He was extremely nervous. What if Little Yiren rejected him?
It seemed like she was more interested in eating.
Why did Su Yun not teach him what to say over the course of a meal?
Zheng Ren's mind was filled with a rampage of thoughts. He had yet to receive any reply from Xie Yiren.
Zheng Ren's fear grew over time.
Gaining new feelings and the worry of losing them…
He had never felt something like this when he was…single.
[I've browsed through the showtimes. The earliest showing for the latest film is within an hour. We might not have time to eat. Let's watch the movie first.]
Zheng Ren felt relieved after reading Xie Yiren's reply.
However, there should have been a lot of movies screening at the same time. What would be the newest movie premiering now?
The question flashed across Zheng Ren's mind.
He should do whatever Xie Yiren wanted, why was he thinking so much?
[I'm in the changing room, just tell me when you're ready to leave.]
[You're not doing ward rounds?]
[I completed my rounds before surgery today. Su Yun just texted me that the ICU patient is in the diuretic phase and has regained consciousness.]
[Great, give me 5 minutes.]
[No need to rush.]
Zheng Ren tightly grabbed the phone in his hand, his heart full of affection.
Life was great. He was able to watch a movie with Xie Yiren after successfully completing a surgery.
He had totally forgot about buying movie tickets.
Chapter 345 - The Importance of Experience
Five minutes later, Xie Yiren's message came in, telling Zheng Ren to meet at the usual bas.e.m.e.nt parking spot at Zone D.
The whole emergency department, be it the wards or the operating room, knew about Zheng Ren and Xie Yiren's budding relationship. However, Little Yiren was still hiding in her own world, unwilling to face the truth.
Zheng Ren happily went down to the bas.e.m.e.nt parking.
He made sure his eyes were wide open as he searched for the curvaceous Volvo XC60.
"Weyh! Here!" Xie Yiren wound down her car window and called out.
It was 20 meters away and he failed to spot it. Sweat dripped from his forehead.
'I will succeed next time, next time!' Zheng Ren thought to himself.
"Yiren, where are you looking at?" Zheng Ren asked.
Xie Yiren drove out of the car park. "There's only one nearby."
Zheng Ren was puzzled and Xie Yiren continued, explaining, "The IMAX, of course."
Oh, so that was what she meant.
Did it mean that 2D and 3D cinemas were nothing in Xie Yiren's eyes?
"The surround sound and cinematic effects are amazing. Back when IMAX was not available in Sea City, I would drive to Provincial Capital to watch movies," Xie Yiren told Zheng Ren as she drove.
The country's first IMAX theater opened in Sorcery Capital when Xie Yiren was still in school. She fell in love with its atmosphere and effects. When Sea City got their first IMAX theater, she was ecstatic.
A third-tier city like Sea City only had one IMAX theater and Xie Yiren quickly became its loyal patron.
Zheng Ren listened attentively to her. Time passed them by gently.
Once they reached the cinema, Zheng Ren felt his anxiety work its way up.
Xie Yiren scanned the barcode to retrieve their tickets. She went downstairs and got them two ice cream cones.
"It's half price for the second cone. Every time I come to the movies alone, I would get two despite not being able to finish the second one. It's a bit of a waste." Xie Yiren chuckled. She handed Zheng Ren a cone and began nibbling at her own.
Zheng Ren did not know what ice cream flavor it was. The scene was playing out in a different fashion from what he had imagined. Life was not his to control.
He had thought to arrive at the cinema late so they could walk into the theater while it was dark.
He should have spent more time making the rounds, perhaps checking up on the ICU as well. That would have taken up some time.
He would take this as a lesson for the next time they came to the movies.
The ice cream was mediocre when compared to the faint smell of perfume on Xie Yiren's body, and Zheng Ren soon found himself intoxicated.
"Let's go!" Xie Yiren suddenly stood up.
"It's starting?"
"Yes."
Zheng Ren trailed behind Xie Yiren, his mind in a daze. She was wearing a white cap with two pom-poms that wiggled as she walked. She was adorable.
They entered the theater. The room was brightly lit, a stark contrast to what he had imagined.
Xie Yiren led them down the aisle, a youthful spring in every step.
Row 7, seat number 17 and 18. They took their seats.
Zheng Ren noted the armrest between the two seats and sighed.
This would be a learning experience for him. He would summarize all the learnings today and make sure history did not repeat itself.
Xie Yiren's ice cream was gone. She had her cap in her l.a.p and was toying with the two pom-poms.
How Zheng Ren wished he could be the pom-poms in her hands.
The lights in the theater dimmed as the movie started.
Zheng Ren did not pay attention to the movie. Instead, he was surreptitiously moving his arm. He wanted to rest his arm around Xie Yiren's shoulders and pull her into his embrace.
At that moment, he realized the importance of the advice Su Yun had given.
Hypothetically speaking…
If he moved his arm over and Xie Yiren did not pull away, the biggest barrier between them would be the armrest.
Should he then remove the armrest?
Would that be too eager?
The gentle and unrushed atmosphere would be broken by that abrupt action.
At that moment, Zheng Ren had a measure of respect for the experienced Su Yun.
That guy ought to have gone through a lot of relationsh.i.p.s to be able to distill such knowledge.
When Yang Lili's condition was better, Zheng Ren would have to consult Su Yun on the matter.
These thoughts occupied his mind as the movie played onscreen. He was oblivious to its plot.
He had abandoned the d.e.s.i.r.e to get Xie Yiren into his arms. Instead, he focused on breathing the air that carried Little Yiren's scent. It calmed his wildly beating heart.
Unfortunately, fate had scheduled an interruption.
Less than an hour into the movie, Zheng Ren's phone buzzed in his pocket, snapping him out of his daze.
The number was from the emergency department. He answered the call.
The movie was at its climax and the booming sound effects effectively muted the caller.
He nudged Xie Yiren and signaled that he was going out to answer the call. He ducked down as he hurriedly made his exit.
"What's happening?"
"Oh, okay. I'll be back as soon as possible. Get gynecology to consult."
He ended the call.
He turned and found Little Yiren closing the theater door.
"An emergency case?" Xie Yiren asked.
"Yes, a 17-year-old girl with lower abdominal pain. A B-scan ultrasonography was inconclusive and they're asking for me to have a look," Zheng Ren said apologetically.
Xie Yiren gave him a sweet smile and put on her cap. She shook her head and the two pom-poms bounced in response.
"Come on, let's make haste."
Zheng Ren put aside his earlier musings and focused on his job.
They jogged to the car and quickly strapped themselves in.
This time, Xie Yiren's driving was no longer the slow crawl that Zheng Ren had gotten accustomed to. He felt the car's acceleration push him deeper into his seat.
Like a feral dog unleashed, the Volvo XC60 tore down the streets as it made its way to Sea City General Hospital.
Zheng Ren headed straight to the emergency department, forgoing
a change of clothes.
Meanwhile, Xie Yiren went to the operating room and waited for Zheng Ren's call.
In the emergency rescue room, a young, pale-faced girl was clutching her abdomen in pain.
The gynecology department chief resident, whom Zheng Ren knew, was present.
There was no time for pleasantries. Zheng Ren asked, "What's your diagnosis?"
"Could be an ectopic pregnancy but the family and the patient denied any form of s.e.x.u.a.l contact," the gynecology chief resident whispered.
Zheng Ren questioned the sonographer. "What did the ultrasound show?"
"The blood vessels don't seem to be branching from the ovaries, though the pain is radiating from that area. I don't think it's a gynecological problem."
There was a disagreement between the two departments. Zheng Ren got the patient to lie flat on her back. The patient's pants were pushed down to reveal her lower abdomen. He applied the ultrasonic couplant and personally performed the ultrasound.
Chapter 346 - Accessory Spleen?
As the family and the patient had denied any past s.e.x.u.a.l contact, Zheng Ren could not suggest a transv.a.g.i.n.a.l ultrasound and instead, settled for an abdominal ultrasound.
Although it was not as suitable, Zheng Ren had the System on his side.
Zheng Ren had trouble believing the System's diagnosis was true.
An accessory spleen torsion…
This diagnosis… If the patient was experiencing upper abdominal pain, Zheng Ren would take the System's word for it. However, the patient was hurting in the lower abdomen. Therefore, he decided to perform the ultrasound.
The uterus and the two ovaries showed no abnormalities. There was a lump next to the left ovary, approximately 5cm wide.
The doctors' disagreements lied there.
Zheng Ren held the ultrasound scanner in his right hand while his left hand depressed the patient's abdomen.
When he exerted pressure, he noticed the lump moved away from the ovary and the area between the two masses showed large blood vessels.
Zheng Ren was leaning toward the sonographer's diagnosis but understood why the chief resident suspected an ectopic pregnancy.
"Where's the family?" Zheng Ren asked.
An anxious, middle-aged woman approached him. "Doctor, how is my daughter?"
"We'll have to perform a surgical procedure to find out the tumor's roots." Despite having the System's diagnosis, Zheng Ren spoke in rather general terms to avoid trouble. "Let's begin the admission and surgery prep."
Sweat dripped from the middle-aged woman's forehead.
Most people were not keen on surgery.
Jokes of appendectomy patients dying post-surgery were constantly on people's minds. The probability of it happening was low but was still present.
"Chief Zheng, ring me when you start the surgery. I want to have a look," the gynecology chief resident said. She was excited to have encountered a tricky case.
She was confident in her diagnosis but the sonographer's observation made sense. Hence, she wanted to have a closer look.
In general, doctors hated exploratory laparotomies.
There were too many unknowns as no one knew what laid inside the patient's body.
It required a doctor with sufficient clinical and surgical experience to solve the unknown as a misstep could be fatal.
The gynecology chief resident was fine with the exploratory laparotomy. If a gynecological problem was identified, they could fix it there and then.
There was another reason she was keeping tabs on the case. She was worried Zheng Ren had never done an ectopic pregnancy surgery.
Zheng Ren's reputation in the gynecology department had been on the rise ever since he had successfully handled the medical dispute. While the chief resident did not agree with some of Zheng Ren's views, she refrained from challenging him outright.
Zheng Ren did not mind the extra pair of eyes. He nodded at the chief resident.
Zhong Min was on duty today. Zheng Ren made a call to Yang Lei and then Chu Yanzhi to inform them of the surgery.
To be honest, Zheng Ren was not sure how the twins had split their duties but either one was enough.
He brought the patient to the emergency ward for the presurgical preparation.
Zhong Min was responsible for getting the patient settled and doc.u.menting all their details and history. While she busied herself with the patient, Zheng Ren took the time to explain the procedure to the family.
Regardless of which diagnosis was correct, time was of the essence.
The patient's mother was wiping tears from her eyes as she signed the informed consent doc.u.ments.
The gastric catheter and urinary catheter were all set up as soon as the signing was complete.
Yang Lei stayed a distance away from the hospital, so Zheng Ren wheeled the patient to the operating room with her family's assistance.
Once inside, Chu Yanzhi had arrived. A few staff worked together to move the patient onto the operating table while Zheng Ren went off to change.
There would be approximately ten minutes before Zheng Ren would be needed inside. The anesthesia for this case was tricky so he took his time.
Accessory spleen? Zheng Ren mulled over the System's diagnosis.
Based on tissue biology, the existence of the accessory spleen was due to the failed fusion of the original spleen buds located in the dorsal mesangial membrane of the stomach during the fifth week of embryo development.
It was hard to diagnose in practice.
In CT scans, the accessory spleen was a mass less than 2cm in diameter with a smooth outline and even contrast. An MRI would show a feeder artery that branched from the splenic artery to supply nutrients to the accessory spleen.
A B-scan ultrasonography was rudimentary. It could not clearly visualize the branching of arteries in the abdomen.
As the patient came in through the emergency department, there was no time to arrange for the various scans. An exploratory laparotomy was the only solution.
Once changed, Zheng Ren called for a pathologist's consult.
If the accessory spleen was in the upper abdomen, Zheng Ren would not have worried.
However, it was in the pelvic cavity. There was a chance of it being cancerous.
In order to rule out cancer, a histological sample would be required.
Zheng Ren had informed the patient's mother on the particulars.
Due to this possibility, Zheng Ren opted for a laparotomy instead of a laparoscopy.
The small incisions made in a laparoscopic procedure were too small to retrieve the accessory spleen. If the mass was damaged during retrieval and happened to be cancerous, metastasis could occur en masse, leading to late-stage cancer.
The surgical procedure was decided after a thorough risk assessment. Zheng Ren informed the gynecology chief resident of the surgery, then proceeded to scrub in.
Chu Yanzhi was bouncing on her feet while the patient lay sedated. She was chatting with Xie Yiren.
Well, chatting was not the right term. It was more like Chu Yanzhi was talking at Xie Yiren as she prepared the surgical tools. Xie Yiren's replies came in the form of affirmative noises.
Chu Yanzhi was asking about Xie Yiren's absence at home. She did not notice the awkward silence from Xie Yiren and Zheng Ren.
The total opposite from her sister, Chu Yanzhi spoke in a direct manner, oblivious of the room's mood.
Chu Yanran had gotten all the tact and attentiveness.
Yang Lei was still nowhere to be found. Unwilling to wait, Zheng Ren began the disinfection process and laid down the surgical dr.a.p.es.
A solo surgery was nothing new to him.
The surgical lamp illuminated the area before him. He studied the surgical site. The patient was young and to minimize scarring, he made an 8cm incision down the left flank of the rectus abdominis.
The incision was long as he had to investigate the blood supply's source.
If the incision
was too small, he would have to extend the cut midway through surgery.
The layers beneath the skin were parted carefully.
The young patient had less adipose tissue which made the surgery easier.
At this point, the gynecology department's chief resident arrived.
She saw Zheng Ren alone at the operating table and asked, "Chief Zheng, do you need my assistance?"
"No, Yang Lei should be here soon." Zheng Ren gently manipulated the peritoneum and accessed the cavity.
Seeing the exposed abdominal cavity, the chief resident stopped talking and paid close attention to the ongoing surgery.
A retractor held the skin and muscles of the lower abdomen at bay. Zheng Ren and the gynecology chief resident saw the culprit—a visible mass sat right beside the ovary.
The redness of the mass was almost black.
Chapter 347 - The Melon That Leads To The Vine
"Chief Zheng, you're amazing," the gynecology chief resident said from behind. She had gotten a glimpse of the necrotic organ and saw that it was not attached to the surrounding tissues of the patient's reproductive system.
She was not a sore loser. The medical field was different from others.
If they had proceeded based on her diagnosis, it would be troublesome.
The surgeon would have to quickly leave the table to inform the family.
A reasonable family would understand and the gynecology surgeon would have to seek a general surgeon to resume the surgery as they would have to change the surgical method.
If the family was unreasonable, then congratulations!
If the unreasonable family had some power or was up the social ladder, then you would have hit the jackpot!
Therefore, the gynecology chief resident was grateful if nothing else. Competitiveness was not an issue here.
"I'm alright." With a clamp and his hand, he carefully separated the accessory spleen from the surrounding organs. He did not want to risk tearing any unseen connections and damage the other organs.
"It's an accessory spleen?" the gynecology chief resident asked.
"We'll know more later. We have to finish up here first." Zheng Ren focused on identifying the connections within the site. The artery supplying blood to the accessory spleen was twisted, leading to organ necrosis. He would want to avoid puncturing the organ as there would have been pus buildup within.
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