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Chapter 23 - Chapter 23: The Appendix Dilemma

"Hey, hey, hey, Tian-ge, did you see the video?"

Barely had Xia Tian sat down for the day when Wang Xiaobei rushed over, face glowing with gossip.

"What video?" Xia Tian asked, sipping tea from his thermos as he chatted casually with his colleagues.

"Did I get secretly filmed and go viral again?"

Wang Xiaobei exchanged glances with the chubby Yang, both looking hesitant, as if unsure whether to speak. The others in the office stayed unusually silent.

Xia Tian waved his hand grandly, his tone breezy.

"What are you two being so sneaky about?"

"Come on, there's nothing you can't tell me. Even if you guys came out of the closet right now, I wouldn't bat an eye."

With a cheeky grin, Wang Xiaobei pulled out his phone and held it up to Xia Tian.

On the screen, Li Tiantian was completely soaked, dripping from head to toe. A crowd had gathered on the upper floors—patients, nurses, and doctors—watching her with barely concealed amusement as she screamed and cursed at them all, her insults growing more vicious by the second.

Xia Tian's eyes darkened.

He had completely given up on Li Tiantian after the slap from Song Pengfei. Watching her now, he felt no emotion at all.

That garish makeup—she was no longer the innocent village girl he once knew.

But still... screaming like that in public? She was a doctor, for heaven's sake.

"She's a pediatrician, isn't she? Yelling like that—does she not care about her job anymore?" Xia Tian asked.

"Job?" Wang Xiaobei scoffed. "She's already been fired. The Children's Hospital gave her the boot. Now she's a celebrity for all the wrong reasons. No provincial or municipal hospital dares to hire her."

"Looks like she really shot herself in the foot."

Xia Tian shrugged.

Maybe she had found a wealthy sponsor. Maybe work didn't matter to her anymore.

More importantly… her life had nothing to do with him.

Still, Wang Xiaobei leaned in with a warning.

"Tian-ge, you better watch out. If Li Tiantian really hits rock bottom, she'll come crawling back to you. And when that happens, good luck trying to shake her off."

Xia Tian tensed. "No way."

"Never say never," Wang Xiaobei muttered.

The ER was bustling with patients. Xia Tian saw two with fractured arms before noon—one serious enough to need a cast, the other mild enough to send home with rest instructions.

At 11:30 a.m., just before lunch break, a woman around 25 came in, stylishly dressed and accompanied by a young man—likely her boyfriend.

The moment they entered, she collapsed onto a chair, her face pale, forehead beaded with sweat.

"She has stomach pain," the boyfriend said anxiously.

"How long has it been hurting?" Xia Tian asked.

"Since last night," the boyfriend replied. "It started out mild and came in waves. She had diarrhea around midnight, felt a little better after, but an hour ago the pain suddenly got worse."

The woman was in too much pain to speak, trembling and hunched over.

Xia Tian quickly called a nurse to bring a stretcher. He helped the woman lie flat and gently pressed around her navel.

"Does it hurt here?"

The moment he touched her, she flinched violently.

"Yes, yes—everywhere hurts!"

Abdominal pain, diarrhea, tense muscles—all textbook signs of appendicitis.

Xia Tian immediately ordered an abdominal ultrasound and brought Wang Xiaobei and others to assist. If it was acute appendicitis, she would need surgery right away—any delay could lead to perforation, which would be far more dangerous.

"Ow, it hurts so bad!"

Even lying down, the woman's body was curled up like a shrimp. Her boyfriend looked on the verge of tears.

"Hold her steady," Xia Tian instructed. "We need to run the ultrasound—this could be acute appendicitis."

"Hang in there, babe. It'll be okay soon." The boyfriend kissed her forehead while Wang Xiaobei helped her lie flat and exposed her abdomen.

They applied the gel and positioned the probe.

Thickened, inflamed appendix walls. Tissue swelling.

No kidney stones.

Looking at the scan, Wang Xiaobei relaxed.

"Acute appendicitis. I'll tell the attending to prep for surgery."

"Wait," Xia Tian said, frowning. "Have the lab results come back yet?"

Two crucial indicators for appendicitis: ultrasound imaging and a full blood count. Swelling on the scan, and a spike in white blood cells, are both key markers of infection.

Chubby Yang returned from the lab with the report.

"WBC count: 7.5 x10⁹/L, neutrophils at 60%, platelets 200 x10⁹/L, hemoglobin 120g/L, hematocrit 40%."

"All within normal range."

"That's odd," Xia Tian muttered. "If it were appendicitis, her white count should be way higher. Something's off."

Everyone paused. Her symptoms screamed appendicitis, but her bloodwork showed no signs of inflammation. How could that be?

Suddenly—

"Ahhh! Help!"

"Babe, wake up!"

The woman had passed out.

Xia Tian and his team sprang into action.

"Get her to the resuscitation room! Call Dr. Zhang!"

Xia Tian climbed onto the stretcher, performing chest compressions. A nurse rushed over with an oxygen mask, placing it over the woman's nose and mouth.

Two other nurses cleared the hallway, shouting, "Emergency! Clear the way!"

Inside the resuscitation room, Xia Tian barked orders:

"Quick—administer lobeline, reserpine, and clamine!"

Three injections, one after another.

The woman's eyelids fluttered.

"She's awake! She's awake!" Wang Xiaobei shouted.

Everyone let out a breath of relief.

Soaked in sweat and ignoring his sore arms, Xia Tian briefed Dr. Zhang Ming on the situation.

Dr. Zhang studied the test results and nodded.

"The ultrasound clearly shows inflammation. She needs surgery immediately."

"As for the white cell count... I've never seen anything like this before."

"She's in critical condition—we can't afford to wait. Prep the OR. You're coming in with me."

Appendectomy—a routine level-two surgery.

For an experienced surgeon like Zhang Ming, it was nothing.

He smiled at Xia Tian.

"You'll be leading the operation."

"Don't worry. I'll be there with you the whole time."

Lead surgeon? After just three months of internship?

Wang Xiaobei and the others were on the verge of tears from envy, ready to kneel and worship him.

Tian-ge, you're a legend!

But Xia Tian wasn't basking in glory. His expression remained grim.

"Director Zhang… I have a suspicion."

"I don't think this is appendicitis."

"I think we're looking at a misdiagnosis."

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