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 displeasure 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.
