Chapter Sixty-Five: Four in One Night

Work in the Department of Internal Medicine has begun, and the first requirement there is to maintain stability and composure. What does it mean to maintain stability? It means being able to sit still. Morning rounds involve reviewing returned laboratory reports, modifying medical orders, and writing new requisitions for various tests.

Most of the day is spent typing away at the computer, interspersed with frequent flipping through medical textbooks. When necessary, discussions are held with other physicians. The Department of Cardiology comes with an additional treatment modality: interventional procedures, which are extremely time-consuming and energy-draining.

Interventional cardiology at the municipal hospital was truly kept afloat by a few women. They forged ahead despite the heavy pressure from Old Huang. After Ouyang took charge, the department received vigorous support and brought in quite a few new doctors.

Ren Li no longer performs interventional procedures; the newer physicians have taken over. Having pushed herself hard for years, she absorbed too much radiation, and her leukocyte count could no longer recover. Nowadays, she mostly stands behind the lead shields to guide everyone through the procedures.

Zhang Fan’s supervisor, Ye Jing, would never touch interventional work. Radiation is hazardous; despite protective gear, the risk remains. She flatly refused the department director’s proposal.

She preferred to be a routine ward physician without any desire for advanced fellowship training. When a patient arrived, she would examine them if she could; if not, she would defer to a senior physician. Since there were always senior physicians in the department, any case she could not handle would simply be passed on to someone else.

However, her strength lay in her meticulousness. As a rule, patients under her care presented virtually no flaws. She followed the senior doctors' instructions to the letter, never deviating and never harboring independent ambitions.

She led a carefree life, unlike other physicians who were as busy as working dogs. Content without contending for honors or competing with peers, she was considered a pleasant presence in the department. She tended to patients assigned to her, but never went out of her way to vie for more.

With her husband pulling in a decent income, she faced no financial pressure at home, freeing her from worrying about money. A little extra was welcome, but less was fine too; freedom from excessive desires breeds true independence. She acted as an invisible entity within the department, ignored even when emergencies arose, and she thoroughly enjoyed this peace.

Currently, she had seven patients, all in relatively stable condition. Standard treatments sufficed without requiring special nursing care. Naturally, she was more than happy to have someone else write the medical records for her.

The moment the workday ended, she left, while Zhang Fan still had to write progress notes and paste laboratory reports. Occasionally, he even had to help other physicians by performing tasks like electrocardiograms.

Today marked Ye Jing’s twenty-four-hour shift. Zhang Fan was efficient during the day, recording all required progress notes, pasting every laboratory report, and ordering necessary examinations.

After the other doctors went off duty in the evening, Ye Jing and Zhang Fan made their initial rounds. Before leaving, the other physicians had already briefed her about any critically ill patients.

Nevertheless, conducting rounds three times a day was an iron-clad rule. The internal medicine wards were filled with chronic patients who understood treatment procedures inside and out—some even knew them better than rotating residents. Missing a single round would prompt them to storm into the duty room and demand the doctor within minutes.

As the rounds concluded, Ye Jing’s brows furrowed. Although Zhang Fan was not yet proficient in internal medicine, he could tell that several patients were in rather poor condition.

In cardiology, matters of life and death are counted in minutes. A single improper treatment or a brief delay could mean a patient loses their last chance at survival.

Furthermore, unexpected crises abound in cardiology. A person who appeared completely fine might suddenly develop atrial fibrillation or acute angina pectoris, passing away before the physician could even reach the bedside. Such occurrences were far too common.

Therefore, cardiologists must possess strong hearts and nimble feet. They need to withstand intense pressure and be able to sprint swiftly.

Frowning, Ye Jing remarked, "There will be no peace tonight. This shift is going to be brutal." Regardless of anything else, as a veteran physician of over a decade, her judgment and experience were solid.

Zhang Fan, however, lacked such foundation. He had skipped the internal medicine rotation during his internship, had not rotated through it since starting work, and the system had not yet unlocked the internal medicine module for him. Consequently, he felt somewhat at a loss.

"Is that so? Then I suppose I won't be sleeping," Zhang Fan said naively.

Ye Jing turned her head and smiled wryly at Zhang Fan, saying, "If not sleeping could solve the problem, it wouldn't be a big deal at all. I truly regret being naive and ignorant back then, choosing cardiology. It’s an absolute killer."

"It's too late for regrets now," Zhang Fan thought, pursing his lips.

Despite everything, Ye Jing was generous, treating Zhang Fan to meals and buying him water. All of this was to keep him on her good side so she could avoid writing medical records, pasting lab results, and handling admissions and discharges.

"Xiao Zhang, where is your hometown? Do you have a significant other?" While Zhang Fan was busy writing medical records, she had nothing to do and resorted to gossiping beside him.

"From Gansu Province. No significant other yet."

"Oh, are you used to the frontier region? Didn't you date anyone in college? I see all the newcomers arriving in pairs. The last batch of rotating residents even featured a young couple who joined our department together."

"It's alright, I guess," Zhang Fan muttered inwardly, utterly speechless at how gossipy this woman was.

"I heard you’ve been assigned to a department—one of the surgical ones, right? You surgical folks have it good. Once you finish a surgery, you're done for the day. You live such carefree lives every day."

That remark was thoroughly layperson. Carefree? A senior surgeon at a Grade III Class A hospital? Only department directors or retirees could possibly live like that.

Helplessly, Zhang Fan replied, "It's pretty much the same everywhere. It's very busy too. There are many surgeries, and sometimes we don't even have time to eat."

"What are you talking about? I always see you surgical doctors attending dinner banquets almost every day, and you frequently go out for karaoke. I've seen the surgical staff from our hospital doing that several times." Not only did she gossip about others, but she also claimed to have witnessed it herself—unbelievable!

"Really? I just arrived, so I wouldn't know," Zhang Fan replied, truly at a loss for words and too terrified to say anything more, given how endlessly talkative she was.

"Once you settle into your department, you'll find out. Internal medicine is truly terrible. A pile of women together creates endless drama. Even if you wear a pretty dress, people will gossip behind your back. It's thoroughly annoying."

"I see." Zhang Fan had planned to finish writing his medical records early and review internal medicine textbooks, but Ye Jing’s endless chatter made it impossible for him to concentrate, causing him to make several typos.

Finally, past midnight, she went to wash up. Peace was restored to Zhang Fan's ears, though he still had three progress notes left to record.

Since Ye Jing was sleeping in the doctor's duty room, Zhang Fan had nowhere to sleep there. Furthermore, the internal medicine wards were completely full, leaving no empty rooms for him to rest in, and she had given no instructions for him to go back elsewhere.

Just as Zhang Fan was hesitating about what to do, a nurse burst into the room. "Quickly! Bed Number 5 is crashing! Where is Dr. Ye?"

"In the duty room."

"Go call her. Hurry!"

Without another word, the nurse rushed back into the ward. There were three night-shift nurses, but usually only one unrotated resident doctor.

Zhang Fan hurried to the entrance of the duty room and shouted, "Dr. Ye! Bed Number 5 is crashing, the nurse is calling!"

*Clang!* With a loud crash, something dropped to the floor, and Ye Jing emerged with her hair in disarray. Running as she spoke, she shouted, "I knew it, I knew it! Tonight was never going to be peaceful. Quickly, go wheel over the bedside electrocardiogram machine."

When Zhang Fan pushed the ECG machine into the ward, Ye Jing had already started chest compressions. Gasping for breath, she said, "You take over, I can't press anymore. I'll set up the ECG."

Chest compressions require pressing down five centimeters at a rate of one hundred times per minute; anyone physically weak would find it impossible to maintain. Rib fracture is the most common complication of chest compressions, demonstrating just how much force is required.

Zhang Fan hastily relieved Ye Jing and began chest compressions. "Adrenaline, intravenous push! Maximum dose, rapid administration!"

Family members were shooed outside, pressing their faces against the door glass to peer inside. Bed Number 5 belonged to an elderly man in his sixties. The old woman outside was already in tears, supported by several children who looked on with eager, hopeful eyes toward the doctors inside.

*Beep! Beep! Beep!* The bedside monitor began to alarm as the heartbeat trace flattened into a straight line.

"It's no use. Run a final ECG trace. Stop resuscitation," Ye Jing said, halting her movements and speaking to Zhang Fan.

They slowly stepped out of the ward. There was nothing more to say; the patient's grave condition had already been explained to the family earlier—death could occur at any moment.

Scarcely had they sat down for a few minutes when the nurse appeared again. "Bed Number 9!" she yelled, turning on her heel and sprinting away. Zhang Fan pushed the ECG machine and ran after Ye Jing.

"Nurse! Nurse! Come quickly! My mother doesn't look like she's going to make it. Hurry!" cried the family member of Bed Number 23.

"You go to Bed Number 23 first, I’ll handle Bed Number 9. Do an ECG immediately and keep the strips," Ye Jing instructed Zhang Fan.

While they were frantically trying to save the patients in Bed 23 and Bed 9, trouble struck Bed Number 18 as well. Zhang Fan didn't even have time to perform an ECG before the patient slipped away. Throughout the entire night, rushing until dawn, four patients passed away in a single shift.

Before they could even catch their breath, morning arrived, bringing the burden of reviewing mortality records. They had to frantically write medical records and complete the resuscitation logs.

With no time to lament the sorrow of the spring or autumn, Zhang Fan survived his first twenty-four-hour shift in the Department of Internal Medicine.