On Standby - Chapter 2

The Critical Care and Trauma Team originally consisted of one Chief Physician and two senior Associate Chief Physicians, overseeing a total of 25 doctors and 62 nurses. In June of this year, to streamline academic research and scheduling, the team was divided into three smaller groups. Lin Ye, recently promoted to Associate Chief Physician, was entrusted with the crucial role of leading the second group.

Although their group had fewer members, the two Attending Physicians who had worked with Lin Ye for years were highly experienced and capable of sharing much of her workload. As a result, no new members had joined the team for over two months. Ten days prior, Director Gao had mentioned to Lin Ye that a new colleague would be arriving at the end of the month, but she had been too busy to inquire further at the time.

Director Gao introduced her with a cheerful smile: “This is the capable assistant I’ve been telling you about—a top graduate from Heidelberg University, Doctor Tang Feihuan.”

“Hello, Doctor Tang,” Lin Ye’s voice, like a gentle breeze, brushed past Tang Feihuan’s ear, devoid of any discernible emotion yet sharp enough to rouse her from her daze.

Tang Feihuan’s throat tightened. “Director Lin.”

The stilted exchange ended, leaving a brief, awkward silence. Lin Ye broke the silence: “Director Gao, please carry on with your work. We’ll be leaving now.”

“Alright, alright, you two get back to work,” Gao Zongxiang nodded, knowing Lin Ye wasn’t one for small talk and indicating that he indeed had matters to attend to.

The two left the Director’s office together. Tang Feihuan, still dazed from their long-awaited reunion, followed silently behind Lin Ye as he showed her the break room, the on-call room, and finally the office area.

“This is our team’s office,” Lin Ye said, pointing to the space left of the water dispenser. “Your desk is over there.”

Tang Feihuan nodded numbly. “Okay.”

“Can you get started right away?” Lin Ye asked without looking at her, walking over to Wang Can’s desk to review patient records.

“Y-maybe,” Tang Feihuan stammered, biting her lip in frustration at her lack of confidence.

“Wang Can used to work under Lao Liu, but Lao Liu will be teaching at the medical school starting in September, so you’ll be supervising Wang Can from now on.” Lin Ye handed Tang Feihuan a stack of patient files. “These are her patients. Familiarize yourself with them first.”

Tang Feihuan took the files.

“WeChat,” Lin Ye added.

“Huh?” Tang Feihuan was bewildered for the third time that day.

Lin Ye’s slender eyebrows furrowed slightly. “You don’t use WeChat?” He had assumed that Tang Feihuan, having lived abroad, would rely on WeChat as her primary communication tool.

“I do, I do,” Tang Feihuan said, pulling out her phone and displaying her WeChat QR code. She held it out, waiting for him to add her as a friend.

Lin Ye scanned the QR code. A few seconds later, a red dot appeared in Tang Feihuan’s contacts. She subtly sniffled and tapped to open the request.

“I’m Lin Ye.” The four words, both unfamiliar and familiar, brought back memories of eleven years ago. It was the first semester of her sophomore year, October 12th, when Lin Ye had taken the initiative to add her on QQ, using the exact same words.

It felt like everything had come full circle.

After the verification was approved, Lin Ye sent Wang Can’s contact card.

“Wang Can’s WeChat. If you have any questions, you can reach out to her.” His tone was completely professional, like any ordinary colleague.

“Thank you,” Tang Feihuan replied.

Lin Ye returned to his seat and buried himself in work. Tang Feihuan settled at her own desk and began organizing files. Colleagues came in and out, exchanging brief introductions before returning to their tasks. After reviewing patient records, Tang Feihuan chatted briefly with Wang Can, who had just returned from rounds. Only then did she finally have time to look up at Lin Ye, who sat by the window with his back to her.

The person before her was the quintessential Jiangnan woman: naturally fair-skinned with delicate features. Tang Feihuan had often praised her eyes, saying even comparing them to spring water wouldn’t do justice to their gentle warmth. For now, she didn’t dare meet Lin Ye’s gaze directly, contenting herself with quietly savoring the sight of her back.

She was still as thin as before, looking like a gust of wind could knock her over. But Tang Feihuan knew how strong she was—she could carry a dummy and even give Tang Feihuan, who was four centimeters taller, a princess carry.

Her thoughts drifted until someone’s intrusion snapped her back to reality. “Lin Ye, the patient who arrived at 6 AM has a slightly elevated ST segment on the ECG and elevated troponin levels, strongly suggesting a myocardial infarction. But when Cardiology performed a coronary angiography, they found no significant lesions—far from the severity of coronary artery disease, let alone a heart attack. Go take a look?”

“Okay,” Lin Ye replied, rising from her seat and taking a few steps toward the door. Remembering Tang Feihuan, she was about to speak when Tang Feihuan stepped forward. “I’ll go too.”

The three rushed to the Catheterization Lab, where the patient still lay on the operating table.

Lin Ye asked, “What are the patient’s main symptoms?”

Liu Zhinan replied, “Chief complaint is severe chest pain and tightness.”

Tang Feihuan followed up, “What kind of chest pain? A dull, suffocating pain from hypoxia, or a sharp, tearing pain like being stabbed?”

“A dull, suffocating pain. You suspect aortic dissection?” Liu Zhinan immediately understood Tang Feihuan’s suspicion, both being experienced clinicians.

Tang Feihuan hummed in agreement.

Liu Zhinan turned to ask, “Should we do a thoracic aortography while we’re at it?”

Lin Ye pursed his lips, visibly hesitant. Aortography is an invasive procedure and no longer a common method for diagnosing aortic dissection. However, since the patient was already on the operating table for coronary angiography, adding aortography wouldn’t significantly increase discomfort. After consulting with the Cardiology Department’s Attending Physician in the Catheterization Lab via microphone and obtaining consent from the patient’s family, he finally nodded. “Do it.”

Moments later, multiple pairs of eyes stared intently at the screen as contrast dye flowed smoothly through the thoracic aorta, showing no signs of dissection.

Liu Zhinan groaned, “Could it be a pulmonary embolism?” In the absence of trauma, after ruling out myocardial infarction and aortic dissection, pulmonary embolism is the next most likely diagnosis.

“Have you ruled out abdominal organ issues?”

“What about upper abdominal conditions?”

Lin Ye and Tang Feihuan asked simultaneously, their long-dormant synergy undiminished as they remained focused on the operating room.

Liu Zhinan shook his head. “I checked. The abdomen is soft and non-tender. It’s unlikely to be an abdominal organ problem.”

Lin Ye observed the patient’s condition on the monitor, debating whether to send him for a CT scan or perform pulmonary angiography right on the operating table. Fortunately, the patient’s bl00d pressure remained relatively stable, though his heart rate was elevated at 108 beats per minute. Sending him for an emergency CT scan should be safe. With the patient’s best interests in mind, she instructed Liu Zhinan to order a pulmonary CT angiography (CTA).

The patient was wheeled to the CT room, and the team waited nearby for the results. When the images came back, the pulmonary arteries showed no abnormalities.

Having ruled out the three major life-threatening conditions, the three doctors and the attending physician from the Cardiology Department breathed a collective sigh of relief. However, the cause of the patient’s chest pain remained elusive, and his symptoms persisted. What should they do next? The team was stumped.

“Did we do a cardiac ultrasound?” Tang Feihuan asked, having spent five years studying and working at the Heidelberg Hospital Cardiac Center.

Liu Zhinan replied, “We did one at the beginning. There’s no pericardial effusion.”

Just as they were at a loss, a nurse rushed in, shouting, “Emergency! Bed 2’s bl00d pressure is dropping—now 85/42 mmHg!”

The three doctors’ hearts leaped in alarm. They raced after the nurse to the patient’s room, pulled back the curtain, and found the patient grimacing in pain, gasping, “I’m in agony, Doctor! I’m in agony!”

The family members anxiously pressed, “Doctor, what’s going on? He’s getting worse with treatment! This is the best hospital in Shu River—if you can’t cure him, what are we supposed to do?”

Tang Feihuan stood to the right of the bed, observing the patient clutching his chest with one hand and his abdomen with the other, his forehead drenched in sweat from the pain. She immediately asked, “Does your stomach hurt?”

“Yes! It was just chest pain before, but after the examination, my stomach started hurting too. This is killing me!”

Without hesitation, Tang Feihuan pulled back the patient’s blanket, revealing a distended abdomen.

Liu Zhinan exclaimed in surprise, “Hey? His stomach wasn’t bloated when we first arrived!”

Tang Feihuan slightly lifted the patient’s shirt and palpated his abdomen with her right hand, detecting fluid. This is bad. She turned to Liu Zhinan urgently. “Get a bedside ultrasound immediately.”

“Right away,” Liu Zhinan instructed the staff to prepare. Lin Ye watched Tang Feihuan’s accurate diagnosis and methodical actions, his gaze lowering slightly as the corners of his lips curved upward almost imperceptibly.

The bedside ultrasound would take time, but the patient couldn’t wait, constantly crying out, “It’s killing me! I’m dying! Save me!”

His abdomen grew increasingly distended, and his face turned even paler. Suddenly, a family member said, “Could he have injured his stomach yesterday?”

Liu Zhinan immediately asked, “Injured? How? Where?”

“He slipped in the shower and hit the sink—right here,” the family member pointed to the left side of the patient’s abdomen.

The spleen.

“But when I asked if he wanted to go to the hospital, he said he was fine.”

“It could be delayed splenic rupture,” Tang Feihuan said urgently. “We can’t wait. Let’s do an abdominal paracentesis immediately.”

Lin Ye agreed, gesturing for Tang Feihuan to proceed while he explained the situation to the family, reassuring them.

With everything prepared—the site located, disinfected, and locally anesthetized—Tang Feihuan held a 50ml syringe and, without hesitation, pierced the abdominal cavity with the needle. She forcefully pulled back on the syringe, and in an instant, dark red bl00d began to flow from the abdomen.

Liu Zhinan exclaimed, “Good heavens! It might actually be a ruptured spleen!”

Lin Ye immediately took charge, arranging for further treatment. “Start IV fluids to stabilize his bl00d pressure,” he ordered. He contacted the Director of Emergency Surgery, informing him that an exploratory laparotomy might be necessary once the patient’s vital signs stabilized.

Five minutes later, the Deputy Director of Emergency Surgery arrived, assessed the situation, and immediately ordered the patient rushed to the emergency operating room for an exploratory laparotomy.

With the patient finally in surgery, the rescue team in the emergency ward could finally catch their breath. Liu Zhinan leaned against the wall, gulping down half a bottle of water. He turned to Tang Feihuan and said, “So, you’re the new colleague in our department?”

“Hmm?” Tang Feihuan raised a hand to wipe sweat from her forehead.

Liu Zhinan chuckled. “I was wearing a mask and cap earlier, so you probably didn’t recognize me.” He clapped Lin Ye on the shoulder. “Hey, she’s definitely going to be a great comrade-in-arms.”

“I suppose so,” Lin Ye replied coolly, turning to walk away. But a faint smile, unnoticed even by herself, flickered in her eyes as she murmured, “Let’s wait and see.”