As total anesthesia was taking effect, the general surgeon laid out the surgical dr.a.p.es and accessed the abdominal cavity through the incision Zheng Ren had made.
Fang Lin was on death's door. Hence, the emergency rescue had to be carried out at the same time as anesthesia.
The damage was shocking.
The knife had sliced through part of the liver and diaphragm.
The surgeon shot a look at Zheng Ren. He knew that had it not been for Zheng Ren's decisive actions controlling the bleed from the hepatic artery, Fang Lin would not have made it to the operating table.
"Young man, come on down. Let me handle this," the surgeon said in a low voice.
Zheng Ren's rational mind told him there was nothing more he could do, but his heart wanted to scrub in and fix the problem himself.
Logic won out in the end.
A gloved hand entered his field of vision and rested by his own.
The surgeon and him exchanged a glance. Zheng Ren nodded and removed his hand from the liver. The surgeon took over his duty.
Zheng Ren had to remind himself that this was Imperial Capital, not Sea City General Hospital.
As he climbed off the operation table, Zheng Ren's vision darked.
The brightness of the surgical light had temporarily blinded him.
He shut his eyes and tried to relax.
However, as soon as his eyes were closed, the scene in the consultation room appeared in his mind.
It was the violence and cruelty of humanity on display.
Zheng Ren swayed slightly on his feet. He lacked the energy to walk out of the operating room.
He leaned on the wall of the operating room and slid down onto the floor.
One of the nurses noticed Zheng Ren's odd behavior and gave him an opened bottle of glucose solution. With a gauze dipped in saline solution, she helped to wipe away the bloodstains on his body.
A deadly silence filled the operating room.
Deathly.
"Ah!" A cry broke the silence. "Get our ortho and hand surgeons!"
Eyes turned to look at Zheng Ren. There was an open wound bleeding out on his left shoulder.
Attempts to contain the bleed were futile as the blood simply seeped through layers of gauze.
This…
Had he been performing hemostatic control while injured?
Chapter 185 - Thoracic-Abdominal Surgery
A doctor came over with a mercury sphygmomanometer. "Young man, are you alright?"
"I'm fine." Zheng Ren opened his eyes. They were clear and focused.
The doctor relaxed, as Zheng Ren could still speak coherently, but he measured his blood pressure anyways.
It was slightly below average.
"Come, we'll go to the other operating room. The orthopedic surgeon and hand surgeon will have a look at the wound," a young nurse said. "Lean on me so you don't fall."
"It's okay. Thank you." Zheng Ren shut his eyes and forced a smile.
Zheng Ren knew he had to leave the sterile room as soon as possible. He had already violated standard operating procedure due to the emergency nature of the situation.
Once the surgery was done, Fang Lin would have to battle bouts of infection.
A bottle of iodophor was not equivalent to a sterile surgical setting.
After he left, the surgical team would have to perform another round of sterilization to prevent contamination.
It was vital for a successful emergency trauma surgery.
He had done all he could.
He would leave the rest to fate.
Leaning against the wall for support, Zheng Ren stood and felt a wave of nausea hit him. The rush during the emergency rescue had resulted in elevated hormone levels.
Once he was no longer required to be in a state of heightened awareness, the pain and soreness made themselves felt. His injured shoulder was especially bad. The slightest movement sent jolts of pain up his arm.
'Hopefully it's nothing major,' Zheng Ren thought.
At this point, he realized the System display at the upper right corner of his vision showed nothing about his status.
Zheng Ren's thoughts raced like a wild horse. Could this System not evaluate his own body?
His frustration lasted only a second before his body fell limp and he lost the strength to even stand.
He leaned hard against the operating door and breathed heavily.
The young nurse helped Zheng Ren out of the room.
"Over there." She guided Zheng Ren to the operating room next door. They went in and she switched on the surgical light.
The nurse helped him lay down on the operating table. A pained smile graced his face.
He had never imagined a day would come where he would be the one lying on the operating table under the surgical light.
"Which hospital are you from? Your emergency rescue techniques are amazing!" The young nurse gave him a thumbs up.
Most people would be frightened at the bloody scene but this was an operating room in one of the best Class Three Grade A Hospitals nationwide. Its employees were used to gore.
From the rate of blood flow and Zheng Ren's mental state, the young nurse determined that it was not a fatal injury.
Out of habit, she chatted to relieve the patient's tension.
She was incredibly impressed by the man's quick decision that saved Fang Lin.
"Sea City."
The nurse stared blankly at him, as if she had never heard of the city. "I saw the 50ml syringe. Did he have a tension pneumothorax?"
"Yes." Zheng Ren had to force his eyes shut as the surgical light was blinding. He said slowly, "Ruptured liver, penetration trauma. Ruptured diaphragm, trauma right lower lobe of the lung, ruptured bronchial artery, tension pneumothorax. He needs a large-volume transfusion. If possible, the thoracic surgery should go hand in hand."
Hearing the familiar instructions, the nurse stared at the stranger from an unknown city hospital.
"Tell them the closed c.h.e.s.t drainage system is insufficient," Zheng Ren mumbled. "Now!"
His voice was low but demanding.
It was the voice of a department chief, the kind that did not like to repeat themselves. A lenient department chief would never say such things in an operating room1.
Zheng Ren's tone reminded the nurse of old and virtuous professors. She nodded without hesitation and left the operating room.
Entering the operating room next door, she quickly repeated Zheng Ren's words verbatim, worried that any delay on her part might affect the surgery's success.
Zheng Ren laid still on the operating table. It was a bit chilly and the surgical light was truly a pain in his eyes.
He waited in silence, hoping for an update from next door.
A few minutes passed and the young nurse returned. "When I went in, the thoracic surgeon was laying down surgical dr.a.p.es to start his operation. I've told them what you told me."
A soft mumble of affirmation left Zheng Ren's mouth as he closed his eyes. Finally, he could relax.
Not long after, two doctors entered his operating room and started to give him medical attention.
Silence filled the chamber. It seemed that was the norm here.
Zheng Ren did not like it.
He liked Xie Yiren's quirky eyebrows and the synchrony they had when working at the operating table.
He liked Chu Yanzhi's fiery spirit that cheered them on.
He liked Chu Yanran's quiet attentiveness at the head of the operating table, recording patients' vital signs and medication dosage.
He liked Chang Yue's genuine conversations with patients.
He liked… Even that sharp-tongued nancy boy, Su Yun, was more familiar than this.
They were a beacon of hope amidst a bloody battlefield.
"How's the surgery going?" Zheng Ren asked suddenly.
"No harm to the bone. Just some damage beneath the skin," answered one of the doctors who were treating him.
However, the
doctor knew Zheng Ren was actually asking about the surgery next door.
Had it been any other patient, the doctor would have ignored the question. However, he knew Zheng Ren was the man who had performed the needle thoracostomy on Fang Lin.
"Hey! Someone from outside," the doctor called out.
"Yes?" one of the patrolling nurses replied.
"How's the situation next door?" the doctor asked.
"Thoracic and abdominal are ongoing. The bronchial artery has been sealed; they're now fixing the ruptured lung and diaphragm. The general surgeon is fixing the liver. Systolic blood pressure detectable at 50," the nurse replied from the door then left.
"They're doing good," the doctor said to Zheng Ren.
Zheng Ren nodded.
A detectable blood pressure was the best news they could hope for.
The bleeding was under control. Coupled with blood and fluid transfusion, Fang Lin stood a chance at surviving this ordeal.
Of course, it was just a chance. Postsurgical care was key to full recovery from such a grievous injury.
Zheng Ren trusted the capabilities of the hospital's personnel. After all, this was the country's top hospital. If one did not survive here, it was simply fate.
Ten minutes later, Zheng Ren's shoulder was stitched up.
As he had been dressed for the winter cold, the force behind the attacker's swing had been dampened by the thick fabric. The damage to his shoulder was mostly external.
With his wound bandaged, the doctor helped Zheng Ren up and brought him out to the hospital corridor.
"Let me take you to the admissions lounge," the doctor said.
"No. I'll stay here, by the operating room," Zheng Ren said curtly. I am unsure what the author is referring to here, whether it's giving orders to other surgeons on how to do their jobs or giving orders while being a patient.
Chapter 186 - Many A Little Makes A Mickle
In the operating theater, resuscitation was proceeding in an orderly manner.
Both the thoracic and general surgeons were busy performing the operation at the same time; the atmosphere was tense.
Generally, no doctors were willing to do such a thing.
The surgery could have a significant impact on Fang Lin or even exceed his physical capacity.
However,
There was no other way.
Zheng Ren's insistence was merely one factor in proceeding with thoracoabdominal surgery. The bigger deciding factor was the 500mL of dark red blood that had been instantly drained into the drainage chamber.
The drainage chamber had filled in mere minutes, requiring replacement.
Continuous blood drainage indicated a serious condition—a few large arteries had been damaged. Otherwise, there would not have been so much blood acc.u.mulated in the cavity.
Performing thoracoabdominal surgery and stopping bleeding simultaneously would have a profound effect on Fang Lin's physical state.
If the procedures were done successively, massive blood loss would certainly kill Fang Lin.
A.d.u.l.ts also had to answer multiple-choice questions when the time came.
When Zheng Ren had asked the nurse to convey the message, the thoracic surgeon was already prepared to operate, but the doctors were still hesitant.
Everyone hoped that the blood drained would peter out in the next moment.
Everyone hoped that blood pressure would elevate in the next moment.
However, their hopes were in vain.
Zheng Ren was the first witness and an experienced doctor, so his opinion was valuable and had to be taken into account.
Thus, after the nurse conveyed his message, no one hesitated further and the surgery was prepared with haste.
3 minutes and 33 seconds later, the deputy chief consultant of the thoracic surgery department took over the chief surgeon's position while the anesthesiologist switched to single-lung ventilation, collapsing the right lung for surgery.
Everyone gave their best. Whether the patient would survive now depended solely on fate.
At the 13th minute and 54th second, several medical personnel returned with fresh frozen plasma and red blood cells, thawed using their body temperature, and hung the bags on the infusion stand.
One after another, the blood bags were soon depleted via pressurized infusion and replaced with new ones. The empty bags were set aside neatly.
These bags would be checked and verified again after the surgery was over.
The cold and stifling atmosphere permeated every breath of air in the operating theater.
No one told funny stories or cracked dirty jokes.
At the 15th minute and 15th second, chief consultants of relevant departments rushed over for intraoperative consultation.
At the 18th minute and 23rd second, the chief of the medical administration division left his home with a gloomy face, as if a volcano was about to erupt from within him.
However, instead of losing control of his emotions, he started directing the resuscitation to ensure coordination between various departments.
Even though it was a weekend, the incident had spread like wildfire throughout the entire hospital. Everyone in each department went all out, no matter how insignificant their efforts could be, to save this young doctor with a bright future ahead of him.
It was like ten thousand tributaries feeding into a river1.
It was a song that stirred the heart.
At the 43rd minute and 5th second, the ruptured bronchial artery and diaphragm, as well as the entry wound on the right lower lobe of the lung, were sutured. After confirming the absence of active bleeding spots, the surgeon began to close the thoracic cavity.
At the 57th minute and 27th second, the liver was sutured, the abdominal cavity irrigated and a surgical drain inserted.
The tense, dark atmosphere lifted slightly.
The patient's systolic pressure had returned to 70mmHg and blood oxygen saturation was maintained at 97% via pure oxygen ventilation. Several episodes of atrial fibrillation had been corrected by the anesthesiologist through medication, but now the patient was suffering sinus tachycardia of 147 beats per minute.
Fang Lin's condition remained unsatisfactory, but he had at least managed to survive despite severe trauma.
More than a dozen medical staff escorted Fang Lin out of the operating theater in an orderly manner. The thoracic surgeon and the chief consultant of the general surgery department went to their locker room and removed their surgical caps and masks, which were drenched in sweat.
Only then did they feel relief and their nerves calm.
"He survived," said the deputy chief consultant of the thoracic surgery department as he recalled the incident, still terrified.
This was especially because he had rushed over and seen a man in casual wear kneeling on the stretcher trolley until the patient's transferral to the operating table; the astonishment in his heart had persisted until now.
"Yes, first-aid measures were provided just in time without any delay in subsequent treatment. Fang Lin has really been pulled back from the brink of death." The chief consultant of the general surgery department lit a cigarette and passed it over.
Chronic smokers got along well with each other.
The spicy tobacco quickly neutralized their anxiety and fatigue from resuscitation, and they fell into silence after expressing their thoughts.
The deputy chief consultant of the thoracic surgery department felt better after the cigarette burned to its end, asking, "The young man who had performed an emergency laparotomy for hemostasis must be a doctor too. He reacted without the slightest hesitation; that's a good quality."
"I heard that he is a young doctor from Sea City in the northeast." The chief consultant of the general surgery department smiled and said, "Accurate diagnosis with appropriate first-aid measures. He is indeed a good man."
"Was he compressing the porta hepatis throughout the journey?"
"Yes."
"Was there any tissue ne
crosis or rupture?"
The hepatic hilum was an important but fragile structure. Compared to the use of hemostatic forceps to obstruct blood flow during surgery, it was at least ten times more difficult to achieve hemostasis using only one's b.a.r.e hands.
In addition, care had to be taken not to cut off blood supply for too long to prevent hepatic necrosis under such dangerous circ.u.mstances.
Furthermore, it would have been difficult to maintain a fixed posture on a stretcher trolley being pushed at full speed. Had there been a laceration in the hepatic hilum, the patient would have been disabled forever.
Even though the surgery had been completed, the deputy chief consultant of the thoracic surgery department still subconsciously asked his question despite knowing the answer.
"It was well-protected," the chief consultant of the general surgery department said, "I think that young man had intermittently supplied blood to the liver with precise control. An excessive supply would have caused leakage through the wound into the cavity, and it would not have helped with blood loss. By the way, I noticed a needle thoracostomy when I arrived at the operating theater just now; did he have tension pneumothorax?"
"Yes," the deputy chief consultant of the thoracic surgery department said, still shaken, "Hemorrhaging was a small issue, but a tension pneumothorax could have cost him his life within ten minutes. Fang Lin is really lucky to be transferred to the ICU alive."
"In that case, I'm starting to develop an interest in that young man." The chief consultant of the general surgery department smiled and took out his phone to make a call.
"It's me. About the young doctor who has performed emergency hemostasis just now, let me know his location and try to get some information about his background.
"By the way, transfer him to a deluxe room.
"Inform the matron that it's my order."
After he hung up, the deputy chief consultant of the thoracic surgery department grumbled, obviously perplexed, "It was just a resuscitation, is this really necessary? Your doctoral students can't graduate this year, and besides, Fang Lin is under the thoracic surgery department."
"You say this as if you can demand a transferral to a deluxe room at will." The chief consultant of the general surgery department smiled. "I didn't mean to make him stay anyway. I'm just doing my part by providing a better environment so that he can recover soon."
The Surgeon's Studio c1-799 Page 94