Chapter 71: Hysterectomy or No?
Zheng Ren rushed to the first floor of the emergency department building and found Old Chief Physician Pan waiting for him.
The two men ran toward the ICU. At the changing room before the ICU entrance, they put on surgical caps and masks, changing into dark green sterile scrubs and even swapping their shoes for slippers before entering.
The ICU was like treasure vaults in movies, where one had to change their clothes and go through two rounds of scrubbing before being allowed in.
This was to prevent the risk of contamination as most ICU patients had tracheostomy tubes connecting them to ventilators. They had very poor immunity and microorganisms that were usually commensals could become lethal pathogens.
Inside the ICU, many department chiefs were already there on the case.
The System display at the upper right corner of his vision told him that it was a placental abruption of the hemorrhagic sort.
The patient was a young female, 20 months into pregnancy. Due to pregnancy-induced hypertension, the placenta had detached from the uterine wall. The distance between the placenta and the uterus was half the length of the placenta.
The patient was bleeding excessively, resulting in a pallid complexion. She was sweating profusely and her heart rate was rising while her blood pressure was plummeting. She was exhibiting symptoms of hemorrhagic shock.
Fetal asphyxia had set in and the fetal heartbeat was undetectable. The baby was already dead.
This was a tricky case…
As this was the patient’s first pregnancy, a hysterectomy would close the door on any future pregnancies. It was a cruel thing to do to an expecting mother.
However, if an emergency hysterectomy was not performed, the bleeding would not stop. The obstetric and gynecology department had tried to manage the bleed but antihemorrhagic drugs had helped little.
They were stuck between a rock and a hard place.
A few of the department chiefs that came to consult had the same opinion. The case was a tricky one. They frowned at the worrying numbers on the vitals monitor, deep in thought.
The diagnosis was simple, but the biggest problem was the decision to remove the uterus.
Su Yun stood by the patient’s bed with a blue clipboard in his hand. His coat was white as snow and a stethoscope hung over his neck. He stared at the department chiefs with an impassive look.
“I suggest that we discuss this in the office. Time… There should be only ten minutes left. Xiao Su, start prepping for surgery,” the ICU chief spoke.
The various department chiefs filed out of the ICU. Su Yun saw an unobtrusive Zheng Ren at the end of the crowd. Anyone would have missed his presence had they not been paying attention.
Su Yun gave the usual orders and the nurses got to work.
He left the observation room and went into the second room in the corridor. The room had clear windows and a large, makeshift table made up of a few office desks. There were a dozen or so chairs around it.
The ICU chief glanced at the clock and said, “We have nine more minutes.”
“I don’t think there’s much more to debate,” the obstetric and gynecology department chief, Su Yun, spoke firmly as he adjusted his horn-rimmed glasses, “We have tried many ways to stop the bleed but none were effective. Any more delays and the patient could go into hemorrhagic shock. By then, surgery won’t be a viable option.”
“Haih.” The anesthesiology department chief sighed audibly. He started to speak but paused at the last second.
“Old Wang, what do you have to say? Don’t sigh and just say it.” The ICU chief was in an agitated mood and did not welcome dithering.
“If we only had an interventional surgery expert,” Anesthesiology Department Chief Wang said. It was what everyone was thinking.
“Ask if the endovascular team can help us out.”
The ICU chief’s expression was dismissive. “The endovascular team has 18 myocardial infarction patients today among the three wards, all lined up for surgery.”
If a myocardial infarction acted up without surgical intervention, death was guaranteed for the patient.
It was unlike the pregnant patient in the ICU who had the alternative of a hysterectomy to save her life.
These razor-sharp contradictions were a daily occurence in the hospital. Which lives were more virtuous? None. In the face of death, every person was equal and the only inequality lied in society.
Even if the endovascular surgeon was free to assist in the surgery, if something were to happen, who would be blamed? According to the law, surgeons were only licensed to practice within their expertise. Among all the specialties, only trauma surgeons were allowed some leeway.
The crowd was silent.
Zheng Ren stood at a corner. He had no authority to speak in this sort of large-scale emergency rescue meeting that involved the whole hospital.
If it were not for Old Chief Physician Pan’s insistence, Zheng Ren would not have even been allowed to attend this meeting. The other department chiefs respected his seniority.
Zheng Ren understood the point they were making. If they wanted to preserve the uterus and stop the bleed, it had to be through interventional methods.
Surgeons involved in interventional radiology were exposed to large amounts of radiation. After one of the specialized surgeons had been diagnosed with diffuse large B-cell lymphoma, such surgeries became less popular. Doctors preferred placements in the endovascular team for coronary angioplasty and as time passed, there had been no one in the interventional radiology-assisted surgery department.
For this, Anesthesiology Department Chief Wang lamented.
The mention of interventional radiology reminded Zheng Ren of the System. It had once tempted him to choose interventional surgery.
Maybe he could try it out? Zheng Ren considered.
There was only a few minutes left. He had to decide.
Zheng Ren entered the System and opened up the Shop. He stared at the interventional surgery training option and hesitated.
He was not debating whether he wanted to purchase the training. Experience points were nothing if he could save one life or let the patient retain her reproductive ability.
His hesitation was self-doubt. He was unsure if he was eligible for the training.
Ever since attaining the System, Zheng Ren’s memory had improved significantly. His knowledge of anatomical positions had gotten better alongside his general surgery skill.
Based on his memory, interventional surgery for a placenta abruption called for the embolization of the uterine artery. It was the easiest interventional surgical procedure.
Then… that was it.
Once the decision was made, Zheng Ren confidently selected the training.
In a flash, the operating theater rose from the ground. Zheng Ren felt a tug as a lead apron was affixed to his body. With a simulation mannequin before him, Zheng Ren gripped the catheterization kit in his hand.
How should he do this?
Zheng Ren was in a stupor.
[Please add skill points into interventional surgery to proceed with training.]
The robotic female voice of the System reminded Zheng Ren of his own thoughts. You idiot, you should have prepared your skill tree before trying a new surgery. Did you think you could just waltz in with zero preparation and pick up interventional surgery?
Sweat rolled down Zheng Ren’s back. He used a skill book to raise his interventional surgery skills to Graduate rank, at 1000 skill points. Then he added 1 more point to achieve Expert rank.
The jump in skill level felt like a thunderbolt striking him from the sky. His whole body was paralyzed.
In an instant, his mind was clear as unfamiliar memories started to file in.
During his climb up the general surgery skill tree, Zheng Ren did not feel any noteworthy changes. That was because he was a general surgeon and was routinely exposed to pertinent cases. Even when he got 2000 skill points in general surgery, he only felt pride for his achievement.
This was a different case. Zheng Ren went from zero to Expert and it made him regard the System with wonder.
He had a total of 189920 experience points, worth around 52 hours. Equipped with the Expert rank, Zheng Ren bought 50 hours of surgical training time. The remaining points would be kept as a backup.
Interventional surgery training had begun!