Tang Feiwan was startled awake by Lin Ye’s icy voice. Her throat moved with difficulty as she pulled herself out of her daze. Like a puppy that had done something wrong, she hung her head and apologized. “I’m sorry.”
Lin Ye ignored her, reached over, and twisted open the bottle of saline. She motioned for Tang Feiwan to stretch out her leg.
A plastic basin sat beneath her knee. Lin Ye leaned forward slightly and tilted the bottle, pouring saline over the gauze. The saline would soften the dressing so that when she lifted it later, it wouldn’t stick to the wound. After pouring out nearly half the bottle, Tang Feiwan frowned as she watched. Although Lin Ye was already moving as gently as possible, the pain still made Tang Feiwan suck in a sharp breath and cry out.
The wound was deep. Though not deep enough to need stitches, the on-duty doctor had still recommended flushing it with hydrogen peroxide first, then rinsing the hydrogen peroxide away with saline, and finally disinfecting with iodine. Tang Feiwan could hardly imagine how she had managed to endure the hydrogen peroxide flush without screaming the night before.
“Does it hurt? I’ll be gentler.” Lin Ye cleaned the wound with saline and said softly.
“Mm.” Hearing that long-missed gentle voice, Tang Feiwan felt a slight itch in her heart and allowed herself to voice the pain.
“Hiss, it hurts, Junior Director Lin.”
Lin Ye soothed her while softening her movements. By the time she disinfected with iodine, Lin Ye began to suspect Tang Feiwan was exaggerating on purpose. She asked, “Dr. Tang, why didn’t you cry out last night?”
Tang Feiwan made excuses, “There were too many colleagues coming and going outside the door last night. I was embarrassed.”
Lin Ye looked at the tears at the corners of her eyes and believed her. She lowered her head to tidy the remaining saline and gauze on the coffee table. Her voice was so low it was barely audible. “Someone helped rub the bruise medicine on your back, right?”
“Yes, I asked a bone-setting master at the traditional Chinese medicine clinic behind the back gate to help.” Tang Feiwan knew she couldn’t let Lin Ye do it for now. First, she feared Lin Ye would be unwilling, and forcing it would be bad. Second, she herself was embarrassed. The night before, just lifting her clothes to check the injury had made her blush and her heart race.
“Okay.” Lin Ye kept tidying with her hands, but her ears gradually flushed red, even more obvious than earlier outside the door.
Having learned her lesson, Tang Feiwan didn’t dare stare directly. But stealing glances, she caught this scene. Why was Lin Ye blushing? Could it mean she was willing?
While Tang Feiwan was still puzzling over it, Lin Ye stood up to take her leave. “Dr. Tang, rest well. I won’t disturb you.”
“Thank you for tonight.” Tang Feiwan saw her to the door.
“No need to thank me. Colleagues should care for one another.” Lin Ye deliberately emphasized the word “colleagues.” After she left, Tang Feiwan didn’t feel upset. Instead, because of that half hour together, she was even more certain that Lin Ye still cared.
She just needed more contact, so that Lin Ye would know she cared just as much…
The next day, Tang Feiwan returned to work at the hospital. The injuries on her back and knee still affected her work, so she could only handle manageable tasks in the office and wards. It wasn’t until the fifth day after her injury that she joined a resuscitation.
That day, she and Lin Ye worked the day shift. During rounds, she heard Lin Ye at the next bed ask Gu Yan, “Gu Yan, tell me, what are the types of abdominal pain?”
“Intermittent…”
“Not quite. Think again. It’s divided into pathological and physiological.” Lin Ye frowned, prompting her.
It suddenly dawned on Gu Yan. “Visceral pain.”
Tang Feiwan finished checking the neighboring bed, walked past her, and said casually, “Gu Yan, your theoretical knowledge is all mixed together. When someone asks you to pick it out on the spot, it always catches you off guard.” After speaking, she walked to another bed.
Lin Ye followed up. “What are the characteristics of visceral pain?”
“Pain localization is imprecise.”
Lin Ye looked through Gu Yan’s glasses, saw her uncertain eyes, nodded in approval, and asked, “And?”
“The pain sensation is unclear. It can be bloating pain or cramping pain.”
Watching Lin Ye and Gu Yan’s back-and-forth, it was clearly easier than Tang Feiwan directly having her establish multiple venous lines. But that night, Tang Feiwan had sent Gu Yan a WeChat message explaining: “Gu Yan, when I first started clinical work abroad, they made you get hands-on immediately. So you had to practice privately, over and over. Here in China, with equal degrees, if a woman is even from a slightly better university, hospitals still prefer male applicants. Since Director Lin gave you this chance to study in the emergency critical care rescue team, if you want to do clinical work, you must work hard. Read more medical records, observe other doctors more, think more, and get hands-on more.”
So Gu Yan intended to learn from both sides. First get struck down by Tang Feiwan, then go to Lin Ye for a bit of confidence building.
Just after they finished rounds and returned to the office, the nurse’s phone rang.
“Director Lin, a thirty-one-year-old female patient has just been brought in.”
“What’s the general situation?” Lin Ye was on second-line duty that day and signaled for Tang Feiwan to take the patient.
The nurse answered, “She had sudden difficulty breathing this morning. Blood pressure ninety over sixty, heart rate one twenty-four, respiration twenty-five, oxygen saturation ninety-five percent.”
“Let’s go now.” Tang Feiwan heard Lin Ye and quickened her pace.
In resuscitation bed three, the patient was already connected to a cardiac monitor. Tang Feiwan came over to examine her and saw that her lips were cyanotic, but she was still fairly alert. Her forehead was covered in fine sweat. When she inhaled, there were obvious depressions above her clavicle and sternum, a classic sign of oxygen deprivation.
“What’s her temperature?” Tang Feiwan pulled the stethoscope from her white coat pocket and slipped it into the patient’s clothing to listen.
The nurse replied, “38.5°C.”
“Crackles. Order a chest X-ray first.” Tang Feiwan withdrew the stethoscope and asked, “Who came in with the patient? Where is her family?”
The nurse said, “Outside. A young woman, about the same age as the patient.”
“Mm, I’ll go out and ask.” Questioning the patient’s family could reveal her medical history and help identify the cause of her breathing difficulty in time.
Tang Feiwan had just stepped out of the resuscitation room when a nurse called over the intercom, “Is Qian Xiaoli’s family here?”
“Yes, I’m here!” The young woman with a shoulder bag had already been standing outside the resuscitation room. She raised her hand and craned her neck anxiously to peer inside.
“Are you Qian Xiaoli’s family?” Tang Feiwan asked routinely.
The woman nodded. “Yes.”
“Does she have any previous medical conditions? Like heart disease?”
The woman faltered. “No… I don’t think so. She’s never mentioned any. She’s always been in good health.”
“When did her breathing trouble start?”
The woman recalled. “Last night. She started coughing the day before yesterday. We thought it was just a common cold, so we got medicine from a clinic. She took it for two days, then suddenly had trouble breathing last night.”
Tang Feiwan frowned. “Why didn’t you come last night?” In respiratory and circulatory issues, the smallest lapse could cause major problems.
The woman rattled on, “She’s a web novelist. She has to update at night. I told her to come to the hospital, but she insisted the novel was almost finished and said she’d write a little more and rest early. This morning she felt even worse, and she still hasn’t finished writing the novel.”
A web novelist. Tang Feiwan seized on that key information and asked, “Does she sit in front of the computer for hours without moving when she writes?”
“Yes, yes. Half a year ago, she developed a blood clot from writing. She was treated for two or three months.”
Venous thrombosis. This isn’t good, Tang Feiwan thought. The patient might have developed a pulmonary embolism from the venous thrombosis. Pulmonary embolism was an extremely dangerous disease. Two days ago, Dong Guo’s autopsy report came back. They had been right. It had been acute pulmonary embolism.
“Okay, thank you.” Tang Feiwan didn’t finish the rest of her questions. She turned and walked back into the resuscitation room. She had to rule out pulmonary embolism first. Given the patient’s current condition, it shouldn’t be too severe. If they could confirm the diagnosis and treat immediately, they might make it in time.
She pushed aside the curtain and instructed, “Quick, skip the chest X-ray for now. Order a pulmonary artery CTA.”
Outside the resuscitation room, the woman holding the requisition form was about to go pay. Tang Feiwan stopped her. “Hello, may I ask if you’re her roommate or a relative? If we confirm pulmonary embolism, it’s a critical condition. Her immediate family needs to know.”
The woman looked troubled. “I…”
Tang Feiwan asked directly, “What’s the difficulty?”
“Doctor, I…” The woman stammered, still hesitating.
“You can say whatever you need to say. It’s confidential.” Tang Feiwan sensed she had something hard to say.
The woman tested Tang Feiwan’s reaction. “We’re in that kind of relationship.”
“Don’t worry, I understand. Can you contact her family?” Tang Feiwan, worried about making her uncomfortable, brought the topic back to the key point.
“Xiaoli’s phone is with me. I can contact her mother, but her mother has cut off contact for more than four months.” The woman was Qian Xiaoli’s girlfriend, Zhang Wan, five years younger than Qian Xiaoli. She took the phone from her bag and entered the password.
Probably just like me. Her family doesn’t accept it. Tang Feiwan felt a pang of sympathy and sighed. “Okay, contact her as soon as you can.”
Zhang Wan hadn’t expected Qian Xiaoli’s mother to answer after only two rings. She froze, not knowing how to start. It was the mother on the other end who spoke first. “Xiaoli?”
“Auntie, this is Zhang Wan.” Qian Xiaoli’s mother knew of Zhang Wan.
The other end went silent.
Zhang Wan summoned her courage. “Auntie, she’s in the hospital. The doctor says you need to come in person.”
Qian Xiaoli’s mother sounded urgent. “The hospital? What’s wrong with Xiaoli?”
“We don’t know yet. The doctor is doing tests to rule things out.”
“Okay, which hospital? I’ll come right away.”
“Second Affiliated Hospital.” As soon as Zhang Wan finished, Qian Xiaoli’s mother hung up immediately.
So at the most critical moment, you learn that the person closest to you still cares.
Tang Feiwan returned to the office to work and waited for Qian Xiaoli’s results. Emergency test results came back quickly. About an hour later, a nurse received the report and called her. Outside the resuscitation room, Zhang Wan was also asking. She said Qian Xiaoli’s mother had arrived, so Tang Feiwan took the report and went directly over.
“Doctor, what’s the situation?” Qian Xiaoli’s mother looked anxious.
“First, some good news. We’ve ruled out the most dangerous possibility, pulmonary embolism.” Tang Feiwan pulled out the complete blood count. “White blood cells, neutrophils, and the other blood work are normal, so we can basically rule out pneumonia.”
Qian Xiaoli’s mother asked, “Then what’s the cause?”
“The ECG and troponin are both normal, so at this point we can also rule out a cardiac problem.” Tang Feiwan considered it. “So we’ll keep observing. We’ll keep her on medication and treat the symptoms first.”
“Okay, doctor. Do whatever tests you need to do.” Qian Xiaoli’s mother implored.
“Don’t worry. We’ll do everything we can.” Tang Feiwan was still studying the report in her hands when the door to the resuscitation room suddenly opened. Qian Xiaoli’s primary nurse rushed out. “Dr. Tang, her heart rate is one thirty-seven, oxygen saturation dropped to ninety percent, and then, and then…”
Tang Feiwan asked, “And then what?”
“I tried to give her some water, and she threw it all up.”
