The Emergency Department was somewhat dirty and messy at night.
There were discarded clothes and rubbish on the floor. The positions of the IV stands, chairs, and even hospital beds also became haphazard. In the corner of the room near the rubbish bin, there was even something that looked like vomit, covered with a rag that was soaked in antiseptic fluids.
Ling Ran walked quickly. When he reached the treatment room, the patient had already been pushed into a curtained cubicle. From outside, Ling Ran could see the reclined upper-half of the patient's body, and that the patient was staring at the ceiling with glazed eyes.
"Come in, Doctor Ling." Nurse Liu drew the curtains after letting Ling Ran in.
The patient did not move at all even after hearing the commotion.
"Does he have a concussion?" Ling Ran chose a more logical assumption. If it were anything more serious than that, it would not even matter if the scrotum was sutured.
"He's in shock." Zheng Pei, the experienced resident doctor kneeling at the foot of the bed to look at the wound, raised his head.
"Oh." Ling Ran glanced at the messy condition of the patient's crotch. He could kind of understand how the patient was feeling.
Zheng Pei was bespectacled and had a small goatee growing under his chin. His hair was around the length of his beard. He would become the chief resident after this year, and if he managed to get through it alive, he would be promoted to attending physician. He was also the most experienced doctor among the first-string doctors on shift tonight. He had been a houseman for three years, a resident doctor for another three years, and had sutured a few thousand patients.
Since Zheng Pei knew that Nurse Liu had sent someone to call Ling Ran, he questioned Ling Ran with the intention to test him. "What information can you derive based on your observations right now?"
Senior doctors tested junior doctors when they were in a good mood… and a bad mood. There was the possibility that both medical interns and resident doctors would get thrown a lot of questions anytime and anywhere.
Of course, since this was the kind of life medical students led in universities, Ling Ran was not surprised. He thought about it as he observed the patient under the sufficient lighting.
Because he obtained only the Specialist Level Interrupted Vertical Mattress Suturing Technique, which was suitable for the suturing of stomachs and scrotums, he still had to depend on himself when it came to aspects such as the observation and diagnosis.
Fortunately, Ling Ran had obtained knowledge related to this by himself early on. He earnestly studied the patient's bloody and messy wound and answered, "Laceration on the right side of the scrotum, exposing the testicle. Obvious dust and fine debris can be seen on the surface of the scrotum and in the soft tissue. The wounded area reaches the tunica vaginalis, but the tunica vaginalis should be intact."
The patient on the hospital bed trembled with every word Ling Ran said. It was not so easy for a patient to put up with this with grace.
Zheng Pei glanced at Ling Ran, a little surprised. He hummed in acknowledgement and said, "Very detailed observations, and your knowledge is quite vast."
Ling Ran flashed a slight smile.
Zheng Pei did not receive a humble reply even after waiting a few seconds. He slapped his forehead and said to Nurse Liu with a smile, "Look at who I'm talking to."
Immediately after that, Zheng Pei made room and said, "Come and inspect the patient, and tell me your judgements one by one."
Ling Ran put on a pair of gloves. He went forward and fiddled with the wound for a bit. The patient, whose eyes were glazed, trembled even more violently.
"I don't see any associated injuries. It's a nonlinear wound and is definitely contaminated. Was it sustained on the road? It doesn't really look like it…" Even though Ling Ran had studied about it before in books, it was very hard for him to come out with an accurate analysis when it came to actual practice.
Zheng Pei chuckled and said, "I asked when I was outside. He sustained the injury while skateboarding in a park. Isn't there a move in skateboarding where you jump onto the metal handrails and slide down? Guess what happened."
"He jumped onto it, but his skateboard did not follow?" Ling Ran felt as if he got an answer for a riddle.
Zheng Pei snapped his fingers and said with a smile, "You are correct. He ended up riding the metal handrail. And the handrail wasn't even round. So—"
"So we have to consider the possibility of tetanus and give him a tetanus shot," Ling Ran finished Zheng Pei's sentence.
Zheng Pei was dumbfounded. Were they not chit-chatting excitedly? Why did he go back to the topic in an instant?
"The bleeding isn't too serious. As for the condition of the spermatic cord…" Ling Ran recalled what he learned during the anatomy lessons. He asked rather hesitantly, "What is a normal spermatic cord supposed to look like?"
If you were to give Ling Ran an intact male scrotum, and let him cut it to take out the spermatic cord, he could still determine whether the cord was normal. But because the situation right now was quite atypical, Ling Ran did not dare make an absolute conclusion when it came to an anatomical structure he was unfamiliar with.
Zheng Pei had not performed such an in-depth examination yet. When he heard what Ling Ran said, he started to observe carefully and muttered to himself, "If it's abnormal, we need to first consider the possibility of spermatic cord torsion."
The patient finally could not keep quiet anymore, and asked with a rather hoarse voice, "Both of you are still talking about My Fair Princess[1]?"
Zheng Pei was bewildered by the question. "When did we talk about My Fair Princess?"
"The… Jin Suo[2] both of you talked about just now is the Jin Suo from My Fair Princess, right…?" The patient's cheeks twitched twice. He glared indignantly at the ceiling and said, "The doctors are still talking about a television drama when I'm so seriously wounded. Who the f*ck sent me to this hospital, I—"
Zheng Pei was angry and amused at the same time. "My Fair Princess? What era is that television drama from? Do you know why you got hurt so easily even though other people don't get injured as easily as you during skateboarding accidents? It's because you are too old."
Nurse Liu quickly asked, "Doctor Zheng, what drugs are we going to administer now?"
It was really not worth it for doctors and nurses to fight with patients, mishaps could also happen easily because of that.
Zheng Pei shook his head and said, "Ling Ran, can you explain what a spermatic cord is to the patient first?"
"A spermatic cord is a structure that holds the testicle in place and provides nourishment to the testicle. Its contents include arteries, veins, lymphatic vessels, nerves…" Ling Ran answered as though he was reciting from a book. He then said to the patient, "We are checking to see whether your spermatic cord is working normally. If there's a problem with it—for example torsion—we'll have to perform surgery on it. We might also have to remove your testicle. In that case, stitches won't be needed anymore "
Ling Ran looked a little regretful as he said the last part.
The patient said nothing and stared at the ceiling with glazed eyes. His entire body trembled.
"The testicle is a little lower than usual." Zheng Pei paused for a moment and said, "There's no torsion. It's just that the position of the spermatic cord itself is considerably rare."
Ling Ran looked at where Zheng Pei was pointing at and nodded in confirmation.
"Go ahead and debride and suture the wound. Make sure that you don't separate the wound too much when you debride it." After Zheng Pei made sure that there were no other problems, he decided that he would not do the work himself. He took off his gloves and gestured for Ling Ran to get into action.
Ling Ran came here with the intention to do the surgery. Right then, he took the center position without hesitation and began his task, which was familiar and strange at once.
The Specialist Level Interrupted Vertical Mattress Suturing Technique was finally being put to use.
A few minutes later, the egg was returned to its nest.
Ling Ran left the small cubicle satisfied. He felt like his shift today was not a waste.
When Lu Wenbin caught sight of Ling Ran, he quickly walked over and said, "Doctor Ling, the edema of the patient in bed number five has subsided."
"You made another ward round just now?" Ling Ran glanced at his watch, it was already dawn.
Lu Wenbin glowed in excitement. He said, "I took a look while I was at it, but I did not expect the edema to subside so soon."
A notification from the system simultaneously appeared before Ling Ran's eyes.
[Mission completed: Treating Patients]
[Reward obtained: Incision (Specialist Level Bow Hold Style)]
Translator's notes:
[1] A Chinese-Taiwanese television drama which began airing in 1998 and is considered the most commercially successful Chinese-language series in history.
[2] Spermatic cord is pronounced as 'jin suo' in Mandarin, which is the same pronunciation as the character Jin Suo in 'My Fair Princess'.