Chapter 162: Crisis in the ICU

In the corridor, many anxious family members lingered, some sitting, some standing, and others squatting on the floor.

Without exception, these people waited here because their loved ones or friends were in the Intensive Care Unit.

Patients admitted to the ICU were, for the most part, critically ill.

To put it bluntly, whether they would make it out alive was unknown.

After pressing the doorbell, the person in charge waited a moment before the large door slid inward to the left, revealing a nurse inside.

Immediately, the anxious family members surged forward.

“Hey, family members—if you want to request a visit or get updates, please use the side entrance. These doctors are here to help; let them go in first.”

The nurse’s tone was sharp and her voice loud.

Honestly, she was the only one who could control these anxious family members.

One by one, they obediently cleared the way.

Zhou Can and the others followed the person in charge into the ICU.

There were two more doors before reaching the patient area.

Including the team leader, there were ten doctors in total—a rather impressive number.

Once everyone was inside, the outer protective door quietly closed, isolating the family members and all external noise.

“Dr. Yu, are you bringing a new batch of trainees today?”

The female nurse greeted the leader with a smile.

“Absolutely! We just received thirty-two new trainees. Get ready—you’ve got plenty to teach!”

Dr. Yu, the team leader, replied with a laugh.

After a brief exchange with the nurse, his gaze turned to the nine trainees.

“Let me explain the key procedures for entering the ward. After passing through the first door, you need to wash your hands over there, then head to the changing room to don your isolation gowns and shoe covers. Once you exit the changing room, you may proceed to the second door. Do you see the bold characters on the floor? Entering through that door still leaves you in a potentially contaminated area, hence it’s called the Potential Contamination Zone.”

“After entering the Potential Contamination Zone, your entire body will be disinfected—mainly using ultraviolet light. Then you can go through the third door, which leads to the actual patient area. Inside, keep your voice down, coordinate closely with other medical staff, and perform effective patient rescue measures.”

These procedures are the same as those in specialized ICUs.

However, compared to specialized ICUs, this facility is much larger.

Every aspect appears more professional, with a far greater number of staff.

Just within the contamination zone at the first door, several busy nurses could be seen hurrying about.

“Over there is the duty room, that is the temporary meeting room, here’s the supply room, and over there is the waste disposal room. This is where patient waste—feces, liquefied pus, sputum, and such—is handled.”

Through a frosted glass wall, a few doctors and nurses could be seen gathered around a desk in the duty room, working on computers or discussing patient conditions.

After washing his hands and donning his isolation gear, Zhou Can stepped out.

“Don’t enter the ward yet; wait here until your senior doctor, once free, calls your name. Then follow their instructions,” he was told.

Once they were all gathered here, the team leader’s task was essentially complete.

He walked to the duty room and knocked on the door.

“I’ve got a new batch of trainees here—the list is right here. Each doctor is responsible for one trainee.”

“Dr. Yu, these trainees come in waves. When will we get a stable group? They only stick around long enough to learn a bit, help out, and then leave,” a younger doctor complained to the leader.

The complaint echoed a common frustration, especially in the Nursing Department.

Training a nurse to handle things independently takes at least three to five years.

Right after training, nurses often resign or jump ship.

Due to its reputation,待遇, and growth opportunities, Tuyu Hospital experiences much lower nurse turnover compared to smaller hospitals.

Many smaller hospitals often face staffing shortages.

“You’ll need to report this to the hospital administration. I only handle the trainees—it’s hard to make changes on my own,” Dr. Yu said with a wry smile.

“Hey, Zhou Can, right? This trainee was assigned to a senior resident right away. Care to share—is he a connected candidate?”

Doctors were always cautious when dealing with candidates with connections.

In their work, they tried to avoid offending influential figures.

As the saying goes, even when you beat a dog, you have to consider its master.

Offending the people behind the connections was simply not an option.

“What do you mean by connected? He earned his spot through merit! He’s one of the top trainees, one the hospital is keen to nurture,” Dr. Yu explained.

“That impressive, huh? Fine, just leave them there. We’ll arrange everything. Now, go about your work!”

Hearing that Zhou Can had risen by merit, several doctors and nurses felt an increased curiosity about him.

After Dr. Yu left, as names were called out one by one, the assigned trainees happily followed their senior doctors into the ward for training.

Zhou Can’s situation was rather unfortunate.

His supervising doctor, a senior resident, took an incredibly long time to emerge from the inner area.

Left with no other option, Zhou Can had to wait outside.

“Bed 6 has encountered a problem. Your supervising doctor is busy handling it, but if you want, I can take you there,” a friendly doctor in his thirties said.

“That’d be great, thanks!” Zhou Can replied with a grateful smile.

“No need to thank me. When I was a trainee, I was just as nervous as you. Stick around a few more years, and you’ll realize senior doctors aren’t so hard to handle. They bark when a patient’s in trouble or fear their juniors will mess things up,” the doctor advised in a mentor-like tone.

Following him into the ward, Zhou Can saw several doctors and nurses working frantically.

The sound of alarms from various machines rang out continuously.

Stepping inside felt like entering a real battlefield.

The tense atmosphere weighed heavily on Zhou Can, instilling an invisible pressure.

“That’s Dr. Hu over there. He already knows you—just go over to him,” the friendly doctor instructed.

Looking over, Zhou Can saw at bed 6 a middle-aged doctor, around forty, bent over as he tended to his patient.

A nurse was assisting at his side.

The patient’s breathing was critically poor, with oxygen levels dangerously low.

The patient had blue nails, a gloomy, purplish complexion, and generally looked very unwell.

At the bedside, Zhou Can watched Dr. Hu carefully suctioning the patient’s sputum—and dared not disturb him.

“You’re Zhou Can, right?”

Dr. Hu, ever vigilant, had noticed Zhou Can’s arrival.

“Exactly,” Zhou Can responded, his voice tinged with apprehension.

“You can’t help with this bed for now. Go over to bed 7 and help reposition the patient there. This patient is suffering from gastrointestinal bleeding, so handle with extra care,” Dr. Hu instructed.

“Alright,” Zhou Can replied.

He walked over to bed 7, where a lean, emaciated male patient lay.

He appeared to be around thirty-seven or thirty-eight years old.

The patient’s condition was dire.

His breathing was shallow, aided by a non-invasive ventilator.

Gastrointestinal bleeding often worsens over time—a minor issue can escalate into something serious.

Another notable feature of gastrointestinal bleeding is unexplained weight loss and dark stools.

If the bleeding is from the upper digestive tract, even vomiting blood is possible.

Zhou Can carefully turned the patient over.

“Ugh… it’s… going…” the patient murmured weakly.

Zhou Can seemed to understand—the patient needed to defecate.

“Just use the commode,” a nurse said, approaching and skillfully placing the commode to catch the output.

As they began to pull the patient’s pants aside, Zhou Can felt a wave of nausea and revulsion.

The patient had already soiled himself.

It was red.

“It looks like he’s bleeding with his stool,” Zhou Can said, uncertainly.

“Bleeding with stool is common in gastrointestinal cases. This patient has had unexplained lower gastrointestinal bleeding for quite some time and only came in when it worsened significantly,” the nurse explained while efficiently managing the situation.

Zhou Can admired the nurse’s dedication.

He watched as she worked, mentally noting the process—after all, he couldn’t always rely on her help.

“What’s that? It doesn’t look like just blood and stool—it looks like intestines,” Zhou Can said in a moment of horror.

In the process of defecation, the patient had actually expelled part of his intestine.

Medically speaking, it could be described as a form of procidentia.

It was terrifying.

On his very first day in the ICU as a trainee, Zhou Can felt as if he had stepped into a hellish realm.

Every patient here was teetering on the edge—half a step, or more, from the gates of death.

Such near-death terror could never be felt in a regular ward.

“Don’t be afraid! In cases like this, just check if there’s no perforation or continuous bleeding, and then simply reposition the intestine back inside,” the nurse advised Zhou Can, subtly amused by his visible shock.

After swiftly and skillfully handling the situation, she added, “Remember, any contaminated waste must be taken immediately to the waste disposal room in the contaminated zone.”

Watching her hurry off with the waste, Zhou Can felt a pang of guilt.

At last, he had a chance to carefully examine the critically ill gastrointestinal bleeding patient.

Dr. Hu hadn’t assigned him any new tasks for now, so he began reviewing the patient’s test reports and records.

According to the diagnosis, the patient was suffering from diffuse intestinal bleeding, a very challenging condition to manage.

If the bleeding source were clear and limited to one or two spots, an endoscopic procedure might be possible.

But for unexplained bleeding like this, the value of an endoscopy is minimal.

Traditional open exploratory surgery? Forget about it.

Given the patient’s state, who would risk taking him to the operating table?

Zhou Can reviewed the patient’s history—black stool had been an ongoing issue for nearly half a year.

The attending doctor had even ordered X-ray barium and angiography tests to pinpoint the bleeding source, but to no avail.

At this point, the only certainty was that the patient had diffuse intestinal bleeding.

He was still alive only because the bleeding was chronic.

“Tumors and polyps can largely be ruled out,” the report noted.

With Tuyu Hospital’s medical expertise and equipment, even a tumor as small as a few millimeters would be detected.

At just thirty-six, in the prime of his life, what could be causing this intestinal bleeding?

Zhou Can pored over the test reports repeatedly.

“Zhou Can, come here and help!” Dr. Hu called out.

Reluctantly setting the reports aside, he hurried over.

The condition of the patient on bed 6 was deteriorating rapidly—the complexion had turned an even deeper shade of blue, as though an invisible hand was squeezing his neck.

His breathing had become exceedingly labored, as if he were struggling to operate an air pump.

“What’s happening to him?” Zhou Can thought, his heart filled with dread.

He couldn’t shake the feeling—a sixth sense—that the patient was nearing the end.

“Pesticide poisoning, multiple organ failure, and pulmonary fibrosis!”

Dr. Hu’s face remained impassive, his eyes fixed intently on the patient as his furrowed brow betrayed his inner struggle. It was evident he had exhausted every effort to save this man, yet success remained elusive.

Meanwhile, a nurse had already initiated nebulized treatment for the patient, though with similarly poor results.

Pulmonary fibrosis is irreversible—it made every breath more difficult for the patient.

A normal lung consists of countless alveoli.

The total alveolar area in an adult is roughly that of a small house—spread out over a hundred square meters.

Once pulmonary fibrosis sets in, the alveoli’s ability to contract and function is severely compromised.

It’s like a balloon made of soft rubber that, when its wall hardens and loses elasticity, struggles to inflate or deflate.

“Given the situation, this patient probably won’t make it. Paraquat’s devastating effects are too severe. Very few people who ingest this pesticide can be saved. Once it’s into the body, it’s like opening Pandora’s box—the consequences are inevitable and irreversible,” Dr. Hu lamented as he watched the patient’s vital signs deteriorate.

Doctors work around the clock, employing every rescue measure, treatment, and careful nursing to help patients survive the toughest moments and eventually transfer from the ICU to a regular ward.

But doctors, being human and not deities, can only rely on their training and available medical tools and medications.

For ordinary people, paraquat is just a herbicide.

But in the eyes of doctors, this pesticide is a demon incarnate—a harbinger of death.

Many patients gulp it down in a moment of despair or impulse, only to later be surrounded by grieving loved ones, realizing too late the rashness of their actions.

Encouraged by family pleas, they fight hard to live.

In the first few days after ingesting paraquat, following treatments like gastric lavage and IV fluids, patients might feel surprisingly well—eating, drinking, and buoyant in spirit.

Just when recovery seems imminent, the condition relentlessly worsens.

It becomes an irreversible decline—kidney failure, pulmonary fibrosis, and eventually multi-organ failure. Breathing becomes a monumental effort as the body gradually collapses.

Doctors try every available method—from gastric lavage to blood dialysis—but this pesticide is just too ruthless.

They can only watch helplessly as the patient’s condition deteriorates day by day until death inevitably follows.

At least on a national level, strict pesticide safety measures have led to paraquat being banned.

“Go and inform the family. Let them have a final farewell with the patient—he won’t have much time left,” Dr. Hu said in a low, somber tone to the nurse.

“Alright! I’ll notify them immediately!”

In these final moments, the hospital, out of humanitarian concern, allows families to see their loved ones one last time.

It’s a final goodbye before death.

“Zhou Can, have you ever witnessed a patient pass away?” Dr. Hu asked, turning to him.

“Yes, I have,” Zhou Can replied.

During his internship in a regular ward, he had seen it all from afar—family members gathered around, crying and calling out for their loved ones—a scene he would never forget.

“That’s good. In the ICU, you’ll often face moments when even we doctors are helpless. Despite tremendous advances, medical science still can’t cure every ailment. I’ve heard about your accomplishments—your performance in all aspects is excellent,” Dr. Hu said, then shifting his tone to address Zhou Can directly.

“Rumors aren’t always true. At best, I’m just a bit better in certain areas than other trainees,” Zhou Can replied, not entirely out of modesty—it was partly true.

Currently, his skills were at the assistant chief level, though most of his peers were attending physicians or residents.

And in the future, acquiring new skills might even mean starting from the intern level again.

So, in truth, he was not yet exceptional.

He simply accepted his position wholeheartedly.

“You are quite modest. For these three months in the ICU training program, I will be your mentor. If you perform exceptionally well later, you might even have the chance to be directly mentored by a chief physician. Rest assured, the hospital is keen on nurturing you. Just keep that humble and eager-to-learn attitude,” Dr. Hu said, locking eyes with him.

“I will,” Zhou Can replied with a resolute nod.

“I truly hope that Tuyu Hospital will train more and more excellent doctors—ideally, to a point where no patient ever has to be admitted to the ICU. After all, prevention is better than cure,” Dr. Hu expressed his inner feelings and vision.

The constant influx of ICU patients only highlighted how lagging our current medical practices were, with many conditions still lacking timely and effective treatments.