Ling Ran was indeed carrying out emergency surgery.
The patient was under general anesthesia. After his abdominal cavity was open, a small amount of fluid could be seen oozing out. There was a large amount of blood-like fluid oozing out around the spleen. Together with the fact that the spleen had adhered to the abdominal cavity, the patient’s abdominal cavity was practically a mess. It looked like a pot of almost dried-out hotpot.
If this were to happen more than two years ago, doctors from the General Surgery Department would have been called over, and the patient would have been quickly transferred to the General Surgery Department.
However, the chief surgeon today, Doctor Zhou, had other ideas. He called Ling Ran over, and when Ling Ran was standing before him, he immediately said, “Ling Ran, you’re capable of performing splenic surgery and surgery on patients with peritonitis, right? How about pancreatic surgery? Do you know how to do it?”
“I don’t know how to perform pancreatic surgery, and I have not operated on many patients with peritonitis either,” Ling Ran answered frankly.
He was capable of total splenectomy, and it was so easy for him that it felt just like a game. Peritonitis was not very hard to deal with either, and Ling Ran was still learning how to do that on his own. But pancreatic surgery was very hard, and he had never really done it up until now.
Doctor Zhou nodded when he heard that. As he washed his hands alongside Ling Ran, he said, “The patient has already done an abdominal as well as pelvic CT and was initially diagnosed with splenic rupture along with effusion around the spleen. There is also the possibility of peritonitis and pancreatic pseudocyst. Now, can you continue with the exploratory laparotomy and deal with his spleen? If you encounter a problem with the pancreas, I’ll call a doctor from the General Surgery Department over. If there’s no problem, there would be no need to trouble them.”
Ling Ran agreed without thinking much of it. In his opinion, even though this was a more complicated emergency surgery, he could deal with it with the skills he possessed.
Doctor Zhou breathed a sigh of relief. As of late, the relationship between the Emergency Medical Center and the General Surgery Department was not as good as it seemed on the surface.
Now that the Emergency Medical Center was becoming more and more renowned, they had been taking in a lot more patients who needed emergency surgery. That was because more patients from other counties, other areas, and even other cities had been seeking emergency surgery here. This was a natural progression as the Emergency Medical Center upsized and became more known to other people.
On the other hand, patients suffering from internal medicine diseases such as myocardial infarction and cerebral infarction would most probably choose to head to Yun Hua Provincial Hospital or the People’s Liberation Army General Hospital. This was because Huo Congjun mostly held authority in the field of emergency surgery, and the Emergency Medical Center was not really capable of dealing with that many internal medicine diseases. Besides, compared with emergency surgery, Huo Congjun was not really inclined toward developing the Emergency Medical Center so that it had the capacity to treat more internal medicine diseases.
Moreover, because Ling Ran’s treatment group had greatly increased the number of surgeries carried out, the ratio of patients receiving emergency surgery to patients with internal medicine disease in the Emergency Medical Center was huge. Naturally, they had breached the territory of the General Surgery Department.
The General Surgery Department was still relatively calm in the face of this situation, though. After all, they had so many surgeries and patients that the doctors in the department could barely handle all of them. It was to the point that it was becoming a burden. But this did not mean that they would sit idly by as the Emergency Medical Center breached their territory.
In the past, whenever doctors in the Emergency Center carried out appendectomy and operated on patients with intestinal obstruction, not only did the General Surgery Department not care, but they were also very happy about it.
Even after Ling Ran started carrying out liver surgery, the development of the General Surgery Department was not really affected. However, the Emergency Medical Center was threading a thin line when they started carrying out gastrointestinal surgeries. Take gastrectomy as an example. The General Surgery Department themselves needed to scramble for patients with the Digestive Surgery Department. Of course, they were not happy now that the Emergency Medical Center had joined in the fight. The only reason the two departments had not gotten into a conflict yet was that the Digestive Surgery Department never showed any objection and Huo Congjun was an oppressive person.
With the way that the Emergency Medical Center continued to increase in scale, though, the General Surgery Department’s attitude toward the matter had generally changed. If Doctor Zhou were to encounter such a patient in the past, he would have called a doctor over from the General Surgery Department without hesitation. However, he now had to put much more thought into it.
When it came to splenic surgeries, no one really knew which department held the jurisdiction. If the General Surgery Department were to take this opportunity to meddle with the patients in the Emergency Medical Center with spleen problems, Doctor Zhou would get into trouble.
He recalled the way Huo Congjun mercilessly scolded resident doctors. Doctor Zhou was once a resident doctor, and this memory was fresh in his mind.
“Since you’re capable of treating the patient’s spleen, we’ll handle this within our department. Nonetheless, this patient’s symptoms are kind of special, so you’ll have to pay extra attention to it.” Even though Doctor Zhou was concerned with office politics, he only talked about the patient’s symptoms with Ling Ran.
As long as the patient’s symptoms were alleviated, the problems related to office politics would be solved naturally. Doctor Zhou was confident in this.
Ling Ran was washing his hands, and he could feel the strength of the water that flowed out of the faucet. “What’s special about it?”
Doctor Zhou organized his thoughts and said, “Two months ago, the patient started experiencing upper left abdominal pain without known reasons. It is a continuous, distending pain, and it happens along with distending pain in the waist too. The pain is also relatively intense. After he went to consult a doctor in a county hospital, the doctor treated him by alleviating his symptoms, and he showed some improvements. However, not long after he was discharged, the pain happened again, and without any known reasons too. He then got admitted into a local hospital and received treatment that focused on the symptoms too. Even though the symptoms were once again alleviated, it came back soon after he was discharged, which is why he came to Yun Hua Hospital…”
“He wants further treatment? Shouldn’t he have gotten a slot in a specialized department instead…?”
“The patient took an ambulance over. He came too late and was unable to get any slot, so he came to the Emergency Department. We thought about transferring him to another department, but he went into circulatory collapse, perhaps because the journey was too tiring to him. So we had no choice but to send him for emergency surgery.” Doctor Zhou did not talk much about the patient not being able to get a number.
For top tertiary Grade A hospitals in an area like Yun Hua Hospital, a lot of patients brought slots from scalpers to see specialists. This was why a lot of patients started queueing up the day before for slots.
For patients like the one they were dealing with right then who had been experiencing continuous abdominal pain and could not get a slot at a short notice, he had no choice but to go to the Emergency Department.
This could be considered a technique used by patients to receive proper treatment. If there was really a need, after obtaining a place in the Emergency Department, the Emergency Department would transfer them to specialized departments. Even though it involved going through unnecessary procedures, they would at least get to receive adequate treatment. Correspondingly, patients who sought treatment using this method had no control over which department they would be transferred to. It was just like a student who allowed the government to place him in whatever university they wanted after he passed his college entrance examination.
After that patient was sent into the operating theater for emergency surgery, he would have even less control over who the surgeon was. Doctor Zhou did an exploratory laparotomy, and if the patient’s illness required general surgery, Doctor Zhou could call a doctor from the General Surgery Department over. He could also ask Ling Ran to do it or do it himself. However, if he found out that the patient suffered from an illness that required other kinds of surgery, he would have to call over doctors from other departments.
Ling Ran listened to Doctor Zhou as the latter explained the patient’s situation. After he wiped his hands dry, he tossed the towel into a pail. He crossed his hands before his chest and returned to the operating theater. He saw that Ren Qi who was acting as the assistant was aspirating the thick, blood-like fluid in a flustered manner.
“Are there fresh blood oozing out?” Ling Ran craned his head to look at the patient’s abdominal cavity.
“Yes, the situation inside the abdominal cavity is very complicated.” As a doctor who was there for in-service training, Ren Qi had seen many things and was considered very experienced. He could be said to be a well-rounded member of the Ling Treatment Group. If a person were to put it in more practical terms, he could compare Ren Qi to a blue-collar worker at the prime of his life. Even though that blue-collar worker was not exceptionally talented or skillful, because of his years of experience and hard work, he could be put into good use in various kinds of occasions.
He was not especially good at anything and was just an ordinary doctor. But he did really have any obvious flaw, and he rarely made any mistakes. Even when he made mistakes, they were mistakes that could be easily rectified. Hence, he had plenty of opportunities to participate in surgeries within the Ling Treatment Group.
Despite that, Ren Qi was mediocre when it came to observing the situation.
Doctor Zhou looked at the patient’s abdominal cavity and gently fiddled with the organs a little. “The problem right now is that the adhesion is too serious. His abdominal cavity has adhered to the abdominal wall, and the cauda of his pancreas is surrounded by the adhered structures. And the blood is probably oozing out from his spleen…”
Ling Ran hummed in acknowledgment and looked at the patient’s abdominal cavity too.
Exploratory laparotomy could be said to be the ultimate method to detect bugs in a patient’s abdominal cavity. Take the patient on the operating table as an example. Even though he had done many scans and examinations, the source of his symptoms could not be traced. But exploratory laparotomy showed that there was hemorrhage in his spleen and that there were many adhered structures in his abdominal cavity. A diagnosis was easily made.
“Seems like a chronic splenic rupture.” Doctor Zhou sighed and said, “With such serious adhesion, I’m afraid that we’ll have to remove his spleen along with the cauda of his pancreas.”
Ling Ran raised his head a little and said, “I’ve never done it before.”
“Alright… If you can’t do it, I’ll call someone from the General Surgery Department over…”
“I can separate the spleen and the cauda of the pancreas.” Ling Ran’s words gave Doctor Zhou a pleasant surprise.
Doctor Zhou immediately became elated, but he became a little hesitant soon after that. “Don’t force yourself. What if something wrong happens? It would be good enough if we can keep the rest of his pancreas…”
“I’ll give it a try.” Ling Ran did not promise anything either. The pancreas was renowned for being a very tender organ. If a person were to hold a pancreas, he would feel like he was holding a bag of oil. It was extremely difficult to separate the pancreas from other structures.
Doctor Zhou immediately felt at ease. He said with a smile, “It would be best if separation is possible…”
“Oh, by the way, tell Zuo Cidian that I’m doing this.” Ling Ran reminded Doctor Zhou. This surgery would definitely take more than one and a half hours.
Doctor Zhou hummed in acknowledgment and asked, “What’s Zuo Cidian up to?”
“Hospital Director Bo from Junan Clinic invited the director of Dongjia Group over. They’re probably going to arrive at the VIP patient building soon,” Ling Ran explained.
Doctor Zhou’s eyes almost shot out of his sockets. “Today?”
“Yeah. He sent me a message half an hour ago to say that they have landed.”
“They’re here today, I mean, now?” Doctor Zhou confirmed again.
Ling Ran nodded. “I’m going to get started with the separation.”
After he said that, he ignored Doctor Ling and started operating on the patient.
Doctor Zhou stood beside Ling Ran and muttered. ‘So, I’ve still gotten myself into trouble, haven’t I?’
