Chapter 5

The human body’s entire vascular system is a circulatory system. Repeated problems with lower limb arteries are a sign that many vessels are in a precarious state. Professor Zhong suffered from acute myocardial infarction due to coronary artery hypoxia. When his blood pressure dropped, the attending physician promptly administered vasopressors and performed an EKG, which showed significant ST segment elevation. Before a decision could be made about the next step, the patient went into ventricular fibrillation.

When Lin Ye and Tang Feiwan arrived at the EICU ward, the attending physician was performing CPR and a defibrillator was at the bedside.

“Let me take over,” Lin Ye said, her expression serious. She pressed on Professor Zhong’s chest, working against the clock. “Prepare the defibrillator.”

Tang Feiwan took the defibrillator paddles from the nurse and cooperated with Lin Ye: “200 joules.”

“200 joules confirmed.”

Tang Feiwan: “Charging complete, clear the bed.”

Lin Ye stepped back to give space, and Tang Feiwan delivered the shock.

The patient remained unresponsive. Lin Ye continued chest compressions and said, “One milligram of epinephrine IV push.”

The nurse administered the medication: “One milligram of epinephrine IV push complete.”

Tang Feiwan held her breath: “Continue, 200 joules.”

“200 joules confirmed.”

Tang Feiwan didn’t hesitate for a second: “Charging complete, clear the bed.”

Everyone stepped back from the bed, and Tang Feiwan delivered the shock. After the defibrillation, Professor Zhong still hadn’t regained his own heart rhythm. Lin Ye continued compressions, and the nurse followed instructions to administer medication. Chest compressions are physically demanding, and Lin Ye had been pushing for several minutes. Tang Feiwan noticed the fine beads of sweat on her forehead and said, “Let me take over.”

When it came to the patient’s emergency rescue, Lin Ye did not insist on taking charge. She took a step back to the side, allowing Tang Feiwan to step forward.

Time ticked by, minute by minute. Seven minutes had passed when the attending doctor took over, then another five minutes before Lin Ye resumed compressions. The night shift doctors from Critical Care Teams One and Three also gathered around. Someone asked, “Need a hand?”

“Director Lin, it’s been 22 minutes,” the attending doctor reminded her.

Clinically, the golden window for cardiac resuscitation is within four minutes of cardiac arrest. Beyond that, the patient risks irreversible brain damage let alone Professor Zhong, whose heart had already stopped for 22 minutes.

Lin Ye remained unfazed, gritting her teeth and persisting.

“26 minutes now, Director Lin.”

Standing beside the attending doctor, Tang Feiwan recalled the professor’s brief moment of consciousness and his request. Her voice grew louder as she directly called out Lin Ye’s name: “Lin Ye!”

At the sound of her shout, the green flatline on the cardiac monitor suddenly changed the patient’s heartbeat had returned.

“Go call the family in from outside,” Lin Ye instructed without pause. She reached into the pocket of her white coat, retrieved a pupil flashlight, and checked the professor’s pupils.

Tang Feiwan asked nervously, “How is it?”

“They’re dilated.”

As expected.

Tang Feiwan watched as the slight flush from Lin Ye’s exertion drained from her face. Just as she was about to ask why Lin Ye had insisted on continuing resuscitation past the 25-minute mark when the chances were slim, Lin Ye had already pulled back the privacy curtain and walked toward the door, lips pressed tightly together, preparing to deliver the news to Professor Zheng.

Lin Ye stopped in front of the elderly woman and spoke gently, “Professor Zheng, after our resuscitation efforts, Professor Zhong’s heartbeat has been restored, but both his pupils are fully dilated.”

Tears welled in Professor Zheng’s reddened eyes. “Are you saying… there’s no saving him?”

Lin Ye gave a slight nod. “And his heart could stop again at any moment.”

“I understand. Thank you.” Professor Zheng pressed her hands together in gratitude.

“You should go see Professor Zhong.” Lin Ye tilted her head slightly, her sharp jawline tensing as she held back her emotions.

Doctors, especially emergency physicians, battle life and death every day. They give their all, yet sometimes they cannot defeat death. They can only quietly adjust their own mindset.

Not far away, Professor Zheng, trembling slightly, made her way to Professor Zhong’s bedside. She took his right hand gently in hers and whispered, “Yuanzhao, I was selfish to want you to stay with me for a few more days. I’ve made you suffer.” Her frail hands stroked his white hair as she sniffled. “We won’t continue treatment. If you need to go, go in peace.”

Only the attending nurse remained by the bedside. The others stood outside the curtain, not disturbing the couple who had been together for over fifty years as they said their final goodbye.

Two minutes later, the lines on the bedside monitor shifted before finally flattening into a straight line. Professor Zhong’s life had come to an end.

In the break room, by the window, Tang Feiwan spotted Lin Ye. The woman, still in her white coat, had her hands in her pockets and was gazing out the window. Just like before whenever something weighed on her mind, she would find an open space and look up at the night sky.

Tang Feiwan didn’t know what Lin Ye was thinking, but she could sense a deep sadness and helplessness. Yet, she hesitated to approach, unsure of what role she should take in offering comfort a colleague?

Before she could decide, Lin Ye had already turned and walked toward the door, passing by without acknowledgment, as if she were air.

Did she even frown slightly?

“Am I really that annoying?” Tang Feiwan muttered to herself.

The next second, Lin Ye, three meters away, turned back and called out, “Come on, Team One needs help.”

Tang Feiwan quickly followed. “What?”

Lin Ye spoke as she walked, “They’ve admitted a new patient Type A aortic dissection. Surgery needs to happen immediately.”

“What does that have to do with us? Has Cardiothoracic Surgery been notified?”

“Director Wang from Cardiothoracic Surgery is performing the operation, but both of their on-call attending surgeons are occupied with other emergency surgeries. Type A aortic dissection surgery is a major procedure, and Director Wang doesn’t trust a resident to be the first assistant.”

“So you mean” Tang Feiwan was beginning to understand.

“Director Fang from Cardiothoracic recommended you as the first assistant,” Lin Ye stated, fully confident in her abilities.

So it was someone else who recommended her. Tang Feiwan pursed her lips but quickly shifted into focus. “Straight to the OR?”

Lin Ye picked up her pace. “Yes, time is critical. Director Wang said he’ll discuss the details with you in the operating room.”

“Which OR? Lead the way.”

Their hurried figures disappeared down the corridor.

At 10:25 PM, the operating room doors closed.

For a Type A aortic dissection surgery, an open-heart procedure was required, involving cardiac arrest. The operation was complex and lengthy. Director Wang, a cardiothoracic surgeon with over 20 years of experience, explained the patient’s condition in detail to Tang Feiwan, pointing out key challenges and how he planned to handle them, as well as the support he needed from her.

“The patient’s CT scan shows a tear in the ascending aorta. The inner membrane has split, allowing blood to enter the false lumen. The dissection hasn’t extended distally and is mostly confined to the ascending aorta and aortic arch.”

Tang Feiwan responded, “I assisted in a similar surgery 20 days ago. The blood will continue accumulating in the false lumen, increasing tension in the outer membrane. That makes it tricky.”

“I heard from Fang that you were Dr. Borner’s last disciple, and that you were performing minor surgeries independently by 28,” Director Wang said with a warm smile. “I look forward to working with you tonight.”

Tang Feiwan nodded. “Looking forward to it.”

At 10:57 PM, the surgery officially began.

Chest opened, cardiopulmonary bypass established, heart arrested the procedure proceeded smoothly.

Sichuan River University Medical School’s affiliated hospital was a teaching hospital, so every operating room had an adjacent observation area for medical students.

Having no other immediate tasks, Lin Ye stood in the observation room with her arms crossed, watching through the glass.

Her gaze unconsciously followed Tang Feiwan’s every move.

Lu Yuqing suddenly appeared behind her. “What are you looking at?”

“Ahem.” Lin Ye cleared her throat to ease the awkwardness and then replied, “A patient from the emergency department. Type A aortic dissection. The cardiothoracic surgery department was short on staff, so Tang Feiwan was temporarily called in to assist.”

Lu Yuqing made a sound of acknowledgment but then frowned. “Wait, what does her surgery have to do with you?”

Lin Ye’s face instantly turned red, though she herself didn’t notice it. She explained, “I’m her supervisor. I need to stay informed about her work.”

“Oh, well, you go ahead and keep ‘staying informed.’ I’m going back to sleep. Hopefully, I won’t have to do sit-ups in bed tonight.” Lu Yuqing waved her hand and left the observation room. Lin Ye glanced back at the operating room, then followed her out.

The surgery continued for another several dozen minutes. When it reached the critical moment of cardiac resuscitation, an issue suddenly arose.

“The heart isn’t restarting properly. How did you manage the anesthesia? How much dopamine was administered? How much epinephrine?” Chief Surgeon Wang asked, looking up.

“Um… uh…” The anesthesiologist checked the records.

Wang’s temper flared. “Go get Dr. Lu.”

The anesthesiologist hesitated. “She’s in the operating room next door. I don’t know if she’s finished yet.”

Wang signaled for a nurse to check, instructing them to call if they couldn’t find her.

Five minutes later, Lu Yuqing was summoned by an urgent phone call. After quickly assessing the situation, she made a decisive judgment and took over. Before long, the patient’s heart successfully restarted.

Watching the heart resume its rhythm, Wang smiled. “It had to be you, Dr. Lu.”

“It’s the same for everyone. Chen Gang” she referred to the previous anesthesiologist “ hasn’t handled many aortic dissection surgeries, but he’s done well in other procedures. He might have just been a little nervous tonight.” She kept a close eye on the patient’s vitals as she spoke.

Once everything stabilized, she sat down and watched the rest of the surgery leisurely.

During the final suturing stage, Wang entrusted the task to Tang Feiwan, stretching his back as he spoke. “I’m getting old. Just five hours in, and I’m already feeling it. Xiao Tang, remember to join our cardiothoracic department. Dr. Fang has been talking about it all day.”

Tang Feiwan focused on the suturing. “Alright, Chief Wang, get some rest.”

As an attending physician, Wang wasn’t required to be on night duty at the hospital. He had rushed in from home in the middle of the night and, now that his work was done, was preparing to leave.

He gave a quick nod and opened the operating room door.

At 4:23 AM, after a total of five and a half hours, Tang Feiwan tied off the last stitch, put down her instruments, and waited for the circulating nurse to finish counting the tools, sutures, and gauze before stepping away.

Since anesthesiologists had to monitor patients until they regained consciousness, Lu Yuqing stayed to oversee the recovery. She checked the patient’s wound, then casually remarked, “Not bad, your suturing is better than old Wang’s.” Then, muttering to herself, she added, “No wonder Lin Ye hasn’t dated anyone all these years. Is she still hung up on her? Hmm, she does look pretty charming while she works.”

Back at the office, Tang Feiwan poured herself a full glass of water and gulped down most of it to quench her thirst. Bending over, she pulled a mango and a dragon fruit out of her bag. Looking over, she saw Lin Ye and another resident doctor busy at a computer.

“Want some fruit?” she offered.

Before Lin Ye could respond, the resident chief physician sitting next to her dramatically cried out, “Dr. Tang, you actually brought mangoes and dragon fruit to a night shift! And you’re planning to eat them?!”

Tang Feiwan was puzzled. “Uh… what’s wrong? I need to replenish my vitamins. Gotta take care of myself.”

“Great, no wonder it’s been non-stop chaos all night.” Just as he finished speaking, a nurse from the triage desk rushed in. “Dr. Tang, we have a new patient suspected gastrointestinal bleeding from excessive drinking. He’s vomiting blood.”

“Got it, on my way.” Tang Feiwan and the resident chief physician hurriedly followed the nurse out.

Lin Ye turned back to her work without joining them. Since associate chief physicians were on 24-hour shifts, admissions were handled by attending physicians and residents. They were only called in if complications arose.

Two more emergency cases came in, keeping them busy for another hour. By the time 5:30 AM rolled around, Tang Feiwan removed her gloves and took a few steps before hearing the resident chief scolding a patient.

“If you take one bite of that bun, everything we just treated will be for nothing. Do you understand?”

The patient, who had stabilized after receiving fluids, protested, “Ten IV drips won’t do as much for me as one bite of food.”

The resident chief reasoned with him. “No way. You have gastrointestinal bleeding. You must fast, or you’ll start bleeding again.”

The patient tried to bargain. “What if I just drink half a bowl of porridge?”

Tang Feiwan, unable to listen anymore, suddenly cut in, “Half a bowl of porridge, and you can forget about ever drinking again.”

“Huh?” The patient froze. The moment he realized he wouldn’t be able to drink anymore, he immediately relented. “Okay, I won’t eat.”

Sometimes, a doctor had to know exactly what a patient cared about most in order to “prescribe the right treatment.”