On Standby - Chapter 5

The human body’s entire vascular system is interconnected. When problems repeatedly occur in the arteries of the lower limbs, it often indicates that the condition of many other bl00d vessels is also precarious. Professor Zhong, for example, was suffering from myocardial infarction caused by acute oxygen deprivation in his coronary arteries. When his bl00d pressure dropped, the attending physician promptly administered vasopressors and performed an electrocardiogram, which showed a significant elevation in the ST segment. Before they could decide on the next course of action, the patient developed ventricular fibrillation.

By the time Lin Ye and Tang Feihuan arrived at the Emergency Intensive Care Unit (EICU), the attending physician was already performing cardiopulmonary resuscitation (CPR) with full force, and the defibrillator had been wheeled to the bedside.

“Let me take over,” Lin Ye said urgently, taking over the chest compressions. “Prepare the defibrillator.”

Tang Feihuan accepted the defibrillator paddles from the nurse, coordinating with Lin Ye. “200 joules.”

“200 joules confirmed.”

Tang Feihuan: “Charging complete. Clear the bed.”

Lin Ye stepped back to create space as Tang Feihuan delivered the defibrillation shock to Professor Zhong.

The patient showed no response. Lin Ye immediately resumed chest compressions, calling out, “Epinephrine, one milligram IV push.”

The nurse administered the medication. “Epinephrine, one milligram IV push complete.”

Tang Feihuan held her breath, focused intently. “Continue. 200 joules.”

“200 joules confirmed.”

Without a moment’s hesitation, Tang Feihuan said, “Charging complete. Clear the bed.”

The person at the bedside stepped back, and Tang Feihuan delivered the defibrillation. After the shock, Professor Zhong’s heart still failed to regain its natural rhythm. Lin Ye continued chest compressions while the nurse, following medical orders, administered medication. Chest compressions were physically demanding work, and Lin Ye had been performing them for several minutes. Noticing the fine beads of sweat on her forehead, Tang Feihuan said, “Let me take over.”

During a patient’s emergency resuscitation, Lin Ye didn’t let pride get in the way. She stepped aside, and Tang Feihuan moved forward to take her place.

Time ticked by, minute by minute. After seven minutes, the attending physician took over. Five more minutes passed, and Lin Ye resumed compressions. Night shift doctors from the critical care teams 1 and 3 gathered around, and someone asked, “Need help?”

“Director Lin, it’s been 22 minutes,” the attending physician reminded her.

In clinical practice, the golden window for cardiac resuscitation is within four minutes of cardiac arrest. Beyond that, irreversible brain damage becomes increasingly likely. Professor Zhong’s heart had already been stopped for 22 minutes.

Lin Ye ignored the warning, gritting her teeth and pressing on.

“26 minutes, Director Lin.”

Tang Feihuan, standing beside the attending physician, remembered the old professor’s brief moment of lucidity and his plea. Raising her voice, she called out his name directly: “Lin Ye!”

At her shout, the green line on the cardiac monitor suddenly changed. The patient’s heartbeat had returned.

“Tell the family to come in,” Lin Ye said without pausing. He pulled a penlight from his white coat pocket and checked the old professor’s pupils.

Tang Feihuan asked anxiously, “How is it?”

“Dilated.”

It was the expected outcome.

Tang Feihuan watched as Lin Ye’s face, slightly flushed from exertion, suddenly turned pale. She wanted to ask why he was still persisting with resuscitation after 25 minutes had passed, when the chances of success were slim. But before she could speak, Lin Ye had already pulled back the curtain and left, walking toward Professor Zheng, who stood by the door, her lips pressed tightly together, waiting for news.

Lin Ye stopped before the elderly woman and spoke gently, “Professor Zheng, after our efforts, Teacher Zhong’s heartbeat has returned, but both pupils are dilated.”

Tears welled up in Professor Zheng’s reddened eyes again. “Are you saying… he can’t be saved?”

Lin Ye nodded slightly. “Moreover, his heartbeat could stop again at any moment.”

“I understand. Thank you,” Professor Zheng said, clasping her hands together in gratitude.

“Please go see Teacher Zhong,” Lin Ye said, tilting his head slightly, his sharp jawline lifting as he suppressed his emotions.

Doctors, especially those in the Emergency Department, fought daily against death’s door. Sometimes, despite their best efforts, they couldn’t overcome death and could only silently adjust their own mindsets.

Professor Zheng, his frail frame trembling, finally shuffled over to sit beside Professor Zhong. He took Zhong’s right hand in his own, holding it gently, and whispered, “Yuan Zhao, I selfishly wanted you to stay with me a few more days, and I’ve made you suffer for it.” The elderly man’s trembling hand stroked Zhong’s pale hair, and he sniffled. “We won’t pursue treatment anymore. If you’re ready to go, go peacefully.”

Only the bedside nurse remained by the bed; the others stood outside the curtained area, respecting the final moments of farewell between two elderly men who had shared over fifty years of life together.

Within two minutes, the monitor beside the bed showed the vital signs flatlining, marking the end of Professor Zhong’s life.

Tang Feihuan found Lin Ye in the break room, standing by the window. The woman was wearing her white coat, hands in her pockets, gazing out at the night sky, just as she always did when troubled—seeking solace in solitude and the vastness of the night. Tang Feihuan couldn’t discern what Lin Ye was thinking, but she sensed a profound sense of loss and helplessness. Yet she hesitated to approach, unsure of her place or how to offer comfort. A colleague?

As Tang Feihuan wrestled with her thoughts, Lin Ye turned and walked toward the door, brushing past her as if she were invisible.

Tang Feihuan frowned slightly.

“Am I really that annoying?” she muttered to herself.

The next moment, Lin Ye, standing three meters away, turned and called out to her, “Come on, Group One needs help.”

Tang Feihuan hurried after him. “What is it?”

Lin Ye explained as they walked, “They admitted a new patient with a Type A aortic dissection. They need surgery immediately.”

“Does this involve us? Have they notified Cardiothoracic Surgery?”

Lin Ye cut to the chase. “Director Wang from Cardiothoracic Surgery is the surgeon, but both attending physicians on duty are tied up with other emergency surgeries. Type A aortic dissection surgery is a major procedure, and Director Wang doesn’t trust a resident physician to assist.”

“Your point?” Tang Feihuan sensed his plan.

“Director Fang from Cardiothoracic Surgery recommended you as the surgical assistant.” Lin Ye also believed in her capabilities.

So, someone else recommended me, Tang Feihuan thought, pursing her lips. Her expression turned focused. “Straight to the operating room?”

Lin Ye quickened his pace. “Yes, time is critical. Director Wang said he’ll discuss the details with you in the OR.”

“Which operating room? Take me there.”

Their hurried figures disappeared down the corridor.

At 10:25 PM, the operating room doors closed. Type A aortic dissection surgery required open-chest surgery, cardiac arrest, and was a complex and lengthy procedure. Director Wang of Cardiothoracic Surgery, with over twenty years of experience, first explained the patient’s condition to Tang Feihuan in detail, highlighting the surgical challenges, his planned approach, and how he needed her to assist.

“The patient’s CT scan shows a tear in the ascending aorta. After the inner lining of the ascending aorta ruptured, bl00d entered the false lumen of the dissection, but the tear didn’t propagate distally, remaining largely confined to the ascending aorta and aortic arch.”

Tang Feihuan nodded. “Twenty days ago, I assisted in a similar surgery. As more bl00d accumulates in the dissection, the tension on the outer wall increases significantly, making it quite challenging.”

“I heard from Lao Fang that you’re Dr. Borna’s protégé,” Director Wang said with a smile. “At just 28, you’re already performing minor surgeries independently. Tonight, let’s have a successful collaboration.”

Tang Feihuan nodded. “A successful collaboration.”

At 10:57 PM, the surgery officially began.

The chest was opened, cardiopulmonary bypass initiated, and the heart arrested. The procedure progressed smoothly.

The affiliated hospital of Shu Jiang University School of Medicine was a teaching hospital, so each operating room had a separate observation room for medical students to learn. Currently without other duties, Lin Ye stood with his arms crossed, observing through the glass.

His gaze unconsciously followed Tang Feihuan’s movements.

Lu Yuqing suddenly appeared behind him. “What are you looking at?”

“Ahem,” Lin Ye coughed lightly, trying to regain his composure. “A patient from the Emergency Department. Type A aortic dissection. Cardiothoracic Surgery is short-staffed, so Tang Feihuan was temporarily assigned to assist.”

Lu Yuqing raised an eyebrow. “Wait, why does her surgery concern you?”

Lin Ye’s face flushed instantly, though he didn’t even realize it himself. “I’m her supervisor,” he explained. “I need to understand her work.”

“Oh, then you can keep ‘understanding’ here. I’m going back to sleep. Hopefully, I won’t have to do sit-ups tonight.” Lu Yuqing waved dismissively and left the observation room. Lin Ye glanced back at the operating room before following her out.

The surgery continued for another hour. Just as the critical moment of restarting the heart arrived, a crisis struck. Director Wang looked up and demanded, “The heart isn’t restarting properly! How did you administer the anesthesia? How much dopamine was given? How much epinephrine?”

“Um… um…” The anesthesiologist checked the records.

Director Wang’s temper flared. “Go get Dr. Lu immediately!”

The anesthesiologist replied, “She’s in the adjacent operating room. I’m not sure if she’s finished yet.”

Director Wang gestured for a nurse to check. When she didn’t find Dr. Lu, he ordered her to call.

Five minutes later, Lu Yuqing arrived, summoned by the urgent call. After quickly assessing the situation, she immediately took over. Within moments, the patient’s heart resumed beating.

Observing the patient’s heart, Director Wang smiled. “You’re the only one who could have done it, Xiao Lu.”

“It’s all the same,” Lu Yuqing replied, her eyes fixed on the patient’s vital signs. “Chen Gang (the previous anesthesiologist) hasn’t assisted with many Type A aortic dissection surgeries, but he’s been excellent in other procedures. He was probably just a bit nervous tonight.”

With all vital signs stable, she sat down to watch the final stages of the surgery.

During the final suturing, Director Wang confidently handed the task over to Tang Feihuan. Stretching and rubbing his back, he waved his hand. “Getting old. Five hours is already too much. Xiao Tang, remember to come to Cardiothoracic Surgery sometime. Lao Fang has been nagging about it all day.”

Tang Feihuan focused on her stitching. “Alright, Director Wang. Go home and get some rest.” Chief Physicians and senior Associate Chief Physicians weren’t required to work night shifts. Director Wang had been called in from home in the middle of the night, so he was naturally eager to return after finishing the surgery.

Director Wang nodded in agreement and opened the operating room door.

At 4:23 AM, exactly five and a half hours after the surgery began, Tang Feihuan finished the last stitch and put down her instruments. She waited for the circulating nurse to count all the instruments, sutures, and gauze before leaving. As the anesthesiologist, Lu Yuqing needed to escort the patient back to the ward and stay until they regained consciousness. She stood up to examine the patient’s wound and sighed, “Impressive suturing skills. Better than Old Wang’s.” She muttered to herself, “No wonder Lin Ye hasn’t found anyone after all these years. Could he still be hung up on her? Hmm, she does have a certain charm when she’s working.”

Back in the office, Tang Feihuan filled a glass with water and gulped down most of it, finally quenching her thirst. She bent down to retrieve a mango and a dragon fruit from her backpack. Noticing Lin Ye and another resident physician busy at the computer, she asked, “Want some fruit?”

Lin Ye turned around, but before he could answer, the Chief Resident Physician sitting next to him exclaimed in exasperation, “Doctor Tang, you brought mangoes and dragon fruit for your night shift! And you’re actually going to eat them!”

Tang Feihuan looked puzzled. “Huh? What’s wrong with that? We need our vitamins. We can’t neglect ourselves.”

“Damn, no wonder I’ve been so busy tonight,” he muttered. Just as he finished speaking, the triage nurse rushed in. “Doctor Tang, we have a patient—suspected gastrointestinal bleeding due to alcohol overdose. He’s vomiting bl00d!”

“Right away,” Tang Feihuan replied, and she and the Chief Resident Physician hurried out with the nurse. Lin Ye turned back to his work, not joining them. Since the Associate Chief Physician was on 24-hour duty, the Attending Physicians and Resident Physicians handled patient admissions. They only called for backup when they encountered problems they couldn’t resolve.

After admitting two more patients and working another hour, it was past 5:30 AM. Tang Feihuan removed her gloves and had taken only a few steps when she heard the Chief Resident Physician scolding a patient: “If you eat that bun now, all our treatment will be for nothing! Do you understand?”

The patient, who had been vomiting bl00d due to alcohol poisoning, was feeling better after receiving fluids but was now complaining of hunger. “Ten bottles of IV fluids can’t compare to a single bun!”

The Chief Resident Physician tried to reason with him: “No, you have gastrointestinal bleeding. You must fast, or you’ll start bleeding again.”

The patient bargained: “Just half a bowl of congee?”

Tang Feihuan couldn’t stand it any longer and blurted out, “If you eat half a bowl of congee, you can forget about drinking alcohol for the rest of your life.”

“What?” The patient, hearing he’d have to give up drinking, immediately became compliant. “Then I won’t eat anything.”

Sometimes, doctors need to understand what patients value most to “prescribe the right medicine.”