Chapter 458: Critical Moments in the Emergency Department

After experiencing these real, tangible changes, every nurse and doctor in clinical care would feel just as happy as Zhou Can.

He changed into his white coat and headed straight to the inpatient ward for rounds.

When he reached the extra bed in the corridor, labeled Bed 23, he smiled and greeted her. “Tingting, how are you feeling today?”

After her emergency surgery, Ye Tingting had spent three days in the ICU. Once her condition stabilized, she was transferred back to a regular ward for ongoing treatment. She was young, and with Dr. Xu personally performing her surgery, her recovery had gone remarkably well.

“Much better. The past couple of days I couldn’t eat at all, and my stomach hurt like crazy. Today I really do feel a lot more comfortable.”

Ye Tingting looked noticeably thinner.

Having a punctured intestine is like taking a trip to the edge of death, no matter who you are.

Next to her was her mother, who’d been caring for her.

Her husband is the main breadwinner and had to work every day to support the family. He stayed with her for a couple days, but then after work each day he’d come to the hospital and switch places with Ye Tingting’s mother.

Being a hospital caregiver is an incredibly exhausting job.

It’s noisy here and there’s nowhere to sleep. Most family caregivers end up slumped over the edge of the bed just trying to get a little rest.

You can tough it out for a day or two, but if the patient needs to be hospitalized for an extended period, it’s a huge challenge for any family member.

“Let me check your wound!”

Her wound was on her upper abdomen, really close to her ribs.

If the attacker had stabbed just a bit higher, the consequences would have been unthinkable. She might not have survived at all.

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Zhou Can made a point to give her extra attention every day during rounds.

She lifted her hospital gown, exposing her upper abdomen.

Right now, the wound was still covered by gauze.

Zhou Can carefully peeled off the tape. The wound was long and prominent. The attack itself had only left a small puncture, but Dr. Xu had to perform open abdominal surgery to save her, which was why the incision was so long.

“It’s pretty much healed now. My mentor did an excellent job. As long as you’re careful with your recovery and watch your diet, you shouldn’t have any noticeable scarring. The transverse colon inside your abdominal cavity is healing well too. Otherwise, your temperature wouldn’t be this stable, and the incision would have taken much longer to close—possibly even got infected.”

After examining her, Zhou Can provided a thorough assessment based on her current condition.

“Hearing you say that puts my mind at ease!”

She broke into a smile.

Women care deeply about their looks. A long scar across the upper abdomen, especially with keloid formation, is a terrifying thought.

Ye Tingting works as a nurse herself, so she already knows what she should and shouldn’t eat after surgery.

Zhou Can didn’t need to give her extra instructions.

“How’s He Juan doing?”

Ye Tingting had been afraid to ask about He Juan, but she knew her injuries were serious.

In fact, she suspected He Juan might not have survived.

“She’s still in the ICU. She developed abdominal infection at one point. With so many internal injuries, along with severe blood loss and abdominal contamination, her condition has never been stable. But I checked on her last night. Judging from all her signs and vital stats, things are still looking fairly optimistic. As long as she makes it through this critical phase of infection, her chances will get much better.”

He Juan was lucky Zhou Can rescued her in time and pulled every string he could to save her. That’s why there’s even an optimistic outlook at all.

Even so, she really was hanging by a thread.

She’s got more than one brush with death ahead of her yet.

After finishing his rounds, Zhou Can stepped out of the ward as an emergency nurse rushed toward the doctors’ office.

Spotting Zhou Can, she looked as if she’d found her savior. “Dr. Zhou, Dr. Zhou! A young female patient just showed up at triage—she looks terrible, pale as a sheet. Right now, only Dr. Xie is on shift, but he’s with her and sent me to get a senior doctor to take a look!”

“Senior doctor” usually means an experienced attending or head nurse.

They’re all skilled and usually ranked attending physician or head nurse and above.

Usually, they don’t stick around at patients’ bedsides or deal directly with families—they handle higher-level tasks like directing emergency treatments, reviewing interns’ work, writing key orders, training teams, and so on.

Only associate chief physicians and above are qualified to lead teams.

Take Cardiothoracic Surgery for example. An associate chief physician who leads a team has more authority and say than an ordinary chief physician.

Clinical departments run on real results. Whoever shows stronger skills and brings in more revenue has more clout. Then there are chief physicians who are academic powerhouses—people respect them too.

There’s no official seniority ranking, but everyone knows exactly where they stand and gets the treatment they deserve.

No halfway-qualified chief physician gets to boss everyone around.

Even if someone has connections, at most they’ll avoid some work and still get paid.

The clinical frontline really isn’t suited to people who are only there through connections.

Those with some background usually end up moving to administrative departments.

Those with less backing squeeze into technical departments.

Dr. Xie is a new doctor in the Emergency Department.

He just became a resident last year, so he’s only been in the role for three years. Recently promoted, he’s a new senior resident.

Dr. Luo had his hand injured by a family member not long ago and hasn’t recovered yet, so the Emergency Department has been short-staffed. That’s why Dr. Xie got moved to triage duty.

To be honest, Dr. Xie got kicked out of Nephrology, which suggests he has some shortcomings.

Maybe it’s poor skills, or maybe an attitude problem.

We’re all adults here, so no one spells it out directly.

Emergency needed more hands, so the hospital pulled from Internal Medicine—who, in turn, used it as a chance to cut loose their weaker doctors.

No department is going to willingly give up their rising stars.

Even though Zhou Can is just a junior resident, in the eyes of most of the Emergency Department’s staff, his skills beat out even some attending physicians. So when things get dicey, senior nurses hunt him down for help.

He arrived at triage to see Dr. Xie had already finished talking with the female patient.

She looked very young, about seventeen or eighteen.

Not exactly stunning, but her features were neat and clean, with a bit of charm. Judging by her outfit, she was a student—the kind who plays by the rules.

“What’s her situation?”

Zhou Can asked Dr. Xie.

“She reports abdominal pain, and during the exam she was very tender there.” Dr. Xie specialized in nephrology, but he could handle abdominal cases too.

“Any diagnosis yet?”

“Not yet. Planning to get her an abdominal ultrasound first.”

Clearly, Dr. Xie didn’t realize how serious things might be. He even seemed to think the nurse was overreacting by bringing Zhou Can in.

“I’d suggest drawing blood for a CBC and checking her hemoglobin before the ultrasound.”

That was Zhou Can’s advice.

And that was the direction they’d take.

Dr. Xie might have been reluctant, but he knew Zhou Can’s reputation and immediately added the bloodwork.

“This CBC has to be urgent! Nurse Lu, take her blood right here, don’t make her wait in line!”

As he spoke, Zhou Can helped the girl sit down and turned to the nurse.

“Got it!”

The nurse clearly trusted Zhou Can and quickly headed to Treatment for a test tube, needle, and the rest.

Zhou Can turned to the girl’s companion. “Are you her family?”

“I’m her mother.”

The woman looked in her forties. Her clothes seemed fancy at a glance, but to Zhou Can it was obvious they were off-brand.

She struck him as a proud, tough woman.

Her makeup was heavy too.

“Please go pay for her tests, right over there!” Zhou Can said to the girl’s mom.

“Alright!”

She gave her daughter a reminder and went right to the payment window.

Although the hospital has plenty of self-serve kiosks, some older or less-educated family members still prefer to queue at the window for in-person payment.

Once her mother had gone, Zhou Can looked at the girl. “I looked at your medical record—it says you’re unmarried and have no sexual history. Now that your mom’s not here, tell me honestly, have you ever had sex?”

The girl hadn’t expected that question. Suddenly blushing, she looked down.

“In medicine, you can’t hide things. You’re in danger right now. The moment I saw you, your face and lips told me you were acutely anemic. I’m guessing you’re bleeding down below.”

Zhou Can looked quite serious.

Really, this girl ought to have gone to OB/GYN—not sure how she ended up at Emergency.

Maybe because that department wasn’t open yet.

Plus, the wait in OB/GYN was probably really long.

“How do you know everything?”

The girl looked up, a little startled and more than a little impressed. This new doctor seemed far sharper than the first one.

He hadn’t done any tests, just taken one look at her and figured out most of the story.

He’d even made a point to send her mom away before asking.

It was considerate.

“Because I’m a doctor! You get that you’re in a really dangerous situation, right? The only way we can help you as fast as possible is if you tell us everything.”

Zhou Can’s tone softened, like a big brother looking out for a little sister.

He did his best to help her relax.

“If I tell you the truth, please don’t tell my mom. I got a boyfriend about two months ago, and these past few days I’ve felt pain in my belly—a lot worse today. I’m bleeding down there a bit too. I’ve been scared, but my mom realized something was wrong and took time off work to bring me here as soon as possible.”

The girl poured everything out.

Just as Zhou Can had suspected—she had a boyfriend.

Listening to all this, Dr. Xie started sweating. Now he was completely in awe of Zhou Can.

He’d thought it was a simple case, maybe just indigestion. He had no clue she’d been hiding so much medical history.

And with how scared she was of her mom, Dr. Xie’s respect for Zhou Can kept growing.

With a calm excuse about paying, he got the mom out of the room, then gently got the girl to open up. That’s pure experience.

Dr. Xie had spent ages questioning her but got nowhere.

Zhou Can asked once and got the truth.

“I’m worried you might have an ectopic pregnancy with ongoing internal bleeding. If it’s a big bleed, we need to rush you into surgery right away. You need to take care of yourself, okay?”

Zhou Can looked at the girl, his heart aching for her.

Pregnant at her age—seventeen, eighteen—and having an ectopic pregnancy at that. Who knows how her mom will react when she finds out.

He knew how much her mother cared.

She’d taken time off work and brought her straight to a major hospital instead of saving money at a small clinic.

That gave them a real shot at saving her.

Major internal bleeding from an ectopic pregnancy is incredibly dangerous.

Lots of blood can pool in the uterus and abdomen in minutes, which can cause shock or even death.

Nurse Lu returned with the blood draw supplies.

“Let me do it!”

Zhou Can’s injection skills are way better than hers, and with seconds counting now, every moment mattered.

He rolled up the girl’s left sleeve, pressed her elbow, and with his right hand flicked out the needle.

He used the flying needle technique.

Pop!

The needle slid perfectly into her vein, so quick the girl barely felt it.

Blood flowed swiftly down the catheter.

He filled the tube in no time.

“Get the lab to rush the test—her hemoglobin has to be checked first. The other results can come later. Blood type is crucial, too. The moment we have that, contact Blood Bank to prepare blood. And… have the Operating Room stand by—actually, I’ll handle that myself!”

Nurse Lu was just a nurse at the end of the day—nowhere near Zhou Can’s authority.

This was a critical emergency and, since it involved OB/GYN complications, the Emergency Department handling this surgery would be a first.

“How are you feeling now? Chills? Dizziness? Heart palpitations?”

He checked in with the girl again.

“A little cold and kind of dizzy. If anything happens to me, can you give this note to my mom? Thank you.”

She really trusted Zhou Can.

She fished out a folded note from her pocket and handed it to him.

“Have faith. We’ll do everything we can for you, I promise!”

Zhou Can took the note and carefully tucked it into his coat pocket, making sure she saw how seriously he took her trust.

That was his way of showing her she could rely on him.

Nurse Lu hurried off with the blood sample, and by then, the girl’s mother had returned from paying the bill.

The girl kept her head down, too nervous to even look at her mom.

“Come on, let’s get you to ultrasound. I’ll get you to the front of the line—no more waiting.”

Zhou Can rolled over a stretcher and helped the girl lie down.

Her mother saw how anxious the doctor was and realized her daughter’s illness was no small matter. Panic set in.

They sped her to the ultrasound room at top speed.

“Doctor, what illness does my daughter have? Is it really serious?”

“She may need emergency surgery—please prepare yourself. I need to start calling the other departments now and get the team ready—there’s no time for a full explanation.”

As soon as he finished speaking, Zhou Can moved aside to call Anesthesiology, Dr. Qiao Yu in the Operating Room, Dr. Xu—gathering everyone for the emergency surgery.

He did consider sending the girl to OB/GYN for surgery.

After all, they’ve got plenty of experience with procedures like this.

He just worried they might not make it in time.

Still, he trusted his own skills.