No one would get the chance to perform hundreds over high-difficulty venipunctures. Only the System could provide such opportunities.
Blood flowed on the first attempt!
It was not standard procedure but the results were evident. The seasoned nurses around Zheng Ren were stunned.
This kind of high-difficulty venipuncture usually took at least five minutes. It involved multiple punctures and maneuvers to find the vein, seemingly dependent on luck. Five minutes to get into the vein was for experts.
Yet, how long did Chief Zheng take? Excluding the time it took to position the patient, it had been only two minutes. No, not even two minutes, one minute...or less. In the blink of an eye, venous blood was seen to flow out.
"Fix an IV line and administer the methylene blue." Zheng Ren held the catheter and raised his voice when he saw no one following up with the next step.
He could not shout as his throat was totally wrecked. The previous panic-induced a release of epinephrine and dopamine in his body, keeping him in an excitatory state.
"Oh! Oh! Oh!" The nurses around Zheng Ren woke from their stupor, took the venous catheter and connected it to the infusion tube.
"Maximum flow rate. Once the infusion is done, continue with the glucose solution. Then, perform a gastric lavage," Zheng Ren instructed.
"Yes!" replied the seasoned nurses in unison. They were from other departments but had been reassigned to face the emergency.
He allowed the nurses to administer the treatment and went to position the other patients.
Zheng Ren took the needle and thread from the catheterization kit and started to secure the subclavian vein catheter.
He moved without delay as if under an army general's command.
Once the stitches were done, he watched the glucose and methylene blue solution drip in the drip chamber. Only then was he reassured.
The next patient was already positioned for the procedure. Zheng Ren took off his gloves and rubbed his hands with an alcohol-based sanitizer. He opened the catheterization kit, put on a new pair of sterile gloves, and got to work.
Chapter 45 - Lightning Speed
Old Chief Physician Pan was in the zone, hands gripping the hemostatic forceps as he searched for the shriveled, pale vein.
Thinking back to the war, he was reminded of the many comrades who had suffered hemorrhagic shock. A femoral vein catheterization had been his bread and butter back in the day.
His eyesight was a bit blurry and he could not clearly make out the tissue structure beneath the skin. Perhaps it was old age catching up, but if he did not operate, who would? Youngsters these days very rarely had experience with such invasive methods. His familiarity was built on the lives of others. Where would these rash youngsters find that many patients with hemorrhagic shock to practice on?
Five minutes later, Old Chief Physician Pan finally found the femoral vein and successfully established a catheter access. A bottle of glucose and methylene blue solution was hung on the intravenous stand. He let out a long exhale as the liquid dripped.
Although he was slower than before, finding the femoral vein within five minutes—while not a perfect score—was a pass. He was satisfied with himself; he was still up to it.
Straightening his back, Old Chief Physician Pan could almost hear the cracking of his vertebrae.
One still had to accept his age. Old Chief Physician Pan gave a bitter smile and suddenly realized Zheng Ren was nowhere to be seen.
This chief resident that he wanted had put on a stellar performance, the current patient's diagnosis being one of many already.
Nitrite poisoning was something most people would go about their lives never witnessing. In his younger days, Old Chief Physician Pan had only come across one case and had had to flip through the books for the treatment. Unfortunately, the patient's illness was too severe and they passed away before methylene blue could be obtained.
The many surgeries before, plus this correct emergency diagnosis and treatment, was proof of Zheng Ren's abilities!
Where was he, though?
Old Chief Physician Pan looked around. What he saw made him gasp in surprise.
There were twelve beds lined behind him; seven or eight patients had been shifted into a special position. Some patients with central venous line access had been lifted onto stretcher trolleys and moved into the observation room.
Zheng Ren was hunched over, concentrating fully on central venous catheterization.
Old Chief Physician Pan sighed. Youngsters truly had quick eyes and deft hands.
A moment passed and he realized Zheng Ren was not only quick, he was lightning fast.
Somewhere along the line, Xie Yiren had joined the fray. She quietly stood beside Zheng Ren and assisted him. Between opening the catheterization kit, disinfection, puncturing, stitching and stabilization...the whole process took around 30 seconds?
Old Chief Physician Pan thought he might even have overestimated the time.
As Zheng Ren was stitching and fastening the catheter, Xie Yiren was already preparing the next patient.
This was way too fast.
Other than Xie Yiren, Zheng Ren had about twenty medical personnel around him.
Some were moving patients from one of the 120 ambulances onto emergency beds.
Some were hastily preparing the glucose and methylene blue mixture solutions.
Some were attaching intravenous bottles to catheters and hanging them onto intravenous stands, their drip rate set to maximum.
Some followed Zheng Ren to secure the catheter with dressing once the stitching was complete.
Some delivered the patients that already had subclavian vein catheters to the observation room next door.
The whole operation was smooth and orderly like the flow of a river. In the time that Old Chief Physician Pan had taken to complete a femoral vein central venous access, Zheng Ren had accomplished more than ten subclavian vein catheterizations.
'Haih, I am old,' Old Chief Physician Pan thought to himself. He was a bit sad but grateful.
The future belonged to the young. He would contribute in whatever way he could.
"What is the stock level for methylene blue? And the central venous catheterization kits?" he asked.
"We're running out," the matron answered with dread in her voice. The sirens of the 120 ambulances melded into one. There were still the patients with minor poisoning or those who needed urgent medical attention but opted to come to the hospital in a private vehicle instead of waiting for an ambulance.
It was total chaos outside the emergency rescue room as more and more patients flocked to the hospital. Sea City General Hospital was the best medical care facility in the city. When something was not right with their family, the first thing most people would do was to bring them over to Sea City General Hospital for a check-up.
Even if the city responded swiftly with appropriate patient distribution, their control only extended over the ambulances. The patients in private vehicles all ended up in Sea City General Hospital.
Old Chief Physician Pan's eyebrows furrowed. What was happening here? Why had there been so many cases of nitrite poisoning?
He abandoned that train of thought. It was not something a doctor should concern themselves with. As medical personnel, he should be focusing on saving people.
Old Chief Physician Pan came up by Director Xiao's side. No words were exchanged, but the pair of weatherbeaten eyes shone with alertness. He stared directly at Director Xiao without any pretense.
Although the chief physician said nothing, Director Xiao understood the unspoken message.
The hospital still had a large supply of central venous catheterization kits, so those were not a problem. On the other hand, the whole hospital's stock of methylene blue had been exhausted, which meant that incoming patients would not be able to receive treatment.
Without treatment, the patients would simply be awaiting death in the hospital.
On the receiving end of
Old Chief Physician Pan's knife-sharp glare, the already high-strung Director Xiao became furious. The glare read like a challenge to an argumentative man like him.
"Why are you looking at me? The hospital doesn't have enough stock. I've contacted the city!" Director Xiao roared in fury, as if expressing his disp.l.e.a.s.u.r.e at the situation and at himself.
The office director had never seen Director Xiao this angry. He nearly felt like going up to stop any fights from happening, but hesitated out of fear.
"You are the hospital director. Who the hell am I supposed to ask if not you?" Old Chief Physician Pan said. "If a patient dies, you're good as gone. I'll have you know that a lot of people are waiting for you to make a mistake."
The words were not said in anger or frustration, but as a cold reminder to Director Xiao of the truth. Even when swearing, Old Chief Physician Pan did not raise his voice, which made the reminder much more foreboding.
Based on what he said, Old Chief Physician Pan would not mind giving a nudge when push came to shove.
No one doubted the power behind Old Chief Physician Pan's nudge.
Unless the accident was ruled to be due to negligence, a director's position was untouchable. However, Director Xiao did not want much trouble. More importantly, he was a business director who came from the clinical field. All the commotion in the emergency rescue room rekindled the fiery passion in him.
Director Xiao went through a series of facial expressions. Then, he snatched the phone from the office director's hand and made a call. Once the call connected, he immediately shouted into the phone. "Methylene blue! I want all your stocks of methylene blue shipped to Sea City General Hospital!"
"I don't care about any problems that arise. If it doesn't reach us in ten minutes, I will hold a directors' meeting tomorrow and remove all your company's products from our shelves!"
High-handed and unreasonable.
During a critical time in the hospital, such tactics were a comfort to the people.
The uproar from patients and family members outside died down after hearing his call, as if a savage beast had been unleashed in the emergency rescue room.
Director Xiao made phone call after phone call.
There was no time to wait for the city council to arrange for supplies. According to standard procedure, it would take at least another 30 minutes to an hour to arrive when such a threat was at hand.
He could admit what Old Chief Physician Pan said was true. If a patient were to die, he would be in big trouble.
Rather than face this alone, Director Xiao was willing to rescind some lucrative deals; no one would come out of this unscathed.
Zheng Ren was in the eye of the tornado, wordlessly performing central venous catheterizations. Regardless of the patient's age or gender, he took a solid 25 seconds for each of them.
After each completion, a glucose bottle was hung above and methylene blue flowed like a mini waterfall into the patient's subclavian vein. The solution would circulate peripherally and then into the liver where it would take part in the metabolism process to remove the nitrite.
The hospital stock of methylene blue was diminishing. As the last bottle was opened and mixed with 10% glucose solution by a nurse, a Wuling SUV appeared in front of the emergency entrance.
The vehicle seemed to be in much more of a rush than the ambulances. One could almost see sparks erupting from the vehicle's sudden stop.
A middle-aged man with a beer belly came down from the car wearing a suit. He carried a box of methylene blue and hurried into the emergency department.
"Director Xiao, eight minutes!" The pale-faced man deposited the box on the floor. His breathing was loud and labored like a pair of bellows. He seemed incredibly tired.
Director Xiao's expression changed for the better when he saw the arrival of the methylene blue. He said to the man, "Inform the Health Department and ask about the situation in the city. Take the initiative."
Then, he went to monitor the patients with Old Chief Physician Pan and relocated patients who were responding well to treatment to other wards.
Chapter 46 - Unboxing Rewards
246 subclavian vein catheterizations. It took three hours in total including preparation time.
In the emergency department, all medical personnel had forgotten the passage of time and were solely focused on the lives that required saving.
They were all doing their best.
Zheng Ren completed another central venous catheterization and looked up. The emergency bed opposite him was empty. That was the last nitrite poisoning patient.
It was over? Really?
Zheng Ren was a bit surprised.
Repeating a procedure for such a long time was bound to paralyze a doctor, especially someone like Zheng Ren who had exchanged all his experience points for surgical training time in the System and practised a few hundred venipunctures. After that, he had performed two hundred more catheterizations in the emergency room. Although a catheterization was not comparable to an actual surgery, the sheer number of them was enough to make Zheng Ren feel tired.
Zheng Ren turned and asked, "Any more patients?"
"I'll ask." Xie Yiren had also noted the lack of patients and walked out to inquire, a spring in her step.
Watching Xie Yiren's retreating figure, Zheng Ren noticed the alterations made to her lab coat. The waist was pinched and showed off her perfect curves in each movement.
It was unlike the others, whose lab coats made them look shapeless and unflattering.
In a flash, Xie Yiren was back. Her mask was removed to reveal a flushed face. She spoke excitedly from the door, "Chief Zheng, there are no more patients. Old Chief Physician Pan said he would handle the hospital admissions and that you should stay put."
"Okay," Zheng Ren mumbled a reply.
Once the end was confirmed, fatigue flooded his body.
During the rescue, Zheng Ren had operated single-mindedly to save all the patients' lives.
His lethargy, hunger and basic human needs had been overshadowed by the epinephrine and dopamine released in his body. He had been unaware of his body's needs.
Zheng Ren had not even kept track of the mission given to him by the System.
What was the mission again? Zheng Ren could not recall. Faced with the 'Avatar'-like patients that kept coming in, he had no time to think about the experience points he would gain.
There were only subclavian vein catheterizations, methylene blue infusions and nitrite poisoning on his mind.
Ambulance sirens and the desperate cries of families filled his ears.
The end. It was finally the end.
Zheng Ren walked to the door and the world suddenly started to spin. His vision went blurry and he knocked into Xie Yiren.
"Ah!" Xie Yiren pushed Zheng Ren away. A loud bang echoed as his head crashed into the door. His boneless body collapsed onto the floor.
Seeing Zheng Ren on the floor, Xie Yiren was stunned. A moment passed and she called out. "Help!"
That was the most-repeated word in the emergency department today, especially this afternoon.
All the patients with nitrite poisoning were already receiving treatment, so who was yelling for help? Did a patient suddenly take a turn for the worse?
A few doctors and nurses put down their non-urgent work and came to check on the situation.
They were surprised to find Xie Yiren shouting. "Little Xie, what's wrong?"
"Chief Zheng fainted!" Xie Yiren was still stunned and did not know what to do.
Did she cause it? Maybe… He was the one who fell into her… This pervert!
He was not injured, right? What if he hurt his brain?
Xie Yiren's mind was filled with images of trepanation and drainage for intracranial hemorrhage.
A few medical personnel hurried to help Zheng Ren up.
Zheng Ren was sweating profusely. The people who helped him up had wet hands after.
"Move him to the bed!" a doctor said.
/> Zheng Ren only fainted for a moment. He was half-awake now.
He could feel the changes in his body. Mustering all his strength, he spoke, "Help me sit, don't move me. 20 milliliters of glucose, injected, then another bottle of 10% glucose."
He was weak, lightheaded, sweating, and there was ringing in his ears—the symptoms of low blood sugar. Zheng Ren only realized now that he had not eaten for almost 24 hours.
The last proper meal he had was supper with Xie Yiren, the crayfish.
That seemed like a long time ago.
Hearing Zheng Ren's medical instructions, everyone's panic abated as they figured it was likely hypoglycemia.
Soon, a large syringe of syrupy 50% glucose solution was injected into Zheng Ren's veins as he leaned against the wall. Sitting on the floor, he gulped down the 10% glucose solution.
Sweat dripped down from Zheng Ren's hair. Some family members of patients were heartbroken to see him. They wanted to ask after him and maybe send him some food, but Zheng Ren's pallid complexion made them hesitant.
A human's heart was made of muscles. If these were the people who usually wrote nasty online posts about doctors without ethics, even their hearts would be wrung upon seeing the doctor who fought tooth and nail for each patient collapse from exhaustion.
A phrase appeared in their hearts: what a great doctor!
A few minutes passed and the symptoms of hypoglycemia abated. Zheng Ren felt revived.
Although he had little interest in food, he had to at least consume something at regular intervals.
The previous night of appendectomies had exhausted him. After today's endoscopic transrectal appendectomy, he had gone home and taken a small nap before coming in again to check on his patients.
He had totally forgotten to eat.
Tsk… He had to pay more attention next time.
The emergency department corridor was filled with hospital beds. Zheng Ren felt sincerely happy and giddy at the sight of the bluish tint gradually fading from the patients' skins.
This was perhaps the happiest moment for doctors and nurses.
The Surgeon's Studio c1-799 Page 27
