Chapter 578: with translation of chapter title

"Oh, as long as you're satisfied." Zheng Ren's expression was a bit stiff; he had something on his mind and didn't even bother to placate Zhao Sister, saying it lightly.

Translation: "Oh, as long as you're satisfied." Zheng Ren's expression was a bit stiff; he had something on his mind and didn't have the energy to placate Sister Zhao, so he said lightly.

We need to keep as single line. Use quotes? Probably keep quotes as is. Use English punctuation.

We'll output: 【1】 "Oh, as long as you're satisfied." Zheng Ren's expression was a bit stiff; he had something on his mind and didn't have the energy to placate Sister Zhao, so he said lightly.

Zhao Sister noticed that Zheng Renhe was behaving differently from usual and asked, "The patient's condition looks pretty good, Chief Zheng—are you worried?"

Translation: Sister Zhao saw that Zheng Renhe's behavior was different from usual, so she asked: "I think the patient's condition looks fine, Chief Zheng, are you worried?"

Note: "Zheng Renhe" is Zheng Renhe. "Chief Zheng" is Chief Zheng. Use exact forms.

"Yes, Zhao Sister." Zheng Ren said: "The patient is thought to have a traumatic carotid artery injury; it looks fine now, but perhaps in the next second a gush of blood could spray out and the person would die."

Translation: "Yeah, Sister Zhao." Zheng Ren said: "The patient is considered to have a traumatic carotid artery injury; it looks fine now, but maybe in the next second a gush of blood will spray out and the person will be gone."

Zhao Sister was surprised; even an experienced clinical assistant doctor had never seen the situation Zheng Ren described. She half-believingly operated the machine to perform a neck vascular CTA on the patient.

Translation: Sister Zhao was surprised; even an experienced clinical assistant doctor had never seen the situation Zheng Ren described. She half-believingly operated the machine to perform a neck vascular CTA on the patient.

The examination took over twenty minutes, and Zheng Ren had Su Yun send the patient back.

Translation: The examination took over twenty minutes, and Zheng Ren had Su Yun send the patient back.

He also reminded Su Yun not to let the patient move at all.

Translation: He also reminded Su Yun not to let the patient move.

Su Yun understood the seriousness; Zheng Ren's worry was also his worry.

Translation: Su Yun understood the gravity; Zheng Ren's worry was also his worry.

With many emergency patients, we've seen all sorts of strange things. As the saying goes, "careful navigation brings long voyages"—that's all we can do.

Translation: With many emergency patients, they've seen all sorts of strange things. "Careful sailing gets you a ten-thousand-year voyage," so that's all they can do.

Su Yun, in the capital, had once seen a patient with spontaneous pneumothorax.

Translation: Su Yun, in the capital, had once seen a patient with spontaneous pneumothorax.

The patient walked in, was diagnosed with left-sided spontaneous pneumothorax with 60% lung compression, reported a history of pneumothorax, and after receiving closed‑tube drainage treatment recovered.

Translation: The patient walked in, diagnosed with left-sided spontaneous pneumothorax, lung tissue compressed 60%. The patient reported a history of pneumothorax and recovered after receiving closed drainage treatment.

Such patients aren't much to talk about—their history is simple and treatment straightforward. If they refuse open‑chest or thoracoscopic surgery, just observing the chest bottle for a few days is enough.

Translation: Such patients aren't worth much discussion; their history is simple, treatment simple. If they refuse thoracotomy or thoracoscopic surgery, just observing the chest bottle for a few days will do.

However, after the chest bottle was placed, dark‑red fresh blood began to drain out through the chest tube.

Translation: However, after the chest bottle was inserted, dark red fresh blood began to drain out through the chest tube.

Su Yun didn't take it lightly; she pulled over a stool, sat beside the patient, and monitored the chest bottle drainage.

Translation: Su Yun wasn't careless; he moved a stool to sit beside the patient and observed the chest bottle drainage.

Two hours later, the drainage had reached about 200 ml per hour.

Translation: Two hours later, hourly drainage had reached about 200 ml.

Su Yun made a quick decision, explained the situation to the patient's family, and proceeded with an exploratory thoracotomy.

Translation: Su Yun made a quick decision, informed the patient's family of the condition, and performed a thoracotomy for exploration.

The result was both laughable and lamentable.

Translation: The result was both laughable and tearful.

Because the patient had previously undergone closed‑tube drainage, adhesions had formed between the lung and pleura. During this spontaneous pneumothorax, as the lung tissue was compressed, the adhesions at the pleural apex were torn.

Translation: Because the patient had undergone closed drainage before, there were adhesions between the lung and pleura. This time, during spontaneous pneumothorax, when the lung tissue was compressed, it caused the adhesions at the pleural apex to tear.

Intra‑operative exploration revealed only a torn area the size of a thumb's fingernail, which was oozing blood.

Translation: Intraoperative exploration revealed only a torn area the size of a thumb's fingernail, which had oozing bleeding.

It was just this slight oozing; under normal pleural pressure it was not noticeable, but once the air was withdrawn and the pleural pressure returned to normal, the bleeding became profuse.

Translation: It was just that bit of oozing blood; under normal intrathoracic pressure it wasn't noticeable. But when the air was drained and intrathoracic pressure returned to normal, significant bleeding began.

By the time they went to the operating table, the patient was already on the verge of hemorrhagic shock.

Translation: By the time they went to surgery, the patient was already in the early stages of hemorrhagic shock.

He was just a step away from death.

Translation: He was almost dead.

If Su Yun had been even a little careless,

Translation: If Su Yun had been a little careless,

If there had been a major resuscitation effort that day, with everyone rushing to the table, it would have delayed observation and treatment.

Translation: if there had been a major resuscitation that day with everyone rushing to the operating room, delaying observation and treatment,

If …

Translation: if...

With countless "what ifs," the patient would have died in the ward.

Translation: countless "ifs," and the patient would have died in the ward.

So, clinicians often develop a habit—any doubt or lack of confidence gets endlessly magnified.

Translation: So, clinicians develop a habit—any doubt, any lack of confidence in their mind, gets endlessly magnified.

Perhaps this is also a form of pessimism, or a kind of obsessive‑compulsive tendency.

Translation: Perhaps this is also a kind of pessimism, and also a kind of obsessive-compulsive disorder.

Nowadays, Zheng Renhe and Su Yun apply this attitude when dealing with patients suspected of carotid artery laceration.

Translation: Nowadays, Zheng Ren and Su Yun treat patients with suspected carotid artery injury with this attitude.

Seeing that Zheng Ren hadn't left, Zhao Sister knew he was anxious and promptly expedited the imaging.

Translation: Seeing Zheng Ren not leaving, Sister Zhao knew he was anxious, so she simply expedited the imaging.

When the neck vascular CTA image appeared on the screen, both were stunned.

Translation: When the neck vascular CTA image appeared on the screen, both were stunned.

A triangular shard of glass was lodged in the carotid artery.

Translation: A triangular shard of glass was lodged in the carotid artery.

Although it staunched the carotid bleeding, nobody could say when this unstable factor might cause trouble.

Translation: Although it prevented carotid artery bleeding, when this unstable factor might cause trouble, nobody can say.

The instant Zheng Ren saw the glass fragment, he immediately picked up his phone and called Su Yun.

Translation: The instant Zheng Ren saw the glass shard, he immediately picked up his phone and called Su Yun.

"The patient's carotid artery shows a glass fragment. Do not compress the left‑side laceration area—definitely do not press on it!"

Translation: "The patient's carotid artery shows a glass shard. Do not compress the left-sided laceration area; definitely do not compress!"

"Yes, please call vascular surgery for a consultation, inform them, and prepare for emergency surgery."

Translation: "Yes, please have the vascular department come for consultation, notify them, and prepare for emergency surgery."

"Comfort the patient and keep his emotions stable."

Translation: "Comfort the patient, keep the patient's emotions stable."

After giving those instructions, Zheng Ren finally let out a sigh of relief and put his phone away.

Translation: After giving those instructions, Zheng Ren finally exhaled and put his phone away.

If you can detect the problem, you can solve it.

Translation: Being able to detect the problem means it can be solved.

The most difficult and dangerous period for this patient has already passed.

Translation: The most difficult and dangerous period for this patient has already passed.

This type of surgery was originally performed by general surgery, since it is a neck procedure, but after vascular surgery split off, it became their responsibility.

Translation: This surgery was originally performed by general surgery, after all it's a neck procedure. But as vascular surgery split off, it became their responsibility.

Zheng Ren isn't unwilling to try, but first he lacks the appropriate supplies to block the carotid artery, and second, surgical training time has been exhausted—who would dare to touch the carotid artery without practice?

Translation: Zheng Ren isn't unable to try, but first he lacks the handy consumables that could block the carotid artery or similar; second, his surgical training time has run out, and without further practice, who would dare to touch the carotid artery?

As for the vascular surgery department at Haicheng City First Hospital, its technical capability might not be sufficient for this operation.

Translation: As for the vascular department's technical capability at Haicheng Shi Yiyuan Hospital, they might not be able to handle this surgery.

But Zheng Ren doesn't mind.

Translation: But Zheng Ren doesn't mind.

If general surgery can't handle it, he can join the procedure himself, select a suitable approach, enter the carotid artery, and place a stent‑graft at the bleeding site—that would be enough.

Translation: If surgery can't be managed, he can go up himself, perform super-selective access into the carotid artery, and place a covered stent at the bleeding site—that would be enough.

Although that approach isn't strictly rigorous or standard, any means that can save a life is good.

Translation: Although the latter approach isn't rigorous or standard, any means that can save a life is good.

"Chief Zheng, how did the glass get in there?" Zhao Sister asked while doing the post‑processing.

Translation: "Chief Zheng, how did the glass get in there?" Sister Zhao asked while doing post-processing.

"It's probably a high‑speed glass shard that pierced the skin, and this kind of glass‑fragment injury shows no obvious external signs, but the internal condition is severe." Zheng Ren, recalling it now, still can't help feeling afraid.

Translation: "Probably a high-speed moving glass shard pierced the skin, and this kind of glass shard injury shows no obvious external signs, but the internal condition is serious." Zheng Ren, recalling it now, still can't help but feel afraid.

A slight lapse could cause the patient to suddenly hemorrhage when the glass fragment dislodges from the carotid artery, leading to death within a minute.

Translation: A little carelessness, and this patient could at any moment have the glass shard detach from the carotid artery, causing massive bleeding, leading to death within a minute.

Holding the freshly printed film, Zheng Ren hurried back to the emergency department.

Translation: Holding the freshly printed film, Zheng Ren hurried back to the emergency department.

The head of vascular surgery was also pulled from the cafeteria.

Translation: The head of the vascular department was also pulled from the cafeteria.

Because vascular surgery is a small department with few related procedures, they don't even have an inpatient service.

Translation: Because the vascular department is a small unit with few related procedures, they don't even have an inpatient chief.

A small hospital is just a collection of various non‑standard practices.

Translation: A small hospital is just all kinds of noncompliance.

As Zheng Ren entered, the head of vascular surgery, Director Fan, was just coming out.

Translation: As Zheng Ren entered, the chief of the vascular department, Fan, was just coming out.

They met face‑to‑face; Zheng Ren lifted the film and said, "Director Fan, could you take a look?"

Translation: They met face-to-face; Zheng Ren lifted the film in his hand and said, "Chief Fan, could you take a look?"

Director Fan nodded solemnly; Zheng Ren had the patient's spouse go to the office, found a viewbox, and placed the film on it.

Translation: Chief Fan nodded solemnly; Zheng Ren called the patient's loved one to the office, found a viewer, and inserted the film.

On the neck vascular CTA, the triangular glass fragment less than 1 cm in size stood out starkly.

Translation: On the neck vascular CTA, that triangular glass shard less than 1 cm in size was especially conspicuous.

Almost as soon as they saw the image, the glass shard looked like something from a horror film, appearing to "stab" out of the picture.

Translation: Almost as soon as they saw the film, that glass shard looked like something from a horror movie, as if it "stabbed" out of the image.

"Director Fan, let's prepare for surgery," Zheng Ren said.

Translation: "Chief Fan, prepare for surgery," Zheng Ren said.

"Ah," Director Fan shook his head and said, "The patient's life is truly huge."

Translation: "Ah." Chief Fan shook his head and said, "The patient's life is truly huge."

Zheng Ren deeply believed it.

If it weren't for many coincidences, the patient brought to the hospital by the Emergency Rescue Service vehicle would just be a corpse.

The diagnosis was clear, nothing much to say; the Jizhen Wai Ke doctor issued an admission slip, and Director Fan hurriedly took the patient back to prepare for the Shou Bing.

This kind of Shou Bing, recovery is also quite fast.

Zheng Ren estimated that discharge would be possible in two or three days after the Shou Bing.

Many big things, once discovered, turn out to be trivial trifles.

Deadly injuries and diseases, with a clear diagnosis, the patient can be discharged two or three days after the Shou Bing. Think about it, that's indeed her great luck.

After working in clinical practice for a long time and seeing many cases, one slowly begins to believe in fate.

At the car accident scene, the patient who was hit beyond recognition would be discharged and go home in half a month or a month.

Minor scrapes, the patient had no issues, yet they suffered a one-in-fifty-thousand delayed-onset carotid artery intimal tear; after three to five days in hospital, they suddenly lost bowel and bladder control and consciousness—a case Zheng Renye also personally witnessed. (Note 1)

So, to say, people...

……

……

Note 1: Carotid artery intimal tear, this case was encountered by a friend of mine in neurosurgery; later I looked it up in books, the probability is one in fifty thousand.

Carotid artery cases, I recall that the US TV show *The Good Doctor* has similar content. This case is selected from the *Journal of Vascular Surgery*; there are some parts I also find amazing. But clinically, there are just some low-probability events.