Chapter 294: Into the Night Shift: A Doctor’s Unyielding Vigil

“Very good! Besides controlling blood sugar, what other treatments do you think this patient needs?” Zhang Bihua was clearly satisfied with Zhou Can’s answer.

She followed up with another question.

“Even though the patient’s condition has improved, there’s still a risk of relapse. We should continue IV fluids to correct dehydration, maintain a steady low-dose insulin drip, and actively work to correct the patient’s electrolyte imbalances. If she refuses chemotherapy for her pituitary lesion, surgery might be our only option.”

After some thought, Zhou Can realized that unless the pituitary problem was properly treated, focusing solely on the diabetes wouldn’t cure her.

Both diabetes insipidus and amenorrhea were caused by pituitary disorders.

If these two issues went ignored, the overall treatment would end up half-baked.

Intensive management of her hyperosmolar diabetic coma and ketoacidosis might save her life, but that’s it.

“I’ll try again to convince her family.” Honestly, Director Zhang probably couldn’t sway them, so they needed to prepare for the worst.

……

Just as the end of the workday neared, Zhou Can got word—the results for the patient’s hypothalamus-pituitary axis function test were in. ACTH was 18.1 pg/ml, way below the normal 46 pg/ml.

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Hemoglobin F measured at 16.12 ug/ml, which was within normal limits.

E2 was 167.59 pmol/l, T was 1.0 nmol/l…

After reviewing the stack of results, it was clear the central amenorrhea stemmed from her pituitary disorder.

All Zhou Can could do now was hope Director Zhang managed to convince the family to accept radiotherapy.

By evening, the family still refused radiotherapy—and their stance was firm.

Zhou Can was completely helpless.

They’d finally pinpointed the cause, but the family wouldn’t go for treatment. No wonder doctors sometimes feel so frustrated.

It seemed Xinxiang Maternity and Child Hospital even wanted to use this as a model case and sent someone to try persuading the patient and her family.

Meanwhile, the pregnant woman in the resuscitation room finally made it through the most dangerous first six hours.

After work, Director Zhang made a point of going to check on her.

She was very pleased with the crisis response team’s efforts.

“Bringing this mother back from the brink was no easy feat. You all worked hard.”

Director Zhang gave their work high marks.

“Director Zhang, I’d like to stay for the night shift.”

The medical staff at Xinxiang Maternity and Child Hospital were a bit lax, and Zhou Can just couldn’t relax.

He volunteered to spend the night in the on-call room, just in case something sudden happened and they needed to act fast.

Director Zhang paused, then shot a meaningful look at the doctors and nurses from Xinxiang Maternity and Child Hospital. Whether it was the doctors or nurses in the resuscitation room, their joking and laid-back manner made her frown.

But she was only there temporarily, a guest after all.

It wasn’t her place to meddle in their affairs.

After all the effort to save this pregnant woman, handing her over to the hospital’s staff wasn’t exactly reassuring.

But Zhou Can was a key player. Doing a night shift—even with just one patient—was still exhausting. If he couldn’t rest well, his performance the next day would definitely suffer.

“Dr. Zhou might officially be the deputy leader of our crisis team, but he’s actually been taking on the main leader’s role. If he does the night shift alone, tomorrow’s work will be impacted. I’m willing to stay with him and take turns overnight.”

This was Ji You stepping forward on her own.

Pairing a doctor and a nurse for duty was clearly the most efficient option.

“Sounds good! If we’ve got two people on night duty, things will go a lot smoother. I’ll talk to Section Chief Tang about reserving a dedicated on-call room for you. Maybe our hospital’s other doctors can use it too in the future.”

Director Zhang’s comments made it pretty clear she’d lost faith in the hospital’s own staff.

It saved trouble to talk to a seasoned pro like her.

After consulting Section Chief Tang, they cleared a small room near the resuscitation area for them. It used to store bedding and linens. A quick tidying, a simple folding bed, a little table, a chair.

That’s all it took to create a basic, temporary on-call room.

“Dr. Zhou, sorry the conditions are a bit rough. Please bear with us.”

Section Chief Tang apologized to Zhou Can with a smile.

“Honestly, having a bed to sleep on at night is already better than expected. We’re the ones causing trouble for your hospital.”

Despite his privileged background, Zhou Can wasn’t spoiled.

He never fussed about food, clothes, or where he stayed.

He could eat a luxury meal that cost a fortune, or grab a cheap lunchbox. As long as the place was quiet and had a bed, he was content.

“Thank you for understanding, Dr. Zhou! If you need anything, just tell me.” Section Chief Tang produced a business card like a magic trick. “Here’s my card. Call me any time if there’s a problem.”

Anyone could see Section Chief Tang was treating Zhou Can with extra courtesy.

Not only was he polite, he was especially welcoming.

Director Zhang and the others noticed but didn’t overthink it. Zhou Can truly deserved the recognition—the Section Chief’s high opinion was well earned.

Whether resuscitating a sick child or saving this pregnant woman, Zhou Can was always the main force, the indispensable hero.

While no one at Xinxiang Maternity and Child Hospital said it out loud, it was clear Zhou Can was held in high esteem.

……

After dinner, Zhou Can planned to head back to the hotel, grab a shower, and pick up a medical book.

He’d be stationed at the pregnant patient’s bedside for his night shift.

No need to stare at the monitors the whole time—just check them occasionally. If the monitors caught any major changes in her vitals, they’d automatically sound the alarm.

Of course, Zhou Can still had to handle tasks like changing IV drips, swapping out dressings, and adjusting ventilator settings himself.

But before he could even leave the hospital, his phone rang.

A quick glance—an unfamiliar number.

“Hello, who’s this?”

Zhou Can picked up.

“Dr. Zhou, it’s Dr. Pang! The patient’s blood oxygen’s dropped all of a sudden—please come right away!”

Dr. Pang’s voice trembled with nervousness.

She was an attending physician with intensive care experience—so why was she panicking just because a patient’s oxygen level fell?

As Zhou Can turned and sprinted back to the resuscitation room, he couldn’t help but wonder.

Dr. Pang’s skills were decent. If she was this rattled, it could only mean one of two things: either she’d been negligent and something happened, or the patient’s oxygen dropped and her interventions hadn’t helped.

He rushed in to find Dr. Pang and Nurse Chen Qingling trying to resuscitate the patient.

Three of the hospital’s doctors and nurses were just standing by, watching.

“She was fine when I went to dinner. How did her oxygen level suddenly plummet?”

Zhou Can coolly checked the patient’s vitals. Her blood pressure hadn’t dropped much at all.

So things weren’t as dire as he feared.

Her breathing was short and labored and her face was cyanotic.

Her lungs, already compromised by diffuse infiltration after a fat embolism, definitely weren’t normal.

Still, she’d stabilized on the ventilator.

So what caused the sudden crash?

Zhou Can and his team had been protecting this patient all day.

There was no way he’d let all that work go to waste.

“I went to the bathroom and came back to find her oxygen dropping,” Chen Qingling explained.

In the ICU, it was typically one nurse per patient and one doctor per three patients.

What does that mean?

Basically, at minimum, each bed gets one nurse. A doctor covers at most three patients.

This woman really should have been in the ICU. But considering her family’s finances—and that she wasn’t yet out of danger—Zhou Can had gone the extra mile providing four-to-one care.

There were just five crisis team members. Deputy Director Shi was only present in name.

The real work was up to Zhou Can, Dr. Pang, and two nurses.

Tonight, with Zhou Can and Ji You covering the night shift, Dr. Pang and Chen Qingling handled the current watch.

Everyone needs bathroom breaks. No one could fault Chen Qingling for leaving during her shift.

The incident happened when Dr. Pang was alone.

Zhou Can turned to look at Dr. Pang.

“I—I stayed right by the bed. When I noticed her oxygen plummeting, I took a series of emergency measures right away.”

But her eyes darted away.

She wasn’t telling the full truth.

Dr. Pang had always been unhappy with Zhou Can getting promoted to deputy leader. Now, with this halfhearted attitude, Zhou Can was starting to get angry.

“If you called me as soon as her oxygen started dropping, how did it get below 70%?” Zhou Can snapped, his voice tinged with anger.

A nurse from Xinxiang Maternity and Child Hospital muttered, “I saw her on the phone for ages.”

Seeing her excuses falling flat, Dr. Pang finally came clean.

“I was by the patient’s side when my family called. My mom’s been bedridden for years, so I got worried and talked a bit longer. Because nothing scary had happened with the patient all day, I relaxed my guard. When Nurse Chen Qingling got back from the bathroom, she saw the patient’s blood oxygen had dropped to 85% and the monitor was blaring. That’s when she hurried over to alert me.”

Dr. Pang knew she was at fault and owned up.

But this wasn’t the time for blame—more important to zero in on the problem and save the patient.

“How long was it between the monitor’s alarm and when you contacted me?”

“Less than five minutes, I think. Dr. Pang tried some emergency measures but the patient didn’t improve. Her oxygen actually dropped even faster, so she called you right away.”

Chen Qingling answered.

“Her oxygen tanked in just a few minutes. What emergency steps did you take?”

While searching for the cause, Zhou Can questioned Dr. Pang.

“I increased her oxygen concentration and flow…”

Dr. Pang listed everything she tried.

Zhou Can had suspected the resuscitation measures were off. After listening, he checked the ventilator settings more closely and finally figured it out.

He quickly reduced the nebulization and tweaked several ventilator parameters.

Then he checked whether the patient’s intubation was secure.

Little by little, her oxygen levels stopped plummeting—and even began to rise.

In just over twenty minutes, her blood oxygen level had climbed back above 95% and the alarm stopped.

The bluish tinge on the woman’s face faded away.

She still had a faint purplish mark left on her fingertips.

Dr. Pang looked like she’d survived a disaster—her face gaining color as relief washed over her and the fear faded from her eyes.

If anything had happened to the patient, Dr. Pang would have had to shoulder the blame.

With Tuyu Hospital’s strict stance on medical safety, her career would’ve been over. She’d be lucky just to keep her job until retirement.

“Dr. Zhou, why did adjusting the ventilator parameters help her oxygen stabilize and recover so fast?”

For the first time Dr. Pang, an attending, addressed Zhou Can the trainee with real respect.

Gratitude and genuine admiration filled her tone.

“From the beginning, increasing oxygen concentration and flow wasn’t the right call. Sometimes, trying to rush things makes them worse, you know? Next time, try tailoring your response to the patient’s true condition. And when you saw the higher oxygen wasn’t working, you threw nebulized inhalation at her—that only made it worse.”

“Look at it this way: her airways were already flooded. Adding another downpour is just asking for disaster.”

Zhou Can didn’t hold back, patiently explaining the principle.

Maybe Dr. Pang already knew part of this, or maybe she’d only heard it vaguely before.

Still, distraction from her family call meant she didn’t notice the oxygen drop to 85% until it was almost too late. Instinctively, she panicked.

When you’re flustered, it’s easy to lose your sense of proportion and make mistakes.

Desperate measures in desperate moments aren’t just for patients—doctors can fall into the same trap.

Dr. Pang listened to Zhou Can’s explanation, thinking it through for several minutes before finally getting it.

“So that’s how it is… Ah, it’s all because I panicked! I nearly made a huge mistake.”

Having worked through the reasoning, she kept smacking her own forehead.

“Thank you for your guidance, Dr. Zhou. Thank you!”

This time her gratitude was genuine—she truly admired him.

That actually made it harder for Zhou Can to come down on her. He’d planned on reporting her to Director Zhang for a stern scolding, but seeing she was middle-aged with a sick mother at home, he hesitated.

Ruining her livelihood seemed almost cruel.

“No need to thank me. The most important thing in medicine is safety. Saving the patient this time doesn’t mean we’ll always get lucky if something goes wrong again. I truly hope you treasure this job. Patients trust us with their lives—what greater responsibility is there? Don’t you agree?”

Zhou Can didn’t lay into her, just offered a gentle reminder.