The Surgeon's Studio

Zheng Ren put on his lead apron and scrubbed in.

When the surgical drapes were in place, Dr. Shen took a step back. He was surprised when it was not Department Chief Kong who entered the operating room.

“Little Shen, assist Boss Zheng. Time is of the essence,” Department Chief Kong’s voice echoed through the speaker.

Dr. Shen did not argue. His boss had spoken.

Nodding in response, he left to wash his hands and put on a surgical gown.

Lin Jiaojiao laid on the operating table. Without a second’s hesitation, Zheng Ren performed a radial artery catheterization.

It was successful on the first attempt and the introducer sheath was put in its place. The guide wire was fed into the artery at incredible speed. As the scrub nurse tied the strings of his surgical gown, Dr. Shen heard Zheng Ren urge him, “Hurry up.”

Dr. Shen was baffled.

Was the man talking to him?

Who did he think he was? This doctor from a small city was criticizing him for following standard gowning protocols?

Many high-ranking doctors liked to throw their weight around in smaller hospitals and pick on junior doctors. There had been cases where junior doctors resigned en masse, unable to cope with the mental harassment.

However, those were senior doctors from esteemed hospitals.

‘This guy is from a small city. Who does he think he is?’ Dr. Shen glared spitefully at Zheng Ren.

Bullies were not limited to school grounds. They existed in operating rooms as well.

Some fly-in surgeons had thrown tantrums in operating rooms when they found the surgical tools not to their liking.

However, this was the first time he had encountered someone criticizing his gowning speed.

“Hurry up! We’re waiting for you to start up imaging,” Department Chief Kong hollered over the speaker. He could not see Dr. Shen’s dissatisfaction, only the man’s unhurried pace.

Dr. Shen was startled.

He had just washed his hands and imaging was already on its way?

Impossible.

The department chief’s orders succeeded in making him speed up. A million questions ran through his mind as he put on his sterile gloves.

Once he was set, he walked up to Zheng Ren’s side. The scrub nurse exited the room and the heavy lead door shut soundlessly behind her.

Radial artery catheterization was complete. The guide wire and catheter were all in place. Zheng Ren’s crossed arms were still, clearly waiting for Dr. Shen to show up.

‘He’s already in position?’ Dr. Shen was shocked.

Zheng Ren saw the assistant zoning out and said sharply, “Pressure injector.”

“Em…” Dr. Shen snapped out of his daze and immediately connected the guide catheter to the injector.

With the device on, Zheng Ren commenced angiography.

The signal from the patient’s body was thrown onto the display screen. Dr. Shen was surprised to see the catheter positioned right at the carotid bifurcation.

The ophthalmic artery was branched off the internal carotid artery. Dr. Shen was amazed by Zheng Ren’s ability to maneuver the guide wire to the carotid bifurcation without any imaging assistance. His anger faded before such undeniable talent.

He felt guilty for making the surgeon wait.

Avoiding eye contact with Zheng Ren, he realized the man was not being insolent; he was.

If it were his own boss standing there, a hemostatic clamp would already be flying at his head.

Dr. Shen vowed not to humiliate himself in front of this outsider.

Department Chief Kong was one of the more mild-tempered supervisors. He did not want to risk failing his residency.

When his senses returned, Zheng Ren was already performing superselection. Onscreen, there was no contrast in the ocular region, indicating a distinct lack of blood reaching it.

‘What’s the next step? Thrombolysis?’

“30000 units/cc urokinase in 100ml saline solution. Prepare for thrombolysis,” Zheng Ren ordered.

Dr. Shen was still deep in thought, one step behind Zheng Ren.

When the assistant doctor did not move, Zheng Ren nudged him with his right shoulder. “Get the nurse to prep the solution.”

Dr. Shen startled and mumbled, “…Yes.”

Zheng Ren switched off the imaging system as the scrub nurse entered the operating room. “100ml saline, 30000… No, 50000 units/cc urokinase.”

The dosage was higher than usual, but Zheng Ren had weighed the risks. Time was of the essence and the patient was not geriartric, so an acute, high dose of urokinase was unlikely to elicit an adverse reaction.

The scrub nurse was quick on her feet and soon, the urokinase solution was fitted into the pressure injector.

Zheng Ren started up the imaging system again and paid close attention to the screen.

“You moved,” Zheng Ren pointed out. There was a hint of frustration in his tone.

“Ah?” Dr. Shen had only an unrefined response to give. Had he moved?

At that moment, Department Chief Kong’s voice boomed through the speakers again. “Little Shen! What are you doing? Hold the catheter steady!”

Dr. Shen wanted to cry.

Had he made a mistake? No.

He had performed each step according to protocol.

He simply could not keep up with Zheng Ren.

Zheng Ren was like a Ferrari at top speed while Dr. Shen was a 30-year-old Jetta, struggling to keep up. His movement had been an unintentional mistake on his part and had cost them precious minutes as Zheng Ren would need to perform superselection again.

However, Zheng Ren did not make a fuss as he repeated the procedure.

Once it was done, the urokinase solution was administered into the ophthalmic artery.

Zheng Ren handed the guide catheter to Dr. Shen once more and chided him, “Hold it steady. Any movement will require selection again. It’s all very tedious.”

Dr. Shen wanted to protest his innocence. He understood the intricacies of the procedure but could not explain his earlier mistake.

After all, he had performed interventional surgeries before and was at least an Expert by the System’s standards. However, he was insignificant compared to Zheng Ren.

Had this been a routine surgery, Zheng Ren would have done things a few beats slower. Dr. Shen might have been able to keep up.

However, given the emergency nature of Lin Jiaojiao’s diagnosis, there was little time left before the damage became irreversible. The unnatural speed at which Zheng Ren operated left Dr. Shen in shambles.

Zheng Ren left Dr. Shen with the catheter and went into the control room. “Department Chief Kong, what’s your view on this?”

“The urokinase will help but the large amount of hyaluronic acid might not be so easily removed,” Department Chief Kong said with a frown.

The patient’s condition would not deteriorate as quickly as that of a simple thrombosis. Zheng Ren’s hypothesis was spot-on.

Presumably, blood supply to the eye had been cut off by hyaluronic acid causing an obstruction in the ophthalmic artery.

This was a tricky case, indeed.

Zheng Ren nodded, then turned to Su Yun. “Are you able to assist?”

“No issue, I only had a pound of alcohol[1].” Su Yun, ever the attractive drama queen, let out a breath of air that made his tousled, black curls twirl.

Without a word, Zheng Ren looked at Department Chief Kong.

The chief took a moment to consider, then he nodded his assent.

“Scrub in,” Zheng Ren said to Su Yun.

[1] 一斤酒 translates directly, as Su Yun is bragging about his alcohol tolerance.