Chapter 5

The human body’s blood vessels form a single circulatory system. When lower limb arteries repeatedly have problems, many blood vessels are in bad shape. Professor Zhong’s condition was myocardial necrosis caused by acute coronary hypoxia. When his blood pressure dropped, the ward physician promptly administered vasopressors and obtained an ECG showing clear ST elevation. Before they could decide the next step, the patient went into ventricular fibrillation.

By the time Lin Ye and Tang Feiwan arrived at the EICU, the ward physician was already performing CPR, with the defibrillator wheeled to the bedside.

“Let me take over.” Lin Ye, her expression grave, began compressions on Professor Zhong without wasting a second. “Prepare to defibrillate.”

Tang Feiwan took the defibrillator paddles from the nurse and coordinated with Lin Ye. “200 joules.”

“200 joules confirmed.”

Tang Feiwan said, “Charged. Clear.”

Lin Ye stepped back half a step, and Tang Feiwan defibrillated Professor Zhong.

The patient didn’t respond. Lin Ye resumed compressions, saying, “Epinephrine, 1 mg, IV push.”

The nurse administered it: “Epinephrine, 1 mg, IV push complete.”

Tang Feiwan held her breath. “Continue. 200 joules.”

“200 joules confirmed.”

Tang Feiwan didn’t waste a second. “Charged. Clear.”

The medical staff at the bedside backed away, and Tang Feiwan defibrillated again. Professor Zhong still didn’t regain a spontaneous rhythm. Lin Ye continued compressions, and the nurse administered more medication as ordered. Chest compressions were physically demanding, and Lin Ye had been at it for several minutes. Tang Feiwan saw the fine sweat covering her forehead and said urgently, “Let me take over.”

Since the patient’s life was on the line, Lin Ye didn’t try to tough it out. She stepped back, and Tang Feiwan stepped in.

Time ticked by, minute by minute. Seven minutes later, the ward physician took over. Another five minutes later, Lin Ye took over again. The night-shift doctors from critical care Groups 1 and 3 gathered around. Someone asked, “Need help?”

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

In clinical practice, the golden window for CPR is within four minutes of cardiac arrest. Beyond four minutes, irreversible brain damage may occur, let alone when the heart had been stopped for 22 minutes.

Lin Ye ignored it, gritting her teeth and pressing on.

“26 minutes, Director Lin.”

Tang Feiwan, standing beside the ward physician, remembered the old professor’s request during his brief moment of consciousness. She raised her voice, calling her name directly: “Lin Ye!”

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

“Go outside and call the family in,” Lin Ye said without pause, pulling a pupil flashlight from her white coat pocket and lifting the old professor’s eyelids to check.

Tang Feiwan asked nervously, “How is it?”

“Dilated.”

As expected.

Tang Feiwan watched the flush on Lin Ye’s face drain to white from exhaustion. She wanted to ask why, when it had been 25 minutes and resuscitation was already futile, she had persisted. But as she opened her mouth, Lin Ye had already pulled back the curtain and left, heading toward the door where Professor Zheng, lips pressed tight, waited for the news she would bring.

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

Professor Zheng’s already red-rimmed eyes shimmered with tears again. “You’re saying… he can’t be saved?”

Lin Ye nodded softly. “And his heart could stop again at any moment.”

“I understand. Thank you.” Professor Zheng clasped her hands in thanks.

“Go see Teacher Zhong.” Lin Ye tilted her head slightly, her sharply defined jawline lifting a touch as she suppressed her emotions.

Doctors, especially emergency doctors, fight disease and race against time at the gates of hell almost daily. They usually do their best but still can’t resist death. They can only quietly adjust their mindset.

Not far away, Professor Zheng shuffled over, finally sitting beside Zhong Yuanzhao. She took his right hand and held it gently, murmuring, “Yuanzhao, I was just selfishly hoping you’d stay with me a few more days. I’ve made you suffer.” Her trembling hand stroked his graying hair as she sniffled. “We won’t treat it anymore. If you need to go, go in peace.”

Only the ward nurse remained at the bedside. Everyone else stood outside the curtain, not disturbing the two elders who had been married for over fifty years as they said goodbye.

In just two minutes, the curve on the bedside monitor changed, finally flattening into a straight line. Professor Zhong’s life had reached its end.

Tang Feiwan found Lin Ye by the window in the break room. The woman wore her white coat, hands in her pockets, looking out. Just like before, whenever she had something on her mind, she would go to an open space alone and gaze at the night sky. Tang Feiwan didn’t know what exactly she was feeling, only that she could vaguely sense a deep loss and helplessness. But she didn’t dare approach, nor did she know what identity to use to comfort her. Colleague?

While she was still wrestling internally, Lin Ye turned and walked over, passing her as if she were air.

Had she even frowned slightly?

“Am I really that annoying?” Tang Feiwan huffed and muttered. The next second, Lin Ye, three meters away, turned back and called, “Let’s go. Group 1 needs help.”

Tang Feiwan followed. “What?”

Lin Ye explained as she walked: “They admitted a new patient with a Type A aortic dissection. He needs surgery as soon as possible.”

“What does that have to do with us? Has cardiac surgery been notified?”

Lin Ye kept it brief. “Director Wang from cardiac surgery will be the primary surgeon. But both attending physicians in their department on duty tonight are already in other emergency surgeries. A Type A aortic dissection is a major operation, and Director Wang doesn’t trust a resident as the first assistant.”

“What do you mean?” Tang Feiwan had an idea of what she was planning.

“Director Fang from cardiac surgery recommended you as the first assistant.” Lin Ye also believed she was capable.

So someone else had recommended her. Tang Feiwan pouted, but the next moment her eyes turned focused. “Heading to the OR now?”

Lin Ye quickened her pace. “Yes. No time to lose. Director Wang says he’ll discuss the details with you in the OR.”

“Which OR? Take me there.”

Their hurried figures disappeared at the end of the corridor.

At 10:25 p.m., the OR doors closed. Type A aortic dissection surgery required an open chest, cardiac arrest, and was complex with a long operative time. Director Wang of cardiac surgery had over 20 years of experience. He first explained the patient’s condition to Tang Feiwan in detail, the surgical difficulties, how he would handle them, and how she should cooperate.

“The patient’s CT shows a tear in the ascending aorta. After the intima of the ascending aorta tore, blood entered the false lumen of the dissection, but it hasn’t extended distally, mostly confined to the ascending aorta and aortic arch.”

Tang Feiwan replied, “Twenty days ago, I participated in a similar surgery. The blood would keep accumulating in the dissection, and the adventitia would be under great tension. It’s a bit tricky.”

“I’ve heard from Old Fang. You were Dr. Bollner’s last student and could perform minor surgeries independently at 28.” Director Wang smiled. “Tonight, let’s work well together.”

Tang Feiwan nodded. “Let’s work well together.”

At 10:57 p.m., the surgery officially began.

Open chest, cardiopulmonary bypass, cardiac arrest. The procedure went smoothly.

The Shujiang University Medical School Affiliated Hospital was a teaching hospital, so each OR had a separate observation room where medical students could learn. Lin Ye, with no other tasks, stood in the observation room, arms crossed, watching through the glass.

Her gaze unconsciously followed Tang Feiwan’s movements.

Lu Yuqing appeared behind her out of nowhere. “What are you looking at?”

Cough. Lin Ye cleared her throat to cover her embarrassment. “An emergency patient with a Type A aortic dissection. Cardiac surgery was short-staffed, so they asked her to fill in.”

Lu Yuqing said, “Wait, what does her surgery have to do with you?”

Lin Ye’s cheeks flushed, though she didn’t notice. She explained, “I’m her superior. I need to understand her work.”

“Oh, then continue your understanding. I’m going back to sleep. Hope I don’t have to get up in the middle of the night.” Lu Yuqing waved and left the observation room. Lin Ye glanced back at the OR, then followed her out.

The surgery continued. Dozens of minutes later, during the critical cardiac resuscitation phase, a problem suddenly arose. Director Wang looked up. “The heart isn’t restarting well. How did you anesthetize him? How much dopamine? How much epinephrine?”

“Mm… mm…” The anesthesiologist checked the records.

Director Wang’s temper flared. “Go get Doctor Lu.”

The anesthesiologist said, “She’s in the next OR. Not sure if she’s finished.”

Director Wang signaled a nurse to check. If she wasn’t there, they’d call.

Five minutes later, Lu Yuqing was summoned by a frantic phone call. She first assessed the situation, then immediately made a judgment and took over. Before long, the patient’s heart successfully restarted.

Director Wang observed the patient’s heart and smiled. “It has to be you, Xiao Lu.”

“They’re all the same. Chen Gang”—the anesthesiologist from before—”might not have done many aortic dissection surgeries, but he’s been great in other procedures. He might have been a bit nervous tonight.” Lu Yuqing closely monitored the patient’s vitals as she answered.

All the numbers were normal, so she sat down and leisurely watched the two operate.

During the final closure phase, Director Wang confidently handed it to Tang Feiwan. He stretched, pressed his back, and waved. “Getting old. Five hours and I can’t take it anymore. Xiao Tang, come to our cardiac surgery department sometime. Old Fang was talking about you all day.”

Tang Feiwan focused on suturing. “Sure, Director Wang. Go home and rest early.” Chief physicians and senior associate directors didn’t need to stay overnight at the hospital. Director Wang had been called in from home late at night, so he naturally wanted to go home after finishing.

Director Wang gave an affirmative and opened the OR door.

At 4:23 a.m., the surgery had lasted exactly five and a half hours. Tang Feiwan set down the instruments after the last stitch. She waited for the circulating nurse to count the instruments, needles, and gauze before leaving. Lu Yuqing, as the anesthesiologist, had to escort the patient back to the ward and wait until he was awake before her job was done. She stood up to inspect the patient’s wound and couldn’t help exclaiming, “Nice suturing. Better than old Wang.” She muttered to herself, No wonder after all these years, that Lin Ye has stayed single. Does she still have feelings for her? Mm, she is quite attractive when she’s working.

Back in the office, Tang Feiwan poured half a cup of water and gulped it down, finally quenching her thirst. She bent down and took out a mango and a dragon fruit from her backpack. Looking up, she saw Lin Ye and another resident busy at the computer and asked, “Want some fruit?”

Lin Ye turned around, but before she could answer, the chief resident sitting next to Tang Feiwan said in despair, “Doctor Tang, you brought mangoes and dragon fruit to a night shift? And you want to eat them!”

Tang Feiwan was confused. “What? They’re full of vitamins. Gotta treat yourself.”

“We’re doomed. No wonder we’ve been busy all night.” As he finished, a nurse from the triage desk burst in. “Doctor Tang, incoming patient. Suspected GI bleed from alcohol overdose. He’s vomiting blood.”

“Okay, coming.” Tang Feiwan and the chief resident followed the nurse out quickly. Lin Ye turned back to her work without going. Deputy directors on 24-hour duty didn’t handle incoming patients; attendings and residents did. They only got called when problems couldn’t be solved.

They admitted two patients in succession and worked for another hour. It was past 5:30 a.m. Tang Feiwan removed her gloves. She had just taken two steps when she heard the chief resident scolding, “One bite of a bun and your treatment is wasted. Understand?”

The patient who had vomited blood from drinking felt better and was demanding food. “Ten bottles of nutrient solution can’t compare to one bite of a bun.”

The chief resident explained, “No. You have a GI bleed. You must fast, or you’ll bleed again.”

The patient bargained. “Just half a bowl of porridge?”

Tang Feiwan couldn’t stand it and suddenly said, “Half a bowl of porridge, and you’ll never drink alcohol again for the rest of your life.”

“What?” Upon hearing he couldn’t drink, the patient immediately obeyed. “Then I won’t eat.”

Sometimes, doctors need to know what patients care about most and prescribe accordingly.