They are All Complicated Cases of Acute Appendicitis

In the surgical demonstration classroom, both Chief Surgeon Liu and Chief Physician Pan occupied one side of the room without acknowledging each other.

Just like tigers who had marked their territories, they eyed each other with covetous gazes.

Chief Surgeon Liu appeared dispirited, however, especially with his messy hair and bloodshot eyes that stared blankly into emptiness. On the other hand, Chief Physician Pan, wearing spectacles with presbyopia lenses, sat next to the window leisurely with his legs crossed while reading an old book called Limited Views.

Someone popped his head into the room furtively through the half-closed door.

"Chief Surgeon Liu, please come here for a while," whispered Cen Meng.

The anxious Chief Surgeon Liu, who was on a couch, was momentarily stunned upon hearing Cen Meng's voice. Pretending as if nothing had happened, he stood up and ensured that his outfit was neat before leaving the room and closing the door.

Chief Physician Pan stared at Chief Surgeon Liu's back and sneered. "What scheme are you cooking up for us now?"

"Two patients with acute appendicitis are coming in right now."

"Yeah, and?"

"A twenty-eight-week pregnant woman is suspected to have acute appendicitis as well as symptoms that threaten miscarriage. Her family made it very clear that the baby must survive, and other hospitals didn't dare to accept this case," replied Cen Meng with a grin.

"Oh." Chief Surgeon Liu nodded in response.

Acute appendicitis in pregnancy was one of the trickiest and most troublesome diseases in the world. Moreover, this patient was twenty-eight weeks pregnant with signs pointing to potential miscarriage, which greatly increased the difficulty of an appendectomy. 

They would not have accepted this risk into the hospital were it not for the fact that they wanted to make things difficult for Zheng Ren.

Cen Meng smirked. "Let's give him some fun!" 

Chief Surgeon Liu nodded in satisfaction and asked, "What about the other one?"

"Thirty-two-year-old male, 168 centimeters, 112.5 kilograms."

It was a simple introduction, but every surgeon understood the meaning behind it.

A subcutaneous adipose layer approximately ten centimeters thick was enough to be one of the biggest obstacles of an appendectomy. The general surgery department usually called this sort of case 'well drilling'.

Apart from its intense difficulty, the patient would have an increased risk of complications such as fat liquefaction of the post-surgical incision. Thus, no one would willingly accept such a case, and anyone who did would treat the patient as conservatively as possible.

Chief Surgeon Liu was content with the appendicitis cases today and a smile finally appear on his face. "Very good."

The compliment exhilarated Cen Meng, who figured all his hard work had been worth it if he got Chief Surgeon Liu's approval.

"Protect the patients at all costs and prepare to take over the operations at any time. Also, ask Chief Surgeon Su from the obstetrics department to come and consult them. We need to ensure their safety and prevent any intraoperative accidents."

Conspiracies and schemes between doctors were usually simple and ethical. Hardly any doctor would have the heart to exchange a patient's life for their own success.

Even though a medical dispute involving iatrogenic death would send a doctor straight to the pits of hell, few doctors would resort to setting up such an unethical scheme. Perhaps this was why no one had clawed their way to the peak of the medical world after all these years.

"Don't worry, I've made the necessary arrangements. I've sent someone for Chief Surgeon Su and they should both arrive very soon."

Chief Surgeon Liu was grateful to have such a competent chief resident to save him so much trouble.

He tapped Cen Meng's shoulder gently and returned to the surgical demonstration classroom confidently with his hands on the man's back.

…

Zheng Ren and Xie Yiren returned to the hospital as fast as they could. Neither of them cared about their unfinished supper, it was the 'night of the appendix' they were having that had them bouncing off the walls.

The restaurant was not far from the hospital, so as soon as they arrived, the nurse on duty informed Zheng Ren that the patient had been transferred from elsewhere to Sea City General Hospital via ambulance and was currently in the first general surgery department.

Zheng Ren and Xie Yiren rushed to the inpatient building without a second thought.

Incidentally, at the main entrance of the inpatient department, Zheng Ren passed the elderly lady from earlier who had tinnitus and dizziness.

The elderly lady's son's expression darkened instantly upon noticing Zheng Ren.

As he passed by, the man snarked, unintentionally or not. "What a lousy doctor."

"Huh?" Zheng Ren noticed them both, whom he had referred to the oral surgery department for the removal of a denture, only after hearing the man's hostile voice.

"You didn't get a tooth extraction?" asked Zheng Ren.

The middle-aged man lost his composure and started complaining aggressively. "The doctor from the oral surgery department said that wasn't the case at all. Do you even know how to diagnose a patient? Did you think it was fun to mess around with us in the middle of the night?"

Helplessly, Zheng Ren could only smile bitterly and spread his hands in response.

The keening wail of an ambulance siren approached the hospital.

Zheng Ren was not an oral surgeon, nor could he force the patient to extract a tooth. Unable to do anything else, he explained, "Truth be told, this is a rare condition. You can go to Peking University Third Hospital if you've the chance. They've better knowledge of oral medicine and surgery."

Zheng Ren and Xie Yiren then darted to the first general surgery department.

Cen Meng, who was standing by at its corridor, started mocking as soon as he saw them.

"Chief Zheng, you've become more impressive after working in the emergency department."

"Chief Cen, don't make fun of me," replied Zheng Ren; he had no desire to start an argument with the chief resident. The only thing on his mind at the moment was to finish ten perfect appendectomies as soon as possible.

Cen Meng sneered upon seeing Zheng Ren's usual 'cowardice'. He then approached Zheng Ren and patted his shoulder gently, just like Chief Surgeon Liu normally did. "Chief Zheng, I'll give you my full support even when you're in the emergency department. Let me know if you can't perform the surgery later. I'll do it for you."

"Thank you, Chief Cen." Zheng Ren smiled in response, but failed to detect the murderous aura radiating from Cen Meng's soul.

Cen Meng snickered and thought, 'Enjoy your triumph and pride while you still can. The acute appendicitis and pregnancy case will bring you straight to hell later.'

However, he made no attempt to inform Zheng Ren in advance, and looked forward to seeing Zheng Ren's face when the upstart surgeon finally realized the patient was twenty-eight weeks pregnant.

Both men's expressions turned serious as the transport stretcher trolley's wheels rolled across the marble floor. 

Spotting them, a rural medical escort running ahead of the stretcher trolley said, "The patient is here."

He let out a sigh of relief.

"What's the situation?" Despite being slow and woozy at the moment, Zheng Ren detected something fishy about this one.

"Acute appendicitis in pregnancy. Twenty-eight weeks of gestation with symptoms of potential miscarriage due to abdominal ache," explained the escort.

Soon, Zheng Ren saw the patient with her distended abdomen being wheeled into the department.

Hiss…

What a tricky case!

Acute appendicitis in pregnancy was uncommon and its current appearance in Sea City General Hospital had taken him aback.

Well, to operate or not to operate… That was the question.

It was a question that would stump even a chief surgeon of any department.

"Doctor, please save my child," pleaded an anxious young man in his twenties, who had followed the stretcher trolley into the first general surgery department.

"Are you the patient's family?" asked Zheng Ren.

"I'm her husband. Doctor, please save my child," replied the young man as he held onto Zheng Ren's arm.

Xie Yiren frowned in disgust at the young man, who clearly cared only for the safety of his unborn child without a word about his pregnant wife; she hid in the office to stop herself from berating the irresponsible husband.

This sort of situation happened in hospitals nearly every day.

Since nothing could be done, it was better to simply escape.

Cen Meng approached Zheng Ren, who did not have that luxury to escape, and said with a wide grin, "Chief Zheng, the case is yours. Don't forget to ask for my help if you need anything."