The middle-aged man remained silent. An emergency doctor in charge of ultrasonography dashed over with a portable ultrasound machine cart and examined the elderly man. The diagnosis of cholecystitis was confirmed.
When Chang Yue keyed in the patient’s personal information into the inpatient admission form, only then did Zheng Ren realize that the middle-aged man was Lin Yuanshan, who worked in the province.
The admission process was soon complete, but before Chang Yue could explain the patient’s condition and everything about the surgical treatment to Lin Yuanshan, the directors of Sea City General Hospital, Chief Surgeon Sun of the second general surgery department and a few clerks rushed into the emergency department.
“Mr. Lin, why didn’t you inform me about your arrival in Sea City General Hospital?” Xiao Keming greeted enthusiastically from afar, even extending his right hand from more than ten steps away from Lin Yuanshan.
“The girls from the Chu family said that Doctor Zheng of the emergency department is very professional, so here we are,” answered Lin Yuanshan indifferently, appearing unapproachable and arrogant.
However, Director Xiao and the rest acted as if this was perfectly normal.
“This is Old Chief Physician Pan of the emergency department, and he is Chief Surgeon Sun of the second general surgery department. They’re here to ensure everything is up to par,” Director Xiao introduced them one by one.
Lin Yuanshan nodded, annoyance clearly visible in his slightly furrowed brows.
After chatting casually for a while, Chief Surgeon Sun hurried to the resuscitation room and performed a detailed examination on the patient.
Zheng Ren was also experienced in examining patients, but since he had the System, the clinical examinations were merely for show and mostly performed out of habit. In all honesty, skipping the examination was completely acceptable as the System always provided him with comprehensive information and definitive diagnoses of the patients.
Chief Surgeon Sun’s professionalism and thorough examination eased the irritation in Lin Yuanshan’s eyebrows to a certain degree.
“He has acute cholecystitis. According to the B-scan ultrasonography report, there is a lot of gas near the gallbladder, presumably due to the inflammatory stimulation on the bowel. Surgery is the better option in this case.” Chief Surgeon Sun gave his judgment.
“The patient is old, so we’ve to check if there are any comorbidities,” Director Xiao instructed.
“Sinus bradycardia noted on the patient’s electrocardiogram. Bilateral lung fields are clear without any signs of hypostatic pneumonia. Preoperative blood investigations have been ordered and the laboratory will send the results within thirty minutes,” Chang Yue reported all relevant information.
The nurses had already started preoperative preparations such as urinary catheterization, nasogastric tube insertion, and surgical skin prep.
“How big is the surgical wound?” asked Lin Yuanshan out of worry.
After all, the elderly man was in his seventies and had a previous history of cerebral infarction. His physical condition had deteriorated and slow recovery was inevitable.
Lin Yuanshan’s concerns were not without basis.
“Quick recovery can be expected if we perform laparoscopic cholecystectomy on the patient.” Chief Surgeon Sun comforted him.
“Laparoscopy? Doctor Zheng strongly suggested an open surgery.” Lin Yuanshan expressed his disagreement.
A senior surgeon in his fifties and a young brat in his thirties, who would the family member believe? The answer was pretty obvious.
When Director Xiao heard that Zheng Ren had diagnosed the patient, he asked nervously, “Zheng Ren, you’re highly skilled in laparoscopic surgery, so why did you suggest an open cholecystectomy?”
“This is a case of acute on chronic cholecystitis. I’m worried about the severe adhesions in the peritoneal cavity,” answered Zheng Ren frankly while ignoring the pressure Lin Yuanshan exerted on him.
A medical nerd like him could not possibly perceive that sort of aura.
Lin Yuanshan frowned.
Sorcerers who predicted upcoming misfortunes would be tied to a stake and immolated. Everyone—from westerners in the Medieval period or the modern world, or even easterners—had the same thought on their minds.
It was unconvincing, especially when it was a young man stating that the patient’s condition could be complicated.
Thus, Lin Yuanshan elected to ignore Zheng Ren and asked Chief Surgeon Sun of the second general surgery department directly, “Chief Surgeon Sun, do you think he can undergo minimally invasive laparoscopic surgery?”
The Chu sisters had already left to prepare for general anesthesia, but their presence would likely not have changed his mind anyway.
“It’ll be difficult,” replied Chief Surgeon Sun truthfully. After answering the question, he quickly turned around and blinked innocently as a form of apology to Old Chief Physician Pan.
“If surgery is necessary, I would like Chief Surgeon Sun to perform the laparoscopic surgery. Open surgery can be attempted when laparoscopy fails,” said Lin Yuanshan decisively.
“Is the emergency operating theater fully equipped?” asked Director Xiao.
If he were honest, Director Xiao would have preferred to let Chief Surgeon Sun handle the operation as well. After all, he was a senior consultant with impeccable skill at surgery, so the chances of success would be much higher.
As for Zheng Ren… It was better for him to stay out of a case that involved a very important patient.
“Yes, I’ve done some laparoscopic cholecystectomies recently,” Zheng Ren remained unconcerned and added, “Chief Surgeon Sun, please check the equipment later and make sure everything is well prepared. You can get a replacement from the general surgery department if there are any missing or incompatible instruments.”
“It should be fine.” Chief Surgeon Sun had a feeling that he had fallen into a trap. He preferred not to provoke these two troublesome emergency doctors, which was why he always backed out of any conflict with them.
However, his involvement in this special case was something he could not have foreseen.
“Once the blood test results come back and there aren’t any contraindications for surgery, let’s proceed to save the patient.” Director Xiao tried to create a relaxing atmosphere and said with a smile, “Sea City General Hospital usually performs around a thousand laparoscopic cholecystectomies each year. We even surgically treated a 108-year-old man last year and he could already ambulate on post-op day one. Don’t worry, Mr. Lin.”
“Hum!” Lin Yuanshan mumbled through his nose and coupled with his worried expression, the atmosphere remained slightly gloomy.
During the wait for preoperative examinations, Chang Yue began documenting pre-admission and preoperative counseling and broke the dead silence in the office with the continuous tapping of her keyboard.
On the other hand, Zheng Ren went to the resuscitation room as he disliked the current office environment.
“You’re an insidious man,” said Su Yun, who followed Zheng Ren everywhere like a shadow.
“What do you mean?” asked the puzzled Zheng Ren.
“You suspected that the patient has severe abdominal adhesions. If whatever you said is true, there is no way he can be treated with laparoscopy,” Su Yun said, “Why didn’t you stop him?”
“Will they listen to my opinion?” Zheng Ren was an honest man, but he was no fool.
He had learned to judge situations more effectively after working in the medical field for so many years. Most importantly, if he insisted on his point after the family members made their own decisions, an argument would be unavoidable.
“Good, you don’t have the heart of Saint Mary. I feel more at ease after knowing this.” Su Yun’s smile stunned a junior nurse, who was preparing the patient for surgery in the resuscitation room.
Zheng Ren felt that this brat was simply causing too much interference in the resuscitation room.
“Let Old Sun perform the surgery first. By the way, I’m curious. How can you tell that the patient has severe abdominal adhesions?”
“In the B-scan ultrasonography image, a band of free air can be seen in the gallbladder area. You can consider that sign as a simple gas disruption in normal patients, but if you look carefully, there isn’t any obvious motility noted in the gas band. That’s why I suspect that some inflammatory organic matter has enveloped the transverse colon and displaced it superiorly to the liver edge.”
Zheng Ren immediately turned on his invincible mode when explaining medical issues.
It was one thing to make conjectures, but it was a different and much easier thing altogether to explain the condition through deduction after acknowledging the final diagnosis of the System.
Su Yun had a pair of delicate eyebrows. The delicacy remained even when he frowned without any trace of solemnity, which made him look calm and steady. His glamor intensified and blinded everyone who peeked in on him.
He desperately tried to recall the B-scan ultrasonography image during the bedside examination.
Was it possible that whatever Zheng Ren mentioned was true? How did he even acquire such an in-depth knowledge of ultrasonography?
