Super Doctor - Chapter 138

Under the astonished gaze of Dr. Zhang Qi outside the door, Xu Ze calmly pressed one hand against the prepared puncture site while using the other to steadily draw 5 mL of lidocaine from the vial Director Qu held. He was ready to begin local anesthesia.

To Xu Ze, since Director Qu had given him the go-ahead, it was only natural for the director to assist in this two-person procedure. Hierarchy didn’t factor into his thoughts.

But for Zhang Qi, the sight was baffling. Director Qu—a nationally renowned expert with an overwhelming schedule—rarely performed minor procedures himself, let alone acted as an assistant. Typically, he only consulted on cases when requested by attending physicians during his weekly rounds.

Yet today, not only was he personally involved, but he was assisting a rookie. It was unheard of.

Quickly masking up, Zhang Qi stepped in and offered, “Director, why don’t you take a rest? I’ll assist Dr. Xu.”

Director Qu shook his head with a faint smile, his eyes fixed on Xu Ze’s movements. He wasn’t just assisting—he was observing Xu Ze’s skills firsthand. No substitute would do.

Xu Ze, fully absorbed in the procedure, paid no mind. Tilting the syringe, he injected anesthetic beneath the skin before adjusting to a perpendicular angle, meticulously numbing each layer from skin to ligament.

Once the lidocaine had fully infiltrated the ligament, Xu Ze took a steadying breath. Gripping the 10-centimeter spinal needle, he anchored the skin with his left thumb and index finger while slowly advancing the needle vertically into the L3-L4 interspace. The lumbar puncture had officially begun.

Director Qu watched with keen interest. By now, he had no doubts about Xu Ze’s competence—but could the rookie succeed on the first attempt? If so, it would confirm Xu Ze’s exceptional clinical acumen, paving the way for greater responsibilities.

Zhang Qi, observing from the sidelines, studied Xu Ze intently. Just how skilled is this newcomer to earn Director Qu’s respect?

Xu Ze, however, felt a flicker of nerves. In virtual simulations, he’d mastered the technique after repeated practice, but reality was different. As he advanced the needle 3–4 cm, a slight resistance gave way—the first ligament breached. The real test lay ahead.

Another 2 cm in, the resistance intensified. Xu Ze tightened his grip and pushed forward. Suddenly, the tension vanished—the needle had pierced the ligament and dura, entering the spinal canal.

But success hinged on one final step.

Gently withdrawing the stylet, Xu Ze held his breath. Under the trio’s watchful eyes, a single drop of clear cerebrospinal fluid (CSF) emerged.

Relief washed over him. Director Qu and Zhang Qi exchanged approving glances—impressive.

Reinserting the stylet to halt the CSF flow, Xu Ze attached a manometer to measure intracranial pressure. The reading stabilized at 150 mm H₂O—well below the 180 mm threshold—ruling out intracranial hypertension. Another point in favor of Guillain-Barré syndrome.

After detaching the manometer, Xu Ze prepared three collection tubes. With practiced precision, he withdrew the stylet again, allowing CSF to drip into each tube. Once all three contained adequate samples, he resealed the needle, removed it, and covered the puncture site with gauze.

Helping the patient lie flat, Xu Ze instructed, “Stay in bed without a pillow for four hours before sitting up.” Then, gathering the equipment and CSF samples, the trio exited the ward.

Back in the office, Director Qu swiftly filled out lab requisitions, urging the nurses to rush the samples for testing.

Zhang Qi, puzzled by the urgency, asked, “Director, what’s unusual about this case?”

“Dr. Xu noticed anomalies during his exam,” Director Qu explained. “We suspect it’s not simple myasthenia gravis but a newly recognized condition—Guillain-Barré syndrome. Timely diagnosis is critical.”

“A new disease? And Xu Ze spotted it?” Zhang Qi’s eyes widened.

“Indeed. His knowledge is extensive, and his insight into emerging conditions is remarkable. Without him, I might’ve missed this entirely.”

Just then, Qian Xuebin walked in. “Director, I’ve returned from lunch—you can head off now.”

Director Qu motioned him over sternly. “Dr. Qian, your notes on this case need revision. Upon re-evaluation, we suspect Guillain-Barré syndrome, not myasthenia. Review the patient’s history and exam thoroughly—no oversights this time.”

Qian Xuebin’s face darkened. Being corrected privately was one thing, but in front of colleagues? His cheeks burned.

Though unsure where he’d erred, he nodded deferentially. “Understood, Director. I’ll conduct a full reassessment immediately.”

“Good. We’ve already performed a lumbar puncture. Await the results while you update your findings. I’ll provide reference materials shortly.” With that, Director Qu left for his office.

Alone, Qian Xuebin replayed the morning’s events. His exams were usually meticulous—where had he slipped up?

Then it hit him. Xu Ze’s odd, seemingly irrelevant questions during rounds.

A cold realization settled in. Xu Ze had noticed something—and gone straight to the director, making me look negligent.

A spark of resentment ignited in Qian Xuebin’s eyes.