CHAPTER 204: RACE AGAINST TIME

Despite having performed only one surgery today, Liu Banxia was thoroughly exhausted. It was only after eating a meal and getting some fruit from Qiu Huaili that he felt truly replenished.

It seems I still have to get used to long surgeries. For major ones, five or six hours, even seven or eight, are all very normal.

When evening arrived, Wang Chao rushed over for his shift and immediately gave Liu Banxia a warm hug.

"Easy there, stay calm," Liu Banxia said, feigning seriousness.

"How could anyone stay calm? President Liu, you’re my guiding star from now on!" Wang Chao said with a wide smile.

"That’s nonsense," Liu Banxia chuckled. "There’s fruit under the triage counter; help yourself if you want some."

"President Liu, who are you partnered with on shift today?" Wang Chao asked casually.

"For surgery, it’s Doctor Wei Yuan, and for internal medicine, it’s Dr. Wang Huan. Dr. Wei isn’t here yet; Dr. Wang is currently with a patient," Liu Banxia replied.

"Sounds good. I’ll grab a mango first," Wang Chao said, nodding.

Liu Banxia shook his head with a helpless smile, unsure if Wang Chao meant the fruit was good or the shift partners were.

Just then, Liu Banxia saw Zhou Li walk in. "Oh, Sister Li, are you on the night shift again today? Have your night shifts been more frequent lately?"

"It can’t be helped," Zhou Li said with a sigh. "This is the final transition period for the Emergency Department. Sister Wang is worried about things going wrong at night, so I’ve been assigned more night shifts recently."

"Still, it’s not too bad. At least I have some time during the day to go check on the house. And let me tell you, Liu Haibing’s crew is doing such a thorough job; I don’t have to worry about a thing."

At the mention of her house, Zhou Li’s face lit up. Her thoughts were mostly consumed by her new home these days, even though the loan paperwork wasn’t finalized yet. That didn’t dampen her spirits.

"Sister Li, when you have a moment, you should try to find a wife for our senior, Shi Lei," Liu Banxia said.

"Actually, I’ve wanted to ask several times: with his qualifications, why is he still single? Is it purely out of dedication to his medical career? He can’t go on like this."

"What choice did he have? His family was quite poor in the past," Zhou Li explained. "He’s the only one who managed to leave and make something of himself. He still has a younger brother back home whom he helps support."

"But it’s true, we really should try to set him up. There were girls interested in him before. It’s just that back then, he was too apprehensive, afraid of burdening them, so it never worked out."

"Dr. Shi is really one of a kind. No matter who asks him a question, he always explains it patiently," Wang Chao chimed in, joining them.

"Let’s just hope he passes the associate chief physician exam next year. His salary would go up a bit, and things would be a little easier for him," Liu Banxia said.

Getting married and starting a family is tough enough for me; Shi Lei has it even harder. At least I don’t have to support my family—in fact, I used to rely on them. Shi Lei is different. He’s only just managed to sort out his family’s affairs and save a little money for himself. Students from other universities start working right after graduation, but what about medical students? We work too, sure, but our training takes so much longer. How much can you earn right after graduating? Especially now with the standardized residency training. It’s a bit better for master’s degree holders with the ’four certificates in one,’ but undergraduates have to go through another three years of hardship. These days, even getting into the primary healthcare system is incredibly difficult. Even if you look down on grassroots positions, there aren’t that many openings. Besides, current policies are leaning towards strengthening primary care, and doctors at that level have a very broad scope of practice.

Everyone has their own cross to bear. We don’t have the right to meddle in Shi Lei’s family affairs. The only way we can really help is by trying to find him a partner.

After a bit more idle chat, Wei Yuan walked in, slinging his bag. "Well, look at our President Liu, really making a name for himself these days!"

"Dr. Wei, please don’t tease me like that," Liu Banxia said with a wry smile.

"For this half of the day, the general surgeons in the Emergency Department are confirmed. Staff from other departments will trickle in more slowly, as there aren’t as many emergency patients for them."

"Don’t worry, I’m completely at your disposal for scheduling," Wei Yuan replied with a nod and a smile.

"Me too! Me too! I’m also a staunch supporter of President Liu!" Wang Chao chimed in eagerly from the side.

"I’m just not sure how many residents there will be," Liu Banxia said. "Anyway, we’ll stick to our previous plan. Brother Wei, you’ll have to take on a bit more responsibility for now."

"But this is all temporary. Once those of us who’ve just finished our residency training get the hang of things, you seniors won’t have to carry such a heavy load."

"The initial phase will definitely be hectic, but don’t worry," Wei Yuan said. "Whether it’s me or Shi Lei, we’ll fully support your work and the Director’s."

He understood the challenges of Liu Banxia’s position. It seemed like Liu Banxia had authority over everything, but in a place as rigidly hierarchical as a hospital, managing too much would inevitably lead to conflicts sooner or later. Being Zhou Shuwen’s disciple didn’t grant immunity; who didn’t have some connections in this place? The old Emergency Department wasn’t a desirable assignment. Now, those who transferred in were either among the initial applicants or had backing—teacher-student ties, family connections, all sorts. If you weren’t careful about navigating these relationships, any one of them could trip you up.

Just then, Zhou Li hurried over. "We’re getting a fall victim soon, abdominal puncture wound!"

"Okay, Wang Chao and I will handle the admission," Liu Banxia decided. "Dr. Wei, you can supervise. If surgery’s needed, you take Wang Chao in. I’ll take it easy for this one."

"Thanks, appreciate it," Wei Yuan said, patting Liu Banxia’s shoulder.

This was one of the reasons Wei Yuan thought highly of Liu Banxia. Not only was Liu Banxia good-natured, but he also wasn’t one to hog all the surgical cases.

Surgery was exhausting, but for a surgeon, not operating regularly wasn’t an option. It would make your skills rusty and your body sluggish, not to mention affect your income. Doctors were human too; they couldn’t survive on air alone. Without many external opportunities for extra income, they relied on their hospital salaries. A few more surgeries each month, even if it meant more fatigue, were worth it. Perhaps such thoughts didn’t quite align with the image of an angel in white, but this was the reality of living in the real world.

It had been different when Qin Hai was around. He often snatched cases to train Qi Wentao. For regular doctors like Wei Yuan and the others, all they could do was harbor resentment in silence. Then came Liu Banxia, this greenhorn, who finally broke the silence with an explosive display, like a dazzling firework.

In less than ten minutes, the ambulance pulled up.

As the patient was wheeled in on a gurney, even seasoned surgeons like Liu Banxia and his team were momentarily stunned. A sizeable tree branch was impaled through the patient’s abdomen, the other end protruding from the right side of his waist.

"BP 70/90, heart rate 110, unconscious. Air-conditioning installer, fell from the twelfth floor onto a tree in the small garden below," the paramedic reported breathlessly.

"Trauma Room One!" Liu Banxia directed. "Did his blood pressure stabilize after fluids?"

"It did. No hematemesis or hemoptysis observed," the paramedic confirmed.

"One, two, three—lift!"

Once they were in Trauma Room One, Liu Banxia began issuing orders: "Sister Li, connect the monitor, run a rapid blood panel, and prepare four units of O-negative blood! Dr. Wei, secure his airway. Wang Chao, establish IV access. Get the ultrasound machine over here and book an OR!"

He hadn’t anticipated the injuries being this severe. From the looks of it, there was already significant internal organ damage.

"Brother Wei, can we handle this?" Liu Banxia asked, performing an ultrasound scan of the patient’s chest.

"It’s hard to say," Wei Yuan replied with a grimace, having just finished intubating the patient.

He’d been at Second Hospital long enough, but he’d never encountered an injury like this. For it to be so severe, yet the patient’s blood pressure hadn’t plummeted too drastically, meant that even if there was a chance of saving him, the road ahead would be incredibly difficult.

"Chest cavity looks clear," Liu Banxia announced after a quick abdominal scan. "But there’s a significant amount of free fluid in the abdomen. We can’t do any more diagnostics here; we need to get him to the OR for an exploratory laparotomy."

"Page General Surgery for backup," Wei Yuan advised. "Two surgeons might not be enough for this."

Liu Banxia nodded grimly. The patient’s injuries were truly devastating. The branches had paradoxically saved his life for the moment, preventing him from dying instantly on impact. But if they weren’t handled correctly, those same branches could easily kill him.

"Oh, Director Zhou, you’re still here?" Liu Banxia exclaimed, startled to see Zhou Shuwen waiting as they arrived at the operating room. No wonder this is a teaching OR.

"The surgery in the other room isn’t finished yet; others are handling it. What’s the specific situation with this patient?" Zhou Shuwen asked.

"High-altitude fall, impaled by a branch through the abdomen to the right lumbar region," Liu Banxia quickly reported. "I suspect multiple organ injuries, especially to the spleen and right kidney. What worries me most right now is that the branches inside the abdomen might be acting as a tamponade due to some kind of recoil or pressure, staunching bleeding from certain vessels. Once we open him up and that pressure is released, our immediate problem will be massive hemorrhage."

Zhou Shuwen nodded. "We have only a few minutes to discuss the surgical approach. The patient’s condition won’t allow for more."

"My suggestion is to first cut the section of the branch protruding from the patient’s right flank. This will allow him to lie supine, which will make the intraoperative access easier. However, this is also risky as it might further disturb the impaled organs."

"For now, prepare plenty of hemostatic clamps. Don’t overthink it. If we encounter massive bleeding upon opening the abdomen, we’ll use every means necessary to achieve rapid hemostasis. What are your thoughts?"

"Director, let’s go with your plan," Wei Yuan agreed. "If we try to position him laterally, some organs might shift, making hemostasis even more challenging."

"Good," Zhou Shuwen said decisively. "I’ll give you all one minute to compose yourselves. Although the chances of saving this patient are slim, as long as he’s been brought to us, we must give it our absolute best effort."

From that moment on, it was a race against time. Once the abdomen was opened, every second would be critical.

Liu Banxia took several unusually deep breaths. I still have 16 attribute points. If things get desperate and there’s even a sliver of hope for the patient, I’ll put 5 points into Agility.