Surgeons Episode 38 Recap
> Surgeons Recap
Zhuang Shu visited Lu Chenxi at the emergency room, bringing medical records for a patient Chu Jun had identified. Lu Chenxi playfully teased him, suggesting he was running errands for Chu Jun, but Zhuang Shu clarified he had no scheduled work that morning and simply wanted to see her. Lu Chenxi expressed concern that his day off was due to the Hospital Affairs Committee's investigation into him.
She then praised Chu Jun's excellent handling of a patient named Zhao Jing, noting Chu Jun's meticulousness in identifying the patient's hypertension and reserpine-induced depression, and for seeking a superior's help. Zhuang Shu gave a non-committal response, which Lu Chenxi found amusing, emphasizing her sincere appreciation for Chu Jun's recent improvements. Meanwhile, a patient in the ER presented with sudden blindness after allegedly falling at home. His wife, also present, supported his story, but Zhuang Shu suspected something more.
Pretending to be a neurologist, Zhuang Shu emphasized the severity of the condition and proposed a battery of extensive neurological tests, including various ultrasounds, CT, MRI, and even invasive angiography. This pressure eventually led the wife to confess that she had hit her husband on the back of the head with a frying pan during an argument that morning.
Zhuang Shu calmed the agitated couple, explained the seriousness of domestic violence, and then prescribed an "expensive" special medicine, which was actually just saline and eye drops. After Zhuang Shu administered the saline injection, the patient's sight immediately returned, confirming it was a case of hysteria. Lu Chenxi commented on Zhuang Shu's effective "Â¥4,500 medicine," and he advised her not to use such tricks casually.
She then asked Zhuang Shu if he could tolerate such an incident with his own wife, to which he smiled and expressed a wish for a playful, inseparable relationship with her. Due to the ongoing investigation, all of Zhuang Shu's surgeries were suspended. However, one patient's family adamantly refused to let anyone else perform their scheduled lung cancer resection, insisting only Zhuang Shu could do it and willing to wait indefinitely.
Dean Yang Fan reviewed the case and, finding it to be a straightforward procedure suitable for any associate chief physician, grew annoyed by the family's stubbornness. He declared that he, the Dean of Renhe Hospital and Director of Thoracic Surgery, would personally perform the surgery.
During the operation, Yang Fan addressed the observing doctors, acknowledging their disappointment at not seeing Zhuang Shu operate, but asserted that all associate chief physicians in Renhe's Thoracic Surgery department should be capable of performing such a surgery, underscoring the hospital's high standards. Later, Zhuang Shu spoke to Chu Jun, expressing his confidence in her.
He told her she had "passed" his mentorship, noting that she was no longer the easily dismissive doctor Lu Chenxi had once criticized, nor was she merely trying to impress him. Instead, Chu Jun was now using her own knowledge and experience to genuinely help patients. Chu Jun was pleased by his recognition but voiced her worry that if the investigation found Zhuang Shu responsible for the induced hypothermia treatment, he would have to leave Renhe.
Zhuang Shu calmly replied that his departure wouldn't matter, as Renhe had many good doctors, and she and her colleagues were continuously growing as professionals. During lunch, Lu Chenxi was visibly worried about Zhuang Shu's upcoming afternoon investigation and barely touched her food. She urged him to "acknowledge his mistake" to Yang Fan or to hire a lawyer, recounting how her own pride had led to her being removed from Thoracic Surgery in the past.
Zhuang Shu, however, decided to "just tell the truth," a philosophy he learned from someone (implied to be Lu Chenxi herself) for navigating difficult situations. As Zhuang Shu prepared to head to the investigation, he found several colleagues, including Yang Zixuan and Chen Shaocong, gathered outside his office. They feigned discussing a patient, but Zhuang Shu knew they were there to offer silent support. He thanked them before entering the meeting.
The investigation panel, including Renhe Hospital Legal Counsel Lawyer Xiao Chuan Ming and Jialin Medical University Deputy Dean Zhang Yi Min and Renhe Hospital Deputy Dean Wu Tian, began their questioning. Zhuang Shu confirmed his specialty was thoracic surgery, particularly combined cardiac and lung transplants and treatment of malignant lung and mediastinal tumors, and admitted that trauma resuscitation was not his primary field.
He stated that his decision to perform the emergency treatment on Cheng Lu (Lu Chenxi's mother) was not by order of a superior, but at the request of Lu Chenxi, the patient's daughter and attending physician. He further confirmed he had not consulted any trauma experts or superiors like Director Ma, Major Surgery Director Fang, or Dean Yang Fan before initiating the hypothermia induction treatment.
When asked about his personal relationship with Lu Chenxi, Zhuang Shu acknowledged she was his lover. The lawyer concluded that all his actions during Cheng Lu's resuscitation were solely his personal decisions, which Zhuang Shu confirmed. Deputy Dean Zhang Yi Min pressed Zhuang Shu on the induced hypothermia method, noting that Chinese medical practice uses external cooling methods (like ice-cold hats or blankets) to decrease body temperature, not infusing zero-degree saline into the central circulation as Zhuang Shu did.
Zhuang Shu admitted the method was not standard in the US, he had never successfully saved a patient with it, and there were no established protocols or published clinical data. He explained that the concept of "induced coma" by trauma specialists to buy time for severely bleeding patients (unable to receive immediate blood transfusions) was being researched by centers like Pittsburgh Medical Center and Boston Medical Center, but official data had not yet been released.
The panel concluded that he had directly used a method that was still purely theoretical, lacking principles, standards, or published clinical data, on a patient. Deputy Dean Wu Tian further criticized Zhuang Shu's method, stating that infusing cold saline into a severe trauma patient was contrary to fundamental medical knowledge and practice, as crystalloids or colloids should be warmed. The panel stated they would appraise him based on his professional background, technical skills, and expert opinions.
Zhuang Shu then requested to present his perspective. He argued that room-temperature solutions would not have saved Cheng Lu, who had lost two liters of blood, and mobilizing sufficient Rh-negative blood within an hour was impossible. He challenged the experts to explain how standard protocols could protect vital organs under such extreme blood and oxygen deprivation. Zhuang Shu emphasized that without immediate blood transfusion, the heart, brain, and other organs would suffer irreversible damage.
He believed that creating an unusual condition to extend the organs' tolerance to low oxygen levels was the only way to save her life. Despite acknowledging the potential for serious consequences, he maintained he could not have stood by and let the patient die. He still believed his method was not wrong, as he could not conceive of another way to save her life.
The panel, however, reiterated that his unconventional treatment had led to an irreparable consequence, leaving the patient in a vegetative state, and thus, his induced hypothermia did not ultimately "save" her in the conventional sense. Separately, Fu Bowen called Yang Fan to seek help for Zhuang Shu, arguing that Cheng Lu's surgery was ultimately successful and that Lu Chenxi, as both attending doctor and family, supported Zhuang Shu, making the prolonged investigation excessive.
Yang Fan, who had recused himself from the investigation to avoid bias, stated he couldn't control the specialists' strong opinions. He countered Fu Bowen, asserting that since Cheng Lu had not yet woken up, the treatment could not be deemed successful by the experts. He warned that if the patient's condition worsened in the future due to the hypothermia, the hospital leadership would face public blame for negligence.
Yang Fan declined to intervene further, citing hospital regulations against supporting such a disregard for standard protocols. Fu Bowen ended the call, frustrated, later telling someone on the phone that he had failed to sway Yang Fan. Meanwhile, in her mother's hospital room, Lu Chenxi anxiously awaited news of Zhuang Shu's investigation. She noticed her mother's fingers and lips twitching, signaling a response.
Overjoyed, she rushed to the conference room, interrupting the investigation to announce her mother was responding and on the verge of waking up. Zhuang Shu immediately left the meeting to check on Cheng Lu. He instructed Lu Chenxi to contact Dr. Donner in the US for advice on future treatment, as her mother was responding to her surroundings for the first time. Elsewhere, Chen Shaocong was moving out of his apartment with the help of Yang Zixuan and Chu Jun.
He revealed he was moving back into his family home because Yang Yu was pregnant and needed care, and his mother wanted a lively household. Chu Jun expressed surprise at his family's wealth, to which Chen Shaocong humorously feigned regret about his single status. Yang Zixuan explained that Chen Shaocong sought genuine love, not someone attracted to his family's money, a common trope in TV dramas.
Chen Shaocong clarified that his father was frugal and believed in self-reliance, which explained his modest living arrangements previously. Their conversation shifted to Zhuang Shu's investigation. Chu Jun and Yang Zixuan believed the investigation should cease now that Lu Chenxi's mother had improved from deep to light coma.
Chen Shaocong, however, was cynical, asserting that Dean Yang Fan's true intention was to force Zhuang Shu out of Renhe, and even if this investigation ended, Yang Fan would find other means to achieve his goal. Yang Zixuan questioned why his father would try to oust a top expert he personally recruited, but Chen Shaocong claimed ignorance, suggesting only Yang Fan and a higher power knew the real reason.
Chu Jun worried about Lu Chenxi's emotional state if Zhuang Shu left, but Chen Shaocong suggested Lu Chenxi could simply follow him. Later, Zhuang Shu was on a basketball court, playing intensely. Lu Chenxi watched from the sidelines, impressed by his skills. She playfully teased him about playing streetball in the States, but he corrected her, stating he played college varsity. She retorted, threatening to make him play golf if he kept showing off. Lu Chenxi's father had encouraged her to accompany Zhuang Shu to unwind, and she provided him with electrolyte water.
