Chapter 2

The Critical Care and Severe Trauma Group was originally led by one chief physician and two senior deputy chief physicians, with a total of 25 doctors and 62 nurses. In June of this year, for the convenience of academic research and scheduling, the large group was divided into three smaller groups. Lin Ye, who had just become a deputy chief physician, was entrusted with a heavy responsibility and appointed as the head of the second group.

Although their second group had fewer members, the two attending physicians who had worked with Lin Ye for many years were both experienced and could help her shoulder a lot of the pressure. Therefore, for over two months, no new members had joined. Until ten days ago, Director Gao mentioned to Lin Ye that a new colleague would be joining at the end of the month. She was busy at the time and didn’t ask for specifics.

Director Gao cheerfully introduced, “She’s the capable assistant I found for you, a top student from Heidelberg University, Dr. Tang Feiwang.”

“Hello, Dr. Tang,” Lin Ye’s voice was like a gust of wind, gently sliding past Tang Feiwang’s ear. It was impossible to tell her tone, but it was enough to wake someone up.

Tang Feiwang’s throat tightened: “Director Lin.”

The conversation, like that between strangers, ended, leaving them in a brief awkward silence. Lin Ye broke the silence: “Director Gao, you go ahead, we’ll be out.”

“Okay, okay, you go ahead and get busy.” Gao Zongxiang knew Lin Ye wasn’t good at socializing, so he nodded, indicating that he had something to do.

The two left the director’s office together. Tang Feiwang was still dazed from their reunion and could only follow silently behind her, listening as Lin Ye introduced the break room, the on-call room, and finally, the office area.

“This is our second group’s office,” Lin Ye pointed to the spot left of the water dispenser, saying, “Your desk is over there.”

Tang Feiwang responded woodenly: “Okay.”

“Can you start working directly?” Lin Ye didn’t look at her, walking over to Wang Can’s desk and flipping through medical records.

“I, maybe.” Why did she lose all her confidence in front of her? Tang Feiwang bit her lip in frustration.

“Wang Can was originally with Old Liu, but Old Liu will be teaching at the medical school starting in September, so you’ll be taking over Wang Can.” Lin Ye handed a stack of medical records to Tang Feiwang, “These are the patients she’s in charge of, get familiar with them first.”

Tang Feiwang took the medical records and then heard Lin Ye say, “We Chat.”

“Ah?” Tang Feiwang was confused for the third time today.

Lin Ye’s slender eyebrows furrowed slightly, her face showing confusion: “You don’t use WeChat?” She thought Tang Feiwang, who had been abroad, would use WeChat as her primary communication tool.

“I do, I do.” Tang Feiwang took out her phone, opened her user QR code, and held the phone out, waiting for the other party to add her.

Lin Ye scanned the QR code. A few seconds later, a red dot appeared in her contacts list. Tang Feiwang subtly sniffed her nose and clicked on it.

“I’m Lin Ye.” The four words were both strange and familiar. She remembered 11 years ago, in the second semester of her sophomore year, on October 12th, Lin Ye had also added her on QQ, using the same four words.

It felt like everything was back to the beginning.

After the verification was complete, Lin Ye sent Wang Can’s contact card.

“Wang Can’s WeChat, if you have any questions, you can talk to her.” It was completely the tone of a normal colleague.

“Thank you.”

Lin Ye returned to her seat, lowered her head and got busy. Tang Feiwang also sat down at her desk and started organizing her materials. During this time, colleagues came in, introduced themselves to each other, and then went back to their own work. When she finished organizing the medical records, Tang Feiwang chatted with Wang Can, who had just returned from rounds, and only then did she have time to look up and glance at Lin Ye, who was sitting with her back to her, by the window in the office.

The person in front of her was a typical Jiangnan woman, with naturally fair skin and delicate features. Tang Feiwang had often praised her eyes back then, saying that even comparing them to spring water wouldn’t do them justice. So she didn’t dare to look directly at her eyes for now and could only take this opportunity to quietly savor her back.

She was still as thin as before, as if a gust of wind could knock her over. But Tang Feiwang knew how strong she was, able to carry a dummy and even hold her, who was 4 centimeters taller than her, in a princess carry.

Her thoughts were wandering when someone’s arrival pulled her back to reality: “Lin Ye, the patient who was sent in at 6 AM, his EKG shows slight ST elevation, and his troponin is also elevated, so we highly suspect myocardial infarction. But cardiology came and did a coronary angiography, and they didn’t find any obvious lesions, far from meeting the criteria for coronary heart disease, let alone myocardial infarction. Go take a look?”

“Okay.” Lin Ye got up from her seat and walked a few steps towards the door. Remembering Tang Feiwang, she was about to speak, but the other person had already walked up to her, “I’ll go too.”

The three of them rushed to the catheterization lab. The patient was still on the operating table.

Lin Ye asked, “What are the patient’s main symptoms?”

Liu Zhinan replied, “His main complaint is severe chest pain and tightness.”

Tang Feiwang seized the opportunity to ask, “What kind of chest pain? Is it the tightness caused by lack of oxygen or the tearing pain like a knife?”

“Tightness, are you suspecting aortic dissection?” Being experienced clinicians, Liu Zhinan immediately understood Tang Feiwang’s guess.

Tang Feiwang nodded.

Liu Zhinan turned to ask, “Should we do a thoracic aortic angiography while we’re at it?”

Lin Ye hesitated, her lips slightly pursed. Because thoracic aortic angiography is an invasive procedure and is no longer the standard method for diagnosing aortic dissection, but the patient was already on the operating table for coronary angiography, doing a thoracic aortic angiography at the same time wouldn’t actually increase the pain. She discussed it with the attending physician from cardiology in the catheterization lab through the intercom and got the patient’s family’s consent, and finally nodded, “Let’s do it.”

Then, several pairs of eyes stared intently at the screen. The contrast agent flowed through the thoracic aorta, smooth and unobstructed, with no signs of dissection.

Liu Zhinan was troubled: “Could it be pulmonary embolism?” Without any external injuries, after ruling out myocardial infarction and aortic dissection, doctors would generally consider pulmonary embolism.

“Have you ruled out abdominal organ problems?”

“Have you ruled out upper abdominal diseases?”

Lin Ye and Tang Feiwang asked simultaneously. They didn’t get distracted by their long-lost tacit understanding and continued to stare intently at the operating room.

Liu Zhinan shook his head: “I checked, the abdomen is soft, no tenderness, it shouldn’t be an abdominal organ problem.”

Lin Ye observed the patient’s condition on the screen, considering whether to push the patient to the CT room for a CT scan or to give him another injection for a pulmonary angiography on the operating table. Fortunately, the patient’s blood pressure was still relatively stable, his heart rate was slightly fast at 108, and it should be okay to push him for an emergency CT scan. With the aim of saving the patient money, she asked Liu Zhinan to order a pulmonary CT scan.

The patient was pushed to the CT room, and they didn’t go far, waiting for the results. Finally, the results came back, and the pulmonary artery trajectory was also normal.

After ruling out the three major fatal diseases, the three of them, along with the attending physician from cardiology, breathed a sigh of relief. However, the cause of the patient’s chest pain hadn’t been found, and his symptoms hadn’t improved. What should they do next? Everyone was stumped for a moment.

“Did you do a cardiac ultrasound?” Tang Feiwang, who had studied and worked at the Heidelberg Heart Center for five years, asked.

Liu Zhinan: “We did it at the beginning, there’s no pericardial effusion.”

Just when they were at a loss, a nurse suddenly rushed over: “Not good, bed number 2’s blood pressure has dropped, it’s only 85/42mmHg.”

The three of them felt a jolt in their hearts and rushed towards the ward with the nurse. They lifted the curtain and saw the patient frowning, groaning, “I’m in so much pain, doctor, I’m in so much pain.”

The family anxiously asked, “Doctor, what’s going on? He’s getting worse, you’re at the best hospital in Shuchuan, what if you can’t cure him?”

Tang Feiwang stood on the right side of the bed, watching him clutching his chest with one hand and his stomach with the other, sweating profusely. She immediately asked, “Does your stomach hurt?”

“It does, it was just chest pain before, but after the examination, my stomach started hurting too, it’s killing me.”

Without hesitation, Tang Feiwang reached out and lifted the blanket covering the patient, seeing that his stomach was already distended.

Liu Zhinan was puzzled: “Huh? His stomach wasn’t distended when he came in!”

Tang Feiwang slightly lifted the patient’s clothes, her right hand resting on his stomach for palpation, feeling like fluid. Not good, she turned her head and said urgently, “Do a bedside ultrasound.”

“Okay.” Liu Zhinan ordered someone to prepare, and Lin Ye watched Tang Feiwang’s accurate judgment and methodical actions, her eyes slightly lowered, her lips unconsciously curving upwards.

The bedside ultrasound took time, but the patient couldn’t wait, constantly shouting, “It hurts so much, it’s killing me, it’s killing me, help me.”

His stomach became increasingly distended, and his complexion grew paler. The family suddenly said, “Did he hit his stomach yesterday?”

Liu Zhinan hurriedly asked, “Hit? How did he hit it? Where did he hit it?”

“He slipped while taking a shower and hit the sink, right here.” The family member pointed to the left side of his abdomen.

The spleen.

“But I asked him if he should go to the hospital, and he said it was okay.”

“It could be a delayed splenic rupture.” They couldn’t wait any longer, Tang Feiwang immediately suggested, “Direct abdominal puncture.”

Lin Ye agreed, gesturing for Tang Feiwang to do it, and then explained to the patient’s family, calming them down.

Everything was ready. After finding the location, disinfecting, and administering local anesthesia, Tang Feiwang took a 50ml syringe and, without hesitation, inserted the needle into the abdominal cavity. She pulled back on the syringe forcefully, and in an instant, dark red blood was drawn out from the abdominal cavity.

Liu Zhinan exclaimed, “My goodness, it might really be a splenic rupture.”

Lin Ye arranged the follow-up: “Fluid resuscitation, stabilize his blood pressure first.” She contacted the chief of emergency surgery, informing him that once the patient’s vital signs stabilized, he might need to undergo laparotomy surgery.

Five minutes later, the deputy chief of emergency surgery arrived, assessed the situation, and immediately had the patient pushed into the emergency operating room for exploratory laparotomy.

After the patient was sent to the operating room, everyone in the emergency ward finally had a chance to catch their breath. Liu Zhinan leaned against the wall and gulped down half a bottle of water, turning his head to say, “So you’re the new colleague in our department.”

“Huh?” Tang Feiwang raised her hand to wipe the sweat from her forehead.

Liu Zhinan laughed, “I was wearing a mask and a hat, you probably don’t remember me.” He patted Lin Ye’s shoulder, “Hey, she’s definitely going to be a good comrade-in-arms for us.”

“Probably.” Lin Ye’s voice was soft. She turned and walked out, but her eyes held a smile that she herself hadn’t noticed, and she added softly, “We’ll see.”