38 Countdown to Death
Page 1 of 3
“Call the second resuscitation team!” Wang Guohua roared.
His voice rolled through the emergency resuscitation room like thunder, so violently that it seemed to alter the patient’s electrocardiogram.
The falling rain of blood splattered over Wang Guohua and Luo Hao. The two men looked as though they had just returned from a sea of blood in hell.
Murderous intent radiated from every inch of Wang Guohua’s body. With both hands pressed against the patient’s chest, he confirmed cardiac arrest and immediately began external chest compressions.
“Adrenaline, one milligram, intravenous push.”
“Give nikethamide and lobeline once more.”
“Defibrillator. Set the energy to…”
Luo Hao directed the emergency department staff from the side. The two men worked together flawlessly.
A minute later, Wang Guohua lifted his hands from the patient’s chest.
There had still been fluctuations on the ECG while he was compressing the chest, but the instant his hands moved away, the line turned flat again.
They tried once more. A minute later, the result was the same.
Wang Guohua sighed and turned to the village chief.
The patient was probably beyond saving. They would have to explain the situation to the family. Every medical worker present knew that, fortunately, Wang Guohua was there. Otherwise, there would certainly have been trouble.
Wang Guohua believed the patient was finished. All they could do now was exhaust every remaining measure, continue compressions for a few more minutes, and then declare clinical death.
The other medical workers thought the same.
Only Luo Hao disagreed.
The system had just issued a mission, and Luo Hao was certain that the patient was not dead yet—not completely dead, at least.
“I’ll do it.”
Luo Hao frowned. His former sunny demeanor had vanished without a trace. Countless droplets of blood covered his face, and a fierce, iron-blooded force surged from him.
He rammed his shoulder into Wang Guohua and knocked him aside.
Wang Guohua froze.
Luo Hao stretched out both arms and clasped his hands together, but he was not using the most orthodox posture for external chest compressions.
Yet the moment Luo Hao exerted force, Wang Guohua suddenly heard a crack from the patient’s chest.
A fractured rib!
The diagnosis appeared in Wang Guohua’s mind.
Violent!
That was unbelievably violent!
And yet—
The next second, waves appeared on the ECG. The patient’s heart had begun beating again.
Damn!
Wang Guohua stood there dumbfounded.
That had actually worked?!
Throughout his medical career, Wang Guohua had performed emergency resuscitation countless times.
He had also performed external chest compressions countless times.
In Wang Guohua’s judgment, the patient before him had already stepped through the gates of death. The chest compressions and emergency treatment were merely a final attempt to fulfill their duty.
Put simply, everything they could do over the next ten or twenty minutes was merely to give the patient’s family some comfort—to show that the doctors had done everything possible.
Doctors were not gods. They could not cure every patient.
But Luo Hao had pressed down only once, and the patient’s heartbeat had returned. Judging from the monitor, it would not stop again anytime soon.
That was impossible. The defibrillator had already been used, and Wang Guohua himself had performed chest compressions. The patient’s heart had shown no response whatsoever.
So how had Luo Hao…
Just as that thought crossed his mind, Wang Guohua suddenly heard a roar beside his ear.
“What are you standing around for? Wang Guohua, you’re in charge. Send the patient to the endoscopy room!”
The voice was cold and severe, thick with the stench of blood. Even the battle-hardened Wang Guohua instinctively responded, “The endoscopy room?”
“Move! Hurry!”
With that, Luo Hao rushed out of the emergency resuscitation room.
Chen Yong had been standing in a corner the entire time. His hands and feet had been trembling from the excessive adrenaline coursing through him.
Only when Luo Hao roared at Wang Guohua did Chen Yong finally calm down.
It seemed that this was exactly the scene he had seen inside the crystal, although the words had been somewhat different.
Chen Yong had always thought that what he had learned was merely for fun. Though he often comforted himself by saying that the end of science was metaphysics, he had never truly believed it.
Yet this scene brought him back to his senses. He went to Wang Guohua’s side, put on a pair of gloves, and began assisting with the resuscitation and transport of the patient.
The village chief, who had entered with Wang Guohua, was completely stunned.
He had never imagined that Wang Guohua—who always kept his word, never tolerated contradiction, and was the only person allowed to curse at others without anyone daring to curse back—would one day be shouted at himself.
The doctors and nurses in the emergency resuscitation room also tucked their tails between their legs and began working with remarkable speed.
Even Wang Guohua had been yelled at. If they failed to do something properly, would Luo Hao from the Medical Affairs Office not flay them alive?
The Medical Affairs Office was terrifying.
Luo Hao was terrifying.
Everyone stood in awe.
…
Luo Hao ran out of the emergency resuscitation room and dialed a number on his phone.
“President Nie, I need supplies for emergency variceal ligation. Do you have them?” Luo Hao asked as he sprinted down the corridor.
“Doctor Luo, we have the supplies. I’ve arranged for an assistant to wait at the hospital. The rented apartment is two minutes away on foot. If you need them, they’ll be there immediately,” Nie Changchun replied simply and crisply.
“The endoscopy room. Immediately!”
Luo Hao hung up.
The system had announced the mission with a familiar chime, but Luo Hao had only glanced at it long enough to confirm that a mission had been issued. He had not looked at the system panel in the upper-right corner of his vision again.
There was no time!
Although the patient’s heartbeat had returned and could still be maintained for the moment, Luo Hao knew it would not last long.
The final episode of hematemesis had sent blood surging to the ceiling because, after fluid replacement, the patient’s blood pressure had recovered somewhat. The varicose veins at the gastric fundus had continued bleeding, and once enough blood had accumulated in the stomach, it had been vomited out.
No matter how much fluid they administered, if the bleeding point was not sealed, the veins at the gastric fundus would continue to bleed. The patient might even suffer another cardiac arrest at any moment.
Luo Hao had managed to bring him back this time, but next time…
Luo Hao had no confidence.
The only way to solve the problem was to seize the brief window created by the restored heartbeat and perform the operation immediately.
After ending the call, Luo Hao immediately dialed Lin Yuming.
“Director Lin, the patient needs emergency endoscopic hemostasis.”
“I’ll have someone go open the room,” Lin Yuming replied calmly.
“There’s no time!”
Luo Hao ran faster. The bitterly cold wind cut across his face like tiny knives.
“What?”
Lin Yuming froze.
Gastroscopy was not normally an emergency procedure. Why was there no time?
“Tell them to hurry. The patient’s heart stopped once already. I estimate…”
At that moment, red light began flashing before Luo Hao’s eyes.
00:18:23
00:18:22
00:18:21
Eighteen minutes?!
Luo Hao realized that the system was showing how long the patient’s circulatory system could continue functioning—the countdown to his life.
Was this some kind of joke?!
The endoscopy room had no emergency services. At night, its doors were always locked. Even if the director of the Medical Affairs Office called to urge them, it would still take the head nurse ten or twenty minutes to arrive.
Page 2 of 3
“Uncle, there’s no time. I’m breaking down the door and operating.”
With that, Luo Hao hung up.
Running while making calls, combined with the adrenaline-fueled resuscitation just moments ago, was beginning to wear him out.
At that moment, Luo Hao missed his attribute points more than ever.
If only his physical strength were higher. How wonderful that would be.
“They say a man remains a boy until the day he dies, but where are the boys…”
His phone rang. Luo Hao acted as if he had not heard it and continued straight toward the endoscopy room.
The iron door was locked.
Luo Hao planted his feet, without the slightest hesitation. He sprinted forward and slammed his right shoulder into the iron door like an ancient beast charging at full speed.
“A man remains a boy until the day he dies…”
Boom~
“A man remains a boy until the day he dies…”
Boom, boom~~
“A man remains a boy until the day he dies…”
Boom, boom, boom~~~
Crash!
Luo Hao smashed the iron door open by brute force, like a beast.
He burst inside, switched on the lights with practiced ease, and began preparing the equipment.
00:13:45
00:13:44
Luo Hao hung up on Lin Yuming’s incoming call and dialed Wang Guohua.
“Why hasn’t the patient arrived yet? What the hell are you doing?” he bellowed before Wang Guohua could speak.
“He’ll be there soon. Is anyone in the endoscopy room at night?”
“None of your business! You have two minutes. If the patient isn’t here by then, go home and hold your grandchildren!”
With that icy curse, Luo Hao hung up.
On the other end, Wang Guohua gripped the phone so tightly that it creaked.
He was elderly and hard of hearing, so his phone’s volume was turned up extremely high. Everyone nearby had heard every word.
In the memories of all the medical workers present, no one—not even the hospital president—had spoken to Wang Guohua with such ferocity in several decades.
And Luo Hao…
No one even dared to breathe, afraid that Wang Guohua might take his anger out on them.
Someone had already summoned the elevator. The route was clear, and the stretcher was pushed straight to the entrance of the endoscopy room.
As long as the patient survived, what did a few curses matter? But if Luo Hao failed to save him…
Wang Guohua thought coldly that Luo Hao had probably panicked. After seeing the rain of blood, he had entered a state of extreme stress and no longer knew what he was doing.
The endoscopy room was locked at night. What was the point of taking the patient there? Could it really save him?
Wang Guohua had the patient brought there because he still retained a measure of respect for Luo Hao—respect that came from the system, and from the operations Luo Hao had successfully performed.
Wang Guohua was the first to reach the endoscopy room. He immediately saw that the door had been smashed open, as though thieves had broken in.
Damn!
Amazing!
Although he had just been cursed at, Wang Guohua still gave a mental thumbs-up at the sight.
Luo Hao’s decisiveness and ruthless efficiency were deeply admirable.
Seeing the damaged door, everyone felt as though they could barely breathe.
They were all emergency medical workers. They had witnessed hundreds, if not thousands, of resuscitations, but none of them had ever seen anything so savage.
Once the patient had been brought inside, a delicate young woman appeared timidly in the doorway, pulling a wheeled suitcase behind her.
“May I ask if Doctor Luo…”
“President Nie sent you, right? I’m performing gastric fundal variceal ligation. Give me the supplies.”
“Yes, Doctor Luo. I’m from Southern…”
“Cut the damn chatter. I need the ligation supplies!” Luo Hao roared in a low voice while he and the others lifted the patient onto the operating table.
At that moment, Luo Hao resembled a furious beast. Anyone who displeased him seemed liable to be bitten, torn apart, and swallowed whole.
The young woman froze, tears welling in her aggrieved eyes. But she did not forget her duty. She immediately crouched down, opened the suitcase, and took out the supplies.
After clearing the patient’s mouth, Luo Hao used up all the remaining surgical training time he had, personally administered basic anesthesia, and advanced the gastroscope into the esophagus.
The screen was filled with red.
As he advanced the scope, he used the suction device to remove the blood. From the entrance of the esophagus, varicose veins could be seen spreading like crawling insects all the way to the cardia.
The varices were nodular. Red thrombotic heads could be seen on the varices in the lower esophagus. The vessels were dark red, and there were no obvious signs of bleeding from the esophageal varices.
00:08:54
00:08:53
00:08:52
Although the death countdown appeared before him like a summons from hell, and Luo Hao could clearly feel the chill of the reaper’s scythe falling upon the patient, he remained calm and cold, concentrating wholly on the resuscitation.
He guided the gastroscope into the stomach.
The entire screen was red. There was no operative field at all.
The suction device hissed desperately, drawing out the blood remaining in the stomach and revealing the treatment area.
But visibility was limited. At least, neither Wang Guohua nor Chen Yong could see the veins that required treatment.
In the brief interval after the suction device cleared away one surge of blood and before the next wave obstructed his view, Luo Hao saw that the gastric fundal varices were arranged like strings of beads. At least three sites were still spurting blood.
Holding his breath and focusing every ounce of his attention, Luo Hao glanced at the death countdown.
00:07:26
Time passed second by second. There was not much left.
Although the operative field was severely restricted, Luo Hao had performed the procedure dozens of times in the system’s operating room. Calmly, he used a seven-ring ligator to capture a bleeding point and place a ligature.
Under normal circumstances, no one was willing to perform ligation during active bleeding unless there was absolutely no alternative.
There was no operative field. Nothing could be seen. How was anyone supposed to operate?
At least, that was what Wang Guohua thought.
Yet right before Wang Guohua’s eyes, Luo Hao used the number-seven ring ligator to capture a bleeding point and complete the ligation.
One vessel.
Two vessels.
Three vessels.
00:03:56
In less than five minutes, Luo Hao completed twelve ligations.
At last!
When the final ligation was finished, fireworks appeared before his eyes.
The pleasant sound announcing completion of the mission rang beside his ear.
Operation successful!
Luo Hao’s body sagged for a moment, but he immediately straightened and began carefully suctioning all the pooled blood from the patient’s stomach.
“Little Luo, you can see the bleeding points?” Wang Guohua asked softly.
Even the usually overbearing and domineering Wang Guohua did not dare raise his voice.
He could not understand what he was seeing, but as the blood inside the stomach steadily diminished, he could tell that the operation was nearing success.
“Yes,” Luo Hao replied calmly. “The operation is finished, Director Guohua.”
Wang Guohua froze, tears streaming down his face.
The damn operation was over, and now Luo Hao remembered to call him Director Guohua?
Who had been the one shouting at him to go home and hold his grandchildren?
“Twelve bleeding points. Fortunately, you brought the patient here in time. If you had been five minutes later, we would be preparing the body now.”
Luo Hao narrowed his eyes and smiled faintly.
Page 3 of 3
Wang Guohua fell silent, filtering out the praise that followed and focusing only on the twelve bleeding points. He suspected Luo Hao was bragging.
He had performed dozens of portal and gastric vein devascularization procedures. His familiarity with the local anatomy was ingrained in his bones.
Twelve bleeding points—Wang Guohua could imagine that.
But with the entire field of vision flooded in red, he himself could not see a single bleeding point. Yet Luo Hao had performed twelve ligations in only a few minutes.
That was impossible!
Although he was suspicious, Wang Guohua was not foolish enough to say so aloud.
The diminishing red on the gastroscope screen seemed to silently tell everyone that the operation had succeeded.
As the accumulated blood obscuring the field decreased, the treatment area gradually came into view.
A string of “beads” appeared along the varicose veins, interspersed with the marks of the ligations.
The medical staff, who had been silent before, became even quieter once they saw the state of the treatment area.
An entire operation had ended, yet no one had clearly seen how the surgeon had performed it. It was astonishing—utterly beyond imagination.
Luo Hao did not immediately savor the joy of victory. He changed angles repeatedly, checking for any active bleeding.
Although both the system and his observations through the scope indicated that the operation had been highly successful, Luo Hao inspected everything for another twenty minutes, as if suffering from obsessive-compulsive disorder.
Searching for any missed active bleeding took several times longer than the operation itself.
Yet no one questioned him. The operating room was frighteningly quiet.
Finally, Luo Hao confirmed that there was no active bleeding, suctioned out the remaining air, and ended the treatment.
Only then did Luo Hao let out a long breath.
He had just been preparing to examine the mission rewards provided by the system when he heard a furious roar.
“Luo Hao, you little bastard! What the hell have you done?”
It was Lin Yuming.
“Send the patient to the ICU. Tell them Director Lin ordered it. Oh, and please trouble Director Guohua to make the trip as well. Thank you for your hard work.”
After the successful operation, the iron-blooded aura had vanished completely from Luo Hao. His gentle, approachable, sun-bright smile had returned.
He removed his gloves and mask, then hurried to the doorway with a broad grin.
“Director Lin, you’re here.” Luo Hao bowed slightly. “It was just an emergency resuscitation. The operation is already finished. You didn’t need to come all the way here in the middle of the night.”
Watching Luo Hao change faces in an instant, Wang Guohua felt a strange emotion rise within him.
Was this really the same person who had just cursed him like a dog?
If Luo Hao could curse him, why couldn’t he curse Lin Yuming?
If he could curse him, why on earth couldn’t he curse Lin Yuming?
“Luo Hao, what the hell have you done? You actually damaged public property. I think you’ve been getting too full of yourself lately.” Lin Yuming rebuked him severely.
Lin Yuming was clearly furious, and his voice had become slightly shrill.
“Director Lin…”
“Director Lin, the patient had severe hematemesis caused by gastric fundal varices,” Wang Guohua explained solemnly.
Lin Yuming had been wearing a stern expression, preparing to give Luo Hao a proper scolding. But when he heard Wang Guohua’s voice, he paused slightly, and a smile appeared on his face.
Exactly the same as Luo Hao’s.
Or rather, Luo Hao was exactly the same as Lin Yuming.
“Director Guohua is here too.”
“The patient went into cardiac arrest once. I couldn’t bring him back. Luo Hao did.”
Wang Guohua added that casually.
Lin Yuming was speechless.
There was a great deal hidden in Wang Guohua’s words, and every bit of it was worth pondering.
“As for the operation, the patient has only just received anesthesia. But the situation was urgent, and he could have vomited blood again at any moment, so we brought him here. Luo Hao performed the ligations. The operation was successful, and exploration found no active bleeding.”
Wang Guohua looked directly at Lin Yuming.
“Do you have any objections?”
“None whatsoever.” Lin Yuming smiled as though he had not been the one scolding Luo Hao just moments earlier.
“When a life is at stake, what does it matter if a door gets kicked in? Report it for repair during the day. If you’re embarrassed to file the request, Director Lin, I’ll do it. Is Little Geng still in charge of the maintenance team?”
“Oh, Director Guohua, listen to yourself. Little Geng is already a section chief. There’s no need to trouble you over something so minor.” Lin Yuming smiled ingratiatingly. “Saving lives comes first. Saving lives comes first.”
“So you do know that human life comes first.”
Wang Guohua began personally helping the others transfer the patient onto a stretcher and take him to the ICU.
As he passed the damaged door on his way out, Wang Guohua gave it another kick with a loud bang.
Lin Yuming’s eyelids twitched.
After everyone had left, Lin Yuming asked, “Why aren’t you going?”
“Uncle, I really was desperate just now. The patient went into cardiac arrest and nearly died. The old Director Guohua wanted to perform portal and gastric vein devascularization. I felt that the patient might not even survive anesthesia and could collapse on the table, so…”
“So what? So you kicked down the door?” Lin Yuming said in anguish. “When you work for the state, the first thing you learn is how to shift blame and protect yourself. Why show off when nothing has even happened?”
Luo Hao nodded repeatedly, but what he was thinking about was Lin Yuming’s own furious argument with the president of a pharmaceutical company over “snatching eggs.”
One thing said, another thing done. Never trust him. Never trust him.
“Director Guohua said he couldn’t bring the patient back, but you did. How?” Lin Yuming asked.
“It’s simple. People who haven’t worked in thoracic surgery don’t dare use enough force during chest compressions. The force is insufficient, so the electrical stimulation to the heart… Put simply, the heart can’t restart. I had enough strength…”
“Strength?”
“To put it even more simply, I broke the patient’s ribs while pressing.”
Lin Yuming was speechless.
“It’s fine. I’ve encountered patients with cardiac tamponade before. They had already stopped breathing, so I opened the chest, squeezed the heart directly under visual guidance, and brought them back. Breaking two ribs is nothing.”
Lin Yuming stared at Luo Hao in silence.
In such a hostile medical environment, Luo Hao had actually dared to do something like that.
A few years earlier, there had been cases in which doctors broke patients’ ribs during CPR, only for the patients’ families to come demanding compensation afterward.
“Do you understand the consequences?” Lin Yuming asked seriously.
“I do. But I still have you, don’t I, Uncle?”
Luo Hao smiled broadly.
“…”
“The Medical Affairs Office can handle it. At worst, we pay a little compensation. We’re publicly owned anyway. Who gets the money doesn’t matter. It’s still better than building a garden behind the hospital, tearing it down, and rebuilding it over and over.”
Lin Yuming burst into profanity.
He cursed for a full two minutes, yet still felt a pressure in his chest.
Looking at the door Luo Hao had kicked apart, he suddenly realized that it was made of stainless steel. Anyone hoping to smash it open needed considerable physical strength.
He clenched his fist and punched Luo Hao in the chest.
Thud.
“Not bad. You’re becoming a real man,” Lin Yuming said with a smile.
“Uncle, give me an access card. If there’s another emergency operation at night, I won’t have to kick down the door.”
“You damn—!”
Lin Yuming’s emotions swung repeatedly between the summit and the abyss.
“Why did Director Guohua speak up for you?” Lin Yuming suddenly calmed down and asked a deadly serious question.
“Old Director Guohua protects his own.”
“You’re my family’s own. Why would you need him to protect you?” Lin Yuming became furious all over again. “Who does he think he is? You’re my family’s own—you’re mine!”
…
Note:
There is a question on Zhihu about a doctor’s finest moment. I did not answer it, but after seeing it, I thought about it for a while. I have not had many shining moments in my career. One of them involved a man who had argued with his wife at home and punched through the screen of a television. His radial artery ruptured, but he refused to go to the hospital.
About half an hour later, he went into hemorrhagic shock. The emergency ambulance doctor performed chest compressions throughout the journey, but by the time he reached the hospital, he still had no spontaneous heartbeat.
I was working in the emergency department at the time. After the patient arrived, I thought he was already gone, but I tried anyway.
I pressed down once. The sound of a fracture rang out, and his heart began beating again.
With a wave of my hand, I said, “Take him to hand surgery. Notify the ICU and hand surgery for a consultation.”
I was extremely pleased with myself at the time.
The next day, I asked about him. The operation had been successful, and the patient had survived.