He immediately replayed the entire process of the operation from memory, stunned by the realization that he had missed out on the action performed right after thrombolysis.
What had they done within that particular time frame? Why had they chosen to use a large catheter?
After asking himself the question a few times, Dr. Shen was becoming more and more anxious. He closed in a few more centimeters and stared at the screen intensely, his eyes fixed on the moving large catheter.
"The artery is being blocked by high molecular weight hyaluronic acid and the suction force of a microcatheter is insufficient to remove it. That's why they are trying it with a large catheter," Department Chief Kong explained, knowing that Dr. Shen could not understand what was going on.
Uhm…
Suction? They were removing the high molecular weight hyaluronic acid that was blocking the ophthalmic artery?
The mere thought of such a solution was so baffling that it stunned Dr. Shen. He stared at the screen blankly with both of his hands supporting his weight on the console.
Even though the large catheter was moving very slowly, it eventually closed the short distance to the blockage in the ophthalmic artery after several minutes.
At that point, it stopped moving forward. Zheng Ren held the catheter absolutely still while Su Yun connected it to an open syringe and started suction.
Resistance was considerably strong. Su Yun faced some difficulty when he tried to pull the syringe by hand.
Everyone in the room tensed up.
Three hours had already passed. This was Lin Jiaojiao's last chance to regain sight in her right eye.
They had to succeed! Department Chief Kong unintentionally clenched his fist, his palm filled with sweat.
Dr. Shen was also on edge. He had connected the dots after hearing Department Chief Kong's explanation of the operative procedure. Had he known, he would not have agreed with Zheng Ren's current plan of action.
However, after running a few scenarios in his mind, Zheng Ren's procedure seemed to be the only feasible solution.
They had to succeed! Dr. Shen began to get nervous. He pressed his full weight on both hands against the table and leaned forward.
"You should just bury yourself in the screen," Department Chief Kong said from behind him.
Only then did Dr. Shen realize that his face was almost stuck to the glass.
Was he close to l.i.c.k.i.n.g the screen?
He literally did just that…
At that exact moment, a phone camera clicked. Despite not comprehending what was going on in the operating theatre, a nearby nurse had found Dr. Shen's posture amusing and immortalized it on her phone.
"Hey, Brother Shen, you looked great the way you licked the screen!"
Missing the nurse's joke, Dr. Shen shuddered and straightened his back at Department Chief Kong's remark.
As he turned away from the screen, there was suddenly a minor reaction in the ophthalmic artery. It was moving!
Department Chief Kong could not parse it, though. When he lifted his head, he saw Su Yun putting down the 50 mL syringe and connecting a pressure injector to the large catheter.
Was it done?
Maybe.
They would only know after radiography.
Chapter 227 - The Tree of Life (Part 1 of 5)
"Sister Lin, please keep your eyes closed. Don't rush to open them," Zheng Ren muttered in the operating theater.
Lin Jiaojiao was a senior nurse in the Interventional Radiology Department and knew how interventional surgeries worked. The moment she saw the blank region on the radiograph of her eye, she knew her fate was sealed.
However, this young doctor had carried on with the usual protocol. He was determined even when she had given up hope.
After hearing what Zheng Ren said, Lin Jiaojiao asked, her voice trembling and her eyes closed, "Doctor, is there still a chance for me?"
"The outcome is promising. If everything goes according to plan, we've already resolved the issue." Zheng Ren smiled, but it was hidden under his face mask. "We can give you a definite answer after obtaining the results from radiography."
Lin Jiaojiao had always complied with medical advice. Even when faced with the possibility of losing her vision, she still instinctively obeyed doctor's orders.
She did not question her doctor's decisions despite the fact that interventional surgery seemed unrelated to whether or not her vision recovered, or that her surgeon was a young doctor that she had never heard of.
When the young physician told her that she had a chance of regaining her eyesight, Li Jiaojiao's eyelids fluttered non-stop while her eyes remained shut, visibly fighting to contain her emotional turmoil.
"The radiograph," Zheng Ren said quietly.
Su Yun immediately pressed the button on the pressure injector. A black image appeared on the screen, the silhouette of the contrast agent resembling a giant tree.
Zheng Ren and Su Yun held their breath and stared at the screen unblinkingly.
In the operating console room, Department Chief Kong, Chief Ma, Dr. Shen, the operator, and the nurse had their eyes stuck to the screen as well.
Whether the procedure had succeeded or not...
It all boiled down to this moment.
The contrast agent spread across the blood vessels rapidly, from the internal carotid artery to the ophthalmic artery…
The branches gradually grew finer until the agent finally reached the region that was previously blank.
The dark contrast agent weaved through the region unimpeded. It instantly branched out into countless capillaries like innumerable masses of rootlets that stemmed from underground roots.
It indicated life!
Life and victory!
Department Chief Kong rose to his feet in one swift motion and looked at Zheng Ren through the transparent lead glass.
Zheng Ren let out a long sigh as he confirmed that the blockage in the ophthalmic artery had been cleared. He looked out of the room and gave a thumbs-up with his right hand.
From the outside, Department Chief Kong mirrored the action with his own.
It was a success!
"Remove the catheter and clamp down," Zheng Ren said before leaving the operating table with a smile on his face.
He tore off his sterile surgical gown and entered the operating console room.
"Little Zheng, well done!" Department Chief Kong did not hold back his acclaim. Words could not express his sincere and deep exhilaration.
"You flatter me," Zheng Ren said, grinning, "The amount of urokinase administered was higher than usual, so we should keep an eye on her post-surgery."
Department Chief Kong waved his hand dismissively. If Zheng Ren had to worry about these things, he, as chief of the department, would be obligated to dash himself against the walls of the operating console room.
Chief Ma of the ophthalmology department had made a 180-degree turn in her attitude towards Zheng Ren. Laughing, she said, "Little Zheng, your medical skills are exceptional."
"You're exaggerating," Zheng Ren said courteously.
"That was an understatement." Department Chief Kong rolled his eyes and continued, "You need to learn to accept credit when you've done something incredible. Don't ever belittle yourself. Your humility is like a slap to my face."
Dr. Shen was hiding in one of the corners, his face covered in tears. He was the one who had embodied the slap on Department Chief Kong's face, not Mr. Zheng.
After recollecting the whole procedure, he had come to the conclusion that he could have performed the entire surgery himself. Even though he might have taken a longer time than Mr. Zheng, he had the skill to execute it without fail.
However, although he could retroactively understand the procedure, few people had the guts to attempt a new surgical technique during an emergency, especially with such a rare case.
Who would take the risk to go through with a procedure beyond their grasp? Those who did had a certain level of con
fidence that it would work. Based on this alone, the difference between them both was crystal clear.
Department Chief Kong sighed internally when he saw Su Yun applying pressure to stop the bleeding. "Little Shen, set up the compression device."
This was someone capable of a heart transplant at postgraduate level, now reduced to stopping bleeding via manual compression under Zheng Ren. What a waste of talent.
Furthermore, no one performed manual compression in Imperial Capital anymore. Here, they used compression devices to achieve hemostasis.
Even though the device cost over a thousand dollars, out of reach of poorer patients, it had its advantages, such as allowing for recovery as soon as four hours post-surgery. Many people… most people did not mind paying the extra cost.
For a moment, Dr. Shen was relieved that Department Chief Kong had not censured him, but in the next, he ran into the operating theater like a stray dog let loose1 to stand in for Su Yun.
Department Chief Kong chuckled and said, "Little Su, is everything fine?"
Su Yun had drunk the most when they were in Tang Song Restaurant—a catty of Maotai.
Under normal circ.u.mstances, it was prohibited to perform surgery after drinking. However, he had just filled an assistant role and appeared perfectly fine with no sign of discomfort, which was why he had been allowed to enter the operating theater at Zheng Ren's request.
Department Chief Kong was concerned for these youngsters.
"Yes." Su Yun removed his sterile surgical gown and passed it to the operating theater nurse.
The nurse received it with a smile and helped him dispose of it in a large red medical waste bin.
"Is a catty a lot?" Su Yun said stoically.
"..." Zheng Ren glanced at Su Yun and saw that the man's fringe had stuck to his forehead in the shape of his surgical cap. This was some top-tier pretense being put on, he mused.
Since two of the chiefs were present, Zheng Ren could not make a jab at Su Yun about the incident involving crayfish and Snow, and thus let him go on with his act.
"Youngsters; such vibrant energy," Department Chief Kong said whimsically.
"Do you need me for anything else?" Zheng Ren asked after checking the time on his watch. It was already an hour past midnight and he wanted to leave.
"It's done. You guys can retire for the night," Chief Kong answered, "You still have enough stamina for tomorrow's surgery, right?"
"Absolutely," Zheng Ren said.
"Okay, I'll hand over at 8 a.m., and you guys can arrive at the operating theater at 8.30," Chief Kong said.
"Sure, I'll be here at 8.30 sharp," Zheng Ren confirmed. After bidding farewell to both chiefs, the operator, and the nurse, he left as quickly as he could.
"So handsome," the nurse mumbled to herself as she stared at their departing backs.
"Stop dreaming." Department Chief Kong was in an exceptional mood, basking in the success of the surgery. He said with a laugh, "Don't waste your time on the both of them."
"Why do you say that?" The nurse looked upset.
"That assistant already had a fan base two to three years ago when he was in Union Medical College Hospital. Now that he's back in Imperial Capital, you probably wouldn't be able to join the fan club in the first place," said Chief Kong. Gossip was inevitable in the operating theater on such a momentous occasion.
'So iconic! He even has his own fan club!' thought the nurse.
"Back to the surgeon: what do you think he's like if he had the ability to make Su Yun his assistant?"
This time, Chief Ma interjected and asked, "About that, Old Kong; who's the guy who operated today?"
"You wouldn't know who he is even if I described him. I'll tell you this much—Old Chu from the CT department, Zheng Ren and I met today and discussed new differential diagnoses and surgical techniques. We perfected it based on his conjecture."
"..."
…
… This is a description used in "", written by Zhang Xiaohua. I really liked it and used it a couple of times.
Chapter 228 - Time to Visit the Doctor (2/5)
Zheng Ren and Su Yun walked out of the interventional operating theater.
As the door opened, a slim figure immediately charged towards them.
"Doctor, how's my mother?" the girl who had accompanied Lin Jiaojiao asked worriedly.
"She should be fine." Zheng Ren's answer was calm.
"Oh, that's great, that's great." The girl was obviously still in shock. This was the only good news she had received after waiting for several hours.
"Don't worry." Zheng Ren did not stay behind to describe what had happened over the course of the operation to Lin Jiaojiao or her daughter.
After all, this was Imperial Capital, not Sea City General Hospital. He could save his breath.
Furthermore, if he told the patient's family members that it was he who performed the surgery, there was bound to be more misunderstanding.
It was still a serendipity that turned out well in the end, but it was already past midnight and Zheng Ren did not want to waste more time as there were four more interventional surgeries waiting for him the next morning.
"When is Uncle Kong coming out?" the girl asked behind them.
"I don't know, he's probably leaving soon," Zheng Ren said as he continued to walk away.
There was a smile on the girl's fretful face and she completely neglected Su Yun's presence beside Zheng Ren.
Su Yun's charms were overlooked by patients' family members most of the time.
…
…
Approximately ten minutes later, a gurney was wheeled out from the theater.
Department Chief Kong and Chief Ma stayed beside Lin Jiaojiao while Dr. Shen pushed the gurney, steered with the help of another doctor, towards the ophthalmology department.
After a discussion in the operating theater, they had finally decided to let Lin Jiaojiao stay in the ophthalmology department as interventional procedures were no longer needed. The remaining work would be focused on rehabilitating her eyes to slowly regain their vision.
After all, the interventional radiational department was not specialized in ophthalmology.
Department Chief Kong assigned Dr. Shen an overnight shift in Lin Jiaojiao's ward to look after her and provide post-surgical care. There would not be any issues.
At the end of the day, Lin Jiaojiao had suffered plenty enough in her past already, her being a loyal employee of the hospital notwithstanding. Department Chief Kong still felt sorry for her.
He would do as much as he could to ensure that she was well taken care of.
After returning to the ophthalmology department, Chief Ma continued to examine the lower region of Lin Jiaojiao's eye.
The clinical analysis was very promising as her retinal vascular network had regained its blood supply and would likely not affect her vision further. However, to be on the safe side, her eyes were covered with bandages soaked in warm saline to promote blood flow and reduce the risk of complications.
After finishing up, Chief Ma excused herself and went home. Department Chief Kong stared at Dr. Shen, waving his hand to summon him out of the ward.
Now that they were alone, Chief Kong's face dropped and he sternly said, "Little Shen, you performed poorly today."
Dr. Shen began sweating heavily.
Department Chief Kong was neither being cruel nor nitpicky. His performance today had truly been subpar.
It started from the very beginning, from his scrubbing in and putting on his surgical gown. It was not that he was trailing behind on purpose; young Mr. Zheng was simply too efficient.
However, one being too efficient during a surgery was never a source of complaint.
During an emergency or resuscitation, it was advantageous to be fast.
Chief Kong probably would have a heart attack if he tried to argue the matter.
It still amazed him how quickly they finished the surgery. How could someone have completed all the prelim
inary steps to surgery in such a short timeframe?
If the problem was that Mr. Zheng was too fast-paced, his situation might have been salvageable.
Yet, he had unknowingly moved his hand holding the microcatheter when they were about to capture the radiograph, which had resulted in a section of the catheter needing to be extracted.
That mistake was practically criminal…
There was a story from an unknown hospital of a professor guiding his students through a transjugular intrahepatic portosystemic shunt (TIPS) surgery. The puncture was the most difficult aspect of the procedure and was thus performed by the professor. His student was helping to hold it while he prepared to insert the stent.
To his surprise, the stent had been unable to enter the guide wire. When he looked at the imaging, the tubing had already been removed by ten centimeters.
Had it been a normal procedure, the professor could have gotten angry, but not as much as he did at that moment.
TIPS was considered the most difficult procedure in all of interventional surgery. The puncture was done almost blindly, which required one's skill and experience as well as some luck.
He had had to redo the entire procedure as the guide wire was out of place.
In the end, the student had not managed to graduate.
Dr. Shen had never expected the story that he had heard and treated as a joke would happen to himself.
Worse, he was not the professor but the idiotic student from the story!
If it were a TIPS surgery, they would be able to redo it. All it would take was for the patient to lie there for a few more hours and the professor to perform it all over again.
However, in his case, it had been an emergency! Every second counted and yet he had made such a huge mistake.
It was unforgivable!
"Boss… I… I'm… I'm sorry," Dr. Shen mumbled with his head lowered, his entire face red.
"Luckily, Mr. Zheng reacted quickly. If he was even slightly slower, your Aunt Lin's eyes would be gone," Department Chief said harshly.
"Yes. Yes." If Dr. Shen could lower his head further, it would reach his ankle and he would fold himself up as Chief Kong continued lecturing him.
"Even though you're slightly senior to Mr. Cheng and Su Yun, don't compare yourself to them." It was a rare sight for Department Chief Kong to gently comfort Dr. Shen without throwing a fit.
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