Even though it was basic knowledge, this manner of gangrenous appendicitis was rare to actually see in the medical field.
As development expanded, the medical and health sectors had grown by leaps and bounds each year. There were hospitals all over the country, and even in the absence of Class Three Grade A Hospitals and community hospitals, there were still "barefoot doctors".
Even in the most remote of villages, "barefoot doctors" still knew how to perform simple appendectomies.
Enduring the intense pain of appendicitis, followed by tearing and further complications from septic shock…
Zheng Ren and the doctors in the live broadcast room had never encountered such a case in all of their careers.
What kind of man was this?!
Zheng Ren used a tiny pair of forceps to gradually lyse the adhesions between the gangrenous and normal tissue with extreme caution.
"Wipe my sweat," he instructed.
Chu Yanzhi obediently took a piece of gauze and approached him.
Zheng Ren turned his head aside and allowed her to wipe the sweat that had drenched his sterile surgical cap.
"Do you need an assistant? I've assisted in surgeries in West China Hospital," said Chu Yanran out of the blue.
"No," Zheng Ren refused bluntly.
Pooh! A bachelor who could not get a girlfriend.
How could he possibly start a relationship when he was so direct in his approach?
Zheng Ren did not even take her suggestion into consideration. He was incredibly nervous, not because of inexperience, but due to the need for extremely gentle manipulation that was necessary to prevent large-scale torsion that would greatly impact the patient's postoperative recovery.
Under present circ.u.mstances, there was nothing Chu Yanran could do to assist him.
The problem lay in his frank and direct attitude. Sigh… Poor bachelor.
[Ligation! He is ligating the artery now!]
[Shut the f*ck up! Your comment blocked my view.]
[A taper-point needle? My guess was correct. A taper-point needle can easily penetrate the tissue and cause minimal trauma, hence reducing the risk of torsion.]
[Don't bullsh*t me. If you'd been the surgeon in charge, the operative field would be a bloody mess of torn tissue. You'd be in the process of resuscitation.]
[That's right. You might as well cut the diaphragm and perform direct compression on the failing heart.]
Zheng Ren held the needle holder firmly and with a dexterous flick, plunged the suture needle deeply into the tissue under the appendicular artery.
He inched the needle forward while being aware of the texture of the tissue until it reached the edematous area. Then, he applied gentle pressure on his wrist and the needle came out of the other side of the appendicular artery.
After passing the needle holder back to Xie Yiren, he made a complicated surgical knot using both hands.
[My heart is about to pop out of my c.h.e.s.t.]
[God, please be careful. It'll tear if you're not careful.]
[I'm not worried at all. He is a god; how can he make such a simple mistake?]
[666! The pressure he applied was just perfect! How did he even acquire such experience?]
[Damn, Xinglin Garden doesn't have a reward system. Otherwise, I definitely would've sent a wave of positive energy to the god.]
After complete ligation of the appendicular artery, Zheng Ren let it rest for a few seconds before reinitiating adhesiolysis between the gangrenous appendix and the peritoneum, the greater omentum, and the surrounding intestines.
Chapter 89 - The First Snow of 2***
The whole operative process was intense. Chu Yanzhi had wiped the sweat off Zheng Ren thrice, and the comments in the live broadcast room were petering out.
Most doctors in the live broadcast room had disabled the livechat and were watching the livestream quietly. Only the younger, livelier doctors preferred a relaxed atmosphere and chatted while watching the video.
The more nervous the surgeon was, the greater the need simmer down by talking. Otherwise, the surgery could go out of control.
The atmosphere eased slightly after Zheng Ren completely resected the appendix.
The gangrenous appendix was so brittle, like a thin slab of charcoal, that it could shatter into pieces with the slightest touch.
When the resected appendix was completely removed from the peritoneal cavity in one piece, many doubting doctors finally expressed their reverence.
[It really could be used as a specimen.]
[This surgeon is indeed a legend who never makes mistakes.]
[This manipulation is breathtaking! I've done a few cases of gangrenous appendicitis, but no matter how careful I was, I had to remove it piece by piece. God, please continue to accept my worship.]
The doctors overwhelmed the live broadcast room with comments to express their heartfelt admiration and deepest respect for the surgeon.
Everyone in the operating theater could clearly see the removal of the entire appendix as well as the bloodstain due to adhesiolysis, which was tiny.
The Chu sisters looked at each other with great surprise.
"Intr.a.p.eritoneal irrigation with gentamicin.
"Continue the irrigation with normal saline.
"Is the antibiotic susceptibility test done? Negative, okay. Give him three vials of ceftriaxone."
Every step was performed quickly and efficiently.
Zheng Ren had broken another record by completing an appendectomy in one hour and thirty-two minutes.
During the crazy night of appendectomies, he had finished ten appendectomies in the same amount of time, anesthesia included.
He could feel a qualitative improvement in his surgery skill the moment the peritoneal cavity was closed.
More difficult surgeries could better enhance a surgeon's standard.
Apart from that, Zheng Ren had performed the surgery alone without any assistance or second opinions.
He had to make choices all by himself.
A wrong decision could have led to severe postoperative complications and even death.
It was stressful, no doubt, but it was good fuel for motivation as well.
Zheng Ren had overcome various difficulties under pressure and thus received an advancement of mastery in surgery once the stress faded.
After closing the peritoneal cavity, he sutured the subcutaneous and skin layers using a reverse cutting needle with size seven suture thread.
The surgery was officially complete. The patient's vital signs were stable and no postoperative complications had occurred thus far.
This patient's physical fitness greatly surprised Zheng Ren. He had undergone two hours of general anesthesia under septic shock and there was not a single hint of complication or cardiac arrest.
He did not look like a vagabond at all. Generally, a homeless person would be more at risk of general anesthetic complications due to prolonged nutritional imbalance and insufficient calorie intake that led to poor physical fitness.
This patient looked emaciated but was actually as strong as a bull.
'I hope his postoperative recovery is drastic as well,' Zheng Ren thought.
The patient was transferred back to the ward afterward. Since he had no companions, Old Chief Physician Pan arranged a nurse to take care of him in the ward for the time being.
It was a human life at stake, after all.
A rich and powerful man was a living soul.
So was an impoverished vagrant.
Every life weighed the same and the doctors would do everything within their power to save them.
After leaving the operating theater, Zheng Ren was astonished to find Chang Yue doc.u.menting the unidentified patient's case in the office.
She was exactly the same as before, and no one would have been able to guess that she had actually been drinking the entire night yesterday.
If there was anything different about her… It seemed like her hair was a little dam
p, as if she had just taken a bath.
Eleven boxes of Snow in one night… 264 bottles in total, equivalent to 171600mL…
Even so, she appeared completely fine without any sign of dizziness.
The handsome guy who had been drinking with her was still receiving an infusion in the on-call room at this very moment.
That was amazing! Zheng Ren gave Chang Yue a thumbs-up.
"Get some rest after writing up this case," said Zheng Ren gently; his emotional quotient increased, which was a rare occasion.
"Not tired," replied Chang Yue with her usual stony expression.
From her rate and tone of speech, this girl was perfectly fine and not the slightest bit tipsy after drinking all those beers.
Zheng Ren bowed down in admiration.
Old Chief Physician Pan rushed into the office after knowing that the surgery had been completed.
"I've explained the treatment expenses to the medical administration division, but it didn't work out. Try to economize so that I can better persuade them next time," said Old Chief Physician Pan helplessly.
"Okay." Zheng Ren nodded.
All hospital expenses were cost-accounted and the social welfare department did not give a damn about this kind of anonymous patient. Therefore, the doctors and nurses of the hospital had to bear all treatment costs for such patients.
Since patients had to be treated, it was necessary to cut expenditure as much as possible. Medical personnel could not possibly stand idly and watch as the patient suffered to death, right?
"Let's go for a ward round," Old Chief Physician Pan then said with a smile. He obviously did not want these trivial matters to depress Zheng Ren.
Upon reaching the postoperative patient's ward, it was found that he had recovered from general anesthesia and had stable vital signs thus far. His rapid drug metabolism made the case for this man's strong vitality.
His body temperature had normalized following the aspiration of purulent exudate.
Based on this, Zheng Ren was very optimistic about his recovery.
They left the ward and went to check on Lin Yuanshan's father again. Lin Yuanshan was absent and a middle-aged woman was currently taking care of the patient.
The elderly man, who had already woken up, remained ins.e.n.s.i.t.i.v.e to the abdominal pain, possibly due to prolonged exposure to chronic cholecystitis. He had been given analgesia once and had not experienced any pain since.
Since he had to fast for a period of time postoperatively, he began making a fuss when his agonizing thirst was not quenched immediately.
There was nothing they could do to persuade an old man in his childlike temper tantrum. Thus, Zheng Ren and Old Chief Physician Pan decided to secure his limbs to the bed via medical restraints to prevent him from pulling out his own nasogastric tube.
Zheng Ren summoned a nurse, but before he could give further instructions, Chang Yue, with her usual flat expression, appeared at the doorstep.
"Hold that thought. Let me have a chat with the patient first." Chang Yue's expression was stone cold even when speaking to Old Chief Physician Pan.
Old Chief Physician Pan was slightly puzzled, but he was used to maintaining his subordinates' dignity in the presence of patients and their family members.
It was a good habit, but unfortunately, Chang Yue had not picked it up.
Zheng Ren and Old Chief Physician Pan left the ward and returned to the office for a chat.
Old Chief Physician Pan was particularly interested at the drinking contest during supper last night. He had to have been a heavy drinker during his youth as well, but with hypertension and hyperlipidemia making his old age miserable, he had reduced his alcohol intake since.
However, he was clearly interested in youngsters competing to out-drink one another.
When he heard that Chang Yue and Su Yun had consumed eleven boxes of Snow respectively, Old Chief Physician Pan burst out laughing. "Just like my soldiers!"
Zheng Ren was completely dumbstruck.
Those who could drink were considered good soldiers? This was another ten thousand critical damage to Zheng Ren, who was alcohol intolerant.
During the conversation, Chang Yue entered the office and said flatly, "The patient has stabilized."
"Huh?"
Zheng Ren and Old Chief Physician Pan stared at Chang Yue, stupefied.
"What did you say to him?" Old Chief Physician Pan was truly amazed. No wonder she could befriend a murderer on a killing spree through her words alone. That was simply amazing!
"I just spoke to him and calmed his emotions," Chang Yue said calmly. "Old men are like children, which makes coaxing very simple."
"How is Su Yun, is he alright?" asked Old Chief Physician Pan out of concern.
"Don't worry about him. There isn't any need to visit him at all." Zheng Ren shook his head and added, "I just saw the nurses working in shifts to take care of him; they probably squabbled over it before coming to an agreement, too."
Looking after the young master, Su Yun? He would rather read or go for a ward round than waste time on that b*stard.
That idiot was a stark reminder of his bachelorhood. Sighing heavily, he stood up and gazed out of the window.
It had been snowing for some time as the ground was covered in a thick blanket of white. Glittering snowflakes drifted down soundlessly from the pure white sky above, taking their time before resting on the window sill, melting almost instantaneously.
"Eh? It's snowing. I guess it's going to be another busy day." Instead of savoring this magnificent view, Old Chief Physician Pan's first thought was how hectic the emergency department was about to be.
Chapter 90 - A Snowy Rescue Operation
As it was still early winter, the temperature had not yet dropped drastically. Thus, the falling white confetti caked every surface it touched and instantly melted, forming a huge blanket of black ice when a cold breeze blew across it.
This was a very dangerous situation as drivers would not realize that the road surface had changed dramatically.
Snowfall in the middle of the night could reduce the risk of road traffic collisions to a certain degree.
However, it was the morning rush hour right now. Thirty to forty kilometers per hour was considered slow, but it was an entirely different story on an icy road.
Just as Old Chief Physician Pan finished his sentence, Zheng Ren watched a rear-end pile-up on the opposite main road through the office window.
Despite both emergency and regular brakes locking, the cars still slowly skidded across the black ice. It was a rare sort of despair to experience firsthand.
This would be one of those times, however.
As traffic was slow on the main road opposite the hospital, the collision merely resulted in small scratches on the cars, which was not a big deal.
Even so, a few meddlesome car owners would insist on a hospital checkup and admission for observation. It was unnecessary but a reasonable request.
Therefore, the emergency department could expect to be swarmed by patients today.
"Ding-ling-ling!" A classical ringtone came from Old Chief Physician Pan's phone.
"Hello. Yes, I am.
"Okay. Rest assured, preparations have been made.
"Yes, and about the blood bank, I'll send someone to collect all types of blood from the bank in the city center."
Zheng Ren knew that something was definitely wrong from those words alone. His epinephrine level skyrocketed, endorphin pumped into his system, and the high-energy phosphate bonds within his cells hydrolyzed and released energy reserves for his body's consumption.
"Witnesses claim that there were several injured in a large-scale traffic collision on Benteng Bridge. Ambulances are currently on their way to the scene, so it's time for us to get ready as well," said Old Chief Physician Pan.
When melted snow refroze, it formed a thin ice layer on the road surface, which made it extremely slippery. Although uncommon, it would still happen in Sea City onc
e every few years.
Vehicles traveling on flat ground in urban areas were not hugely affected due to limited speeds, but the same did not apply to vehicles on the overpass.
The vehicles' inertia combined with reduced friction between the tires and ice, one after another…
The picture in Zheng Ren's mind was tragic, but he knew reality was usually more catastrophic.
He picked up the phone and gave Xie Yiren two tasks. The first was to inform the matron to count the surgical instruments and restock them in case they did not have enough. Secondly, he wanted the Chu sisters to check on anesthesia and other medication to minimize chaos during the upcoming rescue operation.
"Can you work?" Zheng Ren asked Chang Yue.
"No problem at all." She stood and made herself a cup of Nescafe instant coffee.
Truly, Zheng Ren thought, Chang Yue behaved more like a man in drinking and at work…
"Come, let us wait in the emergency department," Old Chief Physician Pan said, "We've to mobilize every department in this rescue operation too."
These were, without a doubt, standard procedures.
The slippery road surface forced all vehicles to slow down. Even though it only took ten minutes to get to Sea City General Hospital from Benteng Bridge, the situation was completely different now and the ambulances would require at least half an hour to complete the journey.
…
…
Medical emergency protocol required the nearest hospital to mobilize ambulances to the crash site within three minutes of a distress call.
A few minutes ago, as soon as a siren blared, the doctor in charge of emergency rescue stood up abruptly, retrieved a first aid kit and, with a nurse, rushed to the ambulance outside the triage center.
The ambulance driver slammed on the accelerator and the anti-lock braking system instantly activated, causing the ambulance to drift ten meters across the pavement before he slowly regained control of the steering wheel.
"The road today is so slippery," said the driver, terrified.
Normally, the siren on the ambulance was off when delivering patients with minor traumatic injuries or non-urgent illnesses, but in this sort of situation, the siren wailed like a baby in distress, emitting a sickening shriek.
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