The Surgeon's Studio

An ambulance was just a mobile emergency treatment facility.

The procedures that could be performed in it were limited.

Zheng Ren had set up a simplified version of a closed chest drainage system to ensure the patient’s breathing was unobstructed and that she would not die of pneumothorax. He then used the suction tube to remove blood from her upper airway to prevent it from clotting, which would result in blockage of her airway.

On top of that, he applied pressure onto Yang Lili’s stab wounds on her abdomen to reduce bleeding.

Faster! Faster!

Zheng Ren kept urging the ambulance driver on.

Sea City General Hospital and No. 9 Elementary School were not that far apart, but the thick metallic scent of blood heightened Zheng Ren’s anxiety.

The ambulance would normally be unable to drive at such speed even with its sirens at maximum volume.

However, with a police car clearing its path, the combination of both sirens cut through the traffic between Sea City General Hospital and No. 9 Elementary. No one knew what happened but all gave way to the two vehicles.

Even at traffic lights, cars stopped to let the police car and ambulance by.

Inside the ambulance, Zheng Ren tried to calm himself despite the terrifying vitals on the monitor and the undetectable blood pressure.

He removed his blood-covered gloves and picked up his cellphone.

“I’m Zheng Ren. Prepare for emergency surgery.

“Yes, pre-operative procedures are not done yet.

“There’s a blood sample, send someone to take the sample and prepare for transfusion.

“Notify the thoracic surgeon to meet me at the operating table. We’ll be operating together.

“Ask Yanran to prepare the double-lumen endotracheal tube.”

Upon hanging up, Zheng Ren frowned deeply. Yang Lili’s breathing was very weak, with deep breaths taken at intervals.

Such breaths were commonly referred to as “gasping” for air on one’s deathbed.

Her condition was very bad. He flushed the dextrose but there were no changes in blood pressure, which remained undetectable.

The police car and the ambulance sped all the way to the emergency department of Sea City General Hospital.

Because the attack had happened in a school, the city council informed Sea City General Hospital that they would be overseeing it closely. Director Xiao was already rushing over with his group. Old Chief Physician Pan stood beside the emergency lane with his hands behind his back, waiting for the ambulance. He did not chat with the hospital’s management as his mind was focused on the emergency rescue plan.

Even though Zheng Ren was on the case, Old Chief Physician Pan was not slacking.

If he managed to develop a more comprehensive rescue plan, he could identify possibly overlooked details more easily, allowing him to pull off the emergency rescue.

Finally, the police car and ambulance arrived.

The high-pitched piercing of the police siren sent Old Chief Physician Pan’s blood pressure skyrocketing and disrupted his thoughts.

Why were they being escorted by a police car? Why was there damage on the front and side of the ambulance? Old Chief Physician Pan was puzzled but had no time to think about it.

The police car moved aside for the ambulance to come to a halt and park steadily in the emergency lane.

The back door of the ambulance opened as a stretcher trolley reached it. They transferred Yang Lili onto the trolley and Zheng Ren ran towards the operating room with her.

Since this was a high-profile case, many from hospital management were there.

A few of them crowded over to make their presence known.

Zheng Ren pushed them aside as they were blocking the way, not caring who they were.

There was someone standing by at the lift. A dark red trail of blood dripping across the marble floor of the emergency building of Sea City General Hospital like a path of blooming flowers.

The nurse from the 120 ambulance passed several tubes of blood to a doctor who made for the blood bank. Their remaining blood samples would be sent to the lab in the emergency department.

Even though it was an urgent emergency rescue, they still had to go through standard protocol including testing for HIV and syphilis.

Two years ago, National Taiwan University Hospital had missed out on one point during an emergency and infected all their organ transplant patients with HIV.

Some procedures had to be completed, but they would omit steps that were unnecessary.

Zheng Ren ran all the way to the operating room on the third floor with the stretcher trolley.

Su Yun, Yang Lei, Xie Yiren, Chu Yanran, Chu Yanzhi and the operating room nurse were all already on standby. The operating room door was also wide open.

There was complete silence but for the faint sound of the stretcher trolley’s wheels rolling against the marble floor.

Zheng Ren handed the trolley over to be delivered to the operating theater while he went straight to the changing room to prepare for emergency surgery.

This was very different from the emergency they had had in Imperial Capital.

When Fang Lin had been injured, he received treatment immediately. This time, however, the golden window for emergency rescue had been lost during the journey to the hospital.

Zheng Ren was not confident that he could save the patient.

Still, regardless of how he felt, he had to save her!

She had used her body to protect the children.

He needed to protect her in return at all costs.

After changing as fast as he could, he strode to the operating room while putting on his surgical cap and mask.

When Zheng Ren arrived, the patient was already on the table.

She was positioned slightly lower. Su Yun had considered the possibility of two concurrent surgeries.

He was in the midst of setting up the closed chest drainage system and did not choose the second intercostal space along the midclavicular line, instead inserting the tube between the sixth and seventh intercostal space along the midaxillary line.

The former option could remove trapped gases, but the latter could allow the drainage of blood. In the ambulance, Zheng Ren had been wary of draining a lot of blood, if the patient lost too much, it would lower her intrathoracic pressure and lead to even more hemorrhaging.

Things were different in an operating room.

“Where should we start?” Su Yun asked.

“Where’s the thoracic surgeon?” Zheng Ren frowned and started scrubbing in.

“Almost here.”

“Thoracoabdominal incision at… raise her right side by 45 degrees,” Zheng Ren said.

General surgery required the patient be in the supine position, but thoracic surgery needed the patient to be in the lateral position.

Since both surgeries would be performed simultaneously, they had to compromise and choose between the two. Even though their surgical view would be restricted by doing so, it would be worth the time they could save.

Su Yun did not speak, moving the patient into the instructed position after completing the suture to secure the closed chest drainage tube.

“Double-lumen endotracheal tube.” Zheng Ren walked to the operating table after scrubbing in.

“Got it,” Chu Yanzhi said.

Chu Yanran also had no time to talk, being busy setting up endotracheal intubation and adjusting the parameters of the ventilator.

Xie Yiren passed him the oval forceps and kidney dish. Zheng Ren picked up several iodophor balls and began disinfecting.

After that, he scrubbed his hands again and put on a sterile surgical gown. As he did so, the thoracic surgeon and other directors of the hospital arrived.

“How’s the patient?” Old Chief Physician Pan asked from behind Zheng Ren

“Not good.” The latter reached out and the handle of the scalpel was put in his hand.

“Does she require a joined incision?”

“Punctured lung, most likely with vein ruptures that need to be treated. Intestinal punctures in the abdominal cavity while the superior mesenteric artery is also ruptured. I’m not sure the extent of the intestines we’ll have to remove.” After the incision, he had direct access to the peritoneum without the need for blunt dissection.

He opened its protective layer and removed the slightly colder, dark red blood via suction.

Seeing the continuous flow of blood, Old Chief Physician Pan immediately called to rush the blood bank.

Right then, a continual supply of fresh blood seemed to be the patient’s only hope for survival.

“How’s the situation in her chest? Is there a CT scan of her chest region?” the department chief of the thoracic department asked at the operating table.