Chapter 55: with translation of chapter title

When the patient arrived, a system prompt appeared in the upper right of Zheng Ren's vision: chronic delayed cholecystitis.

Translation: The patient was brought in, and Zheng Ren saw a system prompt appear in the upper right of his vision: chronic delayed cholecystitis.

When the patient was brought in, a system prompt appeared in the upper right of Zheng Ren's vision—chronic delayed cholecystitis.

His heart sank; Zheng Ren realized this was probably a complication of acute food poisoning.

Translation: His heart sank; Zheng Ren knew this was likely a complication of acute food poisoning.

If we could just hold off on antibiotics for about a week, the complication rate would drop to its lowest. But the current nationwide trend blames doctors for overusing antibiotics—they're all bastards.

Translation: If he could give antibiotics steadily for about a week, the complication's incidence could be minimized. But now the nationwide trend blames doctors for antibiotic overuse, calling them all bastards.

Note: "are all bastards" is colloquial; translate as "are all bastards". Keep tone.

There are indeed some bastards among doctors—for instance, giving post‑appendectomy pediatric patients three rounds of antibiotics, including kidney‑metabolized quinolones.

Translation: There indeed are bastards among doctors, for example giving three courses of antibiotics to a minor after a simple acute appendectomy, even including quinolone drugs metabolized by the kidneys.

But the vast majority of doctors are good; healing and saving lives is what they strive for.

Translation: But the vast majority of doctors are still good; healing and saving lives is what they pursue.

Yet all of this is mercilessly suppressed.

Translation: Yet all this is ruthlessly suppressed.

The veterinary officials in charge of the medical industry have issued rules limiting clinical antibiotic use—antibiotics may only be given if there is fever, a positive bacterial culture, abnormal blood work, etc., and supporting data.

Translation: Veterinary officials in charge of the medical industry issued regulations restricting clinical antibiotic use, requiring fever, positive bacterial culture, abnormal blood counts, etc., plus data support, before antibiotics can be used.

Yet few people realize that the biggest users of antibiotics are the livestock industry. The meat we eat and the milk we drink contain large amounts of antibiotic residues. But if the livestock industry stopped using antibiotics, yields would fall—how could we meet the people's ever‑increasing material needs?

Translation: Yet few consider that antibiotics are used most in livestock. The meat we eat and milk we drink contain large antibiotic residues. But the livestock industry also suffers; without them, yields drop—how can we meet the people's growing material needs?

Are we all supposed to just eat leaves? Zheng Ren, who's always been into grilled meat skewers, won't go along with that.

Translation: Are we all supposed to eat just vegetable leaves? Zheng Ren, who has always been interested in skewered meat, refuses.

There are too many complications here; Zheng Ren neither wants to nor can he resolve them.

Translation: There are too many twists and turns here; Zheng Ren neither wants to nor can resolve it.

Handling the emergency department at City First Hospital well would be a success.

Translation: Being able to handle the emergency department of City First Hospital well would already be good.

'The bedside ultrasound in the ER points to cholecystitis,' Zheng Ren said promptly.

Translation: "Bedside ultrasound in the ER suggests cholecystitis," Zheng Ren quickly stated his diagnosis.

'Mr. Zheng, how did he suddenly develop cholecystitis?' the patient's son said, worried.

Translation: "Chief Zheng, how did he suddenly get cholecystitis?" the patient's son said, distressed.

As I explained, acute toxic liver injury can cause effusion, and that fluid may linger near the gallbladder. In older people, whose bodily functions decline, a week of irritation can lead to secondary cholecystitis, Zheng Ren said.

Translation: "As I told you, acute toxic liver injury can cause effusion, which may linger near the gallbladder fossa. With elderly patients' bodily functions declining, stimulation for about a week can lead to secondary cholecystitis," Zheng Ren said.

That's what I said, but the likelihood of this type of cholecystitis isn't 100%; it's actually under 10%.

Translation: That's what I said, but the chance of this cholecystitis occurring isn't 100%; it's even under 10%.

Now it's a matter of luck, and clearly the patient before us isn't very lucky.

Translation: Now it comes down to luck; obviously, the patient before us isn't lucky.

But you can't tell the patient or their family that they have bad luck. Zheng Ren may be a straight‑as‑steel guy, but that only applies when dealing with women; his communication with patients is still smooth and full of emotional intelligence.

Translation: But saying the patient has bad luck is something you definitely can't tell the patient or family. Zheng Ren is indeed a straight‑shooting guy, but that only applies when facing women. His communication with patients is still smooth, full of emotional intelligence.

After admitting the patient to the ER ward, the old man was 'honored' to become the ER ward's first patient.

Translation: After admitting the patient to the ER ward, the old man was "honored" to become the ward's first patient.

The ultrasound revealed a gallbladder measuring 95 × 47 mm, with markedly increased tension, a rough wall 3 mm thick, no obvious abnormal echoes on the wall, poor internal sound transmission, and fine punctate echoes.

Translation: The ultrasound showed: gallbladder size 95×47 mm, tension markedly increased, wall rough, thickness 3 mm, no obvious abnormal echoes on the wall, poor internal sound transmission, with fine punctate echoes.

Looking at this ER ultrasound report, it's already clear that the patient has chronic delayed cholecystitis. Subsequent admission tests included a CBC, coagulation panel, hepatitis B, HIV/syphilis, liver and kidney function, and so on.

Translation: Seeing this ER ultrasound report, one can already confirm chronic delayed cholecystitis. Subsequently, inpatient ER tests were done: blood count, coagulation panel, hepatitis B, HIV/syphilis, liver and kidney function, etc.

ECG report: sinus rhythm, normal.

Translation: ECG report: sinus rhythm, normal ECG.

Zheng Ren had the nurse insert a nasogastric tube for GI decompression, then called the patient's son into the office for a doctor‑patient talk.

Translation: Zheng Ren had the nurse place a gastric tube for gastrointestinal decompression, then called the patient's son to the office for doctor‑patient communication.

The patient's family felt a bit downcast; he had insisted on leaving the hospital for observation, mainly because the hospital was too noisy for the old man to rest properly.

Translation: The patient's family felt a bit down; at the time he had insisted on leaving the hospital for observation. The main reason was that the hospital was too noisy, preventing the old man from resting well.

I never expected it to turn out exactly as Zheng Ren said—he really did develop cholecystitis.

Translation: Unexpectedly, it really turned out as Zheng Ren said—he got cholecystitis.

Since Zheng Ren had gotten along well with the family during the earlier ER observation, they sat down and he first calmed their emotions.

Translation: Because during the earlier observation in the ER holding room, Zheng Ren's rapport with the family had been fine, the two sat down and Zheng Ren first soothed the family's emotions.

Then he began explaining the condition to the family based on the ultrasound findings.

Translation: Then he began using the ultrasound images to analyze the condition for the family.

This patient's cholecystitis isn't an acute simple case. As noted earlier, acute food poisoning causes a transient liver dysfunction with exudative changes; the fluid pools in the gallbladder fossa, irritates the gallbladder, and triggers acute cholecystitis.

Translation: Like this patient's cholecystitis, it isn't acute simple cholecystitis. As previously stated, the cause is acute food poisoning causing a transient liver‑function abnormality with exudative changes; the fluid stays in the gallbladder fossa, irritates the gallbladder, and results in acute cholecystitis.

If it were a young man, the likelihood of cholecystitis would be low; young people are healthy and have strong immunity, so such inflammation would be cleared quickly.

Translation: If it were a young guy, the chance of cholecystitis would be small. After all, youth means good health and high immunity—this bit of inflammation would be absorbed in minutes.

Older people are different; they clear inflammation slowly, which is why they develop cholecystitis. Conservative antibiotic treatment wouldn't work very well.

Translation: Old people are different; they absorb inflammation slowly, which triggers cholecystitis. If treated conservatively with antibiotics, the effect wouldn't be ideal.

After discussing these points with the family, they agreed to follow Zheng Ren's plan.

Translation: After discussing these matters with the family, they indicated they would follow Zheng Ren's arrangements.

This shows that after some interactions, the family has come to trust the doctor.

Translation: This shows that after some contact, they have developed a certain trust in the doctor.

Had it not been for the successful nitrite‑poisoning rescue, the family wouldn't say they'd follow everything Zheng Ren arranges.

Translation: Without the successful rescue from nitrite poisoning, the patient's family wouldn't say they'd obey everything Zheng Ren arranged.

'Then let's do a cholecystectomy,' Zheng Ren finally decided.

Translation: "Then let's do a gallbladder removal," Zheng Ren finally decided on surgery.

Since the old man felt unwell that morning, hadn't eaten or drunk, and had fasted long enough—plus he was in severe pain—they went straight to preoperative prep.

Translation: Since the old man felt uncomfortable that morning, having eaten or drunk nothing, his fasting time was sufficient. Coupled with severe pain, they went straight to preoperative prep.

Half an hour later, the ER test results showed no surgical contraindications; after finishing the discussion with the family and getting the consent signature, Zheng Ren took the patient to the third‑floor operating room of the ER building.

Translation: Half an hour later, the ER test results came back: the patient had no surgical contraindications. After finishing communication with the family and signing the consent, Zheng Ren took the patient to the operating room on the third floor of the ER building.

When the ER building was designed, the first floor housed the ER department, observation room, ultrasound, CT, lab, etc.; the second floor was the wards with a planned 52 beds; the third floor contained the surgical operating rooms—several thousand square meters, with a full laminar‑flow design, among the best in the country.

Translation: When the ER building was designed, the first floor housed the ER department, observation room, ultrasound, CT, lab, etc.; the second floor was wards with a planned fifty‑two beds; the third floor was the surgical operating rooms—several thousand square meters, with laminar flow design, top‑tier domestically.

Director Lao Pan was eager to launch ER surgeries because just having the operating room drew interest from all the inpatient surgical departments; such a fine OR certainly shouldn't sit idle—if the ER doesn't use it, others will naturally want to.

Translation: Director Pan was so eager to launch ER surgery because just having the operating room attracted covetousness from all inpatient surgical departments. Such a fine OR certainly shouldn't sit idle; if ER doesn't use it, naturally others will.

Moreover, deep inside the third‑floor operating room there is actually an interventional catheter suite dedicated to interventional procedures.

Translation: Moreover, inside the third‑floor operating room there is actually an interventional catheter suite dedicated to interventional procedures.

The interventional catheter suite is designed entirely according to the latest plan, making it a hybrid operating room.

Translation: The design of that interventional catheter suite adopts the latest scheme entirely—it is a hybrid operating room.

A hybrid operating room means it can handle both interventional and surgical procedures.

Translation: The meaning of a hybrid operating room is that it can perform both interventional and open surgery.

This is quite advanced; ordinary tertiary hospitals lack hybrid operating rooms.

Translation: This is quite advanced; ordinary tertiary hospitals lack hybrid operating rooms.

Yet the hybrid operating room at Hai City First Hospital sits idle; if we don't seize the chance to use it, it would be a waste.

Translation: Yet the hybrid operating room at Hai Cheng City First Hospital sits idle; if we don't seize the time to use it, it would be a waste of heavenly resources.

In the laminar‑flow OR, temperature is constant, full sterilization equipment is in place, and even breathing the air gives the illusion that the whole body is being purified.

Translation: In the laminar‑flow OR, temperature is constant, full disinfection facilities are in place, and even breathing this air feels like the whole body is being purified.

While other doctors moved the patient, Zheng Ren went to change into his surgical gown.

Translation: Having other staff move the patient, Zheng Ren went to change his surgical gown.

It's time to use all skill points and experience! Zheng Ren confirmed the system master wasn't plotting anything shady—he'd foreseen that Zheng Ren should do a cholecystectomy—so why not head to the system's OR to train in laparoscopic cholecystectomy right now?

Translation: Time to put all skill points and experience to use! Zheng Ren was sure the system overlord wasn't scheming; rather, it had foreknowledge that he should do a gallbladder removal. Why not go to the system OR for LC (laparoscopic cholecystectomy) training now?

In the smoking room of the changing area, Zheng Ren lit a cheap Zi Yun cigarette, took a deep drag, felt relaxed all over, and then entered the system space.

Translation: In the smoking room of the changing area, Zheng Ren lit a cheap Zi Yun, took a deep puff, felt refreshed throughout, then entered the system space.

After entering, Zheng Ren didn't add any skill points—no amount could get him to master level, so there'd be no qualitative change.

Translation: After entering, Zheng Ren didn't add skill points; after all, no matter how much he added he couldn't reach master level, so no qualitative change would occur.

He opened the system store, selected cholecystectomy, converted the 75,000‑point mission reward into 20.83 hours of operating time, then entered the system OR to begin training.

Translation: He opened the system mall, selected gallbladder removal, exchanged the 75,000‑point mission reward for 20.83 hours of operating time, then entered the system OR to begin training.

Because the patients here are already anesthetized, it saves a lot of time.

Translation: Here the patients are already anesthetized, so it saves a lot of time.

Outside, performing one Gallbladder Removal Surgery, counting pre- and post-operative time, takes at least 2 hours. But in the System Operating Room, Zheng Ren doesn't need to consider the patient's condition, doesn't need to consider postoperative recovery, doesn't need to wait for anesthesia, and can start right away.

First laparoscopic gallbladder removal surgery, Zheng Ren took nearly 1 hour to finish. After all, when he was in the General Surgery Department, he basically had no qualification to be the lead surgeon performing gallbladder removal surgery, even though this procedure belongs to the first‑level surgery category.

After becoming familiar, Shou Bing went much more smoothly.

Time kept getting shorter, just like the training for Appendectomy; in a sense, surgical operation is nothing but practice makes perfect.

In the end, Zheng Ren only needs about 10 minutes to perform one laparoscopic gallbladder removal surgery.

The system training time was only a pitiful less than 21 hours; Zheng Ren seized the time and also performed no more than 80 Shou Bing.

But this was already enough; Zheng Ren felt particularly good about himself.

After the system training ended, he looked back at the skill tree; the General Surgery Department skill had increased from 1692 points to 1930 points. The increase was obvious—whether it was related to the difficulty of the surgery, Zheng Ren didn't know.

Zheng Ren returned to the present world; the smoke he had just exhaled had not yet completely dissipated. He stubbed out the purple cloud he had only taken a puff of, carefully placed it back into the cigarette case, then changed into a surgical gown and entered the operating room.

Xie Yiren was already ready, standing by the instrument table. Seeing Zheng Ren enter, she smiled at him. Her brows curved, her smile full.

The first Gallbladder Removal Surgery was about to begin.