Chapter 789: Once Again Pinned to the Operating Room Floor by the Great Demon King

"The main thing is that I don't lack money."

Lin Jiuze was speechless, looking at Ji Xiang, knowing this guy wasn't lying.

Being able to say he didn't lack money so openly and honestly made Lin Jiuze's mood very complicated; he felt a bit envious.

"Besides, an annual salary of 6 million is on the high side. The teachers probably think that group wants to expand into the big health industry and is looking for old experts to set up the stage, which is why they offered such a high price.

But, there are questions about this money; it's a pie in the sky drawn by the boss.

Even if the KPI is low, it won't work even if you can get the full amount.

After two or three years pass, once everything is smoothed out, they'll find an excuse to kick people out. By then, the director's position will already be taken, and if you want to go back, you won't be able to."

"Is it that informal in the country?" Lin Jiuze was surprised.

"Sigh." Ji Xiang laughed, "Pretty much. Didn't Bai Chuzhang say that the country is just a Fly Restaurant? Michelin chefs aren't worth much in a Fly Restaurant either. It's not like your side, where everything is controlled by capital and turned into a large interest group. Millions of canal workers, that's roughly the meaning."

The two were chatting casually when Dr. Merz suddenly turned serious and said very unhappily, "Do an intraoperative CT."

There was a doctor with good English next to Zhao Yuanzhang acting as a translator; he was stunned when he heard Dr. Merz say this.

"I'm sorry, Dr. Merz, we only have the DSA machine in the Interventional Surgery room that has CT functionality."

Zhao Yuanzhang said apologetically.

"This is the biggest joke I've ever heard! You can't even do a CT during orthopedic surgery! My God, you are practically committing murder!" Dr. Merz waved his arms angrily.

"..."

Zhao Yuanzhang hadn't expected Dr. Merz's temper to be so big, even going so far as to bring up murder. He was startled and didn't know how to explain it to this expert from Massachusetts.

Originally, he had just been looking for a simple Tibiofibular Closed Fracture patient to perform surgery on to build a relationship; as for whether he could connect with Zhao Tianjiao, he didn't have much confidence.

But he never expected that a fixation surgery for a Tibiofibular Closed Fracture would have such a major slip-up during the anesthesia stage.

Just as the skin was opened, before the hematoma was dealt with or the fracture ends were found, the patient's blood pressure plummeted.

It was no wonder Dr. Merz was angry.

"We're performing resuscitation, keep your voice down, focus."

A familiar voice came over, and Zhao Yuanzhang was stunned.

Ji Xiang!

Ever since the Zhao Tianjiao "suicide incident," Zhao Yuanzhang hadn't wanted to see Ji Xiang.

It wasn't that he found Ji Xiang unpleasant; the matter was more like someone else's child having excellent grades while his own child was very disappointing, which dealt a huge blow to Zhao Yuanzhang.

"It's an anesthesia problem!" Dr. Merz's voice was a little lower. He turned his head, but he didn't scold Ji Xiang; instead, he acted as if he were arguing with a superior doctor.

Lin Jiuze was stunned.

Dr. Merz's attitude was very strange.

In Massachusetts, Dr. Merz's bad temper was very famous, especially before his own evaluation; Teacher Tang had even taken him to visit Dr. Merz to try to change his attitude.

Even now, Lin Jiuze could still recall that look of disdain on Dr. Merz's face.

He hadn't expected that after coming to the Second Affiliated Hospital and being directly cursed at by Ji Xiang, Dr. Merz would actually look at Ji Xiang with a hint of fear.

Lin Jiuze also knew it wasn't entirely because of the curse, but more importantly because of Wembanyama's recovery speed.

But he was still willing to think that way.

"The anesthesia... has been very stable, it shouldn't be an anesthesia issue," the doctor in charge of anesthesia whispered in explanation.

"If it's not an anesthesia problem, could it be my problem?" Dr. Merz looked at the anesthesiologist with disdain.

He didn't dare to challenge Ji Xiang, but that didn't mean he didn't dare to reprimand others.

The translator subconsciously translated the words into English, and Dr. Merz expressed his dissatisfaction immediately.

This was the right of a superior doctor!

Especially when unexpected situations occurred during surgery, the surgeon and the anesthesiologist would basically have disagreements.

"Dr. Merz, please be aware that resuscitation is currently underway here," Ji Xiang glanced at Dr. Merz and said coldly.

Dr. Merz's mask moved; he lowered his head before the next words could come out and turned away sheepishly.

Zhao Yuanzhang's heart was burning with jealousy.

Someone else's child is truly good!

If Zhao Tianjiao had half of Ji Xiang's level... no, even if it were just the difference in the number of Tying Knots during the grand competition, he wouldn't have to worry so much and be bossed around by a foreigner.

He looked deeply at Zhao Tianjiao; countless emotions were left unsaid.

But Zhao Tianjiao had a blank expression; he didn't understand what was going on at all.

After all, he was young; he still couldn't distinguish what had happened from the details of Dr. Merz's changing attitude.

"The anesthesiologist gave too much medication, delaying the surgery," Dr. Merz said, dejected, even though he didn't dare to talk back to Ji Xiang.

Lin Jiuze shrugged, suddenly feeling the aura on Ji Xiang's body stagnate, but it felt like his own illusion; in just an instant, Ji Xiang returned to normal.

This feeling was quite mysterious, and Lin Jiuze couldn't say why.

But he just felt that something was wrong with Ji Xiang.

"Dr. Merz, who requested the positioning?" Ji Xiang asked in American English.

"I, I?" Dr. Merz said "I" twice, his tone strange.

"What is the patient's diagnosis?"

"Bilateral Tibiofibular Closed Fracture."

"There's no problem with doing surgery within 48 hours, right?" Ji Xiang spoke very quickly. At first, the doctor translating for Zhao Yuanzhang could keep up, but after only three sentences, he began to struggle.

"No... no problem."

"Then good, what would the complications of doing it this way be? Tell me." Ji Xiang continued to press him.

"!!!" Dr. Merz was stunned.

The young Great Demon King's tone when speaking to him was just like a typical superior doctor lecturing a subordinate assistant.

Him!

On what grounds!

A wave of resentment rose in Dr. Merz's heart.

But Dr. Merz did not dare to speak, swallowing all his grievances back down.

"Lin, you are a radiologist, you can perform an ultrasound, right?" Ji Xiang saw that Dr. Merz was not speaking, so he turned his head and asked.

"I know a little," Lin Jiuze said with a smile.

He especially liked seeing Dr. Merz get deflated like this.

Ji Xiang had never spoken to him in such a stern tone.

"Liu Ge, is there a Transesophageal Echocardiography machine in the operating room for Cardiac Surgery?"

"Yes." The anesthesiologist was shocked by Ji Xiang's fluent English earlier, feeling inexplicably astonished.

"Please push the machine over."

"What do you suspect?" Zhao Yuanzhang asked.

"Pulmonary Embolism."

"!!!" Zhao Yuanzhang was startled.

Pulmonary Embolism!

Ji Xiang actually suspected the patient had a Pulmonary Embolism!!

That's not right, the patient is young and healthy, and it's just a routine general anesthesia surgery, how could a Pulmonary Embolism happen so coincidentally?!

Dr. Merz also realized his emotions were off, and he felt a bit ashamed.

Facing a wicked dragon, facing a Great Demon King, how could he bow his head!

At a time like this, he should demonstrate his professionalism and defeat him in his own field of expertise!

Sports Medicine is a branch of Orthopedics, and Dr. Merz is also an excellent orthopedic doctor.

He believed this was his domain, and the patient's current situation was relatively simple, making it the perfect battlefield.

Unlike the Achilles Tendon Repair surgery, Dr. Merz did not believe the patient would have any accidents.

Those are low-probability events; if a doctor spent all their time thinking about low-probability events, no surgeries would ever get done.

"What are you talking about?" Dr. Merz asked.

"The patient might have a Pulmonary Embolism. I suggest Lin perform a Transesophageal Echocardiography; there is no need to do a CT," Ji Xiang replied.

Pulmonary Embolism?!

Dr. Merz was startled.

He had only said that a CT was needed during the surgery, and he didn't expect it to trigger a series of reactions from the Great Demon King; this was too sensitive!

Besides, Pulmonary Embolism is a disease characterized primarily by sudden onset and cerebral hypoxia.

The patient only had a drop in blood pressure, and the oxygen saturation had been around 100% the whole time.

Dr. Merz was afraid he had misread it, so he glanced at the values on the Cardiac Monitor again; it was indeed 100%.

"Is high-flow pure oxygen being given?" Dr. Merz asked.

The translator translated his words for the anesthesiologist.

"No, it's standard oxygen delivery; the patient's oxygen saturation has been very good throughout," the anesthesiologist replied.

"Impossible!" Dr. Merz swept away his previous dejection and looked back at Ji Xiang, "The oxygen saturation hasn't dropped at all; why would you judge it to be a Pulmonary Embolism?"

"The patient's incision is already open, so it is indeed not suitable to go for a CT, but it absolutely should not be a Transesophageal Echocardiography either!"

"It's an invasive procedure, and there is even a risk of cardiac arrest when performing an ultrasound."

Dr. Merz seized upon one of Ji Xiang's "mistakes" and said loudly.

In the operating room, apart from the alarm of the Cardiac Monitor and the beep-beep-beep of the Anesthesia Machine, only Dr. Merz's voice echoed.

"We are in the middle of a rescue, keep your voice down," Ji Xiang frowned, looking at Dr. Merz.

Dr. Merz sensed a hint of danger in the young Great Demon King's eyes; he had originally wanted to avoid the sharp edge, but the shame from just a moment ago made Dr. Merz refuse to show weakness.

"Based on the current situation, it is impossible for the patient to have a Pulmonary Embolism. The oxygen saturation hasn't changed at all, and you actually say it's a Pulmonary Embolism?! My god, this is the funniest joke I've ever heard in an operating room."

As Dr. Merz spoke, he looked at Lin Jiuze beside Ji Xiang.

That strange guy wasn't holding a pen or a notebook, and he was wearing a surgical gown, with nowhere to store such things.

After seeing clearly, Dr. Merz let out a long breath.

It was good that the diagnosis didn't come from that strange guy Lin Jiuze; today, as a knight of justice, he would teach this young Great Demon King a lesson.

Although he looked young, his strength was formidable, and Dr. Merz did not think he would have absolute certainty of taking him down under normal circumstances.

But now it was different.

The patient clearly had an issue with the anesthesia medication; as for what exactly, Dr. Merz was not an anesthesiologist and could not be certain.

But it definitely wouldn't be that nonsense Pulmonary Embolism.

Zhao Yuanzhang felt annoyed when he saw Ji Xiang directing the anesthesiologist to push the B-ultrasound Machine over.

Him!

On what grounds!!

Especially with his own foolish son standing right there.

Actually, Zhao Tianjiao was true to his name and was indeed a favored son of heaven; otherwise, he wouldn't have broken the Tying Knots record of the competition that Zhao Jixiang had held for decades.

But people, the thing they fear most is comparison.

"Doctor Ji Xiang, are you the Attending Physician for the patient in front of us?" Zhao Yuanzhang asked indifferently with his hands behind his back.

"No," Ji Xiang replied very calmly, "I am just providing a line of thought. Of course, if the patient is eventually diagnosed with a Pulmonary Embolism but the rescue is delayed for some special reason, as long as Zhao Yuanzhang can take responsibility, that is fine."

"!!!"

Zhao Jixiang was cornered by a single sentence from Ji Xiang, metaphorically pinned into the reinforced concrete.

He was furious, yet he found himself completely unable to refute Ji Xiang's words.

It was equivalent to playing a "3" in a game of Fight the Landlord, only for Ji Xiang to immediately slam down a King Bomb and four "2"s.

Was it really necessary!

Zhao Yuanzhang cast an indignant look at Ji Xiang.

Was it really necessary!

Was it really necessary!!

His mind had been subjected to soul-searching interrogation time and time again.

If it were anyone else, Zhao Yuanzhang would certainly have made life difficult for them in countless ways.

But this was Ji Xiang, whom the Dean had recently been holding in high regard; plus, Bai Chuzhang had always protected Ji Xiang as if he were his own son, and since Zhao Yuanzhang was not in charge of the Medical Affairs Department, he really had no effective way to strike Ji Xiang with a thunderous blow.

The doctors and nurses in the operating room remained silent, none willing to join in such a dispute.

Ji Xiang had indeed crossed the line, but that sentence standing on the moral high ground—"Will you take responsibility if something goes wrong?"—dealt a critical hit to everyone's heart.

Soon, the anesthesiologist pushed the ultrasound equipment in.

"Thank you for your hard work, Lin." Ji Xiang did not make a fool of himself; his skill points in ultrasound were not high, so it was better to let Lin Jiuze handle it.

"My god, I have truly never seen anyone so childish; I have developed serious doubts about the medical standards of your hospital," Dr. Merz grumbled.

His voice was not loud, and Ji Xiang might not even have heard these words; he was merely expressing his own unyielding effort.

"Dr. Merz, are you talking to me?" Ji Xiang asked.

"I am saying that there is simply no need for the patient to undergo a transesophageal echocardiography; it would be better for the anesthesiologist to double-check the medication!" Dr. Merz's voice grew softer.

He was certain, but for some reason, he never felt enough confidence in front of the Great Demon King.

"It doesn't affect it," Ji Xiang said calmly. "The anesthesiologist is currently verifying the medication, but I personally feel that doing a CT scan is meaningless."

"!!!"

"Are you suggesting that the possibility of thrombosis is low?"

"..."

"The trauma from the orthopedic patient's own condition is enough to disrupt the coagulation-fibrinolysis system in her body, leading to thrombosis.

Furthermore, this is not an emergency surgery, but an elective one.

The patient's prolonged bed rest has already greatly increased the incidence of deep vein thrombosis. During the surgery, due to the extensive manipulation and the impact on circulation, the thrombus is very likely to detach. A detached thrombus is very likely to travel with the blood flow and block the pulmonary artery."

"Simply put, it is precisely because you did not notice the potential for venous thrombosis when positioning the patient before surgery, and because the scope of the operation was too large, that the current situation has arisen."

Ji Xiang's speaking pace was neither fast nor slow, but in the end, he dumped all the responsibility onto Dr. Merz.

"Impossible!" Dr. Merz said angrily. "Elective surgery for a patient with a closed fracture conforms to clinical treatment guidelines, and the patient is so young that the probability of thrombosis is negligible."

"If it doesn't happen, the probability is zero; if it does happen, the probability is one hundred percent."

"!!!" Dr. Merz was struck by Ji Xiang's one-hundred-percent readiness.

Dr. Merz had been completely overwhelmed by Ji Xiang's aura.

Just like Zhao Yuanzhang, Dr. Merz was unable to refute what Ji Xiang said.

If he were at Massachusetts General Hospital, Dr. Merz would have countless ways to solve the problem at hand, but now he was abroad, in a "crummy" hospital where they couldn't even perform a CT scan in the surgical operating room!

Out of the corner of his eye, Dr. Merz saw Lin Jiuze moving the patient's endotracheal tube, preparing to clear a space for the transesophageal echocardiography.

"Damn it, what you are doing is irresponsible to the patient!" Dr. Merz complained.

"Then what should be done to be responsible?" Ji Xiang asked without hesitation.

"It should... it should..." Dr. Merz suddenly hesitated.

All the necessary treatment measures had been given; where was he wrong in doing this?

Dr. Merz could not say.

Although he thought the young Great Demon King was both stubborn and absurd, if he were really asked to say what should be done, he had no suggestions whatsoever.

Ji Xiang had no interest in bickering with Dr. Merz or Zhao Yuanzhang.

He stood with his hands behind his back beside Lin Jiuze, staring intently at the screen.

As the B-ultrasound Probe moved forward in the esophagus, Ji Xiang gradually felt relieved. Lin Jiuze's operation was extremely skillful, and his mastery of small details revealed a wealth of experience.

Soon, the B-ultrasound Probe reached the position in the esophagus near the heart.

This part was especially critical.

The reason why transesophageal echocardiography is rarely performed is that the technical requirement is very high, far exceeding that of a standard external ultrasound.

But the benefit is that it provides a very clear view.

Just like now, Lin Jiuze changed the angle of his wrist several times, applying slight force to press the probe at the junction of the esophagus and the heart, within the limits of what the patient's heart could withstand.

"There is an embolism in the pulmonary artery, the embolus is approximately 3×4..." Lin Jiuze began to "report" to Ji Xiang based on what he saw.

The anesthesiologist was stunned.

Usually, the Cardiac Surgery department didn't use this equipment often, and few people knew how to use it; those who could perform transesophageal echocardiography during surgery were all big shots.

At least in the eyes of the anesthesiologist at the Second Affiliated Hospital, they were all big shots.

Who would have thought that a patient whose blood pressure suddenly dropped after anesthesia would actually be accurately diagnosed with a pulmonary embolism!

Dr. Merz was also stunned.

The pulmonary embolism shown on the image was very clear, and Lin Jiuze's level was very high, but Dr. Merz simply did not want to accept these facts.

How could his luck be so bad that while performing a closed tibia-fibula fracture surgery, he would encounter such a rare pulmonary embolism!

Dr. Merz even felt his luck was at an extreme point; dark clouds were gathering over the knight's head, with constant lightning and thunder.

Lightning struck his metal armor, and he was left scorched and tender by the electricity.

The young Great Demon King seemed not to have even made a move, yet the knight had fallen once again.

"Find the Heart Surgery Department to resolve this." After Ji Xiang saw the location of the Pulmonary Embolism clearly, he turned his head and instructed the Nurse.

"Oh, oh, oh." The Circulating Nurse looked up at Zhao Yuanzhang, then at the Orthopedics Department professor, and seeing them both staring blankly at the Echocardiogram screen, she realized it must be a Pulmonary Embolism and took off running.

A Pulmonary Embolism is a life-threatening emergency; every second must be cherished!

She quickly ran out of the operating room to call the Heart Surgery Department.

Seeing Lin Jiuze state all the locations that needed to be pinpointed and having the Anesthesia doctor record them for the reference of the Heart Surgery doctors, while also saving the images, Ji Xiang felt relieved.

In Ji Xiang's heart, there was no intention to strike at Dr. Merz or to have a dispute with Zhao Yuanzhang.

It is all for the Patient, Ji Xiang thought to himself.

Soon, the Cardiac Surgery doctors rushed over; upon seeing the Echocardiogram images, they moved as quickly as if they had been wound up like a spring.

"Let's go." Seeing Lin Jiuze come down, Ji Xiang said to him in a low voice.

Lin Jiuze nodded, but instead of turning away immediately, he leaned into Dr. Merz's ear, "Dr. Merz, your level is truly low; it is because Massachusetts has doctors like you that it will always be inferior to Meiao."

After saying this, Lin Jiuze turned and left with Ji Xiang.

Dr. Merz's complexion was as gloomy as if it were about to rain; he stared at the opened incision, saying nothing.

Soon, the Cardiac Surgery doctors began to re-sterilize, and the Orthopedics Department sutured the incision, waiting to reopen it after the Cardiac Surgery doctors finished the Interventional Surgery.

Dr. Merz was depressed to the Extreme Point.

He felt that ever since he arrived in this godforsaken place, nothing he did went smoothly.

He had watched the surgeries he was supposed to watch, but he could not understand them.

He was invited to perform a small, casual surgery, but he encountered a rare Pulmonary Embolism.

Wembanyama was recovering well, and the speed of recovery was something he could not understand.

All of this seemed to have a connection to the Great Demon King, yet it also seemed to have no connection at all.

"Dr. Merz, let's go take a rest." Seeing that Dr. Merz seemed unwilling to let it go and remained standing in the surgeon's position without moving, Zhao Yuanzhang had no choice but to offer words of comfort.

"Impossible, absolutely impossible," Dr. Merz muttered in a low voice.

Through the disposable sterile cap, one could vaguely see Dr. Merz's golden hair burning.

……

"Doctor Ji Xiang, how did you judge that?"

Lin Jiuze and Ji Xiang went to the locker room to change clothes and asked curiously.

Ji Xiang smiled but did not speak.

It was the System Operating Room NPC who told him; did he need to say that?

Moreover, the matter was not over; after the System Operating Room NPC learned of the situation on-site, he instructed Ji Xiang to come find him after the diagnosis.

This was the first time Ji Xiang had heard the System Operating Room NPC ask him to return after a rescue; he was very curious, curious about what exactly the System Operating Room NPC wanted to say to him.

Therefore, he just smiled off Lin Jiuze's question.

After stepping down, he first checked on his own surgery Patient, and after chatting with Zhao Zhe for a few words, Ji Xiang went to the Fire Exit.

Holding his breath and focusing his mind, Ji Xiang arrived at the System Operating Room.

"Hello, Teacher."

"Mm, the rescue is finished?" the System Operating Room NPC asked with his hands behind his back and his waist hunched.

"The diagnosis is finished, the Heart Surgery Department is performing the surgery."

"The level of vascular Interventional Surgery at the Second Affiliated Hospital is this low?" the System Operating Room NPC asked.

Ji Xiang was startled; only then did he realize where the problem lay. He had heard some similar things when Director Bai and Director Liu were chatting, but not much.

It seemed that the level of vascular and Cardiac Interventional Surgery was not high, and they were not confident in using minimally invasive means to remove the Thrombosis of the Pulmonary Embolism.

"Teacher, it seems so," Ji Xiang said.

"Mm, let's not talk about that; the background you mentioned at the time was a bit interesting," the System Operating Room NPC smiled slightly, "How did you do it?"