The Surgeon’s Studio

The operative view opened up, revealing a 5cm wound on the left side of the liver. Despite the rubber drainage tube controlling the bleed at the hepatic hilum, there was still a significant amount of blood flowing out.

Zheng Ren immediately started to clean the wound. There were no signs of necrosis yet as the wound was still fresh.

An in-depth investigation revealed the tear to be on the inside of the liver, around 4cm deep. A few blood vessels were leaking dark red blood.

Zheng Ren extended his arm and a mosquito clamp was placed in his hand.

The ruptured blood vessels were clamped and ligated, followed by the damaged bile duct.

Once the bleed was controlled, Zheng Ren let out a breath of relief. The drainage tube indicated that the bleeding had stopped.

“Blood pressure?” Zheng Ren asked.

“80/60,” Chu Yanran answered.

The ruptured spleen was removed and the bleed at the liver was controlled. In response, the patient’s vital signs took a turn for the better.

The patient would be better after a transfusion of 16U of blood and 1000ml of plasma.

Zheng Ren assessed the area around the wound of the liver and said, “Call Su Yun. Ask if he is confident with handling a hemorrhagic shock patient post-surgery. If he is, get him to the ICU.”

Chu Yanzhi hesitated slightly before dashing out of the operating room to wake the drunken man.

Zheng Ren cut out a part of the greater omentum and used it to plug the leak. Then, he used an interrupted mattress suture to close the wound. The distance between each stitch was precisely 1 centimeter.

[His stitchwork is perfect! You could use a caliper to measure the 1cm!]

[Amazing! The surgeon is very attentive. He left a piece of the greater omentum at the wound to prevent capillary bleeding after blood pressure is restored.]

[To reach his level of skill, one cannot be anything but attentive. Young ones, let me tell you, you need to develop yourself with each surgery.]

[How many minutes have passed? Fifteen?]

[From my calculations, the whole operation took around 13.5 minutes from spleen removal to stitching up of the liver. It’s not a big operation but their speed is impressive.]

[In a life or death situation, speed is key. Notice the surgeon did not make a small incision and just went for a 25cm cut. This surgeon is efficient.]

Xie Yiren had warm saline water ready when the suture was complete.

The abdominal cavity was irrigated, and after that, the mixture of bodily fluids and saline water was aspirated.

Zheng Ren double-checked the abdominal cavity and area of the splenic hilum. He placed drainage tubes at both the splenic hilum and the liver wound and began closing the abdomen.

“Su Yun is awake. He’ll be there soon,” Chu Yanzhi reported when she got back.

“Is he completely awake?”

“Sounded like it.” Chu Yanzhi’s hands were icy from the frozen blood bags. She rubbed her hands to warm them and as she thought of last night’s amazing feat, a smile graced her face.

“Good. The ICU is better-equipped and better-staffed.” Zheng Ren had to agree.

He predicted that the patient would not have many post-surgery complications, but to be safe, he wanted the patient to stay in the ICU for one or two days of observation.

The number of patients who would require the same treatment was not on his mind.

He only focused on the emergency at hand.

“Inform the ICU to prepare a ventilator. Patient arriving in 20 minutes,” Zheng Ren ordered.

Suture, closure. The patient was intubated and sent to the ICU.

Chu Yanran sat atop the trolley bed with her legs tucked to minimize occupied space.

Her position was awkward as she clutched the ventilation bag to sustain respiration. She had to keep an eye on the patient’s vitals during transport.

After transporting the patient, Zheng Ren rushed back to the emergency department.

Although the surgery was quick on his part, from end-to-end, it had taken nearly an hour.

In that time, other injured patients had been brought in.

At the emergency room, Old Chief Physician Pan was managing the crisis. The old chief was calm and collected as he assessed each patient’s condition and triaged them to particular departments.

Zheng Ren’s eyes swept across the room. There were many patients, but most of them had fractures or external head injuries that were minor. His shoulders sagged in relief.

He asked around and found two more patients that had come in with internal hemorrhaging. The more severe case was sent to the second general surgery department with Chief Sun heading that rescue. The other case was sent to the first general surgery department for the deputy chief to work on.

Old Chief Physician Pan was seated calmly amidst the chaos, his presence a source of comfort for many.

As the families of these patients had yet to arrive, medical administrative personnel were extremely busy. They were taking down patients’ details, conditions, justifications for surgery—all information required by-law.

As medical lawsuits were on the rise, the hospital made sure to be extra cautious with legal procedures. The paperwork had to be perfect even in emergencies like this.

This was after receiving hundreds of lawsuit threats in a year.

Zheng Ren once heard an old physician say that back in the eighties and nineties, even though public safety was lacking, doctors were very much respected by society. People with injuries could come in and be treated as an anonymous patient. The lack of procedure meant quicker emergency response.

Now, if a doctor dared to do as such… Zheng Ren was sure one encounter with an unscrupulous family member would end their whole medical career.

Old Chief Physician Pan saw Zheng Ren and asked, “How did the surgery go?”

“Laceration at the liver, ruptured spleen. Surgery went well. The patient’s in the ICU now,” Zheng Ren summarized.

“Good.” Old Chief Physician Pan nodded and said, “There’s a lot of patients today but only a few had internal lacerations and all were from the Pentium Overpass incident. Fractures and external head injuries were the main conditions observed in the other patients. We’ll have to monitor them.”

Zheng Ren uttered a grunt of acknowledgment.

“We need to keep an eye out for delayed traumatic intracranial hemorrhage. Stay on guard,” Old Chief Physician Pan instructed.

Zheng Ren nodded in assent.

As time passed, more patients with minor injuries were admitted. All 120 ambulances were overloaded but even so, a few victims could not catch one and had to walk to the hospital in the cold weather.

These patients mostly exhibited minor external injuries. It was likely that the sudden snow and frozen road made them lose control of their cars, resulting in a frontal collision.

Some of the patients were elderly people who had been on walks. The frozen pavement had caused them to slip and fall, leading to multiple cases of Colles’ and intertrochanteric fractures.

Zheng Ren guessed that the orthopedic department would be bustling. Sea City General Hospital had four orthopedic departments and each received around ten patients.

This was excluding patients with Colles’ fracture being treated in the emergency department.

Colles’ fractures were largely caused by indirect trauma. It was a condition commonly observed when people tried to break their fall with their hands. The frozen ground played a role in today’s incidents.

With the forearm extended and the hand outstretched, the force of a fall would cause the distal end of the radius to fracture.

The treatment was simple—resetting, immobilization with a splint and medication that improved blood flow.

Under normal circumstances, if the patient wanted to stay for further observation, they would allow it. However, with the emergency today, the doctors advised them to recuperate at home.

The whole emergency department was filled with patients. There were no available beds for observation.

Zheng Ren was not from orthopedics. He had only performed resetting once or twice during his housemanship and therefore was of not much use.

For the whole afternoon, he stuck to observing, diagnosing, and distributing the patients.

At 2:25 in the afternoon, a call came from the ICU. The hemorrhagic patient’s condition required input from all departments.

The ground outside was frozen over like a layer of glass. People avoided the outdoors and the number of new patients gradually decreased. Old Chief Physician Pan noted the situation in the emergency room had stabilized and told the doctors on duty to call him if there were any problems. Then, he brought Zheng Ren with him to the ICU.