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 Lei’s 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 Yiren’s absence.
Zheng Ren remained oblivious to the truth, however.
His skill points in general surgery were accumulating at a painfully slow rate, still a long way away from Grandmaster.
Zheng Ren thought of practicing the Whipple procedure in the System’s 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 mission—all top general surgeons would have had countless years under their belt. Even though his rewards were meager, it was better than nothing.
Su Yun’s familiar voice came from behind him. “Where did your mind wander off to?”
“I’m just daydreaming.”
“Are you thinking about Little Yiren? You’re 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, it’s embarrassing,” Zheng Ren refuted without hesitation.
“I’m talking about you, just get the gist of it.” Su Yun smiled, unbothered by Zheng Ren’s retort, which if anything proved his claim.
“How’s the patient?” Zheng Ren asked.
“He’s stable, I just removed the tube. From his current condition, he’ll 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 patient’s survival was all but assured.
“Also, the paper on the hepatocellular carcinoma nodules has been received. I’ve just received a phone call from them asking if there were any more similar cases.”
“Not at the moment,” Zheng Ren said, “Can’t we just publish it as a case study?”
“Yes, but it’ll be slower to gain traction,” Su Yun said, “That stuff doesn’t concern you, anyway. You’re just a wimp, forever doomed to be a chief resident in Sea City.”
“It’s the same everywhere. Didn’t you also leave Imperial Capital?”
“Boss, are you interested in a veterinary hospital? I’m not asking you to work there, I’ll 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.
“They’d mostly be Goldens or Alaskan Malamutes that accidentally swallowed socks which resulted in intestinal obstruction. With your skill, I can safely say you’d finish one surgery every 20 minutes,” Su Yun said, “We can negotiate your pay.”
“I…”
“Don’t say you don’t 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 don’t have a veterinary license. Is that allowed?”
“It won’t 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.
“We’ll do it someday then.” Zheng Ren had no choice but to bow down to reality.
He got butterflies in his stomach at the thought of Xie Yiren’s 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, there’s 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 System’s diagnosis—gallbladder torsion and acute gangrenous cholecystitis.
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 Ren’s 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 cholecystitis had already set in.
At Zheng Ren’s arrival, Chu Yanran said, “Aunt Lin started having abdominal pain after breakfast this morning but didn’t 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 couldn’t endure it anymore, and so she came to the hospital for treatment. There were no chills, fever, nausea, or vomiting. I’ve already done the routine blood and liver function tests; the results should be back soon.”
“It’s acute cholecystitis. She needs to have surgery,” Zheng Ren said.
“You’re Dr. Zheng?” a man in his thirties asked.
He had gold-framed glasses and a studious face, currently etched with worry.
“Yes, that’s me,” Zheng Ren answered.
“Nice to meet you, I’m Zhou Wenxiang.” Despite his anxiety, the man kept his composure and shook Zheng Ren’s hand.
“Dr. Zheng, you said that my mother needs to undergo surgery. Is it okay if she doesn’t?”
“I think she has a gallbladder torsion, resulting in local necrosis leading to acute gangrenous cholecystitis. 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 don’t recommend conservative treatment as it won’t help with the symptoms.”
Zheng Ren’s 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, you’ve never made any diagnoses based on them.” No incongruence could be hidden from Chu Yanran’s keen eyes.
“That’s because they did not identify any problems. I’m just pointing it out now since this is a rare emergency.”
Chu Yanran tipped her head and thought it through; Zheng Ren’s explanation made sense and she did not pursue the matter.
Zhou Wenxiang’s voice rang out. “Chief Xia, can you help us? My mum is still in great pain but doesn’t want to opt for surgery.”
[1] Possibly referring to gambling.