Chapter 272: The Floating Gallbladder (Part 1 of 5)

The surgery was successful. With Yang Lei beside him, Zheng Ren finished it within 20 minutes.

At the operating table, he patiently explained the key steps of the procedure to Yang Lei. Even though it was simply a laparoscopic appendectomy, the techniques he shared were useful and very much applicable to other surgeries, to Yang Leis benefit.

After leaving the table, Zheng Ren felt bored.

He seemed to have lost his direction in life after returning from Imperial Capital.

No, that was not it. It was Xie Yirens absence.

Zheng Ren remained oblivious to the truth, however.

His skill points in general surgery were acc.u.mulating at a painfully slow rate, still a long way away from Grandmaster.

Zheng Ren thought of practicing the Whipple procedure in the Systems operating theater, estimating a gain of over a hundred skill points per surgery.

However, he dismissed the idea when he saw his remaining experience points and surgical training time.

If he spent them all, the possibility of him achieving Grandmaster rank would be next to zero. He would be in trouble in any emergency situation.

It was better to play it safe and slowly build up to the main long-term missionall top general surgeons would have had countless years under their belt. Even though his rewards were meager, it was better than nothing.

Su Yuns familiar voice came from behind him. Where did your mind wander off to?

Im just daydreaming.

Are you thinking about Little Yiren? Youre just too timid. Have you seen Overbearing CEO Falls in Love With Me? You need to be more forward, Su Yun teased.

Chief Liu was very forward when he went to America[1], but he lost so much money, its embarra.s.sing, Zheng Ren refuted without hesitation.

Im talking about you, just get the gist of it. Su Yun smiled, unbothered by Zheng Rens retort, which if anything proved his claim.

Hows the patient? Zheng Ren asked.

Hes stable, I just removed the tube. From his current condition, hell survive. Su Yun was concise when speaking about patients and gave simple, brief answers.

Zheng Ren had expected this result somewhat. The completion status of the surgery had been at 100%. If everything went well in the ICU, the patients survival was all but a.s.sured.

Also, the paper on the hepatocellular carcinoma nodules has been received. Ive just received a phone call from them asking if there were any more similar cases.

Not at the moment, Zheng Ren said, Cant we just publish it as a case study?

Yes, but itll be slower to gain traction, Su Yun said, That stuff doesnt concern you, anyway. Youre just a wimp, forever doomed to be a chief resident in Sea City.

Its the same everywhere. Didnt you also leave Imperial Capital?

Boss, are you interested in a veterinary hospital? Im not asking you to work there, Ill just occasionally need you to save the day in case there are surgeries that require your expertise.

Saving the day in a veterinary hospital such a thing was unfamiliar to Zheng Ren.

Theyd mostly be Goldens or Alaskan Malamutes that accidentally swallowed socks which resulted in intestinal obstruction. With your skill, I can safely say youd finish one surgery every 20 minutes, Su Yun said, We can negotiate your pay.

I

Dont say you dont need the money. I asked Xie Yiren yesterday; her parents will be back in one or two months for Chinese New Year, Su Yun drawled.

Zheng Ren hesitated for a moment. Okay, but I dont have a veterinary license. Is that allowed?

It wont be an issue; what vet can actually perform surgery? They all just do it blindly. Simple sterilization is alright, but if you ask them to perform open or thoracic surgery, they would not be able to handle it, Su Yun said.

Well do it someday then. Zheng Ren had no choice but to bow down to reality.

He got b.u.t.terflies in his stomach at the thought of Xie Yirens parents returning, but did not know why or how to deal with it.

As he pondered it, his phone rang.

It was Chu Yanran. Chief Zheng, theres a woman with me suffering pain in the upper right region of her abdomen. Come and take a look.

Her words were simple and devoid of formality. It would be strange to stand on ceremony, but she also did not mention her location.

That meant she was in the emergency department.

Zheng Ren hurried there, taking long strides while Su Yun trailed him as usual, head lowered.

The emergency department was not very busy as it was in the middle of the cold winter season. There were almost no drunken brawls, the road was covered in snow and everybody drove extra carefully. It was almost deserted.

Still, that was a good thing.

When they arrived, Chu Yanran was standing by a bed; a doctor was performing an abdominal ultrasound on the patient from a B-scan ultrasonography trolley.

Family members watched from the sidelines anxiously. Zheng Ren ignored them and glanced at the Systems diagnosisgallbladder torsion and acute gangrenous cholecyst.i.tis.

Oh? This was a rare disease.

Gallbladder torsion was uncommon. Wendel described it as a floating gallbladder when it was first diagnosed in 1898. It had been over a century since, but Zheng Rens memory of medical literature only yielded slightly over a hundred recorded cases.

Accounting for those that flew under the radar, there were three to five hundred cases at most.

There was no other option but to prepare for surgery.

Torsion of any organ would inevitably lead to necrosis of its tissues. According to the System, acute gangrenous cholecyst.i.tis had already set in.

At Zheng Rens arrival, Chu Yanran said, Aunt Lin started having abdominal pain after breakfast this morning but didnt do anything about it. Three hours ago, the pain intensified and she took some Xiaoyan Lidan tablets, which did not help with the pain. An hour ago, the pain was so intense that she couldnt endure it anymore, and so she came to the hospital for treatment. There were no chills, fever, nausea, or vomiting. Ive already done the routine blood and liver function tests; the results should be back soon.

Its acute cholecyst.i.tis. She needs to have surgery, Zheng Ren said.

Youre Dr. Zheng? a man in his thirties asked.

He had gold-framed gla.s.ses and a studious face, currently etched with worry.

Yes, thats me, Zheng Ren answered.

Nice to meet you, Im Zhou Wenxiang. Despite his anxiety, the man kept his composure and shook Zheng Rens hand.

Dr. Zheng, you said that my mother needs to undergo surgery. Is it okay if she doesnt?

I think she has a gallbladder torsion, resulting in local necrosis leading to acute gangrenous cholecyst.i.tis. There are two options for surgery: either we remove the gallbladder or reposition it. My advice is to surgically remove it to prevent relapse in the future. I dont recommend conservative treatment as it wont help with the symptoms.

Zheng Rens diagnosis was detailed.

Zhou Wenxiang hesitated for a moment before storming out.

Zheng Ren glanced at Chu Yanran, who approached him and whispered, His father is a colleague of mine and on his way back from Provincial Capital. Chief Zheng, gallbladder torsion is a rare condition. Are you sure about the diagnosis?

There. Zheng Ren pointed at the B-scan ultrasonography beside the bed. The imaging confirms it.

When did you learn to read B-scans? From what I remember, youve never made any diagnoses based on them. No incongruence could be hidden from Chu Yanrans keen eyes.

Thats because they did not identify any problems. Im just pointing it out now since this is a rare emergency.

Chu Yanran tipped her head and thought it through; Zheng Rens explanation made sense and she did not pursue the matter.

Zhou Wenxiangs voice rang out. Chief Xia, can you help us? My mum is still in great pain but doesnt want to opt for surgery.

[1] Possibly referring to gambling.