The Surgeon’s Studio

“Have you checked her vitamin levels?” Zheng Ren asked.

“Vitamin?” Su Yun was stunned.

Their usual routine for emergency rescue in the ICU did not include vitamin tests unless the patient had a specific disease.

External injuries did not qualify as a specific disease.

“I’m thinking that it might be vitamin B1 deficiency,” Zheng Ren said. “Stop the patient’s sedatives.”

“…” Su Yun was still in a daze.

“I want to see if the patient is presenting symptoms of oculomotor nerve palsy during agitation.”

Paralysis of the extraocular muscle resulting from oculomotor nerve palsy would lead to misalignment of eyes and a loss of pupillary light reflex.

Right before Su Yun was about to argue, he suddenly recalled the constant trembling of Yang Lili’s eyes while she was conscious. That was also why Su Yun felt as if she had seen a ghost.

He hummed softly for several minutes before abruptly lifting his head, his eyes brightening with realization. “Boss, I think you’re right.”

Chief Qian and the other consulting chiefs were baffled.

Were these two young lads joking?

The city council was still waiting for their morning report, yet they…

If it was not for the exceptional emergency rescue abilities that Zheng Ren had demonstrated in the ICU prior to this or his impeccable surgical skills showed in past emergency surgeries, he would be ridiculed and scoffed at.

Vitamin B1 deficiency?

What a joke.

“Little Zheng, Little Su, stop joking around,” Chief Qian said in a deep voice to indicate his dissatisfaction.

“We’re not joking, Chief Qian.” Su Yun chuckled.

Zheng Ren’s words unveiled the fog and the sky was clear now.

There were times that a seemingly unsolvable problem could be easily resolved with a simple push.

“How are the patient’s symptoms related to vitamin B1 deficiency!” The medical administration division chief roared. “Beriberi? What nonsense is this!”

“We all studied pathophysiology before, right?” Su Yun looked around, a sneer hanging on the corners of his mouth. “The common disease of vitamin B1 deficiency is called beriberi, there isn’t anything wrong with that.”

While he spoke, his smirk grew larger, attracting many pairs of glistening eyes from the ICU nurses.

“Vitamin B1, also known as thiamine, is absorbed by the intestine and phosphorylated into thiamine diphosphate.

“Thiamine diphosphate is an important coenzyme in the decarboxylation of pyruvate and α-Ketoglutaric acid, as well as the coenzyme of erythrocyte transketolase.”

The people present were struck with a string of scientific jargon that seemed to appear out of nowhere like thunder and lightning.

Chief Qian hummed softly. What Little Su said made sense.

The medical administration division chief had an awkward expression because…he could not understand a single thing.

His position was quite important, as it required integrating each emergency rescue segment, ensuring the hospital’s medical quality was up to standard, and handling medical disputes.

He had left clinical practice for a long time and lost touch with things like pathophysiology.

Su Yun could not be bothered about their concerns and continued speaking, “The brain and cardiac tissues have a high metabolic rate. They require sufficient vitamin B in glycolysis to breakdown glucose into pyruvate or otherwise, the lack of thiamine diphosphate will prevent the keto acids from entering the tricarboxylic acid cycle.

“Accumulation of keto acids in the blood results in the dilation of surrounding arteries due to the decrease in peripheral resistance. The increased blood flow would then subsequently raise the cardiac output and cardiac workload.”

Hmm? Finally something about the right ventricle output and cardiac preload?

The medical administration division chief pretended to be in deep thought. He could not risk letting anyone discover his inability to comprehend anything.

Anyway… This rascal, could he just explain it in simpler terms?

“Therefore, I…” Su Yun halted midspeech. “My boss said that Yang Lili’s agitation and mental distress should be the complications from a vitamin B1 deficiency.”

Su Yun glanced at Zheng Ren after he finished speaking.

“Am I right, Boss?”

“That’s about it,” Zheng Ren said straightforwardly. “I suggest giving her a 100 mg shot of vitamin B1. However, intramuscular injections tend to have a lower rate of absorption. We can try simultaneously injecting 20 mL of saline with 50 mg of vitamin B1 intravenously.”

“It should be fine to administer a higher dosage on the first day,” Zheng Ren said.

The department chiefs and the medical administration division chief stared at each other blankly. They could see the confusion in each other’s eyes.

Even though not everybody agreed with what Zheng Ren and Su Yun were saying, they could not come up with a reasonable rebuttal.

They had explained their speculations clearly, with detailed elaborations on the biochemical processes.

Even when the people around them could not follow, their reasoning sounded very professional.

So?

What else could they do?

“Let’s try that out since we have no other choices,” Chief Qian said.

He had known Su Yun for the longest time and was well acquainted with him. Usually, if Su Yun had that obnoxious expression on his face, it usually meant he was right.

They should not argue with him, even if they were a department chief. If not, they might have gotten a slap on the face even when if they backed it up with medical reasoning.

Moreover, a few milligrams of vitamin B1 would not cause any harm to Yang Lili’s condition.

“Stop the sedatives after half an hour,” Zheng Ren said as he stood up, giving the final order.

“Sure, boss,” Su Yun noted down the doctor’s order.

Chief Qian got sentimental as he watched Zheng Ren leaving.

The young cub had matured into an adult.

Some of the older department chiefs did not even have the strong presence that Zheng Ren exuded.

Who dared to speak in such conclusively without knowing the medical treatment’s guaranteed outcome? If they just spoke without careful consideration, they would be given hell toward the end of it.

Chief Qian only encountered a handful of professors from the Imperial Capital and Sorcery Capital with a similar aura, but he had never seen someone like this in the…Sea City General Hospital.

After Su Yun conveyed the doctor’s order, the little nurse hurriedly carried out the orders and gave an intravenous injection of vitamin B1 before injecting another dose intramuscularly.

Su Yun glanced at the time before sitting down beside Yang Lili’s bed, his eyes fixated on her.

There was no problem with the half hour cut-off time that Zheng Ren had mentioned earlier. If they stop the sedatives then, it would take another 2 hours for Yang Lili’s body to metabolize the drug.

If the oculomotor nerve and cardiovascular symptoms were a result of vitamin B1 deficiency, the patient would then be relieved of those symptoms afterward.

What an interesting diagnosis.

…

At the same time, the vertebral resection surgery was ongoing in the major general surgery operating room.

“Little Zhou, were the embolizations from yesterday done precisely?” Professor Tian from the orthopedics department asked while making an incision.

Dr. Zhou said, “The embolization took longer than usual because we only have one interventional doctor. I can’t really tell if it was successful, but he performed embolizations on a patient with peritoneal hematoma after a pelvic fracture and it went really well.”

“Uhm, interventional doctors are quite rare. You’re lucky to have one.” Professor Tian started a blunt dissection to separate the muscles, carefully avoiding a location that was richer in capillaries.