Chapter 13

Tang Feiwai’s working state was completely different from her dazed state in the changing room. At 8:30, after handing over her shift, the attending physician handed her the patient’s medical records transferred from general internal medicine.

“Zhang Yan? Lung abscess patient?” Tang Feiwai carefully browsed through it, then walked towards the EICU.

The attending physician walked beside her, explaining the situation, “Yes, lung abscess caused by severe pneumonia, she started having dyspnea and cyanosis this morning, and her blood oxygen saturation could only be maintained at 95% when she was on oxygen.”

Three days ago, general internal medicine used a bronchoscope to examine the patient, and a large number of inflammatory cells were found in the sputum tissue, consistent with the manifestation of bacterial pneumonia developing into lung abscess.

Tang Feiwai browsed Zhang Yan’s medical records and asked, “Do you have the CT images?”

“Here.” The attending physician found Zhang Yan’s imaging pictures and handed her his phone.

Tang Feiwai zoomed in on the picture, seeing the patient’s diffuse ground-glass opacities with reticular changes in both lungs, as well as multiple round thick-walled abscess cavities, with low-density shadows inside. Cobblestone sign, and typical lung abscess imaging, indicating that the general internal medicine colleagues’ judgment and treatment direction were completely correct. Why was there still no effect? The patient’s fever was close to 40 degrees, and her cough, poor appetite, chest pain, muscle pain, and other symptoms had not subsided. She pursed her lips and fell into contemplation, suddenly interrupted by the noise from a distance.

“Why can’t she be treated in the general ward? Why do you have to make her stay in the ICU, aren’t you trying to rip us off?” Zhang Yan’s son, Zhou Wenyong, was yelling to see Zhang Yan’s attending physician.

Zhang Yan’s 17-year-old daughter, Zhou Wenyun, grabbed his waving arm and explained, “Brother, Mom has been treated in the general ward for six days, her condition is serious, so she was moved to the ICU.”

“Who agreed? You’re not an adult yet, your signature doesn’t count.”

The girl muttered, “Mom wanted to save money and didn’t want to be treated, I persuaded her, and she finally agreed.”

The man raised his voice and questioned, “Do you know how much it costs to stay in the ICU for a day? Your drawing training for three months, 20,000 yuan, your mom can use it up in a few days in there.”

Their father had died early, the elder brother was like a father, Zhou Wenyun rarely talked back, “Brother, which is more important, money or Mom’s health?”

Zhou Wenyong gritted his teeth, “You!”

“This is a hospital, what are you yelling about?” Sun Qinhe heard the commotion, she came from the nurses’ station and warned him, “I’ll call security if you don’t stop.”

Zhou Wenyong was a bully, he noticed that her aura was different from the little nurse before, so he lowered his voice slightly and asked, “Who is my mom’s attending physician?”

He was being unreasonable, outside the EICU, Tang Feiwai, who didn’t want to pay attention to him, turned around and walked over, standing in front of the man, her tone was serious and neither too soft nor too harsh, “It’s me.”

Zhou Wenyong saw that she was at most in her twenties, and a female doctor at that, he mumbled, “So young, no wonder you can’t cure her.”

The attending physician had a quick temper, he immediately got angry and retorted, “What are you talking about? The patient just arrived at our EICU this morning, her attending physician in the general internal medicine department has been practicing medicine for 10 years.” He paused for two seconds and added, “Besides, Doctor Tang studied and worked at a hospital abroad, she has a lot of experience, are you saying she can’t cure her?”

Zhou Wenyong heard that the doctor was a returnee, his desire to pick a fight immediately deflated, he changed the subject, “What’s wrong with my mom? Why is she getting worse?”

Tang Feiwai didn’t bother with him, she spoke briefly, “Preliminary diagnosis is severe lung abscess caused by bacterial infection, we will continue treatment and observation.” She glanced at the girl’s bruised eyes, combined with the man’s previous remarks, she guessed that he was probably at the hospital for the first time, she hinted, “Also, someone needs to stay outside the ICU, if the patient has any situation, we will communicate with the family members in time.”

Zhou Wenyong’s eyes looked at the girl, “My sister is here.”

Tang Feiwai led him down the wrong path, “You said she’s underage, she can’t make decisions.”

 Unexpectedly, Zhou Wenyong was thick-skinned, “She can’t make decisions, but she can stay with our mom, and she’ll call me if anything happens.”

 He finished speaking, took out his phone, and pretended to answer a call nearby.

Having said all that, Tang Feiwai couldn’t interfere any further, and she had work to do, so she turned and left.

In the EICU ward, patients were closely monitored every minute of every day. Tang Feiwai moved to the bedside of each patient, the nurse handed her the blood test results from this morning. The white blood cell count and neutrophil count were still elevated, and the C-reactive protein was also greater than 8.2 mg/L.

She suddenly asked, “Have you ruled out rheumatic diseases?” The patient had a recurring fever, besides infection and tumors, it was also necessary to consider uncommon rheumatic diseases. For example, lupus erythematosus can have various clinical manifestations, such as fever, pleural effusion, alveolar hemorrhage, and even pneumonia.

The attending physician shook his head, “No, because lupus is usually interstitial pneumonia, and the fever is usually low-grade.”

“Check it out, there are exceptions to everything.” The patient was on low-flow oxygen and connected to a cardiac monitor, her current condition wasn’t too bad, giving them some time to find the cause.

After checking the rounds, Tang Feiwai returned to her office and started looking for similar cases from home and abroad. From 10 am to 2 pm, the person at the desk stared intently at the computer, Gu Yan, who had been to the office several times, couldn’t help but remind her, “Doctor Tang, aren’t you going to eat?”

“Yeah, I’m not hungry.” She glanced at the time displayed in the lower right corner of her computer, 2:03 pm.

“Food is fuel, Doctor Tang, don’t develop a stomach problem.”

“Okay, thank you.” Tang Feiwai remembered Lin Ye’s concern for her health many years ago, she had said the same thing, and she vaguely agreed.

 She bent down and opened the snack cabinet, took out a box of instant noodles, opened the lid, put in the seasoning, poured water, convenient and easy, in just 15 minutes, her hunger was gone.

The trash needed to be disposed of promptly. She went out to throw away the noodle box, passing by the EICU, she saw Zhou Wenyun curled up on the bench, drowsy.

 The cleaning lady went to remind her, patted the girl’s shoulder, “Hey, hey, little girl, you can’t sleep on the bench.”

Zhou Wenyun opened her eyes slightly, coughed twice, and agreed, “Okay.” She reluctantly sat up, holding her drawing portfolio, her head drooping, she closed her eyes again.

Tang Feiwai noticed that the girl’s complexion was wrong, she went up to her and asked with concern, “Zhou Wenyun.”

“Yeah?” The girl looked up, her red eyes staring at her, her eyes were glazed.

Tang Feiwai reached out to touch Zhou Wenyun’s forehead, it felt hot, her heart sank, she said urgently, “Come with me.”

In the observation room, the girl sat on a chair, with a thermometer under her armpit.

 Seven minutes later, she handed the thermometer to Tang Feiwai. Tang Feiwai took a look, sure enough, it was 39.2 degrees, she had a fever.

 The mother and daughter both had fevers, was it a coincidence? Ordinary bacterial pneumonia is not contagious, and lung abscess is not either.

 Thinking about this, Tang Feiwai’s brows furrowed tighter.