I Am Diagnosed as a Medical Titan

"City First Hospital? What's wrong?"

"H1N1. City First Hospital is the designated treatment center, so they were already swamped. With the change of seasons and the heavy rain these past two days, there's been a surge in flu and emergency cases. The emergency department hallways are crammed with extra beds. Wang Zhengchu has an extremely critical acute abdomen case and is short-staffed. He called and asked me to come help out."

Jiang He was already getting dressed. "What do you need me to do?"

"Perform a surgery. It's an extremely complicated one…"

Yang Xu suddenly couldn't hold it in and broke into a violent fit of coughing. "COUGH COUGH COUGH!"

Jiang He stopped in his tracks. "Are you sick?"

"It's nothing, just a bit of a cold." Yang Xu suppressed his cough and got back to the point. "The patient has a pancreatic head mass and severe jaundice. She's now experiencing sudden, intense abdominal pain, and all her vitals are dropping. We suspect a ruptured cyst or a concurrent severe infection. The conventional anterior approach won't provide a clear field of view; the vascular adhesions are a complete mess."

Jiang He pushed open his door and stepped into the hallway. "So you need to use the posterior approach?"

"Right. Avoid the gastrointestinal tract and omentum, go straight in from the retroperitoneum, and mobilize the pancreatic head."

"Can't you do it?"

"The problem is, the patient is pregnant. Twenty-eight weeks."

Jiang He, who was halfway down the stairs, froze.

Twenty-eight weeks.

The uterus would already be enlarged to three finger-widths above the navel, completely upending the abdominal anatomy.

The gastrointestinal tract would be pushed upward, the inferior vena cava would be under heavy compression, and the pelvi-abdominal venous plexuses would be extremely dilated.

Performing a posterior approach under these conditions meant not only was the space compressed to its absolute limit, but nicking any one of those dilated blood vessels would result in a massive, spurting hemorrhage.

A mid-trimester fetus is extremely sensitive to maternal hypoxia. If the mother's blood pressure dropped for even a few minutes, it would mean one corpse, two lives.

"I understand." Jiang He started running down the stairs. "I'll be there as soon as I can."

He hung up and rushed out of the apartment building.

It was pouring outside. A quick glance confirmed that the car was, thankfully, still there.

Su Zhi's car had been fixed, but she hadn't left yet.

Jiang He knocked on the car window.

Su Zhi turned her head, startled for a moment, then immediately rolled down the window. "Mr. Jiang? What's wrong?"

"Are you busy? If your car's working, can you give me a ride to City First Hospital?"

Su Zhi unlocked the doors immediately. "Okay, get in."

Jiang He pulled open the door, got into the passenger seat, and buckled his seatbelt while pulling out his phone to dial Yang Xu's number again.

...

...

City First Hospital, Emergency Department.

It was packed to the gills; there was barely room to stand.

Inside the resuscitation room, monitor alarms blared one after another, and red lights flashed.

"It hurts… Doctor… It hurts so much…"

The pregnant woman on the trauma bed was ghostly pale, gasping for breath in agony. Every gasp sent a convulsive twitch through her abdomen.

Wang Zhengchu stood by the bed, assessing the patient's signs by palpating her abdomen with a meticulously controlled touch while rattling off a rapid series of orders:

"Open two large-bore IV lines! Rapid volume expansion! Draw blood for a CBC, amylase, and lipase! Contact the blood bank and have blood ready now!"

He turned to the cyanotic pregnant woman. Though agitated, he did his best to keep his voice down. "Stop crying! The more you cry, the higher your abdominal pressure gets! Deep breaths! If you want to save your baby, you need to relax as much as you can!"

Outside the resuscitation room, several family members were frantic with worry.

Hearing his wife's agonized cries from inside, the husband couldn't hold back any longer.

He shoved the door to the resuscitation room open and stormed in, his eyes bloodshot as he pointed at Wang Zhengchu and roared:

"Are you even a doctor?! My wife is in this much pain, and you can't do anything?! For half an hour, all you've done is press her stomach and hang an IV! Is this just malpractice to you?!"

"Get out!" Wang Zhengchu didn't even look up. "This is a resuscitation room. Family is not allowed!"

"I don't care! I'm not leaving until you give me an explanation—"

The husband lost control, shoving aside a nurse who tried to stop him and lunging to grab Wang Zhengchu by the collar.

Wang Zhengchu cursed, whirling around to roar, "Have you made enough of a fucking scene?! Your wife is breaking out in a cold sweat, her heart rate is skyrocketing, and her blood pressure is about to crash! This is pre-shock! You barging in here and interfering with my assessment of her vitals is only speeding up her death!"

"Bullshit—"

The husband was incandescent with rage.

Fortunately, Yang Xu arrived just in time. He stepped forward, pulled the family member away, and stood in front of Wang Zhengchu.

"Calm down! Attacking the doctor won't save your wife and child."

The husband was panting heavily, his eyes red, but he was taken aback by Yang Xu's steady presence, and his fists slowly unclenched.

Yang Xu's tone softened slightly. "Your wife is in extremely critical condition right now—a pancreatic lesion complicated by an acute abdomen. We haven't operated immediately because the surgery is incredibly high-risk. Without a perfect surgical plan, the moment we make that first cut, she could die right there on the table. One corpse, two lives."

Hearing the words "one corpse, two lives," the husband's legs gave out. He sagged against the wall, covered his face, and began to sob.

Yang Xu gestured for a nurse to lead the family member out and console him.

Wang Zhengchu's eyes were glued to the monitor as a nurse followed his orders, quickly administering an IV push of phloroglucinol and a minuscule dose of analgesic.

The pregnant woman's condition stabilized slightly, but the muscular tension in her abdomen didn't ease at all.

Yang Xu walked over. "How is she?"

"We can't keep it under control. Her heart rate is spiking, and her infection markers must be through the roof. A bedside ultrasound just now detected a massive retroperitoneal hematoma. The cyst has most likely ruptured. She won't make it through the night."

The two men exchanged a look, their eyes heavy with gravity.

"Let's go to the demonstration room for a meeting. Call in all the attending physicians from the department."

...

...

In the demonstration room.

Several of the patient's MRI films, taken just yesterday, were clipped to the light box.

"Everyone, take a clear look."

Wang Zhengchu pointed to the image. "Combined with the results of the bedside ultrasound from the ER, we see a massive cystic-solid mass in the pancreatic head. There's now extremely severe surrounding exudate and fluid buildup. The common bile duct is completely obstructed."

He turned to face the general surgery attending physicians seated below, his gaze sharp.

"An anterior approach is out of the question. At twenty-eight weeks, the uterus is occupying most of the mid-to-lower abdomen, severely displacing the gastrointestinal tract upwards and backwards."

The attending physicians below looked at each other, but no one dared to speak.

Yang Xu coughed sharply a few times, his face a little pale.

He spoke up. "We do a posterior approach. Make the incision directly into the right retroperitoneal space, bypassing the uterus and intestines in the anterior abdomen. We can reach the posterior space of the pancreatic head directly from behind and deal with the lesion."

"Old Yang…"

"It's the only way to reach the pancreatic head without touching the uterus and the compressed intestines."

"In theory, yes, you're right!" Wang Zhengchu raked a hand through his hair in frustration. "But she's pregnant! The inferior vena cava is already compressed by the uterus, impeding venous return. If you go in through the retroperitoneum, the surgical field is extremely narrow. A deviation of even one millimeter, and a massive hemorrhage will flood the entire field in less than twenty seconds!"

"We can perform mobilization and suspension," Yang Xu countered. "If we're careful and avoid the main vascular plexuses, it's operable."

"Old Yang, the posterior approach is a new technique to begin with. There are only a handful of surgeons in the country who can perform it proficiently. Now, add the anatomical challenges of pregnancy to the mix… this surgery will require at least six hours of high-intensity microsurgery. Who's going to be the lead surgeon? You? Or me?"

Yang Xu fell silent.

He stared at the complex images on the light box and took a deep breath. "If Jiang He were here, I could give it a try."

Wang Zhengchu froze for a second, then his temper flared. "Jiang He? That young team leader from Affiliated Hospital No. 1?"

"Yes. The practical details of this posterior approach were his idea. He understands the anatomical layers involved better than anyone."

"Old Yang, has your sickness muddled your brain? Are you telling me we should just sit here and wait for some young doctor to save the day? We can't do it without him?! It's pouring rain out there! What if he gets stuck in traffic, or his car breaks down? Are we just going to stand by and watch that woman die—one corpse, two lives?!"

"COUGH COUGH COUGH… COUGH!"

The moment Wang Zhengchu finished speaking, Yang Xu clapped a hand over his mouth and began to cough violently again.

This fit was more severe than any of the ones before.

Yang Xu bent over, his entire body trembling.

He pulled a tissue from his pocket to cover his mouth, taking a long while to quiet down.

The conference room fell deathly silent.

Wang Zhengchu's Adam's apple bobbed. His anger from moments before vanished instantly.

He understood.

In his current physical state, Yang Xu might not even be able to stand in the operating room for six hours, let alone perform six hours of extreme microsurgery as the lead surgeon.

"You…" Wang Zhengchu looked at Yang Xu. "You can barely even hold a scalpel, and you're talking about being the lead surgeon?"

Yang Xu gave a bitter laugh, the light in his eyes dimming. "You're right. I can't do it anymore."

If even Yang Xu couldn't operate, then there was no one left at City First Hospital who could perform this surgery.

"Then we're left with the worst-case scenario," an older attending physician said softly, breaking the silence.

"Abandon the fetus. Force a C-section and exploratory laparotomy."

No one said a word.

It was a move to save one life at the expense of another.

This meant performing an emergency C-section to forcibly deliver the twenty-eight-week premature infant, and only then performing the laparotomy on the mother.

Putting aside the low survival rate for a twenty-eight-week preemie under current medical conditions…

After the massive trauma of a C-section and the sudden drop in abdominal pressure, it was highly probable that the pancreatic lesion would completely collapse, triggering fulminant pancreatitis and septic shock.

By the time they finished the C-section and moved on to the pancreas, the mother might already be beyond saving…

A sense of helplessness enveloped the entire demonstration room.

No one wanted to make this decision, but the limitations of medicine were forcing them to choose.

Wang Zhengchu picked up the patient's chart from the table. "I'll go talk to the family. Prepare for the C-sec…"

BANG—

The door to the demonstration room was thrown open.

Jiang He had arrived.

He took his phone out of his pocket and said,

"I've had an open line with the Professor. I heard your entire discussion."

He walked straight to the light box, glanced at the compressed inferior vena cava and distorted pancreatic head on the film, and said,

"I believe this surgery is doable."

Wang Zhengchu's brows furrowed as he stared at the young man who had suddenly appeared.

He knew Jiang He was skilled; he had seen Jiang He's incredible use of a Bogota bag at Affiliated Hospital No. 1.

But right now, in the face of such a desperate case, Jiang He's casual confidence struck him as absurd.

"It can't be done."

Wang Zhengchu said, "Jiang He, your posterior approach theory might be perfect, but look at Old Yang's condition. How is he supposed to get on the table and perform such a delicate operation? Who's going to take the lead?"

Jiang He turned around and said calmly,

"The Professor truly cannot operate."

"But I can."

"The Professor and I developed the posterior approach together. I know this procedure inside and out. No one is more familiar with it than I am."

"I'll be the lead surgeon. Director Wang, you will be my first assistant."