Chapter 276 - 182: Wang Zhengchu

Chapter 276: Chapter 182: Wang Zhengchu

Outside the operating room.

Zhang Sui didn’t know how he had endured the past two hours.

It was like being trapped in a mire, or having all the oxygen sucked out of the air around him.

He checked the time every few seconds.

But his vision was always too blurred by tears to see it clearly.

One of humanity’s cruelest truths:

Time flies when you’re happy, but drags on like an eternity when you’re in pain.

His ex-wife had screamed curses at him over the phone.

She’d said that even if he went to Hell, he should never forgive himself.

’That’s right, how could I ever forgive myself?’

He remembered Jiaqi as a little girl, throwing herself into his arms; he remembered taking her for ice cream after he’d broken a promise; he remembered giving up his job at the Mayo Clinic and returning to the country without a second thought, all so he could stay in the same city as Jiaqi...

For half his life, he had been rigorous, rigid, and always in pursuit of absolute procedural correctness in medicine.

He had thought the rules could protect everyone, but tonight, he’d watched helplessly as those same rules became a noose tightening around his own daughter’s neck.

If that door were to open and a gurney covered by a white sheet were wheeled out...

Zhang Sui didn’t even know how he would find the strength to stand up if that was the outcome.

This was even crueler than in his previous life.

In the previous life, his daughter’s death had also filled Zhang Sui with self-reproach, but it was mostly a feeling of powerlessness.

In this life, someone had presented a solution to him, and he had personally refused it.

If his daughter really died.

’How would that be any different from killing her with my own hands?’

Perhaps then, the half-life he had spent stubbornly clinging to his principles would become nothing more than an absurd joke.

For the rest of his life.

He would be forever drowning in Hell, fully conscious.

...

The red light indicating a surgery in progress suddenly went out.

Zhang Sui shot to his feet.

He’d stood so abruptly that his vision went black for a moment.

Jiang He walked out, pulling off his surgical mask.

Zhang Sui stared at him, desperate for an answer.

Finally, Jiang He stopped and uttered those five magic words.

"The surgery went very smoothly."

Zhang Sui stared blankly at Jiang He.

Motionless.

After a long moment.

He dazedly raised a hand to his face, only to realize that tears had already begun to overflow.

Once the dam broke, there was no stopping them.

The tears streamed down, washing away his stubbornness.

Zhang Sui slowly lowered his head and sank to the floor.

Finally, he clutched his head in his hands, buried his face in his knees, and his shoulders began to shake violently.

He was sobbing his heart out.

It was the utter exhaustion of surviving a catastrophe, the profound relief of a father who had gotten his daughter back from the brink.

He sobbed brokenly:

"I’m sorry... Jiaqi... Daddy was wrong, Daddy was wrong..."

"As long as you live... as long as you’re okay... Daddy will never force you to do anything again..."

"You can do whatever you want... anything at all..."

"Just be healthy... healthy..."

"I’d even go to Hell... as long as you’re alive... anything is fine..."

So much for King Zhang the Great.

There was only a father scared out of his wits, incoherently begging the gods amidst his prolonged self-recrimination.

A full five minutes passed.

Only then did Zhang Sui use the wall to slowly pull himself to his feet.

His face was still streaked with tears.

But he had a more urgent need to know his daughter’s condition so he could think about the subsequent treatment plan.

He asked in a hoarse voice, "What’s her exact condition?"

Speaking to a fellow professional, Jiang He didn’t need to embellish and answered in purely technical terms:

"Intra-abdominal pressure was approaching 28 mmHg. After opening the abdomen, we found over 1,500 milliliters of exudate, full of saponification plaques. The gastrocolic ligament was macerated, and there was extensive necrosis in the body and tail of the pancreas. I performed a blunt debridement and dissected out the necrotic tissue."

"Was there bleeding?"

"A branch of the anterior superior pancreaticoduodenal artery had ruptured, eroded by the inflammation."

"How did you manage it?"

"Electrocautery was impossible; the field of view was too poor. I used my left hand to locate and apply pressure, and my right hand to place a single suture and tie it off."

Zhang Sui: "?"

His tears stopped in that instant.

’Wait... what is Jiang He talking about?’

’A blind suture?’

’Blind-suturing an arterial branch in an abdominal cavity that was a complete mess? Huh?’

Jiang He continued calmly:

"After clearing the necrotic tissue, I performed a double lavage with six thousand milliliters of warm saline. Then I placed four double-lumen drains: one by the pancreatic head, one in the omental bursa, and one in each of the right and left paracolic gutters. The bowel was too edematous and under too much tension for a primary closure, so I used a Bogotá bag for temporary abdominal closure."

’A Bogotá bag?’

Zhang Sui was stunned again.

In China in ’08, this kind of open-abdomen therapy had only been attempted in a few cutting-edge departments at the most elite Grade A Tertiary hospitals.

It was an extremely aggressive technique that posed a severe test of postoperative infection control.

Zhang Sui stared at Jiang He for a second.

Then, he swallowed all his questions and said, "It’s fine. Continue."

"The irrigation circuit is established. Blood pressure is stable at 90/60. The frequent PVCs have been suppressed with lidocaine. She’s been transferred back to the ICU."

Jiang He finished his report.

Hitching a sob, Zhang Sui gave his recommendations for the next steps in her treatment:

"Next... the focus is on maintaining circulatory stability. With an open abdomen closure, the infection risk—hic—the risk is huge. We have to escalate the prophylactic antibiotics and start total parenteral nutrition (TPN) at the same time... First thing tomorrow, run a full panel of inflammatory markers and a blood culture. Depending on the trend—hic—we’ll decide whether or not to start hemofiltration..."

"Correct." Jiang He fully agreed. The old dean was still very capable, his judgment sharp and precise.

"Good."

Up to this point, Zhang Sui hadn’t said a single word of thanks.

Words are insufficient for such a great favor.

Some things could only be kept in one’s heart, to be repaid slowly with time and action...

Just then, a string of curses echoed from down the hallway:

"What the fuck is with this goddamn weather! The water under the overpass is up to my thighs! My fucking car stalled right there! I had to walk! What kind of shitty roads and shitty drainage are they building?!"

The newcomer was a man of about forty. His hair was soaking wet, his pants were rolled up to his knees, and on his feet was a pair of Crocs caked in muddy water.

Jiang He recognized him.

’An acquaintance.’

’They’d had quite a few dealings in his past life.’

The top knife in general surgery at City First Hospital: Wang Zhengchu.

He was a legendary and highly controversial figure in the Yangcheng medical community.

He was left-handed.

And a pessimist.

Doctors usually talk about having a benevolent heart, but not Wang Zhengchu.

This guy treated his patients as if they were the enemy.

He believed that not a single true word ever came out of a patient’s mouth.

And in fact, whether to evade responsibility, to save money, or out of pure stupidity, patients often concealed their past medical history and the true circumstances leading up to their illness.

Because of this extreme distrust, Wang Zhengchu was in a perpetually foul mood in the clinic and on the wards.

Grumbling, cynical, spewing profanities...

Arguing with patients and slamming tables at family members were all in a day’s work for him.

The complaints about his terrible attitude received by the medical affairs office at City First Hospital could fill several filing cabinets.

If it weren’t for his ridiculously solid professional skills... this guy would have been fired by City First Hospital eight hundred times over.

Wang Zhengchu strode forward and extended his left hand.

"...Dean Zhang? Wang Zhengchu, from City First Hospital. Yang Xu called me, insisted I come over. Where’s the patient? What’s the situation?"

Zhang Sui hesitated for a moment, extending his right hand before realizing it wouldn’t work.

He then switched to his left hand to shake Wang’s and said, "Director Wang, thank you for coming all this way in the middle of the night. The patient is already out of surgery—hic—the operation is finished."

"Finished?" Wang Zhengchu’s brow furrowed. "Didn’t Yang Xu say the case was complex and that the average person wouldn’t dare operate? Who was the lead surgeon?"

Zhang Sui stepped aside, gesturing. "This is Jiang He. He was the one who—hic—who was the lead surgeon for this operation."

"...Jiang He? Uh, I know you. Yang Xu’s student. If I remember correctly, you just graduated, right? You can perform this kind of surgery? An open abdominal decompression for critical SAP?"

Jiang He gave a faint nod. "Yes."

Wang Zhengchu didn’t hold back, questioning him directly: "Once you were in, to what level did you debride the necrotic tissue?"

"I explored posterior to the pancreatic head and medial to the descending part of the duodenum. The necrotic tissue was grayish-black, had lost all tension, and lacked normal glandular structure. The plane of dissection was controlled between Gerota’s fascia and the pancreatic capsule, preserving the core area tissue that still had pulsation and microvascular bleeding."

Wang Zhengchu narrowed his eyes. ’This kid’s got something.’

These were indeed the standard principles for SAP debridement. Someone who only knew theory couldn’t have described that kind of specific tactile feedback.

Wang Zhengchu continued, throwing out another sharp question: "In a situation like that, with the abdomen full of saponification plaques and bloody fluid, what if you’d hit the gastroduodenal artery or one of its branches and caused a major bleed? How would you have controlled it? Don’t tell me you just used the cautery to slowly coagulate it."

"I did hit a branch. A branch of the anterior superior pancreaticoduodenal artery ruptured."

"How’d you handle it?"

"Poor visibility, suction couldn’t keep up. I used my left hand to find the point for compressive hemostasis and locate the vessel, then threw a one-handed blind suture with a 3-0 Prolene in my right hand and tied it in situ."

Wang Zhengchu: "?"

’Locating with the left hand, a one-handed blind suture?’

’What the hell was that?’

Seeing the look on Wang Zhengchu’s face, Zhang Sui felt a little better.

’Right, right, this is how a normal person should react.’

’It wasn’t that he’d been abroad for too long and was out of touch; it was that Jiang He wasn’t normal at all...’

"...How did you close the abdomen?" Wang Zhengchu’s tone had softened just a little.

"I didn’t close it," said Jiang He. "Bogotá bag. An open, temporary covering to leave space for decompression, with four double-lumen drains for continuous irrigation and drainage."

This time, Wang Zhengchu was left completely speechless.

He stared at Jiang He, dumbfounded.

’A Bogotá bag?’

’A freshly graduated student dared to use such an unconventional, cutting-edge technique in a clinical setting?’

’And he actually managed to pull off the entire rescue procedure?’

After a long moment, the corner of Wang Zhengchu’s mouth twitched. "Not bad."

Coming from Wang Zhengchu, those two words were the highest of praise.

"She’s in the ICU, right?" Wang Zhengchu turned to Zhang Sui. "Dean, take me to see her?"

"Yes, this—hic—way." Zhang Sui immediately led the way.

Inside the ICU.

Zhang Jiaqi lay on the hospital bed. Although her face was still pale, the lines on the monitor had stabilized.

Wang Zhengchu walked over, checked the four negative-pressure drainage bottles at the bedside, and then carefully inspected the suture density at the edge of the Bogotá bag.

Clear saline flowed in, and cloudy, pale-red fluid flowed out.

The drainage was exceptionally smooth.

The suturing was exceptionally tight.

Wang Zhengchu straightened up and turned to look at Jiang He.

After watching him for a moment, he suddenly cursed.

"Fuck, what a wasted trip."

Wang Zhengchu turned and stalked out, grumbling as he went:

"You guys at Affiliated Hospital No. 1 have someone this skilled, so why the hell did you drag me over here in the middle of the night? Are you sick in the head?! Yang Xu is just messing with me! What if I catch a cold from being out in the rain? So fucking annoying!"

At that moment, Jiang He called out to him, "Teacher, wait. Let’s exchange contact information."

Wang Zhengchu turned back. "Huh? Why?"

Jiang He spoke softly, "It’s the middle of the night, there’s a downpour, and the overpasses are flooded, yet you still waded through the water to get here. We appreciate the trouble you went through. Consider this a favor that Teacher Yang and I owe you. I know the general surgery department at City First Hospital is under a lot of pressure with bed turnover and a high volume of emergencies. If you’re ever in a bind and short-handed, feel free to call me. If I can help, I will."

His emotional intelligence was maxed out.

Wang Zhengchu froze.

His favorability meter was starting to shoot up uncontrollably...

If this were a gal-game, he’d probably be on the verge of unlocking a special story route.

A few seconds later, Wang Zhengchu snorted coldly.

"Hmph. A surgery at City First Hospital, and you want to call a doctor from Affiliated Hospital No. 1 to do it? Do you even have the credentials? The medical affairs office would have a field day with that. So much damn trouble..."

Despite his words, he still walked over and wrote down a phone number for Jiang He.

Then he turned, and as he walked away, he was still grumbling:

"When the hell is this shitty rain going to stop... Still have to go push my car from under the overpass. What shitty luck..."

Yes, this time, the tone of his grumbling was noticeably gentler.

’Jiang He was satisfied.’

’He hadn’t expected the person his teacher called to be Wang Zhengchu.’

’This was an unexpected bonus for the night.’

’Not only had he saved a life and repaid Zhang Sui’s kindness from his past life, but he’d also managed to lay the groundwork for a powerful connection.’

’Wang Zhengchu’s skills were formidable.’

Jiang He was already thinking about the future.

’If, and this was just a "what if"...’

’If things really developed in the worst-case scenario, and it came to the point where he had to operate on Teacher Shen...’

’...then for that surgery, he could not allow a single mistake.’

’He had to find the strongest, most trustworthy people to assist him.’

’If Yang Xu was his first assistant, then Wang Zhengchu would make an excellent second assistant.’

Wang Zhengchu, walking away, had no idea yet.

That he, a whole department director, the top knife of City First Hospital, had already been marked by Jiang He as a future assistant.

And not even the first assistant, but the second.