The Enhanced Doctor

"250 ml of 5% sodium bicarbonate," Shi Lei said after glancing at Liu Banxia.

"Boss, what do we do next? Can we still get him to the operating room?" Liu Banxia asked with a furrowed brow.

"Highly unlikely. Clean the abdominal cavity as best as we can to locate all bleeders, then pack with gauze. Let's transfer him to the ICU first," Shi Lei said, shaking his head. "The patient's intestinal wound is too large, and there are too many bleeders in the abdominal cavity. I suspect sepsis. The blood culture hasn't come back yet, and he has acidosis."

"If we can't reverse the acidosis, even if we get him to the operating table, his chances of making it off are slim. Now that his body temperature has dropped so much, our only option is to transfer him to the ICU."

"Ah... even half an hour would have allowed us to deal with most of the situation," Liu Banxia sighed.

He had already considered what Shi Lei said. That was why he had asked Shi Lei—to see if his experience could offer a feasible solution.

As they spoke, their hands didn't stop moving. At the very least, the torn intestine needed to be addressed first. Otherwise, even if he were sent to the ICU, this tear would cause problems later.

What they could do now was merely repair, not definitive treatment. The patient would undoubtedly require a second surgery, but whether he would even get that chance was uncertain.

"His body temperature has dropped to 34.8°C, and there are signs of mild edema in the internal organs. Pack gauze in it now; we're not closing his abdomen," Shi Lei said after completing the vascular repair.

"Not closing the abdomen?" Liu Banxia was stunned.

"The patient's vital signs are extremely poor; time is not on our side," Shi Lei nodded. "Temporarily wrap it with cling film. This way, we can deal with any situations that arise promptly. Cutting open cling film is certainly quicker than removing stitches. If he's lucky, he might start to show improvement in a few hours, and we can take him to surgery then."

"Alright," Liu Banxia nodded emphatically.

He truly hadn't expected the usually conservative Shi Lei to suggest such a radical method. But, undeniably, it was the most appropriate approach for this particular patient.

The purpose of packing with gauze was also to stabilize the internal organs and prevent any missed bleeding points from being overlooked.

The rest of the emergency room team were genuinely a bit frightened. Seeing them actually start to wrap the patient's abdomen with cling film felt incredibly strange.

"Doctor, Doctor, is my husband dead?" His wife couldn't bear it any longer when she saw the patient being wheeled out.

"The patient's condition is currently looking rather grim and he cannot withstand surgery. We can only transfer him to the ICU to stabilize his vital signs before carrying out further emergency treatment," Liu Banxia said.

"But you can't do that! How can you just wrap it with plastic film, not even stitching it closed!" The patient's wife, clutching Liu Banxia's arm, was extremely agitated.

"This can reduce further injury to the patient, buying us more time for the surgery we'll be performing later," Liu Banxia patiently explained. "The patient will be transferred to the ICU shortly. I see you have some abrasions on your forehead and arm. Let us treat those for you first. Please rest assured, we'll keep a close eye on the patient's vitals. As soon as they reach the ideal range, we will proceed with surgery."

"Furthermore, this is Shi Lei, a senior attending physician from our Second Hospital. He will accompany the patient in the ICU. We will perform the surgery as soon as there's an opportunity."

The patient's wife didn't fully comprehend much of what Liu Banxia said. She only understood that they would do their best to save him. But to her, that was almost the same as saying nothing at all.

As for the specifics of the treatment, she wasn't concerned. She had to go to the ICU; even if she couldn't go inside, she would wait at the door.

"Banxia, the operating room called," At that moment, Zhou Li waved the phone in her hand.

Liu Banxia quickly ran over. He had been too busy to inform the operating room earlier.

"Hello, this is Liu Banxia. There's been a complication. The patient has acidosis, mild organ edema, and very low body temperature. We've sent him to the ICU first, and surgery might be needed at any moment," Liu Banxia hastily said as soon as he took the phone.

"Alright, as long as we know what's going on, we're good. I'll fill everyone in on the situation, don't worry," Li Liwei said from the other end of the line.

"Brother Li, I've never handled a patient like this before," Liu Banxia said. "Massive intra-abdominal hemorrhage. We had to perform a laparotomy in the emergency room. Splenic artery, superior mesenteric artery, spleen laceration, intestinal tear... we still don't know if the pancreas is injured. There was no time to check."

"That's intense. The only time I've encountered having to close someone up after a laparotomy was when we discovered a tumor had spread and was incurable," Li Liwei said. "Okay, let's all hang in there tonight. Don't worry about our end; we can be ready at any moment. Have you coordinated with the ICU?"

"Shi Lei was about to finish his shift, but he couldn't leave after encountering this patient. He personally accompanied him to the ICU," Liu Banxia said.

"Alright, that's settled then. Get some rest. You still have at least two hours. Hanging up," Li Liwei said before ending the call.

Although Li Liwei didn't know the patient's exact condition, as an anesthesiologist, he could make a general assessment from Liu Banxia's description.

After hanging up the phone, Liu Banxia also rubbed his face; although the entire resuscitation hadn't taken very long and wasn't particularly physically exhausting, the mental strain was immense.

"Teacher, do you think the patient still has a chance?" Miao Rui asked, edging closer to Liu Banxia.

"It's hard to say. It depends on the sepsis. The acidosis should be correctable if it was caught in time," Liu Banxia replied. "The key is still the patient himself. If his constitution is good, he can pull through. Right now, it's anyone's guess."

Miao Rui opened his mouth as if to say something, but then hesitated.

Liu Banxia patted his shoulder. "Special situations like this, while not always identical, often have similarities. When you encounter critically ill patients and there isn't enough time to get them to the operating room, you have to perform surgery in the emergency room to buy time."

"However, this also depends on your individual capabilities. You can't overreach, or you might face a lawsuit. As for how to make that judgment, that's something you'll have to figure out for yourselves."

"Teacher, how do you make your judgments?" Huang Bo asked.

"Him? He's got plenty of confidence," Wei Yuan, who had just finished cleaning up, also walked over. "At our Second Hospital, he's the one who can perform manual hemostasis and locate the bleeding source by observing the hemorrhage in the shortest amount of time. That's why he has the confidence."

"If it were just me and Dr. Shi, the standard procedure would be to push the patient directly to the operating room upon arrival. All of this would have happened in the OR."

"And a more likely scenario is that the patient wouldn't have even made it to the operating room. The bleeding was truly too severe. Didn't you see how much his abdomen had swollen after we cut open his clothes? Blood was even seeping through the gauze."

"Dr. Wei, please don't praise me like that," Liu Banxia said with a wry smile. "I was just being reckless and ignorant of the potential consequences. It's definitely not something others should emulate."

"We just have to endure a bit longer. Once the new building is operational, we won't face so many dilemmas. We'll be able to take patients directly to the operating room and handle similar cases more safely and reliably."

Listening nearby, Xu Yino and Liu Yiqing stuck out their tongues. Only after hearing Liu Banxia say this did they truly grasp the danger of today's emergency.

But even understanding it, they asked themselves what they would do if faced with a similar situation in the future. They didn't know. There was no definite answer; they would just have to figure it out when the time came.

"Well? Are you guys confident you can learn Teacher Liu's skill of stopping bleeding barehanded?" Xu Yino asked, looking at her three companions.

"Learn it? Don't even dream about it. That's a real skill," Huang Bo replied with a wry laugh. "Even though we're interns, we're not completely clueless. Teacher Liu's skill is genuine; it's also a talent. It's not something you can just learn. Even if we could pick up a fraction of his dressing change technique, we'd benefit immensely."

Miao Rui also nodded. "Teacher Liu's finger dexterity is incredibly high. That's talent."

Xu Yino was visibly disappointed, but she had to admit her companions were right.

Manual hemostasis might seem simple, and other doctors might perform it occasionally. But who could do it as routinely as Liu Banxia? That's why it was a true skill.

When he was teaching them, Liu Banxia had also played the 'hand-in-hand teaching' game with them. The sensation of Liu Banxia brushing a cotton swab across the back of their hands was completely different from just watching him change a dressing.

They had been in the emergency department for some time now, and they realized the gap between themselves and Liu Banxia wasn't merely the difference between an intern and a resident.

Teacher Liu possessed true skill, a level they feared they might never reach, no matter how hard they tried.

Liu Banxia and Wei Yuan were supposed to be resting at this moment, waiting for the patient's condition to stabilize enough for surgery.

But who could truly rest? Their thoughts were consumed by the patient. His life or death hinged on the next few hours.

"Brother Wei, from what Sister Li and the others were saying, was he hit by a drunk driver?" Liu Banxia asked.

Wei Yuan nodded. "It seems so. The driver apparently got out, took one look at the person he hit, and then fled. Someone said they smelled alcohol."

Just then, Liu Banxia's phone beeped with a message from Shi Lei: "No signs of improvement yet."

Liu Banxia showed the message to Wei Yuan. "Looks like it's going to be a long night. But I'm not optimistic. That's just my boss's personality. If the situation weren't critical, he wouldn't have sent this message."

"Sigh..." Wei Yuan also sighed.

If the patient had been brought in with no hope of rescue from the start, he wouldn't feel this upset.

They had been just about half an hour short. With three surgeons operating together, they could have addressed most of the damaged organs within that half hour. If they had been able to do that, the patient's chances of survival would have increased significantly.

This night shift was destined to be a difficult one.