"No, that's alright. Thank you." Zheng Ren let out a long sigh. The doctors from Chengdu Provincial Hospital were indeed very polite, but he was unable to save his words with them.
The older doctor did not deliberately say anything. He only arranged for the young doctor to go and report to the head nurse of the operating theater. He said that it was an appointment under Doctor Zheng and that he would be back in another three hours.
Zheng Ren did not even know when he had become famous.
The operating theater's chief nurse was such a terrifying existence.
Usually, the younger chief physicians would not dare to talk to the operating theater's chief nurse. Was this really a good idea?
Zheng Ren wanted to say that it was better to ask the department chief himself. After all, this was a special period and the operating theater's operating tables were in short supply. The old doctor extended his hand and said politely, "Doctor Zheng, let me introduce myself. I'm Huang Dazhi from the interventional department of Chengdu Provincial Hospital. I hold the department chief position."
"Hello, Professor Huang," Zheng Ren said gently as he extended his hand and.
"I wouldn't dare to be called as such," Professor Huang quickly said. "With your surgical skills, you don't have to be so polite with me."
Zheng Ren did not think much of it and smiled slightly.
"Doctor Zheng, there are too many people in the operating theatre's duty room. Our chief said that as long as you want to rest, you can just go straight to his office," Professor Huang said.
"That...isn't good." Zheng Ren hesitated for a moment.
"What's not good about it!" Professor Huang became serious as he said, "The number of surgeries you've done alone is equivalent to the amount done by three to four people. It's our duty to help you a little. If you insist on being so polite, we will really be embarrassed."
"I still have my assistant..." Zheng Ren looked through the lead-lined glass and saw that Xie Yiren was swiftly packing up the surgical instruments.
The hospitals in the country were almost the same. The only difference was the details. Xie Yiren had received the care of some people. She did not even need to wash the surgical instruments and just needed to tidy them up.
Su Yun had just carried the patient onto the stretcher trolley and was about to come out.
"It's okay. There's still a quiet place," Professor Huang said.
That's good. Zheng Ren nodded and did not say anything.
"Boss, go to the duty room and sleep. Don't sleep on the floor in the corridor." Su Yun was afraid that Zheng Ren would reject his offer. Although Xie Yiren was watching over him, he was still afraid that this guy's head would be filled with water, so he quickly walked out and went to intervene.
"Go to the intervention department and sleep for three hours... It's now 10.15pm. We'll start the show at 1.30am sharp," Zheng Ren said as he looked at the time on the machine.
Su Yun didn't care. As long as he could lie down on a bed and sleep quietly for a while, it would be fine. After coming out of the Imperial Capital, he didn't sleep much nor have a good meal. He was on the verge of collapse.
Zheng Ren saw Xie Yiren handing over the things to the circulating nurse, so he said, "Wait for me."
"Yes, I'll wait for you." Professor Huang was already so old so how could he not be grateful that the additional help Zheng Ren gave? Since he had the time, he treasured it very much. He pulled out an image and asked, "Doctor Zheng, how did your guide wire pass through this position?"
Zheng Ren looked at Xie Yiren's back. His face was filled with a smile that came from the bottom of his heart. He was already in a daze.
After Professor Huang finished speaking, he was stunned for a full three seconds. It was not until Su Yun bumped into him with his shoulder that he asked in shock, "What's wrong?"
"He's asking you how you did the operation." Su Yun knew that Zheng Ren was partly distracted because of Xie Yiren's arrival and partly because he was really tired. He did not rebuke him and simply reminded him in a low voice.
Zheng Ren took off his mask and took two deep breaths.
He had been wearing the mask the whole time, so his breathing was not smooth.
"Here, it's like this." Zheng Ren glanced at the screen and knew what Professor Huang meant. He immediately began to explain.
Chapter 739 - Thiocyanate Poisoning
Huang Dazhi's doubts about the surgery did not lie in the diagnosis but in the technique.
Zheng Ren could demonstrate the technique. As for how it should be used in surgery, it would depend on that individual's comprehension.
Even if Zheng Ren did not hide anything, most people would not be able to understand it.
Professor Huang asked for advice on two more difficult methods to select and remove the suppository. After Xie Yiren finished the handover, she walked out.
He knew that this was not a good time to chat, so he brought Zheng Ren and the others to the intervention department with a smile.
On the way, Professor Huang did not say anything more because Zheng Ren and Su Yun were about to fall asleep. He was just being careful not to let them fall asleep, hurt themselves, or get others hurt along the way.
After entering the ward, Professor Huang came to the door of the chief's office and said with a smile, "The chief specially left the door open for you. He said that if you need anything, you can come and rest anytime."
"Thank you," Zheng Ren faintly said.
Suddenly, there was a burst of hurried footsteps in the corridor and the loud sound of wheels rubbing against the ground.
Subconsciously, Zheng Ren opened his eyes. In a daze, he thought that he was in Sea City General Hospital.
"What's wrong?" Zheng Ren asked in a daze.
"Boss, it seems to be resuscitation." Su Yun was also in a daze. He guessed when he saw the nurse pushing the stretcher trolley into the ward.
"Let's go take a look." Zheng Ren also saw the situation clearly and immediately became more energetic.
Xie Yiren wanted to say something but after hesitating for a moment, she finally let Zheng Ren go.
She originally wanted to take a look at where Zheng Ren was sleeping and then drive around to see what food she could buy.
She did not expect for there to be a resuscitation immediately after getting out of the ward.
Zheng Ren strode into the ward and saw a patient's hands and feet twitching slightly. He wanted to move but was unable to do so. He was mumbling something, but the words were unclear.
The nurses, doctors, and volunteers who acted as nurses were rescuing the patient in front of the bed. They couldn't see the patient, so the System panel didn't give a diagnosis for the time being.
"Boss, this person is probably a programmer. He talks about code in his sleep. He's really dedicated," Su Yun said in a low voice.
"Programmer?"
"According to his delirium, that should be the case," Su Yun said.
"Isn't this a postoperative patient? What happened?" Professor Huang was a little surprised and quickly asked.
"Professor Huang, the patient underwent blood transfusion after the stent operation. He was hypotensive and showed symptoms such as movement disorder, blurred vision, and so on. Then, he began to suffer from delirium, dizziness, headache, accompanied by nausea and vomiting. The vomit was gastric contents," the doctor reported.
"Stent?" Zheng Ren was stunned for a moment.
The current patients were basically those with hemorrhagic shock. A blood transfusion would be more than enough. Generally, there was no blood pressure reduction.
With the addition of the stent, Zheng Ren immediately remembered that he had diagnosed a patient with an abdominal aortic dissection when he first arrived.
That patient had been given a stent, so Zheng Ren was sure that there would be no problems with the stent operation. His own surgical experience and the surgical progress bar given by the System could prove it.
What was g
oing on?
He took a step forward and saw the patient while the volunteer went to get something.
The diagnosis given by the System's panel at the top right of his field of vision was—pelvic fracture after interventional embolization, abdominal aortic dissection aneurysm after stent surgery, thiocyanate poisoning.
He was so sleepy that he was confused. Zheng Ren had misread the diagnosis.
His first reaction was cyanide poisoning!
That was a big deal. Could it be that someone had poisoned him?
Zheng Ren was so scared that he quivered and 'woke up'.
Then, he saw clearly that it was thiocyanate poisoning. His mind quickly recalled what it was and his expression changed slightly.
Su Yun saw that Zheng Ren's condition was not right, so he squeezed forward and asked, "What's wrong, Boss?"
"Nothing." Zheng Ren shook his head. He could not tell Su Yun about cyanide poisoning. If he did, this fellow would simply talk about it until the next year.
"It's a postoperative patient of the abdominal aortic dissection aneurysm that I did, right?" Zheng Ren asked.
"Yes, Teacher Zheng. "Professor Huang felt the powerful aura of a senior doctor, so he subconsciously called him teacher.
"What was done to lower the blood pressure?" Zheng Ren asked.
Even after the operation on an aortic dissecting aneurysm, one had to maintain stable blood pressure. It would be fine once the rupture was completely blocked by the peritoneal shelf. Normally, one had to give blood pressure medicine for one to two days before it could be stopped. There was nothing special about it. It was all routine treatment.
"Sodium nitroprusside, micro-pump it in. The dosage is 8 μg/kg/min." The junior doctor immediately reported the dosage.
Zheng Ren then knew what had happened.
He said in a deep voice, "Stop the sodium nitroprusside. Contact the nephrology department immediately and go for dialysis."
Professor Huang was stunned. What was this operation? Acute renal insufficiency? Under normal circ.u.mstances, the performance of renal insufficiency was on the urine volume and this patient's urine volume was normal.
Although the urine volume was low due to hemorrhagic shock, it was not below the level of 50ml per hour for renal insufficiency.
He had his doubts but when he heard Zheng Ren's words, he immediately stopped the micro-pump and started pumping sodium nitroprusside.
"There's no need to give too much treatment. Just be careful not to accidentally aspirate the vomit and suffocate the patient," Zheng Ren said.
Professor Huang was puzzled. He arranged for the junior doctor to immediately contact the nephrology department. He came to Zheng Ren's side and asked, "Professor Zheng, is it acute kidney failure?"
"Sort of," Zheng Ren replied.
He was sweating... What sort of answer was that?
For the first time, Professor Huang felt that Zheng Ren was a little unreliable. However, this kind of thought was nipped in the bud as soon as it appeared.
Zheng Ren was a candidate for the Nobel Prize. His identity alone could solve many problems.
That was not all. He had personally witnessed the surgery. He was definitely the most awesome doctor he had ever seen. Usually, doctors like him had a lot of clinical experience.
His own suspicions could only prove that he had little clinical experience and his diagnosis was wrong.
Professor Huang looked at Zheng Ren with an inquiring gaze and waited for his explanation.
"It's thiocyanate poisoning," Zheng Ren said.
Uh... It was common practice to use sodium nitroprusside in the clinic. Many patients had high blood pressure and needed to use sodium nitroprusside to control it. For so many years, Professor Huang had rarely heard of the diagnosis of thiocyanate poisoning.
It was not rare, but cases were almost nil.
Thiocyanate poisoning sounded so strange to him.
"It's the metabolism of sodium nitroprusside, right?" Su Yun immediately thought of some possibilities and asked.
"Yes," Zheng Ren said. "Sodium nitroprusside is a kind of nitro-hydrocyanate, a strong dilator that acts directly on the vascular bed of arteries and veins. Sodium nitroprusside was continuously pumped in. First, it was converted from erythrocyte to cyanide, and then from thiocyanate in the liver to thiocyanate, the end metabolite.
"Thiocyanate was excreted from the kidney. The half-life of a person with normal kidney function is four to seven days. Patients with kidney failure have an acc.u.mulation. If the dosage is too high, poisoning is normal."
"But the patient has no abnormal kidney function," Professor Huang said as he tried to recall the patient's test results.
"There wasn't before, but now there is."
Chapter 740 - Just A Step Away From Reaching Prime
Professor Huang was puzzled but Su Yun showed a look of understanding.
"Boss, this is the reason why you proposed to have all the nephrologists in the country come to support you when you were in Nanchuan Town and also to allocate a large number of dialysis machines," Su Yun said.
"Yes," Zheng Ren said, "Considering that it's crush syndrome, some are long, some are short, and the onset time is not fixed. It's usually between 48 to 72 hours."
This diagnosis was rather complicated.
From the rare complication of sodium nitroprusside— thiocyanate poisoning—it went all the way to acute kidney failure and crush syndrome.
However, Zheng Ren's words were reasonable and Professor Huang only sighed. Not only did Teacher Zheng enter the earthquake epicenter at the first moment, but he could also suggest that the whole country mobilize thousands of kidney physicians to come and support him.
How much confidence did he have to be to make such a suggestion to his superior?
Moreover, a large number of dialysis machines had recently been shipped over straight from their factories. Countless kidney physicians had been parachuted in from all over the country. Huang Dazhi knew about this.
Reality proved that the request had been approved by the frontline headquarters and was immediately put into action. It must be known that other than the doctors who had entered the mountains, the doctors transferred by the frontline headquarters, were actually kidney physicians. Almost everyone knew about this. In the beginning, there were still people who silently criticized him but now, reality proved that this kind of operation was really amazing!
Moreover, they did not expect that they would meet a patient with such a complicated condition after surgery, where a kidney physician would actually be needed.
"Professor Huang, there should be a machine that helps us with this." After the junior doctor contacted him, he immediately reported to Huang Dazhi.
"Push it over!" Professor Huang did not hesitate at all and directly ordered for it to be brought in.
"Teacher Zheng, do you have any other medical advice?" Professor Huang then asked Zheng Ren.
"No, as long as the dialysis is timely, the problem will definitely be solved. The patient's symptoms post-surgery weren't serious. I think he'll recover soon," Zheng Ren said.
Seeing the doctors and nurses push the patient away after the surgery, Su Yun was a little impressed.
He naturally could not help but admire him.
In Nanchuan Town when the bearded regiment commander first came, everyone was faced with a desperate situation. They were running out of ammunition and food.
The bearded regiment commander gave hope to the small team and survivors that were trapped on the isolated island.
At this time, only Zheng Ren's mind was clear. He repeatedly proposed to report to the country to mobilize kidney physicians and dialysis machines.
If he waited for a large number of patients with acute renal failure to appear, only to discover that the machines were not enough and there were not enough people...
How many patients would have died before they had begun complete mobilization of their forces?
When he thou
ght of this possibility, Su Yun immediately shivered.
He could not think about it. Just thinking about it made him afraid.
"Boss, I really admire you a little," Su Yun said softly.
"Shouldn't you have admired me since the beginning?" Zheng Ren was a little puzzled. "Otherwise, why did you rush from the ICU to the emergency ward to perform a surgery with me?"
Su Yun spread his hands and was speechless.
"Teacher Zheng, this way. You should go and rest first." Professor Huang led Zheng Ren and the others to the chief's office. There was a bed and a sofa there which could accommodate two people.
Su Yun directly collapsed on the sofa. He didn't even have the time to be polite with Huang Dazhi. He muttered that it was really comfortable and then fell asleep.
"Actually, I should have taken you two to the showers first," Professor Huang said apologetically when he saw that Su Yun and Zheng Ren were exhausted.
"We'll sleep first and worry about it later during surgery." Zheng Ren forced a smile. It affected his bruised and bloodied face, causing a heart-wrenching pain.
Xie Yiren felt a bit of heartache. She reached out and carefully touched Zheng Ren's bruised and battered face. She stood on her tiptoes and blew lightly at it.
In just an instant, a cool breeze brushed his face. Zheng Ren felt that he was completely healed.
He reached out to grab Xie Yiren's little hand, but Xie Yiren let it go just a second later. She turned around and said, "You sleep first. I'll go buy you two something to eat. At 1.15am, I'll wake you both up on time."
Zheng Ren felt a little regretful but there were too many people around. He knew that Little Yiren would be shy.
Xie Yiren and Huang Dazhi immediately closed the door and left. Zheng Ren lay weakly on the bed.
How long had it been since he had laid down in an actual bed? It seemed like many years had passed. Zheng Ren had almost forgotten this familiar feeling.
He did not feel anything during the surgery but once he lay down now, Zheng Ren felt as if his entire body had fallen apart. He was sore and uncomfortable.
He guessed it wouldn't hurt to sleep for a while...
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