossible!

Cao Guozhen was at a loss.

In his ten years as a medical doctor, he had witnessed countless injuries but this was a first.

What was going on?

As Zheng Ren probed the surgical site, Su Yun was mumbling, "Boss, I think the rebar might have hit him really hard. The fractured ribs stabbed inward like a dagger and damaged the middle and lower lobes of his right lung. Furthermore, the elasticity of the ribs returned it to its original position.

"The impact was so strong that the injury caused was akin to penetrating trauma. During the impact, the bronchial artery was damaged and a large amount of blood filled the lung."

Zheng Ren's thought process was similar to Su Yun's.

"The blood had filled the bronchus and bronchioles, which was why we could not observe the pneumothorax. The scan depicted pulmonary edema because the pressure inside the lung was high as the blood could not escape. Hence, we couldn't see signs of a hemopneumothorax."

Su Yun explored the patient's lung as he continued talking, "The chance of misdiagnosing this case is so high." He was in a good mood now.

This Su Yun was a different man from the careful and cautious Su Yun an hour ago.

Cao Guozhen stood as stiff as stone behind Zheng Ren.

Su Yun's explanation made sense. However, if such an idea struck Cao Guozhen, would he risk an exploratory thoracotomy?

No, he would not have the courage to.

Performing a procedure on a patient without any indication or evidence opened oneself to lawsuits and investigations.

These two surgeons were incredibly ballsy.

Nevertheless, Cao Guozhen shuddered to think of what could have happened.

If Zheng Ren and Su Yun had not forced the issue, a few hours of monitoring would have seen the patient expelling blood from his nose and mouth.

The patient would be drowning in his own blood.

This would be more problematic than a typical drowning because coagulated blood led to clogged airways.

The patient would have died in the cardiothoracic department.

He would not have even survived a night in the cardiothoracic department. The truth was a punch to the gut for Cao Guozhen.

Just the thought of what could have happened sent chills down his spine.

His whole body felt clammy as he recalled a patient who came in with rib fractures alongside an aortic dissection. From the CT scan, the dissection appeared minor and went undetected. A few hours after admission, the aorta ruptured and they were unable to resuscitate the patient.

After the patient's passing, the family came en masse in mourning clothes. They placed the patient's body at the cardiothoracic department entrance and carried out the mourning ritual.

The thought of the scene made Cao Guozhen's knees weak.

The fault laid with no one. It was a mistake any doctor could make and the family was not trying to raise a stink, they were just upset at the loss of their family member.

It was not possible for doctors to perform multiple CT scans in the middle of the night to avoid such incidents.

There were a few hundred rib fracture cases taken in by the cardiothoracic department each year. Their department would be rife with lawsuits.

Cao Guozhen's palms were sweaty as the scenario played in his mind. It was a horrifying thought.

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Chapter 403: What Else?

Rules and regulations these days forbade the patient's families from taking matters into their own hands.

Nevertheless, Cao Guozhen could picture a horrible fate awaiting him had he taken over the case.

He would be banished to the medical administration division with no contact with his department chief for six months.

He might be served to the medical board to appease the family. Getting his medical license revoked...

His whole career would be gone in an instant.

Cao Guozhen had not even realized how close to the cliff's edge he was.

He wanted to express his gratitude for Zheng Ren but all that came out were mumbles. "Zheng... Chief Zheng... You..."

The words failed to convey his feelings.

Su Yun looked up from the operating table. There was a twinkle in his eye as he said, "Dodged a bullet there, yeah?"

The surgical mask did nothing to hold his chuckle back.

Even two layers of masks would fail to hide his laugh.

Like how it failed to suppress his natural good looks.

The jibe made Cao Guozhen frown.

In this scenario, Su Yun should be showing some kindness and humility.

Su Yun as a character would not last more than three episodes in a drama.

Su Yun glanced at the patient's right lung.

"You must be thinking I won't survive more than three episodes on screen."

Cao Guozhen was surprised. Did he say his thoughts out loud?

"But with your looks, you probably won't even make it on screen."

"..."

Zheng Ren, who had been listening throughout the conversation, wanted to say Su Yun would likely end up as a eunuch in the drama and it was not something worth bragging about. However, he held his tongue as Cao Guozhen was present.

Zheng Ren interrupted Su Yun's jeering and said, "Su Yun, please inform the family about the situation. The damage is too extensive and I need some time to think. Inform them as you would about a lobectomy."

"Understood, boss." Su Yun turned around and took off his surgical gloves. He used his phone to capture a few photos of the patient's damaged lung before leaving the operating room.

Suturing was unlikely to work. The most extreme option was to remove a part of the lung.

It would be a major surgery that required the family's consent.

There was a clause in the rib fracture internal fixation surgery informed consent document which allowed the surgeon to perform procedures outside the scope in the event of an emergency.

However, that was usually limited to minor procedures such as stitching up the lung. A lobectomy would require the family to be informed.

After Su Yun left the operating room, Cao Guozhen let out a relieved sigh.

"Zheng... Chief Zheng, thank you," Cao Guozhen whispered.

The last thing he expected from Zheng Ren was silence. Zheng Ren ignored Cao Guozhen, his eyes focused on the two massive wounds.

A negative reaction from Zheng Ren would have angered Cao Guozhen. This indifference hurt his pride.

Cao Guozhen had extended an olive branch...

The two devils from the emergency department were undoubtedly exceptional surgeons but their social skills left much to be desired.

...

Cao Guozhen's words did not register in Zheng Ren's mind. Once Su Yun left the table, he entered the System to purchase some surgical training time. He wanted to know if it was possible to suture a wound of this degree.

Zheng Ren had an abundance of points to spend so a few hours of surgery meant nothing.

The System's training room rose from the ground. Simulation mannequins appeared before Zheng Ren.

The simulation mannequin had the same diagnosis as the patient in real life. Zheng Ren proceeded to perform a lobectomy.

The end result was...subpar.

The System gave the treatment a score of 80%.

A lobectomy yielded such a low completion score. Maybe the System could foresee the patient's deteriorating quality of life.

Zheng Ren took some time to think before starting on a new simulation mannequin.

After a few rounds of trial and error, Zheng Ren was surprised to find suturing yielded the best result.

He was speechless.

His surgeon's instinct was to eliminate suturing as a viable option.

The System's judgment...

Looking at the 98% completion score hovering over the simulation mannequin was enough for Zheng Ren to breathe a sigh of relief.

With such a severe injury, a 98% score was more than Zheng Ren could hope for.

The remaining 2% was likely caused by the development of scar tissues at the sutures, leading to decreased lung function.

It was minor compared to losing two lobes of the right lung.

Zheng Ren left the training room. As he walked, he kept an eye on the small fox in front of the thatched cottage.

He had not been in the System for a few days. The fox was more life-like than ever—every strand of white fur was as realistic as the real deal.

Zheng Ren shook the thought out of his mind. He was wasting time, he had to get back to the surgery.

"Large needle, double-stranded No. 7 sutures." Zheng Ren's hand was open and waiting as soon as he was back in the real world.

No. 7 sutures were thick and usually used to sew the skin layer.

Double-stranded would mean even thicker sutures.

Without hesitation, Xie Yiren did as ordered. She got two No. 7 sutures and threaded them through the eye of the largest suture needle.

The needle holder held the suture needle and the sutures. Zheng Ren angled the tool so that the sutures would not get in the way of his movements.

"Chief Zheng, you plan to suture the wound?" Cao Guozhen asked from a few feet away.

"What else?" Zheng Ren said. With a flick of his wrist, the suture needle penetrated the soft lung tissue.

The rhetorical question threw Cao Guozhen off guard.

What else? A lobectomy was the most obvious choice.

It was a straightforward procedure that the family would accept after some explanation.

However, Zheng Ren abandoned the safest method and chose to suture...

If the patient's bleeding continued after the surgery, the outcome would be horrific.

Cao Guozhen swallowed his words before he offended Zheng Ren.

He had nothing of value to contribute so staying quiet was the best thing he could do.

Thinking back to the words he said in the emergency response room made him sweat buckets.

Who gave him the confidence to stand there and lecture Zheng Ren about the ways to save the patient?

Unrestricted Mucosolvan dosage?

Did he think someone like Chief Zheng would not know these hidden tricks?

Cao Guozhen shut his mouth and watched Zheng Ren forcefully close up the huge wound on the middle lobe.

The final knot was tied so tightly, a single-stranded No. 7 suture would have broken under the force.

No wonder Zheng Ren asked for a double-stranded No. 7 suture.

Was this really the best treatment?

Cao Guozhen mulled over Zheng Ren's tactic. He would track the patient's recovery to observe if this simple but brutal way of suturing had any side effects.

The suturing took a few minutes.

Zheng Ren requested for saline solution to rinse the cavity. After a check for active bleeds yielded no positives, he proceeded to perform the fracture fixation.

The material used for the fixation was shape-memory alloy that contracted when heated and expanded when cooled. The material was placed inside a basin of iced saline solution to achieve the largest expansion before fitting onto the fractures. A warm saline gauze was wrapped around the material to shrink it, fixing the fractures in place.

As Zheng Ren was fixing the fractures, Su Yun returned to the operating room in a flurry. "Boss, I've spoken with the family. I've been thinking on the way in, we might not have to remove the lobes. We could stitch them up! I think it's the best solution. You don't have to worry about the post-surgery, I'll monitor the patient in the ICU."

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Chapter 404: Aspiration Was Key

"Oh," Zheng Ren uttered a monosyllable reply.

Su Yun assessed the operating room and saw the basin of iced saline solution.

This... Zheng Ren was already fixing the ribs?

Su Yun was on his way to wash his hands but when he saw Zheng Ren fixing the ribs, he stopped. He approached the operating table to investigate.

Three rib fractures had been stabilized. The fix was not important because even without it, the fractures would fuse and heal on their own after a few days.

More importantly, Su Yun wanted to know how the patient's lung was dealt with.

The tools used for stabilizing the rib cage were gone. The self-retaining retractors had also been removed. Su Yun could not see what was going on.

"Boss, what did you do?" Su Yun scanned his surroundings and found nothing odd. If a lobectomy was performed, he would have to present the damaged lobes to the family.

"Suturing. Didn't you just speak of it?" Zheng Ren answered matter-of-factly.

Su Yun was speechless.

"Scrub in," Zheng Ren told Su Yun.

"Do you still need me? Does my presence even make a difference?" Sarcastic Su Yun was back.

Brother Yun's sarcastic remarks came whenever he felt like it.

An unhappy Su Yun would deliver a few lines of sarcasm.

A happy Su Yun would do the same.

The habit would be incredibly unflattering if it was anyone but Su Yun.

Su Yun had the skills and swagger to make derisive but honest comments because no one could fault him.

This was exemplified by the number of buddies he had back in Imperial Capital.

If he ever wanted to go drinking, there was a long list of contacts he could pick from.

Zheng Ren ignored Su Yun's pointless question and continued with the surgery.

As usual, despite his complaints and rants, Su Yun went to wash his hand and put on the surgical scrubs.

He came back to the operating table fully-dressed. He used one hand to feel the right lung.

He could feel the thick double-stranded No. 7 suture in a figure-of-8 suture pattern.

It was the same technique Su Yun had in mind. Did Zheng Ren have some background in cardiothoracic surgery?

From a cardiothoracic standpoint, what Zheng Ren had done was extremely daring.

Su Yun had spent a lot of time thinking about the various methods to seal the two wounds while speaking to the family.

He landed on the same solution as Zheng Ren.

When he returned to the operating room, Zheng Ren was already done.

Su Yun glanced at Zheng Ren as he was fixing the rib fractures.

Zheng Ren's attention was fully on the procedure, unaware of any unwelcoming stares.

The ribs fixation was a tedious process.

The actual procedure was not difficult but the damage to the rib cage extended from the second rib all the way to the ninth rib. They had to maneuver the clips in a restrictive operative field.

30 minutes later, the internal fixation surgery was completed. They checked for any active bleeds before closing up the chest.

"Su Yun, we'll have to pay attention to the patient's airways," Zheng Ren instructed.

Zheng Ren was referring to whatever fluid that was lodged in the patient's airways. After the surgery, the blood in the patient's airways had to be aspirated.

"Don't worry. The reason why I'm staying in the ICU tonight is to make sure all the blood is removed from his airways. If we followed the standard treatment workflow, the patient could lose up to 40% of his lung capacity."

"Hmm, thank you then."

"Yes, thank me." Su Yun's eyes shifted to Xie Yiren, then back to Zheng Ren. His eyebrows were questioning.

He was asking if Zheng Ren had made any progress.

This man was too nosy for his own good.

Zheng Ren said nothing but nodded before shaking his head.

Su Yun shook his head, his eyes crinkling with a smile.

Once the patient woke from the general anesthesia, he was transported to the ICU.

Cao Guozhen accompanied the entourage to the ICU. He wanted to keep an eye on the patient, ignoring the jabs thrown at him by Su Yun.

If it were not for the two surgeons from the emergency department, Cao Guozhen would have seen his entire career flushed down the drain.

Death or a fate worse than it would take him.

When the patient arrived at the ICU, the vital sign monitor was displaying a steady electrocardiogram. The patient's blood pressure was also in the normal range at 120/72 mmHg while the blood oxygen level was at 94%.

The numbers were satisfactory.

Unless an unforeseen event happens, the patient would survive.

Regardless, Su Yun was stringent with post-surgery monitoring. A set of aspirators was brought to the patient's bed and Su Yun began the process of suctioning the fluids from the patient's airways.

The specialized hard-tube aspirator was only available in the ICU.

As the tube was not flexible, it stimulated the airways and made the respiratory muscles contract, forcing the trapped fluids outward.

The device could not be used mid-surgery but once the rib fractures were stabilized, they would not have to worry about the patient's coughing. There was a lower risk of damaging the lungs once the rib cage was fixed.

Su Yun was relieved at the sight of dark red fluid that crept up the aspirator tube.

The blood in the airways was only starting to coagulate. Su Yun could remove the fluid that was accessible.

As for the blood trapped deeper in the lungs, he would try his best, but the remainder would have to be dealt with through the natural absorption by the body.

"I'm leaving," Zheng Ren announced once the patient was stable. The dark blood being pulled out of the patient's airways was reassuring.

Su Yun did not bother to look at Zheng Ren. He waved his hand as if shooing a fly.

Cao Guozhen followed Zheng Ren and uttered softly behind the surgeon, "Chief Zheng, thank you for today."

Zheng Ren smiled. "It's alright, Chief Cao."

Cao Guozhen was smart enough to know what Zheng Ren and Su Yun had saved him from.

"Let us have lunch together one day," Cao Guozhen said with gratitude.

The two men parted ways outside the ICU department.

Zheng Ren did not communicate with the patient's family. Su Yun would handle all of it.

He texted Xie Yiren as he walked.

It was almost 10:00 pm, too late for a date.

After all, it was improper for a girl to be out late.

Of course, it was unavoidable in this line of work, but work was an exception. Zheng Ren would have to be on standby tonight for any emergency surgery as Su Yun would be busy in the ICU.

He should go home and rest.

Chu Yanran was staying over at Xie Yiren's house tonight so it was unlikely that anything would transpire between Xie Yiren and him.

Xie Yiren, Chu Yanran, and Zheng Ren went back to the neighborhood. Zheng Ren recalled the memory of holding Xie Yiren's hand while they were walking down the streets searching for food. It was a sweet one.

After saying goodbye, Zheng Ren went in and took a shower. Xie Yiren and he texted for a while before he went to bed.

The next day, Zheng Ren made a pit stop to the ICU before taking over the shift in the emergency department.

The patient was in good shape. He only complained about the lack of rest due to the suction procedure.

The charts showed a total of 400 ml of gunk removed from the patient's airways.

Su Yun's presence in the ICU really made a difference. If the surgeon was not available, no nurse would dare to perform a suction in 20-minute intervals.

There was a risk of damaging the trachea.

After seeking the ICU chief's opinion, the patient was transferred to the emergency wards alongside the patient who was stabbed in the heart.

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Chapter 405: Mayo Clinic

Zheng Ren busied himself with the patients that came into Sea City General Hospital, the small hospital that was insignificant in the world of academic medicine.

At the same moment, something was about to transpire in the Mayo Clinic Headquarters in Rochester, Minnesota.

The 38-year-old Mu Tao was flipping through articles and writing up his daily surgical journal.

After leaving Imperial Capital and returning to Shenzhen City, he felt incompetent.

To be the best surgeon, he had to go to the best hospital and receive the most advanced medical training the world had to offer.

He still had the fiery passion of youth in him.

Mu Tao had spoken to Old Wu about his aspirations and the old professor was supportive.

Old Wu had friends in the international medical community. He managed to obtain a six-month international exchange program for Mu Tao in the world-renowned Mayo Clinic.

It was only six months but Mu Tao was very thankful for the opportunity.

When he first arrived at the Mayo Clinic, he began learning enthusiastically despite the jetlag.

Canada's Montreal General Hospital was in the top five hospitals, but Mayo Clinic was ranked first worldwide.

They could compete with Montreal General Hospital in any field, even neurosurgery.

Here, Mu Tao was exposed to all sorts of advanced medical facilities and medical theories. The doctors were knowledgeable and the surgeries they performed were complex and holistic.

In the field of interventional surgery, Mayo Clinic was also ranked first.

They were especially well-known for their TIPS procedure for the treatment of decompensated cirrhosis-induced gastric varices, portal hypertension, and ascites.

One of the best minds in the field of interventional surgery once said the techniques used in Mayo Clinic were five to ten years ahead of time.

After witnessing first-hand, Mu Tao concurred with the assessment.

Sometimes he even believed five to ten years was an understatement.

Mu Tao was regarded as China's best technical interventional surgeon and he carried that reputation with pride.

When he saw the TIPS surgery performed at Mayo Clinic, his pride and ego were shattered.

In Shenzhen City, Mu Tao's TIPS puncture attempts were always limited to a dozen or so and the success rate of the surgery was as high as 85%.

Even Wu Haishi was amazed by his disciple's accomplishment.

With a stellar track record in performing TIPS surgery and his sharp instincts, Wu Haishi had called Mu Tao a prodigy.

Mu Tao was a talented surgeon, no doubt.

Here in Mayo Clinic, the TIPS surgeries that Mu Tao witnessed all had less than ten puncture attempts.

The challenging blind puncture was also an aspect Mayo Clinic was looking into in hopes of a swifter and less damaging TIPS surgery.

The current procedure in all Mayo Clinic branches was to place a specialized guide wire in the portal vein to map out the general area. This reduced the chances of a total miss when performing the puncture.

The method had already been discussed publicly in a journal article.

Reading it in an article was nothing compared to witnessing it live. The additional guide wire significantly improved workflow efficiency.

The TIPS procedure could be completed with five or fewer puncture attempts and the surgery success rate was as high as 95%. The post-surgery hepatic encephalopathy incidence rate was as low as 30% with this method.

These statistics were unbeatable.

Mu Tao believed the crown jewel of interventional surgery had been cleanly plucked by Mayo Clinic.

Learn, research, operate. Mu Tao kept a steady pattern every day while he was in America.

He had even forgone sleep, taking only 4-hour daily naps.

Mu Tao only had six months and found himself running out of time. There were too many things to learn and too many surgeries to perform.

Every day, there were countless dignitaries and rich businessmen who stopped by Mayo Clinic for a consultation or check-up.

A referral letter from a specialist cost USD7,000.

The figure was shocking.

However, Mu Tao truly believed the price tag was worth the service. Even if the price was doubled, it would be worth it because life was precious.

For interventional procedures, the were many patients who were available. Although Mu Tao could not perform the surgeries, he could assist and learn.

Whenever fatigue caught up and threatened to drown him, Mu Tao recalled the situation back in Imperial Capital.

Mu Tao wanted to be the best in the country! Anything less was not acceptable!

For this goal, he would push himself to the brink of exhaustion.

Mu Tao embraced each second he spent in Mayo Clinic.

...

...

Back in Sea City General Hospital's emergency ward, Zheng Ren was performing a physical examination of the patient who was stabbed in the heart.

His recovery was swift. The patient was able to go to the bathroom unassisted while carrying the chest drainage system.

Cardiac stab wounds and cardiac tamponades required emergency medical attention. Time was the main factor in these rescues as once the window of opportunity had passed, there was a high risk of brain damage.

This patient was incredibly lucky.

During the transport of the patient from the ICU, he and his lover had thanked Zheng Ren profusely.

After the initial shock, his lover's mental state had finally returned to normal. She was no longer wailing and sobbing as she had during the emergency response.

The woman seemed to have forgotten what had happened that day.

Zheng Ren watched his words as he spoke to the couple. He did not want to jog her memory lest she remembered how he kicked her aside that day. Had he not brought her lover back from the dead, the woman would likely sue him for assault.

Zheng Ren checked the patient's temperature and listened to his chest sounds. No fever, no signs of infection. Everything was going well for him.

One more week of observation would do before discharge.

As for the sutures on his chest, they could be removed in a few more days.

The other patients were all in stable condition. Under Zheng Ren's management, the emergency wards were orderly and proper.

The key was in the quality of surgical procedures as it dictated the post-surgery care, which was resource-intensive.

Needless to say, the medical staff was essential in maintaining the emergency wards' smooth operation.

Professor Rudolf Wagner had gotten used to the workflow in the emergency department. To end up here in a small general hospital in Northeastern China, the professor believed it was God's will.

He was able to witness Zheng Ren complete a TIPS surgery with a single puncture attempt.

The professor had faith he could practice and master the technique.

On the other hand, the patient with prostatic hyperplasia was on his way to China.

Professor Rudolf Wagner did not forget his initial goal of winning a Nobel Prize. It was his life goal.

With the help of a magnificent East Asian surgeon like Zheng Ren, Professor Rudolf's hopes soared.

This was a sign from God.

After making his rounds, Zheng Ren headed back to his office and picked up on his reading.

He was glad the activity boosted his skills in the System and gave him an edge.

He had no idea why the System had chosen him or when It would desert him but he now had the ability to save lots of people and that was enough.

Zheng Ren treasured every second he had with the System.

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Chapter 406: Boss, You're Mocking Me

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

The department phone rang.

Zheng Ren answered the call. A doctor from the emergency internal medicine had called to inform them a young female with acute appendicitis had been admitted. They were on their way to the hospital.

Zheng Ren called Su Yun. "We have an appendicitis case. Take Yang Lei with you to surgery."

"Oh." Su Yun's head was buried in his phone, likely texting or playing a game.

Nowadays, the emergency ward required two appendectomies on average. Yang Lei had much more surgery opportunities after he was transferred to the emergency ward.

Even though he lacked the talent, his skills improved with continuous surgical practice.

The patient arrived shortly.

Zheng Ren performed a physical examination carefully and reached a diagnosis.

The patient was a sixteen-year-old girl.

She had been experiencing right lower abdominal pain for two days, accompanied by a low-grade fever. The emergency lab report showed elevated levels of leukocytes and neutrophils, which were indications of an infection.

The B-scan ultrasonography excluded the possibility of ovarian disease. The symptoms were typical and Zheng Ren's diagnosis was in line with the System.

She was cleared for surgery.

"The patient's diagnosis is very obviously acute appendicitis. When was the last time she ate and drank?" Zheng Ren asked.

The patient's father was a man in his thirties, most likely from the rural village in the outskirts of the city looking at the way he was dressed.

When he heard Zheng Ren's question, he sized up Zheng Ren cautiously and answered, "Around 6 o'clock this morning."

Zheng Ren was puzzled by the man's defensive behavior.

He glanced at the time and it was still before 10 a.m. She had to wait for another two to three hours to fulfill the 6-hour fasting period before surgery.

"Don't let her take any food or liquids from now onward," Zheng Ren said, "We'll be preparing her for surgery at 1 p.m."

"Surgery?" The man replied immediately, "Doctor, we don't want surgery."

"Hmm?" Something clicked in Zheng Ren and he realized that they would be facing some complications.

He had guessed earlier that it might be surgery-related.

As expected, the patient's father continued, "We don't need surgery; just give my daughter some anti-inflammatory medication."

"If we apply conservative treatment for acute appendicitis, there may be a risk of rupture. It will seriously endanger the patient's life." It was not Zheng Ren's intent to threaten the father; he was merely stating the truth.

Fan Tianshui, for example, was a strong man like, yet he had a close encounter with death just because he did not receive the appropriate treatment in time.

Besides that...

A gay porn star, Masaki Koh from Tokyo, refused to get an appendectomy because he did not want to scar his body. His appendix ruptured and he developed peritonitis and other complications, which ended up taking his life at the ripe age of twenty.

Some diseases healed over time, but they could also progress into a life-threatening condition.

General surgeons usually preferred a radical approach.

The appendix was not an essential organ. Instead of suffering the pain of conservative treatment, they would advise people to have it surgically removed.

"It's nothing. She's just having a stomachache; it's nothing serious." The man was firm.

The man's demeanor seemed particularly cold with the girl in the background, curling up on the bed in pain.

"Are you short of money?" Zheng Ren asked out of 'concern'.

"..." He was met with silence.

"An appendectomy isn't too expensive. If you're facing financial difficulties, we can do an open appendectomy instead of the laparoscopic appendectomy. It'll cost around 1,000 yuan," Zheng Ren tried to persuade the patient's father by lowering the price.

"..." There was still no response.

"The cost of antibiotics, anti-inflammatory treatment, and IV drip will cost quite a bit too, not to mention the underlying risk," Zheng Ren added on.

"Doctor, we don't want surgery. Just treat her," the patient's father said in disdain, staring at Zheng Ren with an annoyed expression.

Zheng Ren was at a loss for words.

He sighed internally and nodded. He then brought the patient's father to the office and asked Chang Yue to issue him an admission notice for the hospitalization procedures.

When the patient's father left, Zheng Ren said, "Go and find out why the patient's family refused surgery."

"They refused surgery?" Chang Yue was shocked.

Why would anyone reject a simple appendectomy?

"Yes, I asked him and even offered to exclude part of the medical bill and reduce the admission fee to around a thousand, but he still refused," Zheng Ren said helplessly.

"Hmm, let me ask them," Chang Yue said. "Chief Zheng, when are you going to do Sister Zheng's surgery?"

"I'm going to the Secondary Hospital for surgery tomorrow. We'll schedule hers on the day after." Zheng Ren continued, "Tell Sister Zheng that she may need to get radiofrequency ablation."

"Do you have a template for the preoperative procedures?"

"No."

"You don't even have that. Are you sure you know how to do radiofrequency ablation?" Chang Yue asked suspiciously.

"It should be fine. Lil Fugui can do it if I can't," Zheng Ren laughed and said, "Right, Lil Fugui?"

"Boss, you're pulling my leg," Professor Rudolf Wagner said with a pout. "You have the best interventional skills of all the interventional doctors. You shouldn't make up a bunch of baloney just because Chang's not in surgery."

"..." Zheng Ren was speechless.

The professor was getting more fluent in the Northeastern dialect; even Zheng Ren rarely used words like 'baloney'.

If it was not for the professor, he would have forgotten that the word existed.

"Chief Zheng, you must always be honest to your resident doctor," Chang Yue said in a serious tone.

"Yes, yes, yes," Zheng Ren answered with three consecutive yesses.

"Right, you're not even taking me with you to Secondary Hospital for surgery. Out with the old, in with the new. So disloyal of you, Boss," Su Yun added insult to injury at the right moment.

After joking around for a while, the patient returned after completing the admission procedures. Chang Yue then examined her once more, wrote down medical notes, and started briefing the patient's family.

Half an hour later, Chang Yue walked in with a sullen expression.

"Chang Yue, can't you look happier?" Su Yun could guess what happened from Chang Yue's expression

Chang Yue's emotions were written all over her face.

"Guess why the patient's family refused to operate." Chang Yue said after closing the office door.

"Do we even need to guess?" Su Yun put on an irritating smirk and said, "A sixteen-year-old girl from the village will be married off soon. If there's a scar on her stomach, people will think that she did an abortion or she had gynecological diseases. Anyway, her bride price will depreciate by a hundred thousand at least, from 300,000 to 200,000 yuan."

"..." Zheng Ren heard about something similar before, but it did not cross his mind.

Chang Yue let out a sigh, indicating that Su Yun's prediction was true.

"Let's start with the anti-inflammation treatment then. Hopefully, it doesn't perforate," Zheng Ren sighed deeply.

These things were beyond their control. If the patient's own parents refused to have surgery, what right did they have to force her?

Ugh... They really should not do this if they wanted their daughter to live.

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Chapter 407: Princess Syndrome (1)

While they were lamenting about it, the phone rang once more.

The landline of the emergency ward was different from the one in Old Chief Physician Pan's office. The Chief would mostly receive calls about office politics between departments.

When the phone in the emergency ward rang, it was likely that the emergency department was either sending patients to them or that the patient had an ambiguous diagnosis that required Zheng Ren's opinion.

After picking up the phone, Zheng Ren spoke for a while before getting up and heading downstairs.

"Boss, what's the matter?" Su Yun asked.

"Intestinal obstruction in a fifteen-year-old girl," Zheng Ren said.

"Let's go check it out," Su Yun followed Zheng Ren to the emergency department.

Intestinal obstruction could be caused by intussusception in the infant stage or from loss of function due to old age.

The patient was still a teenager; she should be in the pink of health. It was rare to see intestinal obstruction in a young girl like her.

When they arrived at the emergency department, the internal medicine doctors were busy tending to the never-ending crowd in the consultation room. Most of them were elderly patients above 60.

This was a common scene in the Northeastern region. The younger generation equipped with skills that had a future ahead all moved to the South in search of jobs, leaving the older folks behind.

When the doctor saw Zheng Ren, he quickly comforted the old man he was tending to and rushed over to Zheng Ren. He brought Zheng Ren to the emergency treatment room. On their way there, he said, "The patient is a fifteen-year-old girl. She has abdominal pain and was vomiting for two days before she visited the hospital. When I examined her, her abdomen was bloated, tender upon touching–general pain without any rebound tenderness. The CT scan on the abdomen showed an enlarged intestinal loop and extensive fecalith in the right abdominal cavity."

The doctor's voice was raspy from the non-stop talking from the morning till now. She was so busy that she had not had the time to have even a sip of water.

"What has been done?" Zheng Ren asked.

"We performed a hypertonic saline enema, but it was not effective," the emergency internal medicine doctor answered. "After the enema, we imaged the plain films of the abdomen and saw that there was an increase in the extent and amount of small bowel distension, along with the presence of air-fluid levels."

"Hmm," Zheng Ren pondered.

When they reached the treatment room, he saw a girl curled up on the bed, continuously retching.

There was an anxious middle-aged woman wiping away tears while she gently patted the girl's back.

"Chief Zheng, these are the scans. Please take a look at them. I'll return to my post now," the doctor briefed Zheng Ren quickly and hurried back to the consultation room.

Zheng Ren came to the side of the patient and positioned her in a supine position with her legs bent upwards. Then, he rubbed his hands together to warm them before starting the physical examination.

The patient was very thin, with long black hair. She also had big round eyes with long lashes, but they were watery because of all the vomiting.

"What's your name?" Zheng Ren habitually asked for the patient's information as he performed the examination. He placed his hand on the patient's left upper abdomen.

"I'm Wang Yutong," the girl fluttered her eyes and answered.

"Are you in middle or high school?" Zheng Ren casually asked as he explored the patient's abdomen.

There was no prominent tenderness on her upper abdomen, which was a typical sign of bloating. However, the patient felt the pain when he reached the left lower abdomen.

Zheng Ren checked carefully to locate the exact location.

The System's monitor diagnosed the intestinal obstruction as Rapunzel Syndrome.

Zheng Ren was a little lost. However, he had to act calm and collected even if he had questions, especially in front of the patient. This was the basic etiquette for a medical doctor.

After the examination, Zheng Ren tapped the girl's shoulders and asked her to cover her abdomen.

He then walked toward the radiographic film viewer and put up the abdominal CT scans and plain films.

It was a typical case of intestinal obstruction, just like the emergency internal medicine doctor said previously. The air-fluid levels and fecalith were all typical symptoms of this disease.

Zheng Ren made a low hum.

Su Yun noticed something was not right when he saw Zheng Ren's expression. He came over and asked softly, "Anything unusual, Boss?"

"What do you know about Rapunzel Syndrome?" Zheng Ren asked.

It never crossed Su Yun's mind that Zheng Ren was actually consulting him. He thought his boss was quizzing him. He quickly searched his mind for information on Rapunzel Syndrome.

A genius like him also had impeccable memory.

Similar to those who made a name in history, Su Yun was equipped with all the skills they had, including photographic memory.

He only took him several seconds to recall information about Rapunzel Syndrome.

"Rapunzel Syndrome, a clinical disease first described by Vaughan Jr. in 1986, manifested by the patient's trichotillomania and trichophagia. The swallowed hair would form a gastrolith and enter the small intestines, causing abdominal pain, vomiting, nausea, malnutrition, hematemesis, diarrhea, and intestinal obstruction if the condition is serious," Su Yun answered softly as if he was back in school, standing beside an old respected professor.

'A test? Did he think he could get me with such a simple question?' Su Yun felt proud.

"Hmm," Zheng Ren nodded after hearing what Su Yun said.

The patient's symptoms matched the description. The intestinal obstruction could be caused by a long-term compulsive eating of hair, which developed into a gastrolith and blocked the colon.

The best treatment method for a conclusively diagnosed intestinal obstruction was surgical resection.

Since the diagnosis was confirmed, the patient could be prepped for surgery.

"Can the patient's family follow me please?" Zheng Ren called out.

The patient's mother was in the middle of taking care of her, so the father followed Zheng Ren out of the treatment room.

"Have you noticed your daughter displaying any unusual behavior?" Zheng Ren asked.

The patient's father looked confused. He tried very hard to recall, but he could not understand what Zheng Ren was asking for.

"It's okay if you don't know," Zheng Ren said kindly. "Your daughter is showing symptoms of intestinal obstruction. After looking at the scans, it was caused by fecalith in the intestines. An enema didn't work, so I plan to treat her with surgery."

Zheng Ren did not directly reveal to the father that the patient had Rapunzel Syndrome, for fear that it would upset him.

Sometimes, the chronology of the briefing was very important.

The patient's parents would feel relieved after they treated her intestinal obstruction. The best option was to explain the cause of this disease and future treatment plans after showing them the gastrolith.

The patient's father had no opinions and agreed with whatever Zheng Ren said.

Zheng Ren then called Su Yun to admit the patient and prepare the preoperative assessment for surgery.

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Chapter 408: Princess Syndrome (2)

Su Yun, Chang Yue, and the others were busy preparing for surgery. On the other hand, Zheng Ren had nothing much to do during this period. He started examining the patient's scans that were put up on the film viewer.

Since the occurrence of Rapunzel Syndrome was rather rare, he should take this opportunity to study it since there was nothing he could do except to wait for the surgery.

This was the privilege of a superior medical officer. Most chiefs would request their subordinates to call them to the operating table after they had finished lining up the sterile sheets.

Zheng Ren did not have that kind of luxury, nor would he be that pompous.

The emergency department was already short-handed at the moment.

After a while, they received the case file and Chang Yue started to write medical notes. The gastric tube and urinary catheter were set aside, prepared. They were only waiting for the patient to complete the preoperative assessment so that they could start the surgery.

"Chief Zheng, are you busy?"

While the staff from the emergency ward were preparing the surgery orderly, a cheerful Chief Sun walked in.

"Oh, Chief Sun," Zheng Ren smiled and greeted, "We have a case of intestinal obstruction. We're in the middle of preparing to operate."

Chief Sun's eyelids started twitching. Recently, the traffic of general surgeries decreased significantly because most of them were dealt with by the emergency department.

However, he did not mention anything about that. Instead, the smile on his face grew, and he said, "Chief Zheng, I'm here to show you the peritoneal loose body you diagnosed the other day."

Chief Sun reached for his phone and showed Zheng Ren the pictures he took.

The specimen looked like a giant goose egg. After closing up, Chief Sun dissected the 'goose egg' and the boundaries of the egg white and yolk were very clear. If the person who saw it did not know anything about medicine, to them, it would look like it belonged in somebody's kitchen.

Zheng Ren had seen it during the operation, but Chief Sun showed him the final diagnosis from pathology and gave a clearer description of the specimen sections.

"Chief Zheng, you're really good at diagnosis," Chief Sun praised him while affectionately patting his shoulder.

"Haha," Zheng Ren laughed dryly and gave him a quick glance before returning to the scans on the film viewer.

Chief Sun felt a little insulted.

He was trying to get on his good side, but Zheng Ren gave him the cold shoulder.

'You really think your diagnostic skills are great?' he thought.

The more he thought about it, the angrier he got.

However, he was far too cunning to express his anger. He just followed Zheng Ren's gaze.

"This is a typical intestinal obstruction. Why are you looking at it, Chief Zheng?" Chief Sun said after glancing at the scans.

The images and the reports of the patient all showed that it was a typical condition; nothing from the scan stood out.

"Oh, this intestinal obstruction is caused by Rapunzel Syndrome," Zheng Ren answered briefly. "I wanted to study it since it's quite rare–to reduce the possibility of misdiagnosing it in the future."

"Ra...what syndrome?" Chief Sun was stunned.

F*ck, what did Zheng Ren say?

Rare disease? Chief Sun regretted right after he asked. He quickly redirected his focus to the scans and tried to look for indicative signs for that syndrome.

"It's called Rapunzel Syndrome." Zheng Ren also had a good memory, but he was busy working part-time to earn a living when he was in school. Therefore, he did not have the luxury to visit the library to read journals.

"The patient has a mental and physical disorder where they can't resist the urge to eat their hair. Since hair is indigestible, it forms a gastrolith in the intestines and causes blockages," Zheng Ren gave a simple explanation while he continued to observe the scans, his hand under his chin, trying to search for other indicative features.

Chief Sun was totally lost.

He had never heard of Rapunzel Syndrome. Eating hair? Why did he never encounter something like that after so many years of practice?

Nevertheless, he buried these questions and observed the scans with Zheng Ren.

"Lil Fugui, can you come here for a moment?" Zheng Ren called out.

"What's the matter, Boss?" Professor Rudolf Wagner rushed toward him enthusiastically.

"Are there any typical characteristics of Rapunzel Syndrome in imaging?" Zheng Ren asked.

"Boss, you're so funny." Professor Rudolf Wagner pointed at the scans. "The images can only differentiate the density of the fecalith that was causing the obstruction, but the difference is too small to be detected. Surgery will be more ideal as a diagnostic method."

Zheng Ren nodded.

The professor's opinion was similar to his.

He would proceed with the surgery then.

Chief Sun was perplexed. Did Zheng Ren get a conclusive diagnosis? Why was he so confident when he mentioned it to him, yet still asked the professor for advice?

"Chief Sun, please excuse me," Zheng Ren said to Chief Sun with a smile when he heard Su Yun call him to go into surgery. "I'm going in for surgery now."

"I'll come with you," Chief Sun said. "I've never heard of Rapunzel Syndrome."

Chief Sun was used to being on the losing side. He had given up on competing with Zheng Ren long ago.

Even though Zheng Ren was younger than him, his surgical skills were much better.

He had a lot of time on his hands since there were not many general surgeries these days, so he decided to observe the operation.

If it was a confirmed case of Rapunzel Syndrome, he would go back and research it so that he could boast during the annual conference of general surgery.

Zheng Ren did not refuse his request. There was nothing wrong with a chief of the general surgery department observing a surgery.

Chang Yue had already completed the preoperative procedures. Zheng Ren took the case file and headed to the operating room.

Suddenly, Chief Sun called out, "Chief Zheng..."

"Chief Sun, please call me Little Zheng. I'm not comfortable with you addressing me as Chief Zheng," Zheng Ren said with a laugh.

"Sure, Little Zheng. I heard that you went to the Secondary Hospital to perform a few TIPS surgeries?" Chief Sun casually inserted this question on the way to the operating room.

"Hmm," Zheng Ren answered. "I've done almost ten surgeries."

"..." Chief Sun stumbled in surprise, but he quickly caught up with Zheng Ren.

It being a rare disease, Chief Sun had no idea what Rapunzel Syndrome was.

However, diseases like decompensated cirrhosis with clinical symptoms of portal hypertension, hematemesis, and ascites were the most common cases in general surgery and gastroenterology.

A few years back, they would need to perform porto-azygos disconnection.

Due to a lack of fibrinogen and the high risk of porto-azygos disconnection, the rise of TIPS surgery in the interventional field had replaced this common procedure from general surgery.

Chief Sun sighed when he thought about how Zheng Ren even managed to master the most difficult procedure: TIPS surgery.

"Little Zheng, I'll be straightforward with you. I have an old mate with serious liver cirrhosis and ascites. His condition is way beyond control," Chief Sun said. "Can you tell me who you learned TIPS surgery from? Can you give me a referral so that I can help my friend transfer to Imperial Capital or Sorcery Capital to receive surgery from your mentor?"

"Learn?" Zheng Ren asked. He was caught by surprise. He was not paying attention to Chief Sun's rambling. His mind was occupied with the Rapunzel Syndrome.

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Chapter 409: Princess Syndrome (3)

"I figured it out with Professor Rudolf Wagner," Zheng Ren said.

Chief Sun was stunned, then he was extremely displeased.

He felt as if something was pressing on his chest.

Even though he did not know how to perform TIPS surgery, he knew its basic principles.

TIPS surgery was one of the most difficult surgeries to date. In certain ways, it could be more challenging than the Whipple procedure.

How arrogant of Little Zheng to claim that he learned it by himself. Who would believe this nonsense?

Chief Sun shook his head and sighed internally.

There was no point in him pestering him further if he was so full of himself.

Chief Sun was so frustrated that he wanted to turn around and leave. Why should he be humiliated by a naive child?

At this moment, Zheng Ren was entirely focused on the surgery. He decided the route of entry from the information he gathered by physical examination and imaging. He then mentally ran through the procedure to think of possible precautions and mitigation measures for any unexpected incidents.

He did not notice the changes in Chief Sun.

When they arrived at the operating room, Chief Sun was silent, as was Zheng Ren. The atmosphere was a little awkward.

After changing, Zheng Ren left the changing room first. Chief Sun found a quiet corner and lit a cigarette to smoke. Then, he took out his phone and made a call.

"Old Xia, I asked Zheng Ren about the TIPS surgery, but he said he figured it out with the professor." Chief Sun poured his frustrations to Chief Xia, with whom he was more familiar.

Chief Xia was the one who told him that Zheng Ren could do TIPS surgery. Initially, Chief Sun asked her to contact the professor in Imperial Capital, but she referred him to Zheng Ren instead.

In fact, Chief Xia actually meant that he should ask Zheng Ren to perform the surgery.

However, Chief Sun misinterpreted that Zheng Ren was able to perform TIPS surgery because he had relations in Imperial Capital.

It was a misunderstanding.

Chief Xia was stunned when she heard him.

"Old Sun, didn't you ask me to refer you to a professor who could perform TIPS surgery?" Chief Xia asked.

"Yeah, you suggested Zheng Ren's mentor, so I came to look for him." Chief Sun felt slightly dejected.

"Who said anything about his mentor!" Chief Xia had a hot temper, the volume at the other end of the phone call increased by at least ten decibels. "I told you that Little Zheng is quite good at TIPS surgery!"

Chief Sun still could not understand what Chief Xia was insinuating. He just stared at the cloud of smoke billowing from the cigarette in hand.

Even though Chief Xia made it very clear, he...

After a few seconds, an irritated voice came from the other end.

"Old Sun, are you in your right mind? What nonsense are you talking about? Wasn't I clear?"

"Old Xia, we're talking about TIPS surgery here. Are we on the same page?" The cigarette bud burnt his fingers and the pain brought Chief Sun back to his senses. He threw away the cigarette bud and explained what he thought she told him.

"I am talking about TIPS surgery here," Chief Xia asked, "My classmate, Old Zhang, is the supervisory director of Secondary Hospital. Once he saw Little Zheng perform TIPS surgery during his last visit, he immediately invited him over."

While Chief Xia was explaining, she paused momentarily and asked, "Old Sun, don't tell me that you asked Little Zheng to help you contact the professor from Imperial Capital?"

"..." Chief Sun had no idea what his mistake was.

"You... nevermind," Chief Xia knew that her speculation was true when there was no response from him. She continued, "Just let Little Zheng do it. Stop wasting your time. Don't come and blame me if the other postgraduate researchers experiment on your friend."

Chief Xia hung up right after that.

Chief Sun gripped his phone with mixed feelings and stared off in a daze.

He had been introduced to Zheng Ren when he started working in this hospital. He was just a normal general surgeon, hardworking and reliable, but that was all. There was nothing exceptional about his surgical skills.

However, he rose to fame just after a demonstration surgery.

Could he perform TIPS by himself? From what Chief Xia said, her intent was already very obvious even though she did not exactly mention it—Zheng Ren's TIPS surgery skills were much better than the professors in Imperial Capital.

... Was that even possible?

Chief Sun had no doubts about Zheng Ren's general surgical skills. He could perform the Whipple procedure alone; a simple surgery like this would not be a problem.

Nonetheless, was he able to surpass other experts in their own field?

At such a young age?

Chief Sun was lost in his thoughts. When he thought of asking Director Zhang about this, he realized that he had already been sitting in the changing room for half an hour.

'Ugh... The surgery would have started by now.' He quickly rushed over.

Chief Sun put on a scrub cap and mask before entering the operating room.

Under the shadowless lamp, the silhouette of Zheng Ren's back seemed larger.

No one was speaking at the operating table. There was not even a single request for surgical tools.

'Was there a problem?' Chief Sun thought subconsciously.

He stuck his head out to check and, to his surprise, the surgery was almost over. Zheng Ren was suturing the muscle layer. After each suture, Su Yun followed up with a knot and cut the excess suture in a fluid motion.

"Little Zheng, you're done?" Chief Sun asked.

"Yeah, the fecalith had hair in it. Do you want to take a look?" Zheng Ren replied.

The surgery went smoothly. They saw a bulge in the intestine after opening the abdominal cavity.

After dissecting the intestinal wall, they removed the fecalith and checked the remaining intestines for other blockages. Then, they proceeded to close and rinse, and the surgery was completed.

Intestinal obstruction might be slightly more challenging if the patient was elderly due to the risk of intestinal adhesion. Otherwise, a typical intestinal obstruction was just as simple as an appendectomy for Zheng Ren.

Chief Sun quickly put on a pair of gloves and opened the yellow plastic bag containing the pathological specimen.

The smell of fecal matter permeated the room.

"Chief Sun, can you do that outside, please?" Chu Yanran could not take it. She had already voiced her objection against intestine surgery. She would have Chu Yanzhi take over the anesthesia for any intestine surgery in the future.

Chief Sun forced a laugh. He did not reprimand Chu Yanran, even though she was still a resident-in-training.

He was afraid of her boss, not to mention that Su Yun was still at the operating table. He had no intention of getting mocked by that mean guy.

Unless he could rebut him, he would never be able to beat that guy.

He carried the yellow bag to the corridor of the operating room and opened it near a vent.

In the bag, there were massive clumps of fecalith with hair in it.

It...it really was Rapunzel Syndrome? Chief Sun quickly closed the bag while he tried to memorize the name of this syndrome. The odor was indeed very pungent; no wonder Chu Yanran was so upset.

It did not matter if he had never heard of this syndrome before. He could always go back and study it.

If not, he could always search Baidu.

Even though they always advised patients not to seek medical advice on Baidu, Chief Sun had no other choice in this situation.

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Chapter 410: How Do We Treat Her?

The surgery ended and Zheng Ren stepped away from the operating table.

He did not remove his surgical gown. Instead, he waited for Su Yun to bring the stretcher trolley over and helped to move the patient.

"Su Yun, does Sea City have a psychiatrist? It would be best if the patient had access to one once she recovers."

Su Yun replied, "No, we don't. There are very few psychiatry departments in our country. I know someone who's based in Imperial Capital."

"Are they any good?"

"Talented; definitely worth a try, but it's a bit pricey."

Su Yun's social circle was a galaxy compared to Zheng Ren's.

Psychiatry was an uncommon specialty in China. The fact that Su Yun had a recommended contact was a testament to his well-connectedness.

"I'll have a word with the family about the recommended therapy for the patient," Zheng Ren said as he watched the stretcher trolley leave the operating room. He had not taken his gloves off.

"Go ahead. Let me know if they want the contact." Su Yun and Chu Yanran wheeled the patient out of the operating room.

"Su Yun, get the father to stay back. I have something to show him," Zheng Ren called out after Su Yun. He had wanted to show the father the evidence.

"I remember!" Su Yun's voice reverberated outside the operating room hallway.

Zheng Ren rotated his shoulders to relieve the tension. He saw Department Chief Sun standing in the corner.

The department chief looked to be in a daze. The yellow plastic bag was untied and a distinct odor permeated the operating room.

Zheng Ren tried to get the department chief's attention. "Chief Sun, the surgery is done. I'm going to inform the family."

Department Chief Sun snapped out of his daze. He wore a confused expression as his mind processed what was being said to him.

His silence prompted Zheng Ren to ask with concern, "Chief Sun, are you feeling well?"

"Uh..." Department Chief Sun hesitated, then he sealed the yellow plastic bag and walked toward Zheng Ren. "Little Zheng, your diagnosis was spot-on!"

The department chief gave Zheng Ren a congratulatory thumbs-up, a wide smile on his face.

This was the second time the department chief had praised him. If Su Yun was here, some sarcastic remark would have been made. The department chief's enthusiastic compliments were met with an awkward smile from Zheng Ren.

Zheng Ren felt he was undeserving of praise.

After all, it was the System that provided the diagnosis.

Truth be told, Zheng Ren could not recall the specifics about Rapunzel Syndrome. He would have to look up the article to refresh his memory. These thoughts raced through his mind as the department chief showered him with praise.

Department Chief Sun did not sense the awkwardness in the air. The smell of the impacted stool might have temporarily impaired his brain functions.

"Little Zheng, that friend of mine will be arriving tomorrow. I'll have to trouble you to perform the TIPS surgery," Department Chief Sun said solemnly.

"It's no trouble. Admit him to your ward. I believe your department is more experienced in handling hepatic encephalopathy," Zheng Ren replied with a smile.

Department Chief Sun nodded faintly.

He wanted to slap himself for his past foolishness.

Zheng Ren had a foreign professor by his side. What was his name? Rudy? Ruben? Even if Zheng Ren could not perform the TIPS surgery, the professor could step in, but why would a foreign professor deign to take up a subordinate role?

The foreign professor's presence was to Department Chief Sun's benefit. He had communicated the Caucasian professor's involvement with his friend to gain brownie points.

He still had doubts about the success rate of the TIPS surgery, but he trusted Department Chief Xia's judgment.

Department Chief Xia was a capable woman. She survived countless altercations with Department Chief Liu; that was an amazing feat on its own.

She rarely praised others, but Zheng Ren was an exception. He came with Department Chief Xia's recommendation and she was not shy with her compliments.

Department Chief Sun had a clearer picture of Zheng Ren's status now. He was in good spirits as he followed Zheng Ren out of the operating room.

Despite the age difference, Department Chief Sun was willing to admit he had misjudged Zheng Ren. The junior doctor had grown into a force to be reckoned with in Sea City General Hospital.

Zheng Ren carried the yellow plastic bag out to the corridor.

"Family of Wang Yutong!" Zheng Ren announced.

Wang Yutong's father immediately appeared before Zheng Ren, concern etched into his worn face.

Su Yun had informed him to wait for the lead surgeon to explain the circumstances and rushed off with his daughter.

Zheng Ren eyed the man. "You're Wang Yutong's father?"

"Yes."

"Your daughter is suffering from a rare illness."

The middle-aged man's face paled. He looked as if Zheng Ren told him his daughter had cancer.

The man's imagination ran amok and panic seized him.

Zheng Ren could see the shift in expression and quickly smiled to lighten the mood.

"Your daughter has a psychiatric disorder," Zheng Ren clarified.

A curveball.

Wang Yutong's father was surprised.

"Psychiatric disorder?" the man questioned.

A psychiatric disorder required surgical treatment?

"It's... The disorder is called Rapunzel Syndrome."

"Rapunzel..." The man eyed Zheng Ren suspiciously. If not for the full surgical gear, he would think Zheng Ren was a sham. Hints of blood splattered on Zheng Ren's gloves made him think twice.

"Rapunzel Syndrome is a rare medical condition resulting in ingesting hair. Hair is made of keratin, which cannot be digested by gastric acid and enzymes, causing problems in the gastrointestinal tract," Zheng Ren explained.

"The body can excrete a few strands, but a person with Rapunzel Syndrome ingests an excessive amount of hair. Often the patient displays symptoms of thinning hair and malnutrition due to gastrointestinal problems." Zheng Ren leaned forward with the yellow plastic bag. "Here is the trichobezoar that formed from the large amount of hair she ingested, so you can get a better idea of what your daughter has."

Zheng Ren opened the yellow plastic bag to show Wang Yutong's father.

The long explanation was helpful for him to understand his daughter's condition and his distrust in Zheng Ren slowly faded.

There were many questions in his mind still, but he understood the gist of it.

Holding his breath in, he peered into the open plastic bag.

Zheng Ren pulled out a piece of the trichobezoar.

The individual strands of hair were a part of the patient's stool and they were numerous. It was a disturbing sight to behold.

A picture was worth a thousand words.

Wang Yutong believed Zheng Ren's diagnosis.

"Doctor, how do we treat her?" he asked Zheng Ren with pleading eyes.

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Chapter 411: Old Chief Physician Pan's Solution

"A patient with Rapunzel Syndrome will require professional psychiatric help. If you can't find a suitable doctor, my assistant knows someone in Imperial Capital. We can provide you the contact details," Zheng Ren said to Wang Yutong's father.

Zheng Ren felt he had to stress the importance of therapy. "She has to seek professional help for this. If it goes untreated, the next round of surgery will be more complicated. There could be issues like abdominal adhesions and intestinal obstruction."

Wang Yutong's father nodded.

Department Chief Sun was impressed by Zheng Ren's knowledge. In his decades of service, he only remembered a single case of Rapunzel Syndrome.

Back then, the surgeon performed a bowel obstruction surgery to remove the trichobezoar, but never bothered to provide any mental health advice.

Without addressing the root cause of the bowel obstruction, the patient was likely to end up in the hospital again for a second bowel obstruction surgery.

Zheng Ren answered a few more questions from the patient's father. Once he was satisfied, Zheng Ren excused himself and went into the operating room. He placed the yellow plastic bag in a corner. The pathology department would run some tests on the sample. He went to change out of his surgical scrubs.

Department Chief Sun was one step behind Zheng Ren. He brought out all the praises and compliments he had once used to sweet-talk his mentor, showering Zheng Ren with accolades and applause.

The flattery rolled off Zheng Ren as if he was waterproof.

Zheng Ren wore an unmoving smile as his mind wandered. He was thinking of the TIPS surgeries in the Secondary Hospital.

A single TIPS surgery was worth a few hundred skill points. In the past, gathering experience points for interventional surgery was incredibly tedious.

That all changed when he learned the TIPS procedure.

In general surgery, a liver transplant surgery could net 500 skill points, but availability was an issue.

Unless Su Yun's previous research on 3D bioprinting organs made it to clinical trials.

That was in the far future.

For now, Zheng Ren's focus remained on interventional surgery. He was ambitious and wanted to achieve a Prime rank.

He wondered how it would feel, reaching the peak of a surgery skill tree.

Zheng Ren emerged in clean clothes and bid Department Chief Sun goodbye.

Before they parted, Department Chief Sun expressed his gratitude again and reminded Zheng Ren of his friend's arrival tomorrow for the TIPS surgery.

Department Chief Sun was puzzled when Zheng Ren made a request for a diffusion-weighted MRI scan of the patient's liver, but he held his tongue.

Zheng Ren paid a visit to the Rapunzel Syndrome patient in the emergency ward.

Her vital signs were stable after waking from the anesthesia.

In a time when the whole country was facing a shortage of anesthesiologists, Zheng Ren was thankful for the Chu sisters. They were professionals and Zheng Ren was glad to have them on his team.

To perform surgery was teamwork. If the anesthesia process failed, Zheng Ren would be in trouble.

He made a round through the emergency ward. He stopped at the room of the 16-year-old girl who was battling acute appendicitis. Despite the intravenous administration of antibiotics, she was not recovering. Her face was scrunched up in pain.

The System display was a bright red.

Although the patient was not exhibiting signs of appendix rupture, the System was able to examine the patient's current condition and warn Zheng Ren about impending disaster.

This would not do!

Zheng Ren frowned. He left the room without speaking with the family.

A ruptured appendix without surgical intervention would lead to acute peritonitis: a critical condition. Zheng Ren was worried the parents would refuse surgery, even at that critical stage.

He recalled Fan Tianshui's appendix experience. Despite being built like an ox, the disease sapped all of his energy.

When he was suffering from a ruptured appendix and acute peritonitis, Fan Tianshui had been on the brink of death.

This was a problem Zheng Ren could not solve.

Therefore, he went to Old Chief Physician Pan.

It was only natural to look for one's superior whenever one encountered problems at work. Su Yun would come to Zheng Ren for help, and Zheng Ren would look for the Old Chief Physician.

Old Chief Physician Pan was no longer attending multiple hospital bureaucratic meetings a day. These days, the emergency department staff could easily find him in his office. The man was nearing 70 years, but he was still the lifeline of the emergency department.

Zheng Ren knocked on the door to Old Chief Physician Pan's office. The voice inside beckoned him and he opened the door.

Old Chief Physician Pan adjusted his presbyopic glasses and placed the article he was reading aside. There was an English-Chinese dictionary on the table. "Zheng Ren, do you need something?"

"Chief Pan, there's an acute appendicitis patient in the ward. The family is being uncooperative and I don't have any solutions." Zheng Ren got straight to the point, even though most doctors would spend a good few minutes complaining about the family before getting to the main point.

Old Chief Physician Pan tapped his fingers on the office table. His eyes closed as he processed the information.

After a few minutes, he asked, "Do you have the family's address?"

"Lot 15, 5th Street, Lianhua Village, Zhonghe District."

"Okay." Old Chief Physician Pan nodded and took out a notebook. His finger trailed down the page as his eyes scanned the rows of words.

After a few pages, he found the contact he was looking for.

He picked up the phone receiver and dialed the number.

"Er Zhuzi, this is Old Pan," Old Chief Physician Pan said casually.

Zheng Ren was impressed by Old Chief Physician Pan's connections. Zheng Ren did not even know where Lianhua Village was.

"Huh? Then, get him for me," Old Chief Physician Pan said.

The phone was passed to another person on the other end.

"Er Zhuzi, I see you have a personal assistant now?" Old Chief Physician Pan joked.

"Ah, the countryside. No, no, I have not finished the food you sent me last year. There's something I wanted to ask you.

"I have a patient here from the Zhonghe District; the family is refusing surgical treatment. The patient is in critical condition and might not survive if we don't operate. Can you help with that?"

Zheng Ren was speechless.

From Old Chief Physician Pan's words, Zheng Ren believed the man on the phone was an important person in Lianhua Village–maybe an elected village official.

Old Chief Physician Pan was full of surprises.

He did not even attempt to persuade the patient's family and went straight for the jugular.

This might be the best solution to their problem.

Old Chief Physician Pan carried on talking on the phone for a few minutes.

Once the conversation was over, Old Chief Physician Pan turned to Zheng Ren. "Zheng Ren, the mayor of the Zhonghe District will be here tonight. Will you be available?"

"Yes, of course." Zheng Ren felt the pressure on him.

"Good. Bring Chang Yue and Su Yun along."

Huh...

"Rural folk like their alcohol. The norm is to drink until you pass out. If we don't do it, the next time we need their help won't be as easy," Old Chief Physician said with a grin.

"Okay." Zheng Ren got up and bowed slightly. He was grateful for Old Chief Physician Pan's willingness to help.

They had grown familiar, but Zheng Ren never forgot his respect for the Old Chief. The man had a special place in Zheng Ren's heart.

The bow was sincere.

Zheng Ren left the office. Outside, he took out his phone to text Su Yun and Chang Yue about tonight's plan. As he looked around, a patient passing by startled him.

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Chapter 412: Needles In The Skull And 8 Luck Points

"Sister Ma, you should get a check-up. A constant headache is something to be worried about." The person accompanying the patient looked to be a good friend.

The patient looked to be in her forties and there were clear signs of age on her face.

She held a medical ticket in her hand. From the look of it, she was searching for the payment counter.

Zheng Ren quickly called out, "Hey! Hold up!"

The patient and her friend carried on chatting as they moved toward the payment counter. Zheng Ren's shout went unnoticed.

Zheng Ren quickened his steps and overtook them. He blocked their path and said, "Miss, I'm the chief resident of the emergency department. You're here about a headache?"

The patient was taken aback by the sudden appearance of this stranger. Nevertheless, she answered, "Yes."

Zheng Ren softened his voice and expression. "What tests are you scheduled for?"

The System's luck points or charm points made him appear reliable to the two women.

The patient handed over Zheng Ren the slip of paper.

He looked through the paper and saw a head MRI scan was ordered. That was concerning.

Luck was truly on his side!

At this moment, Zheng Ren was witness to the miracle of having 8 luck points.

"I don't think this test is suitable for your condition. I overheard some of your conversation just now; the cost of the test is an issue?" Zheng Ren said bluntly.

"Why, yes. 500 yuan for a scan is quite a burden," the patient said with a frown.

"Come on, let's get the Old Chief to have a look at you," Zheng Ren said smiling, guiding the patient and her friend to Old Chief Physician Pan's office.

After two raps on the door, Zheng Ren entered the office without waiting for a response. The unusual entrance put Old Chief Physician Pan on alert, but he played along with Zheng Ren's ruse.

There were many ways to proceed with the medical examination.

A routine examination performed in the emergency department had to be simple as they often had a dozen or more patients waiting in line. Taking more than 30 minutes per patient was not feasible.

If the patient's condition was not critical, the patient would be sent for other medical tests after a simple physical examination.

This way, the steady stream of patients could be controlled and redirected to other parts of the hospital.

Anxiety was infectious, especially among patients.

The graying hair combined with his austere demeanor made Old Chief Physician Pan appear more legitimate than Zheng Ren. The Old Chief performed a detailed physical examination on the patient.

Zheng Ren brought the patient to Old Chief Physician Pan for a reason.

As he performed the check-up, Zheng Ren started to explain.

"Chief, this patient has a chronic headache; this bout is more severe than usual, hence she came to the hospital. She was sent for a head MRI scan, but because of her financial background, I want to suggest a head CT scan."

The explanation was sufficient to give Old Chief Physician Pan some indication of what Zheng Ren was planning.

Old Chief Physician Pan maintained a neutral expression and continued examining the patient for five minutes. Then, he said calmly, "I don't see any major issues. We'll have a clearer picture with a head CT scan. That'll just cost 120 yuan."

The patient was grateful for their help. Although the advice was different from the emergency medicine doctor's original order, Old Chief Physician Pan's age and wisdom was convincing. The two women left the office with a medical ticket for a head CT scan issued by Zheng Ren.

Before they left, Zheng Ren even gave them his contact number so they could call him once the CT scan was done.

After the patient and her friend left, Zheng Ren let out a relieved sigh.

Old Chief Physician Pan raised a curious eyebrow at Zheng Ren. "What are you worried about?"

"Chief, I suggested a head CT scan for this patient because it would be safer. An MRI scan would be disastrous if she had metal in her skull," Zheng Ren said somberly.

Old Chief Physician Pan understood Zheng Ren's concern.

Why would there be metals in the skull?

The everyday person might not be able to comprehend how metals could be lodged in the skull, but as a field doctor who spent years in the war zones of Southern Xinjiang and the Northern Borders, this was not a surprise for Old Chief Physician Pan.

The old chief nodded and said, "You're right. Let me look into our procedures and remind the doctors about this."

Zheng Ren was glad to have Old Chief Physician Pan as a superior. New suggestions and feedback were never taken as signs of disobedience.

After that was settled, he excused himself from the Old Chief's office. Zheng Ren took out his phone and continued texting Chang Yue and Su Yun. There was a dinner tonight that required their drinking prowess.

Zheng Ren was terrible at all these non-medical things.

However, Old Chief Physician Pan was able to shore up his weaknesses. They worked together well as a team.

When Zheng Ren arrived at the emergency ward, Su Yun was waiting for him. The taunts rained down on him like hellfire.

The group chatted for about an hour when Zheng Ren's phone rang. The patient from earlier had undergone the head CT scan and was waiting for the physical copy of the scan.

Zheng Ren described the layout of the emergency ward and told her to bring the scan over. He instructed her to tell the technician Dr. Zheng wanted to have a look at the scan and that the report could be collected later.

After ten minutes, the patient came to Zheng Ren with the scan.

The scan was placed on the viewer and, upon closer observation, Zheng Ren saw the three metal needles embedded in the patient's skull.

The image sent a shiver down his spine. The needles were like the devil's teeth, gripping the patient's head firmly in its jaw.

"Damn..." It was the first time Su Yun had witnessed something like this. He was just teasing Zheng Ren about making mountains out of molehills, but the arrival of the scan really shut him up.

Professor Rudolf Wagner walked over and glanced at the scan. Foreign objects in the body were uninteresting to him and he went back to his table to work on the draft for the TIPS surgery methods and differential diagnosis.

Chang Yue and the others were equally as shocked as Su Yun.

If the patient were to undergo an MRI scan...

Metals interacted with the magnetic field that was generated by MRI machines.

Hence, any item that was remotely metallic was not allowed in the MRI room.

Once, a wheelchair was pulled into the MRI machine in Sea City General Hospital and the staff had such a difficult time prying them apart.

Patients who underwent stent surgeries and fracture fixation surgeries were disallowed from using the MRI machine.

These days, Nitinol was the metal alloy of choice in medical devices as it was considered MRI safe.

If the patient had gone through the MRI scan, the needles in her skull would have been tugged on by the strong magnetic fields.

The patient's brain...

The outcome would have been unimaginable. The thought made every doctor in the room shudder.

"Chief Zheng, how did these get in?" Chang Yue asked as she wrung her hands.

"It probably happened when the patient was young," Zheng Ren said quietly.

The human skull goes through various developmental stages. During the first few months of a baby's life, the skull is soft and malleable and it would not be difficult for needles to puncture the skull.

Decades ago, girls born in rural areas were mistreated and incidents like these were common throughout the country. Despite the stories, Zheng Ren had never encountered a needle-in-the-head case until now.

The patient might not understand the technical aspects of a CT scan, but the contrast of the metal needles was clear against the black background.

"When did you start experiencing the headaches?" Zheng Ren asked.

The patient's expression was a blend of surprise and bewilderment. "Since I was young."

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Chapter 413: The Blunt Approach

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Zheng Ren figured the needles were placed when the patient was still young. He arranged for the patient to be admitted to the neurosurgery department for a consultation.

He would have to open up a new skill tree...

Zheng Ren had the resources to do that. He had three Master-level skill books which would set him above the average surgeon.

However, a Master's rank would be insufficient.

The needles were embedded in the parts of the brain that controlled speech and motor functions. Any mistake could lead to disastrous results.

There was another concern.

The needles had been in the patient's skull for almost 40 years.

As time had passed, the needles would have rusted.

It would not be easy to just open the skull and remove the needles with a hemostatic clamp.

Impossible!

Zheng Ren was sure the needles would have broken in the patient's skull.

How would they remove the needles? How long would the surgery take? What was the postoperative care plan?

The surgery could not be done solo.

Although Zheng Ren had the System backing him, his rational mind believed it was best for the patient to be with the neurosurgery department.

As Zheng Ren explained the scan to the patient, tears rolled down her friend's face.

The patient had had a rough childhood, but it was still shocking to know something like this had happened to her.

By the time the patient and her friend left, Zheng Ren was exhausted. He was glad he managed to save the patient from the MRI machine, but the truth behind her condition saddened him.

He thought of reporting the turn of events to Old Chief Physician Pan. He knew the Old Chief would be shocked.

If the patient had gone to the MRI room, she would be dead now.

After some consideration, he decided it would be too difficult to explain how he knew, so he abandoned that plan.

Zheng Ren appreciated the 8 luck points that came with the past few System missions.

If he followed a similar vein of thought, Zheng Ren believed the important reward from the 'Main Mission: The Crown Jewel – Second Stage' was the 2 to surgical progress instead of the radiofrequency ablation experience.

It was 3:00 p.m. Zheng Ren was reading a book while Su Yun left to check on Yang Lili.

According to Su Yun, the last leg of the recovery was the most important. He was going to make sure everything was proceeding smoothly.

A knock at the door got Zheng Ren's attention. There was a man in a Chinese tunic suit at the office door.

The man asked, "Is there a Dr. Zheng here?"

Zheng Ren stood from his table. "That would be me. And you are?"

Based on the man's wardrobe, he had an idea who it was.

The mayor of Zhonghe District was here.

"Dr. Zheng, nice to meet you. I'm the mayor of Zhonghe District, Pan Ziyao." The man approached Zheng Ren and earnestly shook his hand.

"Mayor Pan, good to see you," Zheng Ren replied in kind.

"I just came from Old Pan's office. I'm sorry you had to go through all this trouble. All these families think of is the betrothal money; it's embarrassing. The young lady's life is more important than money!" Pan Ziyao exclaimed.

"I should be the one apologizing for your trouble."

"No, no. Grassroots like me have very little power. We often only deal with trivial matters. If it was at the beginning of my term, my presence here wouldn't even make a difference," Pan Ziyao said.

Zheng Ren did not know what to say after that.

Pan Ziyao was an intuitive man. He took the pause in the conversation to be his cue to leave. He asked for the patient's ward number and went on his merry way.

Zheng Ren had offered to accompany him, but Pan Ziyao declined, citing how he should not take up Zheng Ren's time for a small matter like this.

A series of angry shouts could be heard from the ward.

"F*cking hell, do you know how much trouble you've given me? Do you want to die? You can go ahead, but leave your daughter out of it. You don't own that land of yours anymore, do you?"

A string of curse words came from the mayor's mouth.

Zheng Ren could hear them from his office.

After a few minutes, Pan Ziyao returned to the office with a smile on his face. Zheng Ren would have never guessed he was the one swearing like a sailor.

"I made Dr. Zheng laugh, I see," Pan Ziyao said.

Zheng Ren ordered his expression.

"It's hard-working at a grassroots level. Being nice gets you nowhere in this job. Right or wrong, you just gotta give the other party a good scolding before trying to talk sense," Pan Ziyao said.

Zheng Ren was unsure as to how he should respond.

"The girl is sick to the point of dying and Old Wang is thinking about betrothal money. He's out of his g*dd*mn mind," Pan Ziyao said dramatically. Then, he shot Zheng Ren a smile before saying, "I'm sorry for the language. Please don't hold it against me."

Zheng Ren waved a hand. "Oh no, no. How did the conversation go?"

Pan Ziyao beamed. "Immediately prepare for surgery. Old Wang's coming to sign the papers."

Zheng Ren let out a relieved sigh.

The System display got redder by the hour and Zheng Ren believed it was not long before the girl's appendix would rupture.

He was glad the family had finally given in.

Zheng Ren quickly called Chang Yue to begin presurgical preparations while he went to visit the patient. He would personally see to the appendectomy.

A few months ago, Zheng Ren would not even have the choice.

Back then, having a chance to step inside the operating room was a blessing. Occasionally, Chief Surgeon Liu would allow him to close up the surgical site and that was enough to brighten his mood.

Who knew that a few months later, appendectomies would not even be on Zheng Ren's to-do list.

The arrival of Mayor Pan was the only reason Zheng Ren was handling this appendectomy himself. It was a favor called in by a friend of Old Chief Physician Pan and he had helped resolve the family's reluctance to consent to surgical intervention.

Half an hour later, the informed consent documents were signed and the patient was ready for the surgery.

Su Yun pushed the patient into the operating room. Zheng Ren excused himself and went to scrub in, leaving Pan Ziyao in the emergency ward office.

Pan Ziyao exhaled and relaxed.

He had graduated 20 years ago and was now in his forties, and yet he was stuck in a mayoral position. His career progression was uninspiring.

His stunted career growth was mainly due to his upright and honest manner in handling matters.

He spent many years at the grassroots level, never really climbing the ranks. His ambition faded throughout the years of toiling for the community.

Today, he was supposed to be busy working on a project on targeted poverty alleviation via mobile registration.

However, when the call from the village chief came, he immediately abandoned his work and rushed over to Sea City.

Pan Ziyao was not surprised to hear the village folk refusing treatment.

He was aware of their reasons.

A few years ago, there was a family who adamantly rejected surgical intervention and their daughter lost her life because of their selfishness. This all happened in Sea City People's Hospital.

It was the family's choice, so they took the body to the funeral parlor without a fuss and did a cremation ceremony. However...

A life was frivolously snuffed out; it would have been an avoidable death if the parents consented to the surgery.

The village chief's call reminded him of that unnecessary death. Although Pan Ziyao had been kicked around by life, he was not about to stand aside and let a girl die.

Thank God he made it to the hospital in time. Pan Ziyao went to the restroom to smoke a cigarette before heading to the operating room.

He wanted to give the patient's father another scolding. He had a hectic day planned and the man-made it worse.

Before he could begin his harangue, the operating room door opened and a stretcher trolley was pushed out. The patient was on board with Su Yun steering them.

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Chapter 414: Cultural Adaptation

'That was quick,' Pan Ziyao thought.

The surgery was likely not over.

Appendectomies were one of the few procedures the rural healthcare center could perform.

Each appendectomy took at least 30 minutes to complete.

Pan Ziyao had only stepped out for a cigarette. There was no way the procedure could be over so quickly.

This must be another patient.

He scanned the waiting area. The only other people there were the family members he had scolded.

Su Yun hollered, "The head of the family, please stay back. Chief Zheng wants a word with you. The others should assist with transport."

'So, it was the patient,' Pan Ziyao concluded.

When he found out Old Chief Physician Pan would not be personally handling the case, he was slightly offended, but that feeling quickly faded when he saw the patient being wheeled out in record time.

The family members went to the patient's side and assisted Su Yun. Pan Ziyao stayed behind with the father.

A few minutes passed before Zheng Ren walked out of the operating room in surgical scrubs. There was a specimen tray in his gloved hand; the other hand held a pair of hemostatic clamps. He was ready to enlighten them about the patient's appendicitis.

"Here is the appendicolith. The wall of the appendix is quite thin; if left to its own devices, it would have ruptured in a few hours," Zheng Ren used the hemostatic clamps to probe the appendix as he explained.

The swelling of the appendix was evident. There were signs of perforation at its tip.

The speed of the surgery was not indicative of the severity of the disease.

Zheng Ren was not exaggerating when he said the appendix was about to rupture. If that had happened, the aftermath would be a severe case of peritonitis.

High pressure in the appendix would cause intense pain right before the rupture.

When the rupture occurs, the pressure in the appendix is relieved. In that case, the patient's symptoms would abate, despite the worsening internal conditions.

The feedback of an improving patient could lead to an error in judgment whereby the peritonitis is neglected.

By the time the patient's condition visibly worsened, the patient would already be in a critical state of toxic shock. The patient would require intensive medical treatment to address the spreading infection.

There was a chance the patient would die fighting such an infection.

The patient that day was considered lucky.

The appendectomy proceeded swiftly once the relevant documents were signed.

As Zheng Ren ended his explanation, the father wore a shocked expression. The appendix piece in the specimen tray taunted him.

In the father's experience, appendicitis could be easily cured with antiinflammatory medication.

People who had suffered from appendicitis back in the village never required surgery. His daughter was of marriageable age, so surgery was simply not an option. What if the neighbors started spreading rumors?

The father only agreed to the surgery after Pan Ziyao gave him a scolding and an ultimatum.

Who was he to refuse the mayor of the Zhonghe District?

The father never considered the possibility of his daughter dying from appendicitis.

Pan Ziyao gave the father a kick in the shin. "You old fool. You nearly killed your daughter. Still thinking about that dowry? A dead daughter will fetch you nothing, and how will you retire then? Probably end up in an old folk's home."

The father scratched his head and put on an innocent face. "Mayor Pan, I really didn't know it was this serious."

"You think this is a trick? Look at that!" Pan Ziyao pointed at the swollen appendix and the obstructing appendicolith in the specimen tray.

There was nothing more the father could say, so he let out an awkward chuckle.

Zheng Ren brought the specimen tray back into the operating room and went to change.

Just as he was done changing, his phone rang.

Another emergency case? It was what Zheng Ren was hoping for, just so he could have a reason to not attend dinner with Pan Ziyao.

Not that Zheng Ren did not like Pan Ziyao; he just did not enjoy business meals.

He answered the call. It was Director Zhang from the Secondary Hospital.

"Director Zhang, hi." Zheng Ren held the phone between his ear and shoulder. His hands were busy putting on his shoes.

"Oh yes." he continued. "Not an issue. If the patients do not exhibit complications, we can keep it to ten or less.

"Alright. I'm done here, so I'll have a look. If everything checks out, we can begin tomorrow."

The call ended.

Director Zhang from the Secondary Hospital had found a few patients who fit the criteria for the TIPS procedure. The patients had undergone the diffusion-weighted MRI and the director wanted to know if Zheng Ren would be willing to operate on them.

There would be eight patients in total this round.

The mission required Zheng Ren to complete one more TIPS procedure. The other patients were extraneous in relation to the mission. As a responsible doctor, Zheng Ren was willing to spend his time to help them.

Director Zhang had sent a courier to deliver the scans. Zheng Ren rushed upstairs to his office.

A plump man stood at the emergency ward entrance.

"Good day, Chief Zheng. We meet again." The plump man gave Zheng Ren a welcoming smile.

"Good day to you too," Zheng Ren greeted as he approached the man.

The plump man noted Zheng Ren's outstretched hand and thought, 'Chief Zheng isn't so aloof once you get to know him.'

He raised his hand to accept Zheng Ren's handshake.

Their hands missed each other by inches. The plump man was stunned.

Zheng Ren reached over and took the bag. "I want the scans." Then, he turned around and walked into the emergency ward.

The plump man was baffled by his social gaffe.

He was slightly disappointed, but he felt no anger toward the young doctor.

Professionals at the top of their game often behaved this way.

The plump man consoled himself and followed Zheng Ren out.

"Lil Fugui, come take a look at the scans." Zheng Ren's voice echoed from the office.

The plump man went into the office and situated himself in a corner to listen in on their conversation.

After Zheng Ren's first visit to the Secondary Hospital, Professor Rudolf Wagner's identity was no longer a secret.

Heidelberg University's top professor, whose main field of research was in interventional surgery, was here in China. The plump man's image of Professor Rudolf was no longer as pristine as it was before.

The first thought that went through his mind when he thought of the foreign professor was his heavy Northeastern accent.

In the plump man's mind, the accented Mandarin coupled with his Caucasian features overshadowed whatever academic accomplishments he had. He was truly adapting to the local customs and language.

The professor's reputation had taken a hit due to the odd Northeastern accent that he had adopted at Sea City General Hospital.

"Sure thing, Boss. How many are there?" the professor asked.

"Four new patients. We'll try to settle all of them tomorrow."

"I admire that Chinese efficiency," Professor Rudolf said.

The plump man smiled at the compliment.

The Secondary Hospital had gone through great lengths to obtain and prepare 16 patients who were eligible for the TIPS procedure.

The professor's words stroked the plump man's ego.

"The researchers back home will be getting a mouthful from me when I get home. They're a reckless bunch. Something always ends up horribly wrong, even when I give clear instructions," Professor Rudolf grumbled in his Northeastern accent as he moved closer to Zheng Ren to get a better look at the scans.

The plump took some time to digest what the professor had said.

Northeastern slang that locals hardly used littered the professor's words.

At this point, the plump man felt like the professor was more in-tune with the local language than he was.

He shook his head with dismay.

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Chapter 415: Hospital's Internal Struggle

Zheng Ren and Professor Rudolf Wagner began to study the scans.

If they had been studying the scans a few days ago to find out the significance of MRI diffusion in guiding the location of TIPS, a few days later, Zheng Ren and Professor had evolved to a level of proficiency that had already been determined.

Previously, it had taken them more than an hour to look at a single scan.

A few days later, the two of them had finished watching the first scan in 20 minutes. Not only did they finish discussing the surgical approach, but they also discussed how to reduce the complications of hepatic encephalopathy after the surgery and the estimated number of days that they would need to take out recyclable stents.

The short and fat man could not tell much, but Su Yun knew that what Professor and Zheng Ren were studying was worth something.

He had grown so fast. It was as if he was watching a video at twice the speed. Just a brief moment and he was about to turn to a new page.

Su Yun was deeply moved. What could she do to be able to keep up with this man and not getting further and further away?

Such a situation had never happened in Su Yun's life until now.

The first time he performed emergency TIPS surgery with Zheng Ren, Zheng Ren's puncture technique was still a little rusty. But it was said that the last time he went to the Secondary Hospital for surgery, all of them succeeded with one puncture.

Su Yun knew that when Zheng Ren performed TIPS surgery for the first time, the technique he displayed was already at the top of the world.

But he seemed to have no limits. In the eyes of others, the mountain peak was just a slope in his eyes. After he climbed over it, he instantly climbed up another taller and steeper towering mountain.

Facing such a person, even a genius like Su Yun felt a trace of helplessness.

It seemed that he had to work harder. Su Yun thought of having to accompany Old Chief Physician Pan to eat and drink in a while and felt inexplicably frustrated.

At 4:30, Chief Pan went upstairs and called everyone to eat.

Chief Pan, who had once worked at the grassroots level, could not be more familiar with the welcoming and sending of people. This time, he looked for someone to do something and the person had done it properly.

It was only right to have a meal, drink some wine, and act as a host.

Although the matter of saving a life had nothing to do with Chief Pan. But if he had the ability, did he really have to ask the patient's family to sign the written document that exempted the hospital from liability and then watch a 16-year-old girl die?

Impossible! Whether it was in Chief Pan's mind or Zheng Ren's, this kind of situation was impossible.

After Chief Pan entered the room, Zheng Ren immediately stood up. He was slightly apologetic. Before he could speak, Chief Pan said, "You study the film. I'll bring the others. "

Knowing that Zheng Ren did not like socializing and drinking, Chief Pan was very understanding.

"Chief, we have to go to the Secondary Hospital again tomorrow. " Zheng Ren had forgotten whether he had mentioned this to Chief Pan. Since the old chief supported it, it was not too late to say it now.

"Okay. " Director Pan pondered for a moment and said, "Su Yun, don't drink tonight. "

This was the rhythm of Su Yun being asked to work the night shift.

Su Yun responded and there was nothing to be unhappy about. After all, Zheng Ren had to go for the TIPS surgery tomorrow, so it was necessary to maintain vigorous energy.

Drinking was a small matter but the surgery was a big matter. Chief Pan would definitely not let go of this opportunity due to this careless mistake. Su Yun also knew the severity of the matter. It was a habit to tease Zheng Ren, but when it came to serious matters, he was still very serious.

Hearing Chief Pan said this, Zheng Ren was relieved. He was a little sorry but Chief Pan did not give him a chance. He directly asked people to leave the emergency ward.

Finally, it was quiet. Zheng Ren and Professor Rudolf Wagner started to study the scans again and made the surgery plan for the next day.

Su Yun did not follow them. He sat quietly behind Zheng Ren and stared at the MRI scans. It was rare that he did not play with her phone.

To Su Yun, this world was like a big toy.

In the past, no matter what he did, it was not challenging. It was easy for him to feel tired and slack off.

After coming into contact with Zheng Ren, he was stimulated bit by bit. The young man finally became serious and prepared to learn the knowledge that was constantly changing.

After seven o'clock, he finally finished reading the few films. The surgery plan was also completed.

Zheng Ren then said goodbye to the professor, picked up his cell phone, and was ready to send a message to Xie Yiren.

"The Little Yiren went to eat. I wonder how long she will drink at that kind of drinking party, " Su Yun sat at the side, crossed his legs, and said leisurely.

"Oh. " Zheng Ren held his cell phone and felt a little awkward.

"Let's go home first. Rest early. I still have surgery tomorrow, " Su Yun said. "It's nothing. I won't call you. "

The special situation last time must not happen again, Su Yun thought to himself.

...

Wang Qiang, a very common name with a very high rate of overlapping names.

He had worked in the city's Secondary Hospital since he graduated from university. It had been fifteen or sixteen years.

With the presence of the old chief physician, Wang Qiang's upward path was blocked.

As the population in the Northeast region flowed out, the number of patients gradually decreased. Cheng Lixue became more and more strict in the management of surgeries. He even refused to let his capable doctors, who might threaten his status, undergo surgery even if it meant losing all decorum.

This was a common occurrence in the medical field.

Many doctors at the level of associate chief physicians had good standards, but they were forced to leave because they did not have any surgeries to perform.

Wang Qiang wanted to leave but he was unwilling to do so.

Moreover, he could only perform common surgeries like interventional embolization for liver cancer. After he left, he would not be able to become a chief physician and could only lead a team.

The key point was that he was unwilling to do so.

The conflicts and wars between the old chief physicians and the new generation had never stopped. Moreover, they would continue to go on forever.

This was the case in the medical world, and it was also the case in the entire society.

This year, Wang Qiang finally decided to go all out.

If he wanted to lead a group, he might as well try leading a group near home. If he could pick up a lot of work, it would not be too late to go out to explore.

His thoughts were rather conservative.

The hospital moved around. His luck was not bad. Coincidentally, the hospital wanted to move. He used the catfish effect to make the entire hospital come to life.

Wang Qiang, on the other hand, became the catfish.

He led the group, split up, and fought Cheng Lixue in close combat. Wang Qiang fought with his life on the line. There was no way he could retreat.

If he won, he could gain a foothold in the city's Secondary Hospital. When Cheng Lixue retired a few years later, it was not impossible for him to become the chief director.

If he lost, he could only take his wife and children and leave.

Therefore, he mobilized all his resources in order to win this 'war'.

After confirming the news, he was not in a hurry to directly lead the group of doctors for surgery. Instead, he went to the provincial capital for a short-term study.

He wanted to improve his skills and build a good relationship with the higher-ups of Provincial Capital Medical University's Affiliated Hospital to invite them to perform the surgery.

Wang Qiang knew that both Director Zhang, who was in charge of the clinic, and Ren Haitao, the head director of the hospital, had an incomparable obsession with TIPS surgery. If it were not for the huge risks after TIPS surgery, Director Ren would have hired someone to perform it long ago.

Two years ago, the former director had led a team to study abroad. When he came back, he was ready to hire someone to perform TIPS surgery. However, due to some accidental factors, he had not been able to do it.

This is your chance.

Chapter 416: Provincial Capital's Professor

However, after Wang Qiang contacted everyone in the provincial capital, news came from the Secondary Hospital that the TIPS surgery had been completed!

What the F*CK!

Wang Qiang was very disappointed. Although he was not at home, he still inquired about the details of the TIPS surgery.

It was not Cheng Lixue who had hired someone to perform the surgery. Instead, it was Director Zhang who had gone to the General Hospital to hire someone to perform the surgery.

As long as it was not Cheng Lixue, everything would be fine. Moreover, did the General Hospital have an intervention department?

It was not that Wang Qiang looked down on the General Hospital. Compared to the Secondary Hospital, the General Hospital's brain drain was even more serious. Moreover, the management was extremely rigid.

If they offer low pay, what right did they have to retain those capable doctors? Did they just rely on the doctor's spirit of dedication? It was impossible!

Everyone was dedicated. If they were merely dedicated and not get paid, they would not be able to pay. They could not even afford to buy a house in Sea City. What right did they have to make people willing to be 'dedicated'?

It was impossible for the General Hospital to do so!

The doctors in their intervention department who could perform surgeries had long gone to the South. Wang Qiang had always been in contact with them. Ever since they left, the excellent machines in the General Hospital had been left idle.

They had not perform an operation for many years, but they could perform a TIPS? What nonsense.

It was said that foreign professors came to perform surgeries, so Wang Qiang finally thought that it must be a coincidence. The foreign professors went to the General Hospital to exchange ideas and they were invited by Director Zhang to perform a few TIPS surgeries.

This was not a long-term solution. The provincial capital was so close to Sea City that one taking the high-speed train would arrive in an hour.

As long as he could contact a professor at the Provincial Capital Medical University's Affiliated Hospital, he would be able to arrive at any time. Like that, would he not have pressure on Cheng Lixue?

Therefore, he shortened the time for learning and communication. At this moment, he had already taken the high-speed train back to the Secondary Hospital with the associate director of the Department of Interventional Medicine and Professor Gao Shaojie.

The doctors under him was already prepared for the TIPS operation. They forcefully obtained a decompensated patient with cirrhosis from the president's patient pool and prepared to perform the TIPS operation.

The associate director was called Gao Shaojie. He was a young man from the Affiliated Hospital of the Medical University. He was a doctoral student majoring in interventional therapy at Columbia University Medical Center in the United States.

After returning to China, he had originally wanted to go to the Imperial Capital, but the competition in the capital was simply too intense. Without background and education, he was about the same as other people. There was no way he could get into the capital's hospital.

Therefore, Gao Shaojie decided to come to the Affiliated Hospital of the Provincial Medical University. He had developed quite well over the past few years. After all, he had done well in the surgery, especially the TIPS surgery.

"Little Wang, don't be nervous," Gao Shaojie, the deputy director of the Affiliated Hospital, comforted Wang Qiang when he saw that he was uneasy.

"Teacher Gao, I just took charge of the group here. The pressure is really great." Wang Qiang forced a smile. "Fortunately, I have your support. Otherwise, I wouldn't know what to do."

"It's okay. The TIPS surgery is already very well-formed," Gao Shaojie comforted him with a smile.

Indeed, in the provincial capital, Wang Qiang had personally witnessed Gao Shaojie perform more than ten TIPS surgeries. The success rate of the surgery reached more than 80%. The number of successful surgeries was maintained at around 10 punctures.

This level could be said to be quite high.

It was said that Teacher Gao had once visited the Mayo Clinic. His level was inferior to the Mayo Clinic, but it was not a lot more worse.

Looking at Gao Shaojie's warm smile, Wang Qiang felt a little more at ease.

He did not know when he would be able to learn how to perform TIPS surgery.

Would there really be a day when he could choose any hospital in the country other than Imperial Capital or Sorcery Capital?

When the high-speed train arrived at Sea City, Wang Qiang's junior doctors drove over to pick up Wang Qiang and Gao Shaojie.

After getting on the train, Wang Qiang could not wait to ask the people from the General Hospital about the process of performing TIPS surgery a few days ago.

"Director Wang, the chief resident of the Emergency Department from the General Hospital is here. There are still not many people in their interventional department," a junior doctor said.

Was it just the chief resident of the Emergency Department?

Wang Qiang was relieved. The Emergency Department would at most perform an interventional embolization to stop the bleeding. It was still thousands of miles away from the TIPS operation.

"But there's also a professor from Heidelberg University who came with us."

"Huh?" Gao Shaojie's ears perked up.

Heidelberg University Medical Center had a similar status in the medical field as Columbia University Medical Center, but the intervention was Heidelberg University's specialty.

"What's the professor's name?" Gao Shaojie leaned forward and asked.

"Uh..." The young doctor did not remember the name of Professor Rudolf Wagner, but the teacher asked, so he could not say that he did not know.

"The professor has blonde hair and is very tall. By the way, he speaks fluent Manchurian. It seems that he has lived here for a long time." The young doctor quickly said what he remembered.

Manchurian? Gao Shaojie really did not know which internationally famous professor could speak Manchurian.

"Tomorrow, Director Zhang arranged eight interventional surgeries."

"Eight?" Gao Shaojie's pupils shrank and he frowned. "Can it be completed?"

Even the professors in imperial city or Shanghai would only arrange for two TIPS surgeries a day at most.

Any more and it would be impossible to complete.

Why would he arrange so many. Gao Shaojie's thoughts were very fast. His first thought was to perform eight TIPS surgeries a day.

It was not impossible, but that was a large medical center. A few professors could perform eight tips surgeries a day.

"Is there anyone else doing it?" Gao Shaojie grasped this point and asked.

"No, it's just chief Zheng from the first municipal people's hospital doing the surgery."

"Is this a joke?" Gao Shaojie was displeased.

To perform an interventional surgery, one had to eat thread. Therefore, many doctors performed surgeries very crudely in order to eat less thread.

For example, at a certain hepatobiliary and pancreatic hospital in Shanghai.

The delayed development of interventional surgery in the country was directly related to the carelessness of the hepatobiliary and Pancreatic Hospital in Shanghai.

However, there were more patients and fewer doctors. This was also an objective fact.

Gao Shaojie was a strict person. He would rather do fewer surgeries and earn less money than fool the patients.

Therefore, when he heard that the chief resident of the Emergency Department of the First Municipal Hospital had to perform eight TIPS surgeries a day, he immediately became angry!

"..." the young doctor was driving when he was shocked by Gao Shaojie's anger. He immediately explained, "Teacher Gao, a few days ago, they also performed eight TIPS surgeries."

"Huh?!"

"The surgeries... seemed to be quite successful. There was no hepatic encephalopathy after the surgery. They said that they would perform the TIPS surgery tomorrow first, and then the second recyclable stent that the patient who had the previous surgery had to be removed."

" ..." Gao Shaojie was speechless.

Was this 16 surgeries a day? The TIPS surgery was very difficult, but after the TIPS surgery, the two stents were removed because after the first covered stent opened up the vein, there was more venous blood that did not pass through the liver's metabolism. The patient had serious hepatic encephalopathy, so they had no choice but to remove the second stent.

And the second stent was not removed.

Everyone knew that the effect was better if it was taken out. But taking out the stent... the risk of liver bleeding was too great!

Could it be that the professor had made a brand new surgical method? Gao Shaojie pondered, but he did not rule out this possibility.

Perhaps there was a new treatment method for TIPS surgery internationally that he did not know about?

As he thought, Gao Shaojie took out his phone, looked at the time, and hesitated for a few seconds before he found a number and dialed it.

...