I Am Diagnosed as a Medical Titan

Chapter 315: Chapter 212: The Topsy-Turvy Observation Room

Intensive Care Unit.

A young nurse reported, ”His blood pressure has dropped to 85/50 mmHg, heart rate has shot up to 125, and bladder pressure has exceeded 22 mmHg and is still rising.”

Less than six hours had passed since the last surgery, and the secondary inflammatory storm had arrived right on schedule.

Beneath the sterile Bogota bag on his abdomen, a large amount of murky, dark-red fluid had collected, with bubbles even visible within it.

The necrotic pancreatic tissue was liquefying and becoming infected due to bacterial action.

Jiang He ordered, ”Increase the norepinephrine infusion rate. Prepare for bedside debridement. Open the bag.”

The nurse quickly unwrapped the sterile surgical pack and pushed the instrument cart to Jiang He’s side.

Liu Jianbang secretly broke out in a cold sweat.

Normally, when a patient’s intra-abdominal infection worsened, the standard procedure was to return them to the operating room for re-anesthetization and a second laparotomy.

But in his current state, Guo Chengyu simply couldn’t withstand being moved or undergoing general anesthesia a second time.

The advantages of the Bogota bag were on full display at this very moment.

’Jiang He is just too far-sighted.’

’I suddenly feel like giving Jiang He a new nickname: Jiang the Far-Sighted.’

”Scalpel.”

Jiang He took the scalpel and, following the suture line that had secured the Bogota bag, picked the knots loose.

A corner of the Bogota bag was lifted.

”Large aspirator. Prepare warm saline.”

Meng Shiyu, now serving as the first assistant, was nervous but his movements were still deft.

Jiang He took the aspirator, avoided the transverse colostomy stoma, and probed the left paracolic gutter and the area around the pancreas.

The turbid pus was quickly suctioned out.

Jiang He’s movements were both fast and steady.

’As long as I don’t have a ”genius” like Xu Chen next to me, the margin for error in this kind of debridement is actually quite high for me.’

The core principle of a second debridement for severe pancreatitis is drainage and decompression.

As long as you open the high-pressure abscess cavity and wash out the toxins, the vital signs will naturally stabilize.

”Irrigate.”

At Jiang He’s command, a large volume of warm saline was flushed into the abdominal cavity...

...

「At the same time.」

Yang Xu had finally finished an incredibly difficult Level 4 Surgery: a pancreaticoduodenectomy.

He rushed over to the ICU in a flurry.

He was accompanied by several experts: Feng Chuxiao, the deputy director of gastrointestinal surgery, and a few senior attending physicians.

The group had originally met up in the operating room’s lounge area.

But just as Yang Xu sat down, he heard the head nurse say that Jiang He was performing a bedside open debridement in the ICU.

The moment Yang Xu heard this, he put down his water glass and rallied the group, ”Let’s go! We’re going to watch my student operate~”

Feng Chuxiao asked doubtfully, ”Old Yang, a debridement right on an ICU bed? How do you control the infection risk? The patient has severe pancreatitis. If anything goes wrong with the intestines, not even a god could save him.”

Yang Xu walked so fast he practically flew. ”What do you know? Jiang He used a Bogota bag for temporary abdominal closure this morning! With this technique, you don’t need to cut the sutures and reopen the abdomen. You can just lift the bag and wash it out! Come on, let’s go. I’ll open your eyes to something new.”

The crowd of bigwigs rushed over to the outside of the ICU.

Through the large glass window, the scene inside was in full view.

The glass was very soundproof, so the people outside could talk freely without disturbing the procedure inside.

”Let me see.”

Feng Chuxiao leaned against the glass, and when he got a clear look at Jiang He’s technique, his playful demeanor vanished.

”Holy shit...” Feng Chuxiao swore. ”He just went straight in like that?”

Yang Xu shot him a look. ’What kind of thing is that to say? It sounds weird.’

Another attending physician stared for a while before exclaiming, ”He’s using only blunt dissection and an oval clamp. Director Yang, how are your student’s hands so steady?”

Yang Xu crossed his arms, looking as if this was only to be expected.

He said nonchalantly, ”It’s alright. Just the basics. I always taught him that a surgeon can’t have any unnecessary movements. He’s barely passing.”

The attending physicians standing beside him really wanted to roll their eyes.

’You call this ”barely passing”?’

’But then again, the one saying it is Yang Xu, so it makes sense.’

’Neither of them, master or student, is normal!’

Inside the room, Jiang He was pouring in a basin of saline, then using two tubes at once for high-negative-pressure suction.

”This use of the Bogota bag is just brilliant. If they had done a conventional closure, reopening the abdomen now would have definitely crashed the patient’s blood pressure. Jiang He has reduced the risk of a major surgery to that of a bedside dressing change...”

”Yeah, look at the monitor. As the pus is suctioned out, his blood pressure is already starting to rise.”

”So damn impressive.”

Everyone chimed in with their comments.

For every move Jiang He made inside, the group of directors outside would offer a round of analysis and a word of praise.

”The irrigation is very thorough. No blind spots.”

”He even readjusted the position of the drainage tube, placing it at the lowest point. His awareness is incredible.”

”Old Yang, you’ve really found a gem. How can you even call this kid a student?”

”No, it’s also because Old Yang is a good teacher.”

Listening to his colleagues’ flattery, Yang Xu was on cloud nine.

On the surface, however, he remained cool and collected. ”Not at all, not at all. The young man still has a lot to work on. We shouldn’t praise him too early.”

At the back of the crowd stood Lin Peidong.

His eyes were slightly red-rimmed.

He was the only one who truly understood that Jiang He was not just saving the patient’s life, but Xu Chen’s as well.

When Xu Chen went to ask the family for their forgiveness that afternoon, their bottom line was clear: they would only drop the matter of liability if the patient was cured.

If any other doctor had taken over, who could have guaranteed they could save the patient in the face of a secondary inflammatory storm?

If Jiang He hadn’t turned the tide, stabilized the situation, and left a fallback option with the Bogota bag, Xu Chen would have been finished today.

Watching Jiang He calmly and methodically clear away the last bit of necrotic tissue...

Lin Peidong took a deep breath.

If it weren’t for the inappropriate setting, he really wanted to kowtow to Jiang He.

This debt of gratitude was too great.

While the group outside was watching, enthralled...

Vice Dean Zhang Sui arrived.

He had just finished an administrative meeting and was passing by the ICU when he saw a crowd gathered at the viewing window from a distance.

Moreover, every single one of them was a director or deputy director of a department.

Zhang Sui frowned and strode forward.

”What are you all doing here?”

Yang Xu turned and explained, ”Vice Dean Zhang, Jiang He is inside treating the severe pancreatitis patient who had the colostomy this morning. It’s a secondary inflammatory storm, and he’s performing a bedside open debridement.”

Several other directors thought, ’This is bad.’

According to the hospital’s current SOP, an operation of this level had to be reported to the medical affairs department and performed in the laminar flow environment of an operating room.

From a procedural standpoint, what Jiang He was doing was a slight violation of the rules.

Vice Dean Zhang Sui was definitely going to bring up the regulations.

Sure enough, Zhang Sui’s brow furrowed.

Everyone thought the Vice Dean was about to criticize Jiang He.

But instead, Zhang Sui pushed aside Feng Chuxiao, who was blocking his view, and said:

”Make some room for me. I want to learn a thing or two as well.”

Feng Chuxiao: ”?”

Lin Peidong: ”?”

The crowd: ”???”

”Reusing the Bogota bag to resolve abdominal compartment syndrome right at the bedside...”

Zhang Sui muttered to himself as he watched, ”This unconventional approach... it actually seems to be effective.”

Yang Xu sighed in admiration. ”Incredible.”

Ever since Jiang He had gone against protocol to save his daughter, Zhang Sui’s double standards had become blatantly obvious...

Just then, a young nurse pushing a treatment cart passed by in the hallway.

She stopped and peeked inside curiously.

One look, and the young nurse was utterly stunned!

Outside the glass window stood the director of general surgery, the deputy director of gastrointestinal surgery, the director of hepatobiliary surgery, a senior attending from anesthesiology, and even the usually impartial Vice Dean Zhang.

This group of bigwigs was lined up in a neat row, staring eagerly at the scene inside.

And inside the glass window, the person leading the surgery was a medical team leader who was only twenty-one years old.

The young nurse rubbed her eyes.

’This world is just too surreal!’

’Who’s the director and who’s the student here?!’

Not daring to make a sound, the young nurse pushed her cart and quietly slipped away, hugging the wall.

...

「Inside the patient room.」

The debridement and irrigation were complete.

Jiang He took a new sterile adhesive film and resealed and secured the edges of the Bogota bag.

”Blood pressure is 115/75 mmHg, heart rate is down to 90, and blood oxygen is 99%.” Liu Jianbang gave a thumbs-up. ”Leader Jiang, he’s stable.”

Jiang He nodded. ”Keep a close eye on him. Call me anytime if something comes up. If I’m not here, you can call another attending. There shouldn’t be any more major issues.”

”Okay, don’t worry.”

Jiang He took off his sterile surgical gown, removed his gloves, and pushed open the door of the isolation room.

The moment he stepped out, a crowd of white coats immediately surrounded him.

Jiang He paused, stunned. ”Vice Dean Zhang? Teacher Yang, Director Feng, Director Li... why are you all here?”

”Jiang He, in such a murky field of view, how did you manage to so precisely avoid the mesenteric vessels of the colon?”

”And the negative pressure control during irrigation, did you do that by feel? Any more pressure and you could have torn the organ’s serosa.”

The directors asked questions eagerly; the ”students’” enthusiasm for learning was high.

’Time for a high-EQ response.’

Jiang He said, ”You all flatter me. It’s mainly because Teacher Yang is a good instructor.”

Yang Xu: ”Hmm?”

Jiang He continued, ”Teacher Yang previously gave me an in-depth explanation of the anatomical difficulties in severe pancreatitis, especially regarding the course of the colonic mesenteric vessels. As for the clinical application of the Bogota bag, that was also an advanced concept that Teacher Yang mentioned long ago. I’m grateful to my teacher.”

Jiang He couldn’t be bothered to explain so much.

’Got questions? Go ask Yang Xu.’

’Teacher Yang is a master in the art of showing off. This kind of face-gaining opportunity is best left to him.’

Sure enough, the directors immediately turned to Yang Xu and began chattering away.

Yang Xu understood Jiang He’s intention, gave him a smiling glance, and then said, ”You’ve worked hard. Go get some rest.”

Jiang He nodded. ”You’ve worked hard too.”

As he walked out of the crowd, Lin Peidong said to him, ”Leader Jiang, words can’t express my gratitude. In the future, if you ever need anything from me, Lin Peidong, just say the word.”

Jiang He understood his meaning and simply said, ”As long as the patient is fine. You should get some rest too, Dr. Lin.”

...

By the time he finished with his hospital duties, it was already very late.

Jiang He planned to go back to the lab to continue his work.

「The university lab.」

After opening the door, he saw Professor Wang Xiaoqing running over excitedly.

She seemed to have good news to share.

Then, Wang Xiaoqing froze and said, ”Old Yang? What are you doing here again?”

Yang Xu had been about to say he was there to offer some guidance.

But the words died on his lips as he suddenly remembered what Wang Xiaoqing had told him before—that he shouldn’t be so childish.

So, Yang Xu dropped the pretense and said, ”I’m done at the hospital, so I came to pick you up from work.”

Wang Xiaoqing: ”?”

She probably never expected the ever-prideful Yang Xu to say something so direct in front of Jiang He.

She shot Yang Xu a look and grumbled, ”You’re so annoying!”

Yang Xu just chuckled slyly.

’This straightforward approach really seems to work! What Jiang He taught me was right!’

That’s right... nowadays, Jiang He not only had to help his teacher show off, but he also had to teach him how to woo women...

Of course, Jiang He wasn’t exactly an expert himself.

It was a case of the blind leading the blind, like a blind cat stumbling upon a dead mouse.

Wang Xiaoqing’s gaze returned to Jiang He, her eyes shining brightly.

Then, she announced excitedly:

”Jiang He! We’ve had a major breakthrough in our experiment!”