top student at medical school

Chapter 685 Life and Death Ups and Downs! (Second Update, Please Subscribe)
The operating room's large and small shadowless lights were focused on the operating table, yet no shadows were visible on the surface of the operating table where nine people were gathered.

The green numbers and time data on the operating room timer panel kept ticking away, second by second.

The intermittent beeping of the anesthesia monitor and the miniature circulator was more annoying than the cicadas chirping on a hot summer night in the wheat field.

"Blood circulation in the left upper limb has returned to normal. Blood oxygen levels are consistent with the bpm rhythm and are approaching synchronization with ECMO," Nie Mingxian reported in a low voice, raising himself up.

"The blood oxygen level in the right upper limb has returned to normal," Li Yongjun reported.

Wu Xuanqi paused a step later and simply said, "Blood flow in the left lower limb has returned to normal."

Du Donglin, a hand surgeon, sniffed: "Blood flow in the left lower limb has returned to normal, and the pulse rate and rhythm are being regulated."

"The liver microcirculation device is functioning normally."

"Urine output in 2 hours: 900 mL"

“The partial obstruction of the mesenteric artery has been relieved…” The voices of the circulating nurse and Professor Tang Meng, among others, were spoken in a clear and orderly manner.

After hearing the replies, Lin Guoqiang's Adam's apple bobbed up and down three times as he swallowed. He looked at Fang Ziye and asked, "Professor Fang, given the current situation, is it possible to restore blood flow to the local organs and the whole body?"

Fang Ziye shook his head, continuing to focus his attention on the patient's vital signs and the DSA monitor: "Don't rush, continue to slowly adjust according to the previously ordered parameters!"

Chen Guangbai and Wang Qishan continued to take Chen Song's pulse on both wrists, murmuring, "The pulse is weak, but..."

They were at a loss for words.

Fang Ziye completely severed the microcirculation in his limbs, cutting off their connection to the heart!
From the perspective of traditional Chinese medicine, if the pulse is unrelated to the flow of blood in the heart, then the pulse at this moment should be no different from before.

If it is related, and the pulse indicates that the blood supply to the heart has been cut off, would it still be considered a pulse characteristic of Chen and Song?

However, this abnormality was indeed present in Chen Song's pulse.

Time continued to pass, second by second.

After about half an hour, when everything was still stable, Fang Ziye said, "Temporarily shut down the skin and arterial sheaths of the limbs!"

After Fang Ziye finished speaking, Li Yongjun and the others, who had been idle, finally found their place and began to fill and embed the arterial sheaths in the limbs.

In times of emergency, it's not that I'm afraid of having something to do, but rather that I'm afraid of having nothing to do, which makes me even more anxious.

Having something to do can actually alleviate the original tension and anxiety.

Back in the operating room, Tan Mengbai tore off a three-meter-long sheet of anesthesia record paper. The thermosensitive curve and the target-controlled infusion curve of propofol were almost distorted by his scrutiny.

After hearing Fang Ziye's instructions, Chen Guangbai said in a low voice, "Professor Fang, breakfast has been prepared outside. My father's condition is stable for now, please go and have some breakfast!"

"We can't stay up all night and then go hungry."

"Professor Tan Mengbai from the Department of Anesthesiology has already eaten. You and Professor Lin Guoqiang should go and have lunch first."

“Now that you’re back, Professor Lin Qiaoshan and the others should go and rest,” Chen Guangbai said, appealing to their emotions.

Fang Ziye nodded slowly.

This is a protracted battle with no end in sight.

After Fang Ziye stepped back two steps, Chen Guangbai personally untied the tie of Fang Ziye's sterile surgical gown and helped him take off his clothes. His gaze was calm, and he did not say another word.

Everyone has witnessed how hard Fang Ziye has worked and how much he has done; words of gratitude alone cannot fully express his gratitude.

Moreover, Fang Ziye needs to continue to stay at his post, and it's not over yet, so it's not appropriate to be sentimental at this moment, so as not to affect Fang Ziye's mood.

But in fact, his goodwill had already been shown in the details.

Chen Guangbai, a man of immense wealth who once held a prominent position in China's business world, was carefully smoothing the wrinkles in Fang Ziye's scrubs on his shoulders.

"Dr. Chen, you should also take a break and eat something. You'll ruin your health if you stay hungry!" Fang Ziye suggested as he and Professor Lin Guoqiang walked out together.

"Okay, I'll go in a bit."

“Chen Xixian has already eaten,” Chen Guangbai replied.

After leaving the operating room, on his way to the dining room, Lin Guoqiang deliberately cracked his neck, making two soft cracking sounds.

"Professor Fang, according to the thinking and logic of traditional medicine, this kind of life-threatening behavior is going against nature. Won't we shorten our own lifespan?" Lin Guoqiang asked.

Actually, he wasn't waiting for an answer!

I've done all that, and I don't know how many brain cells I've lost.

Only then were they able to help Chen Song get through the ordeal wave after wave, and now they have at least taken another step to keep the deadly Ox-Head and Horse-Face, or their superiors, out of the operating room.

"So what if it shortens my lifespan? It's better than being ignorant."

“At least we have proven that reversing life and death is indeed against the natural order.” Fang Ziye made a timely joke and then began to loosen his shoulders.

The lead apron in the operating room is very heavy, and Fang Ziye's procedures are numerous, which is very taxing on his joints.

According to the theory of joint surgery, Fang Ziye's current lifestyle is actually overdrawing his joints, and he may have to undergo total shoulder replacement surgery in the future.

However, this is Fang Ziye's profession, and there are some things that he has to do, even if it means enduring hardship.

Fang Ziye and Professor Lin Guoqiang were actually not in the mood for breakfast either!
There was no enjoyment to speak of. I got some porridge, milk, and steamed buns and started eating them. After filling my stomach, I went back to the operating room.

After washing their hands, putting on clothes and gloves again, the weight of the lead aprons pressed down on the two of them once more.

"Argatroban intravenous infusion: starting dose 0.2 μg/kg/min."

"APTT target value: 1.5-2.5 times the baseline." Professor Tan Mengbai instructed Luo Tingzhu and the other junior anesthesiologists.

After speaking, Tan Mengbai glanced at Fang Ziye again, seemingly seeking instructions.

Fang Ziye shook his head slightly and chuckled, "Professor Tan, the anticoagulation plan was jointly formulated by you and the teachers from the cardiology and vascular surgery departments. I am an outsider and do not understand the underlying principles."

Tan Mengbai, however, was not buying Fang Ziye's argument. Since Chen Song's condition was currently stable, he jokingly said, "I heard from the other people in the operating room that you used to think you were just a professional orthopedic surgeon and didn't understand other specialties."

"The result is that they do nothing right."

Lin Guoqiang and Li Yongjun nodded repeatedly, deeply moved.

……

The people in the operating room were rotated out. Except for Fang Ziye, Li Yongjun, Nie Mingxian and others went to rest again.

Lin Guoqiang had only taken over the shift in the early hours of the morning, so he continued to fight until midnight, when the third shift would come to take over. He then played until midnight of this morning.

It was 10:10 in the morning.

Fang Ziye was awakened once again by the alarm sound of the instrument while he was dozing off.

Everyone in the operating room remained calm despite the panic!
After a quick diagnosis, Professors Lin Guoqiang and Tan Mengbai replied, "The ventricular tachycardia has recurred, with small blood clots forming, but it is not a serious condition."

“Perform DSA vascular retrieval thrombectomy.”

"Pharmacological cardioversion..."

Fang Ziye glanced at the current situation, did not participate in the operation, but after reviewing all the information, he went into a state of dozing off.

It was 4 p.m. that day.

"The bone marrow stem cell suspension is in place." Professor Kuang Hua of the vascular surgery department precisely inserted the catheter into the popliteal artery, and a spiderweb-like network of veins emerged from the thin lower limb.

Professor Bu Yuanchao, an anesthesiologist who participated in the latest round of rescue efforts, used a closed-loop target-controlled infusion of propofol (Marsh model).

"I have followed Professor Tan Mengbai's medical advice and kept the BIS value between 40 and 50! Please let me know if the depth of anesthesia needs to be reduced," Professor Bu Yuanchao said to everyone.

Fang Ziye nodded and said, "Remove the microcirculation devices from both lower limbs, restore circulation in the limbs to the main cardiac circulation, and be careful not to loosen the venous stents and vascular stents."

"Continue argatroban intravenous infusion; the target aptt value remains at 2.0 times the baseline."

"Half an hour later, the microcirculation devices for the liver and kidneys were removed, and the organs were returned to the main circulation."

"Dr. Chen Guangbai recommends injecting edaravone at the Fengchi acupoint at a dose of 30mg + 20ml of normal saline, slowly." Fang Ziye has clearly become the core of the doctor's orders.

After nearly 30 hours of multiple rounds of emergency treatment, Chen Song's condition has gradually stabilized.

It was 6 p.m.

After Fang Ziye ordered everyone to include both upper limbs in the body's main circulatory system, Chen Guangbai and Deng Huai immediately began taking Chen Song's pulse from both sides!
The two had only talked for half a minute when their faces turned almost deathly pale.

Then they each took a few steps back, or their expressions changed unpredictably.

They each muttered to themselves, "It's gone, it's gone."

"How could it be gone?"

"What happened?" The shrimp-shaped pulse that the two had touched many times disappeared completely at this moment, and changed to a yin deficiency pulse, indicating signs of liver and kidney deficiency.

Although Chen and Song have recovered, their worldviews have still been shattered.

Beside them, Chen Xixian, dressed in scrubs, instantly broke into a smile despite her tired face. She first helped Deng Huai up, saying, "Uncle Deng, it's good that it's gone. You should rest for a bit!"

"Gone! All gone." Deng Huai turned to look at Chen Xixian, momentarily oblivious to the difference in their social status, his voice booming like thunder.

Chen Xixian was stunned for a moment. But she still smiled and said, "It's better that it's gone."

Chen Xixian was not a traditional Chinese medicine practitioner; at most, she was just an enthusiast. For her, nothing—Tao, scriptures, classics—was as important as Chen Song living a good life.

Chen Xixian only comforted Deng Huai, not his own father, because Deng Huai was an outsider, while Chen Guangbai was his father.

"Uncle Deng, I'll go make you some tea..." Chen Xixian rushed out the door, overjoyed. As she walked quickly, she immediately shared her joy with Luo Tingzhu.

Luo Tingzhu, who was not sleepy at all, also came out of the lounge and went to make tea with Chen Xixian.

Fang Ziye's tense mood gradually relaxed after hearing and seeing Chen Guangbai and Deng Huai's loss of composure.

He's now a little afraid of the "strange pulse patterns in Traditional Chinese Medicine."

Before he returned to Enshi, Chen Song was perfectly healthy and there was nothing wrong with him.

However, in the face of Chen Song's diagnosis of the shrimp's swimming pulse, all normal signs seemed like heresy.

From Chen Song's sudden discomfort during his morning exercise at the sanatorium, to the subsequent ventricular tachycardia, atrial fibrillation, multiple thrombosis, organ embolism, and multiple small embolisms and small ventricular tachycardia and atrial fibrillation.

If Fang Ziye and others hadn't done the vascular stents and filters in advance, Chen Song would probably have needed to have all his organs, from head to toe, repaired.

The "death pulse" is truly terrifying; it makes no sense whatsoever, at least not in a way that Fang Ziye and others can currently comprehend.

October 7th, 2:00 AM!

"All microcirculation devices have been removed, and all microcirculation interruptions have been integrated into the systemic circulation."

"Currently, the patient's oxygen saturation is 99% under ECMO intervention, heart rate and pulse are regular, bpm is 85 beats/min, and blood pressure is 112/74 mmHg!"

"Sinus heart rate, slight signs of myocardial ischemia, but the ischemia has been resolved."

"The markers of myocardial necrosis have now returned to normal levels, no significant damage has been observed to liver and kidney function, and the electrolyte imbalance has been completely corrected, as has the acid-base balance."

"The whole-body DSA showed unobstructed blood vessels, and the whole-body MRA showed no abnormalities."

"Electromyography of both lower and upper limbs showed weakened nerve conduction. The current blood glucose level is slightly high, with a random blood glucose of 9.9 mmol/L."

"Insulin secretion levels are disordered, and continuous insulin pump therapy has been initiated."

"Following discussion, the patient was transferred from the operating room to the intensive care unit, where they will be cared for by dedicated personnel!"

Current diagnosis: ICU-acquired myasthenia gravis!

"Insulin intensive therapy (target blood glucose 4.4-6.1 mmol/L)"

"Early rehabilitation exercises (30 minutes of bedside bicycle training daily)!"

"Please provide a treatment plan from the Department of Traditional Chinese Medicine." Professor Tan Mengbai and others from the Department of Anesthesiology were responsible for reading out Chen Song's vital signs and the ongoing treatment plan during the operation, confirming that Chen Song could be transferred out of the operating room at this moment.

“Professor Fang.” A professor from the cardiology department instinctively looked at Fang Ziye.

At this moment, Fang Ziye was sitting upright with his back against the wall, his breathing calm, his head tilted to the left as he fell asleep, his surgical mask rising and falling with his breath.

"Shh~~~Shh~~~" Chen Guangbai, whose eyes were bloodshot, immediately hissed Fang Ziye from the side.

Then, lowering his voice, he said, "Professor Fang hasn't rested for a long time. He's been fighting for over fifty hours straight. Let him rest for a while."

Although Chen Guangbai hadn't slept for even longer, he knew that his physical and mental exertion was far less than Fang Ziye's.

After Chen Guangbai finished speaking, Wang Qishan from the Department of Traditional Chinese Medicine quickly took over the topic: "The Department of Traditional Chinese Medicine suggests that the Brain Opening Acupuncture Technique be standardized."

"Neiguan acupoint: insert needle perpendicularly 15mm, rotate at a frequency of 120 times/minute."

"Insert the philtrum obliquely 10mm towards the nasal septum!"

"Acupuncture parameters: sparse-dense wave (2/15Hz), intensity should be such that facial muscles tremble slightly!"

"..."

Fang Ziye woke up around seven o'clock in the morning. Only Luo Tingzhu, Lan Tianluo, and others were on duty in the operating room.

After Fang Ziye woke up, he was quickly led to the cafeteria to eat, and then led to the villa area to rest and sleep again.

Fang Ziye glanced at Chen Song again and saw that Chen Song had opened his eyes and had a deep look in them. Although he was very weak, he was definitely awake.

After that, Fang Ziye ate two full bowls of rice before climbing into his bed and having a good, long sleep...

October 7th, 5:35 PM!

When Fang Ziye opened his eyes, Luo Tingzhu was still beside him, snoring softly. She was holding Fang Ziye's right arm tightly, her arms wrapped around him as if she couldn't bear to let go.

Fang Ziye could only force himself to stay awake, turn on his phone, and see the time.

Then, squinting, he saw light filtering through the corner of the curtains, beams of light radiating throughout the space.

The phone was quiet; there were no missed calls or unread messages!

Time passed quietly, with a beautiful woman by her side, and Luo Tingzhu's familiar and unique fragrance wafted faintly into her nostrils.

This feels so good.

Perhaps Fang Ziye's action of looking at his phone disturbed Luo Tingzhu. Luo Tingzhu's black hair first stirred, then she began to turn her head, and then shook it, revealing her eyes.

"Senior brother, what time is it?" Luo Tingzhu's soft voice was slightly hoarse, possibly due to a cold.

"5:36 PM," Fang Ziye said.

"I slept for five hours too?" Luo Tingzhu slowly got up, and Fang Ziye felt that his right hand, which had been numb from being pressed down, was free again, and he quickly grabbed it in the air.

"How is Dean Chen doing?" Fang Ziye continued to ask.

Fang Ziye only vaguely remembered that Chen Song had woken up.

"The person has woken up and is alive, but it seems they have acquired myasthenia gravis!"

"The range of motion in both upper limbs has been reduced by 70%, and the range of motion in both lower limbs has been reduced by 90%. Rehabilitation may be necessary."

"His speech wasn't very fluent either."

"Dr. Chen Guangbai and Professor Wang Qishan said that Dean Chen is using his breath to survive, and I don't know what will happen in the future!" Luo Tingzhu said while tying her hair.

Upon hearing this, Fang Ziye lowered his eyes slightly.

Fang Ziye was actually somewhat disappointed.

Fang Ziye had heard of ICU-acquired myasthenia gravis, but modern medicine cannot explain it at present. It may only be different from the individual's disease, and eventually it will result in the loss of some abilities.

Recovery is possible afterward, but the effectiveness of recovery varies from person to person.

"It's pretty good too!~"

“It’s been so many ups and downs!” Fang Ziye replied.

Luo Tingzhu nodded: "Dean Chen was very happy. He said intermittently that even the death pulse can be cured."

"The knowledge of the ancients was ultimately limited!"

"Traditional Chinese medicine is a philosophy, and philosophy is also a discipline. As a discipline develops, so too will traditional Chinese medicine develop."

Fang Ziye smiled again upon hearing this. After mastering his right hand, he wrapped his arms around Luo Tingzhu and then clasped his hands together.

Luo Tingzhu's body stiffened slightly, and she glared at Fang Ziye, but she knew she couldn't get rid of those groping hands.

"Senior brother? You were different when you had surgery than you are now." Luo Tingzhu bit her lower lip with her upper teeth, her lips turning white between bites.

"Surgery is surgery."

"Now is now, it's not illegal, it's not immoral! We're not being indecent, what's there to be afraid of?" Fang Ziye hugged Luo Tingzhu's back, pressing her close to his chest, savoring the fragrant feeling of her body against his skin.

Luo Tingzhu also had no way to deal with Fang Ziye.

Fang Ziye has always had a collecting habit, and now he also has an itchy-hands habit. What can be done about it?

As Fang Ziye said, it is neither illegal nor immoral, and it is not hooliganism.

"Senior brother, you're essentially a rogue." Luo Tingzhu raised her chin and said in a hoarse voice!
Upon hearing this, Fang Ziye quickly released Luo Tingzhu: "Go make yourself a cup of hot water, drink some cold medicine, and then have some porridge. Take good care of yourself and rest!"

"I'll go see Dean Chen Song again."

Luo Tingzhu turned her head and said softly, "You want to see your medals, right?"

"Don't talk nonsense!"

"At least we can't say it so bluntly." Fang Ziye stood up and snorted as he put on his clothes.

You can turn the tide of life and death up and down!

A doctor's medals are never worn on their body, but rather they are earned through their travels in the world.

(End of this chapter)