41 – Work

Returning to work was difficult for everyone. If only the national holidays were longer, they thought as they inched the car forward slowly against the rush hour traffic. Heading to work on a crummy Monday morning, to a crummy job, and to a crummy building was not anyone's idea of a life, but that was how the majority of the people in the office environment lived their life.

Lin He Yong, one of the majority, approached the elevator, only to be pushed aside.

"Ah dammit, I was there first!" he yelled at the rude woman.

Noticing she was pregnant, he groaned and looked at his watch. He was going to be late if he waited for the next elevator. Running the stairs with his coffee in hand, he didn't think the day could get any worse. Suddenly, a man bumped into him on the way down the stairs, spilling his coffee all over himself.

"Hey *****, watch where you're going!" Lin He Yong yelled, but his words didn't have any effect on the man, who continued running down the stairs.

"The ***," Lin He Yong cursed again.

He cleaned himself off with the used napkin from his leftover dough stick. Once the napkin was completely drenched, he chucked the napkin to the side, not caring anymore about proper courtesy.

"F*** this," Lin He had enough.

Instead of running, he leisurely walked up the stairs. He didn't care if the boss yells him, he was already late, whether it was ten or twenty minutes, it didn't matter. As he walked up to the 6th floor, he suddenly blanked out.

****

"Incoming, an explosion was reported in the west commercial district, multiple injuries, and potential fatalities. Ambulances are gathering to bring the injured to nearby hospitals. Provincial hospitals are being notified to send help." The announcement was quickly broadcasted to several hospitals throughout the region.

Everyone at the Qinbei Hospital had heard the announcement, but social media had already blown up with reports from the district. All the doctors were already alerted to gather for a brief meeting before heading to the ER.

Attending doctors and surgeons were in charge of the critical cases, from the Chinese Emergency Triage Scale (CETS) level 1 and 2, while all the inexperienced and residents handled the minor injuries from CETS 3 and 4.

Cases that required all the doctors to be involved were rare. When a natural disaster hit, there were protocols in place, but the actual practice was a lot messier. Nurses were rushing to get supplies while the doctors were allocating roles.

"There's a problem, Doctor Nan is on vacation, and Doctor Lao is at a conference," Nurse Yuen reported to Chief Gao. "Doctor Gu is heading here now, but it would take him an hour to get here with traffic. Doctor Sheng is already assisting Doctor Hao, but it's not going to be enough. All the other interventionalists from neuro and vascular are swamped with their own work."

Chief Gao was really in a bind. Although he could perform most emergency surgeries on his own, he couldn't possibly perform hybrid operations without someone working the angiography device.

"Are there any residents with the ability to perform embolization?" asked Chief Gao.

"Doctor Li seemed to have some knowledge of embolization," Technician Wu responded.

"Oh?" Chief Gao wasn't surprised, but he wondered how well Li Yun could perform the procedure.

"When I was training at the Binchu University Hospital, the technician there mentioned that Doctor Li had performed the procedure several times when there was a mudslide," said technician Wu. "It wasn't documented, but the technician who assisted Doctor Li during the operations said they were able to save a lot of lives because of it."

Chief Gao could see why it was undocumented, but it was still impressive. Li Yun back then was just an intern. He may have saved a lot of people, but it was also against regulations.

"How did he get away without being reprimanded?" Chief Gao wondered.

"He didn't say, but one of the people he saved had a bit of pull. Also, it seems that all the patients agreed to sign a waiver, so the event was swept under the rug."

Chief Gao remembered seeing the news of the mudslide where dozens of people were impacted, mainly ethnic minorities. He quickly made the decision to have technician Wu prepare the angiography suite and then contacted Li Yun. Since he was in charge of the ACS, emergency embolization also fell under his jurisdiction.

"Little Yun, I am going to need assistance with hybrid operations," Chief Gao said over his cell. "Can you perform artery embolization and stent?"

"All right, on my way," Li Yun responded while getting up from the bunk bed.

Li Yun only had three hours of sleep, but the rumbling around the hospital had woken him up before Chief Gao called. He combed his messy hair as he ran inside the ER, looking around at the chaotic scene. The ambulances had already arrived, and at least a dozen people had visible injuries from the blast. The nurses were trying their best to calm everyone down.

Nurse Yuen was going ballistic over the phone trying to get more supplies. Doctor Hao was preparing as many beds as possible. Other doctors from other departments were heading in to assist.

As Li Yun was running toward the OR, he quickly surveyed the patients and triage tags. The level 1 tags were the most critical, and they were likely already in the OR ready to be operated on. However, there was one woman with a level 4 tag that Li Yun didn't agree with, and told the nurse to reassign her with level 2 tags.

After quickly scanning around the ER, Li Yun ran to the OR and scrubbed in.

"You're slow getting here," Chief Gao remarked.

"You try running through a mass of zombie-like patients," Li Yun complained.

After the short greeting, Chief Gao explained the operation. Chief Gao was going to handle the emergency damage control operation, while Li Yun took the lead handling intraoperative interventional radiology (IVR).

Technician Wu rolled in the mobile digital subtraction angiography device into the operation room and started the setup as they went through the protocol. Li Yun was wondering who told Chief Gao about his IVR experience, and it seemed likely that Technician Wu had blabbered about him.

Although Chief Gao was focused on the patient, he watched as Li Yun inserted the needle into the arm without looking at the ultrasound. Inserting into the radial artery was not a simple thing. Many doctors use ultrasound to locate the artery.

For a classical Chinese doctor, finding a pulse was a basic skill. Li Yun had been reading his own pulse and various people he came across since college to understand meridians. If he couldn't locate an artery or vein, then one had to wonder what he was doing other than sleep during college.

Afterward, Li Yun injected the nitro and inserted the catheter, guiding wire, and coil. Li Yun finished the operation on the tenth coil and within ten minutes, which was impressive considering a team of experts may need 20 coils.

"How did you learn?" asked Chief Gao.

"From my internship?" asked Li Yun, but he had a feeling Chief Gao wasn't going to buy it.

"Really? From performing them during the mudslide?"

"Chief Gao, I'm just a genius who can understand any operation just by watching something once."

"Probably, you're a strange kid after all."

Li Yun learned from using Zuowang, but it was the mudslide that gave him hands-on experience. During the mudslide a few months ago, the situation was really pressing. Binchu University Hospital didn't have many vascular surgeons, cardiologists, and interventional radiologists, and as the hospital closest to the mudslide, a lot of patients were sent to the hospital.

The situation was really chaotic and all the doctors in the ER were panicking. The mudslide was an hour away, so time wasn't on their side. Li Yun knew how to perform the procedure and had practiced it in the angioplasty suite. Only the radiology technician knew of his ability, and begged him to help out.

On his first attempt, Li Yun amazed even himself. Soon, he took on the remaining patients injured during the mudslide. Luckily, he wasn't doing open surgery, or else he would feel like he was playing around with someone's life. He felt more confident because it was a minimally invasive procedure. He never understood why everything was swept under the rug, but it was likely he had saved someone important during the process.

"You want a break?" Chief Gao asked Li Yun after six hours of work.

"No, there are still patients," Li Yun remembered seeing a lot more patients in the ER.

They continued to work with only quick five minutes of restroom and meal breaks. After sixteen hours and performing close to a two dozen operations, Li Yun collapsed on the bunk bed. Doctor Nan and Doctor Lao had returned from their conference, and took over the emergency operations.

Li Yun woke up four hours later. According to the news, the situation had stabilized a bit, but they were still searching for people under the debris.