On Standby - Chapter 13

Tang Feihuan’s demeanor at work was a stark contrast to her dazed state in the changing room earlier. At 8:30 AM, after the shift handover, the attending physician handed her the medical records of a patient transferred from general internal medicine.

“Zhang Yan? The lung abscess patient?” Tang Feihuan carefully reviewed the records as she walked toward the Eicu.

The attending physician walked beside her, explaining the situation: “Yes, a lung abscess caused by severe pneumonia. She’s been experiencing shortness of breath and cyanosis since this morning. Her bl00d oxygen saturation only stays above 95% with oxygen supplementation.”

Three days prior, general internal medicine had performed a fiberoptic bronchoscopy, and the sputum samples revealed a high concentration of inflammatory cells, consistent with bacterial pneumonia progressing to a lung abscess.

As Tang Feihuan reviewed Zhang Yan’s medical history, she asked, “Do you have the CT images?”

“Here,” the attending physician replied, pulling up Zhang Yan’s imaging scans on his phone and handing it to her.

Tang Feihuan zoomed in on the images, revealing diffuse ground-glass opacities with reticular patterns in both lungs, along with multiple thick-walled abscess cavities containing low-density fluid. The crazy-paving pattern and typical lung abscess morphology confirmed that her colleagues in general internal medicine had made the correct diagnosis and treatment plan. So why was there no improvement? The patient’s fever remained near 40 degrees Celsius, and her cough, poor appetite, chest pain, and muscle aches persisted. Tang Feihuan pressed her lips together, deep in thought, when a commotion nearby interrupted her concentration.

“Why can’t she be treated in a regular ward? Why force her into the ICU? Are you just trying to bleed us dry?” Zhang Yan’s son, Zhou Wenyong, demanded to see her attending physician.

Zhang Yan’s 17-year-old daughter, Zhou Wenyun, grabbed his flailing arm and explained, “Brother, Mom was treated in a regular ward for six days. She was only moved to the ICU when her condition worsened.”

“Who authorized that? You’re not even an adult—your signature doesn’t count!”

The girl muttered, “Mom wanted to save money and refused treatment at first. I had to persuade her to agree.”

The man’s voice rose sharply. “Do you even know how much a day in the ICU costs? Your three-month art training—twenty thousand yuan—Mom could burn through that in just a few days!”

Their father had died young, leaving Zhou Wenyong as the family’s eldest son and de facto head. Zhou Wenyun rarely argued back, but this time she retorted, “Brother, what’s more important—money or Mom’s health?”

Zhou Wenyong gritted his teeth. “You—!”

“This is a hospital! What’s all the shouting?” Sun Qinhuai, hearing the commotion, rushed over from the nurses’ station and warned him, “Keep it up and I’ll call security.”

Zhou Wenyong, a bully who preyed on the weak but cowered before authority, sensed Sun Qinhuai’s different aura compared to the earlier nurse. Lowering his voice slightly, he asked, “Who’s my mom’s attending physician?”

Tang Feihuan, who had initially ignored Zhou Wenyong outside the Eicu, turned back, walked over, and stood before him, her tone measured and serious. “It’s me.”

Zhou Wenyong, sizing her up as no more than twenty-something and a female doctor, muttered, “So young. No wonder she can’t treat patients properly.”

The Attending Physician, known for his fiery temper, immediately snapped back, “What are you talking about? The patient was transferred to our EICU this morning. Her primary care physician in general internal medicine has been practicing for over ten years.” After a brief pause, he added, “Besides, Doctor Tang trained and worked at hospitals abroad. She has extensive experience. How dare you say she can’t treat patients properly?”

Upon learning that the doctor was a returnee from overseas, Zhou Wenyong’s combative spirit instantly deflated, and he shifted the topic. “What exactly is wrong with my mother? Why is she getting worse despite treatment?”

Tang Feihuan, refusing to engage in his pettiness, kept her explanation concise. “The preliminary diagnosis is a severe lung abscess caused by a bacterial infection. We will continue treatment and observation.” She glanced at the dark circles under the girl’s eyes and, recalling the man’s earlier remarks, surmised this was likely his first hospital visit. With a subtle warning, she added, “Also, someone needs to remain outside the ICU. If the patient’s condition changes, we’ll need to communicate with family members promptly.”

Zhou Wenyong glanced at the girl. “My sister’s here.”

Tang Feihuan tried to steer him toward the hallway. “You said yourself she’s a minor and can’t make decisions.”

To her surprise, Zhou Wenyong brazenly replied, “She can’t make decisions, but she can stay with our mother and call me if anything happens.” With that, he pulled out his phone and pretended to take a call nearby.

Having said her piece, Tang Feihuan couldn’t interfere further. With work waiting, she turned and left.

In the Eicu, patients were under constant monitoring. Tang Feihuan moved from bed to bed, and a nurse handed her the morning’s bl00d test results. The white bl00d cell and neutrophil counts remained elevated, and the C-reactive protein level was still above 8.2 mg/L.

She suddenly asked, “Have we ruled out rheumatic autoimmune diseases?” The patient’s recurring fever, beyond infection and tumors, warranted considering rarer rheumatic autoimmune conditions. For instance, lupus can manifest with fever, pleural effusion, alveolar hemorrhage, and even pneumonia, among other clinical signs.

The attending physician shook his head. “No, lupus typically presents as interstitial pneumonia, and the fever is usually low-grade.”

“Check anyway. There are always exceptions,” the patient said, receiving low-concentration oxygen and connected to cardiac monitoring. His current condition wasn’t critical, giving them some time to find the cause.

After finishing her rounds, Tang Feihuan returned to her office and began searching for similar cases in domestic and international medical literature. From 10 a.m. to 2 p.m., she remained glued to her computer screen. Gu Yan, who had passed by the office several times, couldn’t help but remind her, “Doctor Tang, aren’t you going to eat?”

“Hmm, I’m not hungry,” she replied, glancing at the clock in the lower right corner of her screen: 2:03 p.m.

“People are like iron, and food is like steel. Doctor Tang, don’t give yourself a stomach ulcer.”

“Okay, thank you,” Tang Feihuan replied absently, reminded of Lin Ye’s concern for her health years ago, when he had said the same thing. She bent down to open the snack cabinet, pulled out a box of instant noodles, opened the lid, added the seasoning, poured in hot water—quick and easy. Within fifteen minutes, her hunger was gone.

After disposing of the trash promptly, Tang Feihuan went out to throw away the instant noodle container. As she passed the Emergency Intensive Care Unit (EICU), she saw Zhou Wenyun curled up on a bench, drowsy with sleep. A cleaning worker approached and gently shook the girl’s shoulder. “Hey, hey, young lady, you can’t sleep on the bench.”

Zhou Wenyun blinked open her eyes, coughed twice, and mumbled, “Okay.” She struggled to sit up, clutching her sketchbook, head drooping, and closed her eyes again.

Noticing the girl’s flushed complexion, Tang Feihuan stepped forward with concern. “Zhou Wenyun.”

“Hmm?” The girl looked up, her bloodshot eyes meeting Tang Feihuan’s with a dazed expression.

Tang Feihuan reached out to touch Zhou Wenyun’s forehead. The skin burned to the touch, sending a jolt of alarm through her. “Come with me,” she said urgently.

In the observation room, Zhou Wenyun sat in a chair with a thermometer tucked under her arm. After seven minutes, she handed it to Tang Feihuan. As expected, the reading showed 39.2 degrees Celsius—a fever. Mother and daughter both running fevers in quick succession… was this just a coincidence? Ordinary bacterial pneumonia isn’t contagious, nor is a lung abscess. As these thoughts raced through her mind, Tang Feihuan’s brow furrowed deeper.