Chapter 226: Crisis at Bed 51

That patient’s condition was extremely dangerous; it was just that the attending doctor’s skills were limited and he hadn’t noticed it.

Zhou Can gritted his teeth and decided he had to speak up.

After all, lives were at stake.

“Chief Resident Luo Shengsheng, I have something to report!”

Being new, Zhou Can kept a very low profile.

In every department he had worked, not only Chief Residents but even attending physicians treated him with utmost courtesy, constantly trying to ingratiate themselves with him.

“Dr. Zhou, no need for such formality! Just let me know what’s up!”

Seeing Zhou Can’s serious expression, Chief Resident Luo Shengsheng immediately adopted a formal tone.

“When I arrived, I happened to see an attending doctor examining the patient in Bed 51.”

“Yes, I’m aware of that patient. He was admitted due to rectal bleeding, abdominal pain, and severe malnutrition. We’ve already done gastroscopy and colonoscopy—even used capsule endoscopy—but still couldn’t locate the bleeding point. His intermittent bleeding makes it harder to pinpoint.”

After listening, Dr. Luo took the initiative to explain the patient’s situation to Zhou Can.

“Er…when I passed by, the patient looked extremely unstable. Judging from his pallor, lips, and some superficial symptoms, he was probably experiencing internal bleeding. It’s likely bleeding from the jejunum or ileum, where clots form easily. If not treated promptly and the patient goes into shock, our chances would be grim.”

Zhou Can’s tone carried a note of gravity as he spoke.

He intended to make sure Luo Shengsheng understood the urgency.

He hadn’t been too impressed with the Gastroenterology Department, having visited twice.

The doctors there were a bit slow and overly procedural, lacking flexibility.

The last time during a gastrointestinal bleed in the Critical Care Department, Zhou Can even sought out the attending, Dr. Xia Ping, but upon hearing he was just a trainee, the call was abruptly ended.

Old-school ways prevailed.

“It can’t be that serious, right? The patient has been hospitalized for days with intermittent bleeding. But if he is actively bleeding, we could do further tests.”

Luo Shengsheng’s attitude mirrored that of the attending physician.

It was a typical case of habitual thinking.

After all, the patient had been stable all along; why would a crisis suddenly occur?

Many doctors have this complacent mindset.

“I suggest we immediately perform a gastrointestinal angiography. After all, he’s already had his endoscopies; redoing them in such a short time could be too much for him.”

Endoscopies can irritate the anal or colonic mucosa, easily causing minor bleeding and even complications like intestinal damage or perforation.

Thus, under normal circumstances, consecutive endoscopies in a short span are not advised.

Seizing the opportunity, Zhou Can deftly suggested a gastrointestinal angiography—a proposal more likely to be accepted by Luo Shengsheng.

“Yes, Dr. Zhou, your suggestion is excellent. However, the patient is under the care of Dr. Xia Ping. We’ll decide on further tests once he arrives. When he comes, I’ll stress your proposal for angiography.”

Luo Shengsheng spoke with impeccable smoothness, the epitome of seasoned cunning.

“Alright then!”

Zhou Can said no more.

He had fulfilled his duty of caution; if his superiors ignored him, there was nothing he could do.

Time passed slowly as Zhou Can sat quietly in his office, waiting for Dr. Chi to arrive.

Near eight o’clock, a middle-aged doctor, around forty-seven or forty-eight, walked steadily into the office.

“Dr. Xia is truly a role model! Always arriving early and never late,” Luo Shengsheng greeted him with a beaming smile. Observing his sycophantic display, Zhou Can couldn’t help but sigh.

Different people have different ways of living.

Luo Shengsheng’s fawning over his superiors was simply a means of survival.

Getting on well with the higher-ups made it easier to climb the ranks.

It brought little advantages in every possible way.

Be it promotions, training opportunities, involvement in key projects, or surgical practice—those who could flatter had undeniable advantages over the honest types.

“Haha, I’m no role model, but sticking to it day in and day out does require some determination. So, how are the patients in my group? Nothing unexpected, I hope?”

If there was only one Dr. Xia in Gastroenterology, this refined middle-aged man was likely the Dr. Xia Ping whom Zhou Can had spoken to on the phone.

Dr. Xia barely glanced at Zhou Can without saying a word.

Instead, he walked over to a desk, set down his briefcase, and habitually opened his computer to review his patients’ records and nursing notes.

“Earlier, that Dr. Zhou mentioned that the patient in Bed 51 might be experiencing internal bleeding and suggested a gastrointestinal angiography.”

Taking the opportunity, Luo Shengsheng reiterated the matter.

“Dr. Zhou?”

Dr. Xia’s gaze fell on Zhou Can again as he scrutinized him.

“The name sounds familiar, and you have a rather intense look. Who are you?”

“I’m the new trainee, Zhou Can. I hope you’ll guide me well, Dr. Xia.”

Zhou Can greeted him with a smile.

However, unlike Luo Shengsheng, he couldn’t be overly obsequious.

Even towards Chief Physicians, Zhou Can maintained respectful dignity without kowtowing; just proper respect.

There was no right or wrong in this; it wasn’t that he was unwilling to fawn, it was simply a different way of living.

He wanted to live with dignity.

He preferred to earn his prowess through hard work and diligence rather than by flattering superiors.

He might indulge in flattery on occasion, but in a much more sophisticated way than Luo Shengsheng.

His compliments were refined and elevated.

“Oh… I remember now. There was a patient with a lower gastrointestinal bleed in Critical Care—you called me about him. Later, I heard you diagnosed him correctly. Not bad, kid.”

Dr. Xia recalled the incident vividly.

That patient, who had been unresponsive to prolonged treatment and was eventually transferred to Critical Care on the brink of death, had his true condition uncovered by a trainee named Zhou Can—identifying an infection by a parasite never seen before.

The patient was cured, which was quite an affront to Dr. Xia’s reputation.

Thus, Dr. Xia remembered it well.

Today, he feared another such embarrassment.

“How did you deduce that the patient in Bed 51 was experiencing gastrointestinal bleeding?”

Having learned his lesson from past mistakes, Dr. Xia did not take this lightly.

“I arrived this morning and happened to see an attending doctor checking the patient’s vital signs in Bed 51…”

Zhou Can recounted the sequence of events.

“So, I recommend we immediately perform a gastrointestinal angiography and take swift action to avoid a catastrophe.”

“But performing an angiography requires scheduling with the Interventional Department. How can you be sure it’s jejunal or ileal bleeding by just a glance?” Dr. Xia’s tone showed his growing concern.

His skepticism was evident, even for someone with over twenty years of experience; spotting the bleeding site with just a glance was nearly impossible.

Especially with gastrointestinal bleeding, it’s notoriously difficult to diagnose.

At that moment, a nurse burst into the office in a panic.

“Dr. Xia! Dr. Xia! Please come quickly—Bed 51’s patient has suddenly deteriorated and is nearly in shock! Attending Dr. Zhang is doing his best to resuscitate him. I had to report immediately!”

Tragedy had struck.

Zhou Can sighed inwardly.

The doctors in Gastroenterology really ought to be sent for months of training in Critical Care, just to learn what it means when a patient’s life hangs by a thread.

Gastrointestinal diseases are typically chronic, rarely resulting in sudden death. Their slow progression usually gives doctors ample time to treat.

Years of handling such cases had dulled the Gastroenterology doctors’ responsiveness.

“I’m on my way!”

Dr. Xia didn’t even have time to think further as he hurried toward the ward.

When something goes wrong, the primary doctor must bear responsibility.

Especially when it happens after Zhou Can’s repeated warnings—the responsibility becomes even greater.

“Damn, something’s really wrong!”

Luo Shengsheng’s gaze towards Zhou Can had completely changed.

Not only him, even the two interns in the office looked at Zhou Can with awe.

This trainee was practically a prophet.

“Chief Resident Luo Shengsheng!”

Zhou Can stood up and looked toward Luo Shengsheng.

“Y-Yes! Dr. Zhou, just give the orders,” Luo Shengsheng replied, lowering himself to an extreme degree.

He even used the word “order.”

“I’m going to the ward to check the patient, who is already in shock. There’s little time left for resuscitation. When Dr. Chi arrives, please explain everything to me.”

Zhou Can was remarkably skilled in resuscitation, interventional procedures, and endoscopic surgery.

Maybe his presence could actually help.

When it comes to emergency care, every medical professional has a duty to act.

Zhou Can followed to the ward where the patient had lost consciousness, with his grieving family by his side. The attending doctor was frantically administering rescue measures.

“Quick, get the patient to the Interventional Department for an urgent gastrointestinal angiography!”

Dr. Xia’s expression turned ashen.

Observing the patient, his decades of experience sank him into despair.

He knew something major was amiss.

If not handled immediately, today’s mistake could severely impact his career and future.

At that moment, a tinge of remorse flashed across Dr. Xia’s face.

Had they followed Zhou Can’s advice from the start instead of hesitating, this might have been avoided.

“Now that the situation has escalated, you’re only now ordering this angiography? Earlier, when Dr. Zhou suggested it, you refused! If something happened to my father, no matter the cost, I’ll hold you, a negligent doctor, accountable!”

The patient’s son erupted in fury.

Any family member would have been incensed.

Over twenty minutes earlier, Zhou Can had urged Attending Dr. Zhang to rush the patient for an angiography.

Instead, Dr. Zhang had berated Zhou Can.

Now, with the patient on the brink of death, the higher-ups had finally approved the angiography.

To the family, it seemed like deliberate delay until the patient was nearly dead before treatment began.

“This is not the time for arguments—saving the patient’s life is paramount. Once someone goes into shock, they’re in extreme danger and could die any moment.”

Dr. Xia tried hard to calm the patient’s family while arranging for the urgent test.

Zhou Can wheeled in a stretcher; the family, surprisingly, cooperated fully.

“Quick, get the patient onto the stretcher!”

Zhou Can shot a stern look at Dr. Zhang, who had been harshly reprimanded by the family yet dared not retort.

This attending clearly needed a good lesson before he could treat patients properly on his own.

Dr. Zhang promptly helped transfer the patient onto the trolley to rush him to the Interventional Operating Room.

Soon, the patient was in the interventional suite.

This procedure required inserting a catheter into the mesenteric artery. The doctor performing it was a novice, his nervousness nearly palpable.

“Let me handle it!”

Before anyone could object, Zhou Can stepped in and skillfully inserted the catheter into the mesenteric artery.

After injecting the contrast agent, within just two or three seconds an anomaly was evident.

Abnormal staining and contrast leakage appeared in the patient’s left upper abdomen.

The leakage indicated the actual bleeding point.

“So the bleed originates here—no wonder the endoscopy missed it. The patient had stopped bleeding during the exam, making it impossible to detect the source.”

At that moment, Dr. Xia was utterly impressed by Zhou Can.

Words couldn’t express his admiration.

This trainee was extraordinary—by just a quick look, he could pinpoint the bleeding site to the upper jejunal branch.

It was now confirmed that the source was a branch vessel in the upper jejunum.

“Dr. Peng, where’s your mentor? The patient’s condition is critical and needs immediate attention. You don’t operate often—this might be beyond you. Call your mentor right away!”

Dr. Xia’s status in Gastroenterology was clearly significant, as evidenced by the deference shown by the interventional doctors.

“Alright, I’ll call him immediately!”

The young interventional doctor didn’t waste a moment and phoned his mentor.

It was the night shift, and with the handover approaching, nobody expected such a crisis.

The patient was already in shock. Despite his extensive experience with gastrointestinal interventions, this was clearly his first encounter with such a situation; his face had gone pale.

“Before his mentor arrives, let me try operating—you can’t expect the patient to wait!”

Zhou Can said this to Dr. Xia.

“Thank you, Dr. Zhou!”

Dr. Xia felt Zhou Can was nothing short of a lifesaver.

Having seen Zhou Can effortlessly complete the angiography catheter insertion, he was convinced of his exceptional skills in interventional surgery.

After receiving the nod from the higher-ups, Zhou Can did not hesitate further.

He manipulated the microcatheter toward the bleeding supply artery.

Reaching the first branch of the mesenteric artery, at the upper jejunal division, his skill was evident.

Such a procedure would be impossible without deep interventional expertise—something Dr. Xia and Dr. Zhang simply did not possess.

To confirm the accuracy, Zhou Can injected the contrast agent again.

It was clear—the culprit vessel was the one.

Just as Zhou Can was about to discuss the next treatment steps with Dr. Xia, the patient’s condition plummeted again.

The patient’s eyelids flipped, his entire body convulsing, and his blood pressure nosedived.

It fell to 45/28 mmHg.

Dr. Xia was utterly shocked. Not only him, but every nurse and doctor present tensed up, their faces grim as they joined the rescue effort.

Even the surgeons and nurses from another operating room rushed over to assist.

Dr. Xia immediately maxed out the infusion rate.

“Adrenaline—administer two doses immediately!”

He urged repeatedly.

“Two doses aren’t enough—push at least four doses in one go!”

Zhou Can’s resuscitation skills were hardly inferior to Dr. Xia’s.

After observing the anesthesiologist, Dr. Guan, and Dr. Feng, and having trained in Critical Care for three months, Zhou Can’s emergency skills surpassed many experienced attendings.

After all, every doctor has his specialized field.

“Push four doses!”

Dr. Xia hesitated briefly before finally following Zhou Can’s advice.

Though it bruised his pride somewhat, thinking of Zhou Can’s many excellent performances made him comply willingly.

In any resuscitation effort, the two best doctors are always the backbone of the operating room.

Everyone listens to their commands.

For someone as young as Zhou Can, having his rescue decisions accepted by a seasoned attending naturally drew the attention of fellow doctors and nurses.

“Have the red blood cell suspension from the blood bank been arranged?”

Zhou Can didn’t mince words and demanded an update.

“Yes, it’s been arranged and will be delivered shortly,” a nurse replied eagerly.

“Bring me the central venous catheter kit!”

Zhou Can’s skill with catheter placement was unmatched. Taking the kit, he promptly established a central line.

At that moment, the blood bank delivered the blood.

After a series of infusions, catheter placements, blood pressure support, transfusions, and finally embolizing the bleeding vessel, they managed to pull the patient back from the brink.

Every staff member breathed a collective sigh of relief.

However, this was merely a stopgap measure—it did not address the root cause.

“Call General Surgery and have them send a surgeon over for an emergency laparotomy,”

since Internal Medicine surgeons weren’t adept at operations.

Only with the expertise of a General Surgery doctor could the patient’s bleeding source be definitively treated.

Zhou Can nearly swallowed his words, knowing his current status didn’t allow him to lead the surgery.

He could only wait for the General Surgery doctor to arrive.

It was amusing—just yesterday he’d come from General Surgery, and today he’d see them again in Gastroenterology.

One had to wonder: which surgeon would be sent over?