Chapter 321 - Tracheotomy
Chapter 321: Tracheotomy
Huo Congjun was in the first class coach of the bullet train. He sat down with a smile on his face, as though a huge burden had been lifted off his shoulders. He then greeted Ling Ran with a grin and said, “I traveled to quite a few places this time, and I didn’t find it appropriate to ask the hospital to get me a business class seat. Just take a seat, we’ll arrive in a few hours anyway.”
Ling Ran placed all the luggage he brought back in the designated spot and sat next to Huo Congjun. Yu Yuan sat beside Ling Ran with a corridor separating them. She was also a lot more relaxed, and she looked like a little squirrel as she curled up in her seat. “I just hope that there won’t be some pervert sitting beside me,” she said with a smile.
“Shao Jian will be sitting beside you. Boss Shao,” Huo Congjun said.
“Huh? Boss Shao’s here, too? Why didn’t I see him?” Yu Yuan was extremely shocked.
Huo Congjun nodded. “He’s probably here to buy hairy crabs in bulk.”
“What? He’s not here for treatment?” Yu Yuan became even more shocked.
Huo Congjun said earnestly, “It’d be impossible for Boss Shao to seek treatment elsewhere because Yun Hua Hospital knows the condition of his body the best. If he seeks treatment from doctors elsewhere, they’ll only give him painkillers when he has a headache, and give him analgesic cream when his leg’s in pain [1]. It’d be useless.”
Yu Yuan was confused, but she hemmed in acknowledgment. ‘Isn’t it the same as our hospital?’
After a while, Boss Shao entered the coach with a grin on his face. After he greeted Huo Congjun, he was pleasantly surprised to see Ling Ran. He shook hands with Ling Ran and said, “Department Director Huo finally managed to drag you back from Shanghai.”
Ling Ran first sized Boss Shao up as if he was carrying out a visual inspection. Even though Boss Shao did not seem healthy, all the problems with his body were results of old illnesses. Ling Ran smiled and nodded without a word. It would be way too tiring for him to engage in small talk, as he had woken up at four in the morning to make ward rounds. The reason was for him to receive Sincere Gratitudes from patients in the Orthopedic and Sports Medicine Center for the last time. He really did not have much energy left to chitchat.
Boss Shao knew Ling Ran well too. He laughed out loud and said, “It’s good that you’re going back to Yun Hua. Don’t forget to come to my shop for some hairy crabs. Lately, I’ve been preparing to introduce an experiential way for our customers to enjoy their food, I reckon that many will find it pretty interesting.
“An experiential way for customers to enjoy their food?”
“The customers get to fish out the hairy crabs themselves, and the staff will re-tie the crabs’ claws on the spot,” Boss Shao answered very honestly.
Yu Yuan froze for a few seconds before she scornfully said, “Boss Shao, you’re way too stingy. In Hema [2], people get to fish king crabs. Yours are just hairy crabs, and you’re doing the same kind of promotion…”
“There’s no way I can be more generous than them.” Boss Shao gazed at Yu Yuan and earnestly said, “I have one kidney less compared with other people. How can I possibly be generous when I can’t even urinate as fast as others?”
The four-feet-nine Yu Yuan widened her eyes. “Boss Shao, why are you being so disgusting?!”
Boss Shao placed his hand on his chest in dejection. “I can’t believe that you, of all people, just called me disgusting… Oh no, oh no…”
Boss Shao knew the doctors in Yun Hua Hospital very well, and he was also privy to all their secrets.
Yu Yuan was also very open-minded when it came to Boss Shao. She raised her small fist and said, “If you continue to talk, I’ll beat you up until your fecal impaction drops out of your anus.”
“I don’t suffer from that… Forget about it. I’m scared that you’ll dig that kind of stuff out of my intestines… Forget about it, let’s change the topic.” Boss Shao looked a little frightened.
Huo Congjun heaved a silent sigh of relief. Even though he used to be a general surgeon when he was a military doctor, when he did not have his scrubs on, he did not really like to talk about such matters.
[Enemy arriving at battlefield in five seconds…]
Ling Ran whipped out his phone and started to play a game. The bullet train shook slightly and slowly began to move.
The biggest problem a person faced when playing games on a moving train was the lag. But that was not a big problem for Ling Ran because it did not affect the final score a lot. If someone were to write a research paper on it, the conclusion would be that the difference was “not significant”. It would prove that lagging did not affect Ling Ran at all.
Of course, if anyone were to write an excellent thesis on that topic, he or she would also have to look into why lagging did not affect Ling Ran’s gameplay whatsoever. It would become a complicated question that involved multiple factors. One may need to construct a mathematical model that was extremely difficult, involved plenty of parameters, and included immensely difficult equations. Even then, one may not get the correct answer.
Huo Congjun smiled slightly. He could feel the radiance of youth emanating from Ling Ran as he watched Ling Ran play the game. Only a young person would have the drive to win, to achieve victory, and to be in the spotlight. At his age, he was pretty indifferent to things. He just hoped that he got to live longer in his old age, that his job went smoothly, that his family lived harmoniously with each other, that his patients stayed alive, and that his subordinates behaved in a mature manner…
“Doctor Yu.” As if he just remembered something, Huo Congjun looked at Yu Yuan with furrowed eyebrows. She was tearing open a packet of junk food in an effort to increase her height, and he said, “Don’t you still need to help Doctor Ling with his research paper? Hurry up and stop delaying…”
“Oh, I-I’ll get to it now.” Yu Yuan obediently put down the packet of junk food and took out her laptop from her backpack.
The bullet train shot forward at a consistent speed and the scenery outside the window kept changing…
Everything was normal.
Then, the announcer’s voice rang from the bullet train’s speakers again. “Dear passengers, there is a patient on our train who is currently in critical condition, and we urgently need the help of medical personnel… The patient is in coach number seven right now…”
Boss Shao, whose entire body had tensed up, heaved a sudden sigh of relief.
Ling Ran, Yu Yuan, and Huo Congjun raised their heads swiftly.
Huo Congjun was so excited that his heart beat rapidly. He shot up from his seat!
“This is extremely rare,” Huo Congjun said. He was in high spirits. “Let’s go and take a look. Our specialization’s just right for a situation like this.”
As Huo Congjun spoke, he dragged Ling Ran and Yu Yuan along and started to walk. He continued, “You know, saving a patient in the hospital is nothing. It’s more of an achievement to save a life outside the hospital. You guys are considered lucky. After I was transferred to Yun Hua, I only met someone who needed medical help outside after four or five years. Moreover, the patient was only suffering from diarrhea.”
“Did you manage to salvage… I mean, save the person?” Yu Yuan asked out of curiosity.
“Why would anyone die from diarrhea and syncope…”
*Slide.*
The automatic door of the business class coach behind them slid open. A person walked out of the coach with steady steps.
It was obvious from the person’s eyes that he was tired. He was dressed in a pair of sweatpants as well as a stiff-collared shirt, and he held a coat in one hand. He skillfully put it on with no intention to zip or button it up. At the same time, he tapped his chest with his right hand and lowered his head to glance at his sweatpants in dismay. He then raised his head in a relieved manner…
Huo Congjun locked eyes with him and furrowed his eyebrows. “He’s a doctor too.”
“An internist.” Behind them, Boss Shao added.
Huo Congjun nodded. “He’s not a major threat.”
The three of them continued to walk forward.
Two more people who were sitting in the middle of the coach rose.
One of them was older than the other. The older one was around Huo Congjun’s age, while the younger one was around Yu Yuan’s age. Even though both of them also looked tired, they were excited to finally be able to realize their life values with their own hands (just kidding, they really just wanted to showcase their skills).
Huo Congjun glanced at their hands and confirmed. “They’re surgeons.”
Yu Yuan hummed loudly in acknowledgment.
Ling Ran continued to walk slowly behind them. He lowered his head and kept playing the game on his phone to prevent his account from being banned.
“Excuse me.” A middle-aged man, who had been sitting beside the window and was holding a worn briefcase in his hand, joined the crowd.
Huo Congjun immediately became extremely panicked.
“This won’t do. We need to hurry up. This bullet train departed from Shanghai, and there are many doctors out for meetings and freelance surgeries.” Huo Congjun felt emotional when he thought about how all those doctors were his rivals right then. He swung his hands and sped up, forgoing the leisurely image that he was trying to portray at that moment.
Another doctor rose from a seat in the second class coach in front of them.
He glanced at Huo Conjun and flashed a lopsided smile. He then turned and began to run…
He began to run! He ran at lightning speed!
There was a passenger with a standing-room-only ticket in front of him.
He leaped over the passenger in the corridor as if he was crossing a hurdle. After he did that, he even had the nerve to turn and glance behind him.
“I swear, these doctors from local hospitals… are probably forensic doctors who’ve graduated from a sports school,” Huo Congjun muttered. He had no choice but to start jogging.
The train’s announcer continued to call out for doctors. “Dear passengers with a medical background, there is a traveler who is in critical condition in coach number seven right now. He needs emergency medical intervention…”
The passengers with no medical background gazed at the seventeen or eighteen doctors who walked passed them with admiration, zeal, encouragement, and praise.
Some of the doctors who had their large white coats with them could not suppress the excitement within them anymore, and they had already put their coats on.
If anyone were to measure a doctor’s sense of achievement when they saved a patient in the hospital from a scale of negative ten to ten, when a doctor got to save a person’s life on a train while surrounded by a crowd, it would give them such a great sense of achievement that they would have the will and strength to endure at least two scoldings in the hospital. Incidents such as saving a person’s life on a train usually happened during a span of around twelve years of their career.
When Huo Congjun, Ling Ran and Yu Yuan arrived at Coach 7, there were already five or six doctors around the patient.
Due to their arrival, the second half of the coach, which had been cleared up, was starting to seem a little crowded.
“Should I ask the passengers to leave the coach first?” the train conductor asked probingly.
“There’s no need.”
“It’s not a problem.”
“It’s all right.”
The doctors refused in unison.
‘Are you kidding me? If all the passengers leave, there’ll only be a bunch of doctors left here. Then, the situation won’t be no different from didactic ward rounds and guided surgeries.’
“Why don’t we do this? Let’s have the clinicians here examine the patient first. I’ll introduce myself. I am Chief Physician Qu Shengzi from the Nephrology Department of Ruijin Hospital.”
“I am Chief Physician Lao Guateng from the Neurology Department of Huashan Hospital.”
“I’ve met you before.”
“Yeah, during the conference in San Francisco last time. We even consulted a patient together.”
“What a pleasure to meet you again.”
After the two chief physicians from top hospitals introduced themselves, another doctor introduced himself in a slightly regretful tone, “I’m Associate Chief Physician Chang Aida from the Neonatology Department in the Children’s Hospital of Zhejiang University School of Medicine.”
“I’m Associate Chief Physician Ge Ganzi from the Department of Hepatobiliary Surgery of Nanjing Drum Tower Hospital.”
“I’m Associate Chief Physician Duan Laochao from the Department of Gynecology of West China Hospital.”
Huo Congjun did not want to wait anymore. Even if those associate chief physicians were from top hospitals, they were merely associate chief physicians.
Huo Congjun coughed loudly. “I am the department director of Yun Hua Hospital’s Emergency Department, Huo Congjun.”
He had some regrets too. He wished that this had happened a few months later, as the emergency medical center could have been established by then. He would then sound a lot cooler.
The doctors present felt threatened too. Huo Congjun was from the Emergency Department, and that field of expertise was just what the patient needed right then.
As for the junior doctors present, they saw no point in introducing themselves and wasting everyone’s time.
Huo Congjun extended his hands to separate the crowd. He then went towards the patient and stood in front of him.
The doctors who came earlier had already performed a preliminary examination on the patient. They spoke to Huo Congjun in a hushed tone, “Tachycardia, with a heart rate of nine-six beats per minute. There are no signs of cerebral infarction, and his breaths are shallow…”
“It could be laryngeal obstruction caused by tumors or injury. Are any of the patient’s family members around?” asked the chief physician from the neurology department, Lao Guateng.
“He was never injured. About tumors… I don’t know…” The patient’s family member was a middle-aged woman who was about forty years old. She gazed diffidently in the patient’s direction and looked kind of lost.
“No matter what the reason is, we have to perform tracheotomy first to solve his breathing difficulties.” Huo Congjun was used to emergency situations, and his approach was completely different compared to that of doctors in other specializations. He only needed to hear a few sentences to come to a decision.
There were a few seconds of silence in the coach, until someone broke the silence and said, “I agree.”
“That will do.”
“Does anyone have a scalpel?” Associate Chief Physician Chang Aida from the Neonatology Department, who was at the prime of his life, had arrived early on the scene and was standing in a strategic position. He squatted down as he spoke and started to touch the patient’s neck.
The train conductor quickly said, “I’ve already asked someone to get a first aid kit and a scalpel.”
“We need alcohol too, and it’d be great if there’s a soft and thin tube,” Chang Aida said before he explained to the patient’s family member, “The patient’s having difficulty inhaling air right now. We’ll be making a cut on his throat and exposing his trachea. This is a very minor surgery with very low risk. The main problem right now is that we don’t really have all the equipment we need…”
As he spoke, one of the staff brought a small scalpel and a first aid kit over.
Even though it was a first aid kit, it appeared more like a debridement pack, a box of equipment used for physical examination, or a medicine chest. There were instruments such as a blood pressure gauge and a stethoscope. There were also some medication used to cure symptoms such as headache and fever, along with a syringe. Additionally, there were bandages, cotton balls and a bottle of antiseptic solution. But none of the equipment needed for tracheotomy was present.
“Can I have a pen? I’ll make a temporary tube with the tube of the pen…”
Before Chang Aida finished his sentence, a few people handed him a pen.
The patient’s family member was extremely anxious as she watched the scene.
“Can we wait until he gets to the hospital?” the patient’s wife asked in a soft voice.
“It’d be too late. The patient could stop breathing at any time.” Chang Aida shook his head as he spoke. He chose the pen with the thickest tube and prepared to disinfect it.
“Why don’t you let me do it?” When Ling Ran saw that, he felt like it was his responsibility to take over. He squeezed through the crowd with his bag in one hand, and Yu Yuan in the other.
Before the others could respond, Ling Ran kneeled down on one knee, took out his box, and opened it.
Inside his silvery-white aluminum box, various instruments were arranged neatly from left to right. There were a pair of straight mosquito forceps, a pair of curved mosquito forceps, a pair of 5.5-inch unhooked hemostatic forceps, a pair of 5.5-inch hooked hemostatic forceps, a pair of 6.3-inch unhooked hemostatic forceps, a fine needle holder, a pair of small dressing forceps, a pair of large dressing forceps, a pair of tissue forceps, a pair of towel forceps, a pair of tissue scissors, a pair of tracheal expansion forceps, a goiter retractor and a tracheal retractor. What the patient needed most right then were also present; a size seven tracheal cannula, size eight tracheal cannula, size nine tracheal cannula, and size ten tracheal cannula…
It could be said that apart from the fact that there were no scalpels in the blade holders, Ling Ran had all the equipment needed.
Huo Congjun could not help but flash a proud smile.
Ling Ran then opened the second drawer of his box and took out two mouth face masks. He passed one to Yu Yuan before he put on the other one. He then took out two pairs of gloves…
“Please make some space for us.” Ling Ran turned and ordered, “Clean the area where the cannula will be inserted.”
The moment Yu Yuan heard Ling Ran’s words, as though out of reflex, she started to clean the patient’s neck.
She was extremely used to carrying out surgeries with Ling Ran.
Take the idea of people who have never eaten pork before, but may have possibly seen pigs run in their lives. The idea is that those who have never experienced something may have heard of the matter before. Now, take, for example, a butcher who has moved from village to village to slaughter pigs. He can kill more than one hundred pigs in one year. Apply both reasonings to Yu Yuan. Even though Yu Yuan only followed Ling Ran around as his assistant, based on the number of surgeries she assisted him with, she had gathered around seven or eight years of experience as a chief surgeon.
“Drape.” Ling Ran adhered completely to the usual surgical process.
When all the other doctors saw that Ling Ran even had a fenestrated drape sheet, they could not help but inch backward to make more room for Ling Ran and Yu Yuan.
“Keep it in the center.
“Scalpel.
“Hemostatic forceps.
“Perform traction with a small retractor.”
As all the doctors and most importantly, countless other passengers who held up their cell phones, watched him, Ling Ran quietly performed Perfect Level Tracheotomy. The other doctors could barely hold back their excitement.