Chapter 24: Chapter 24: Won Again
Yan Feifanâs heart sank.
That splash of red meant something was terribly wrong.
It was papilledemaâa swelling of the optic disc inside the eyeball, caused by increased intracranial pressure.
Only then did Yan Feifan notice that the twitching of the burly manâs facial muscles was rhythmic.
This wasnât a facial tic caused by pain at all. It had to be a focal seizure brought on by dangerously high intracranial pressure.
Yan Feifan also noticed the manâs gaze had become unfocused.
He quickly examined the manâs head.
After a quick inspection, Yan Feifan felt a swelling about five centimeters in diameter on the upper left side of the back of the manâs head.
Other than that, there were no other signs of head trauma.
Yan Feifan concluded that the man must have suffered an accidental blow to the head, which had unexpectedly ruptured a blood vessel in his brain.
The blood had been slowly pooling inside his skull, gradually increasing the intracranial pressure until the symptoms finally manifested.
Thatâs why the triage doctor had missed it, classifying him as having minor injuries.
He turned to the young nurse and ordered loudly, "Call a neurosurgeon immediately! And go tell Mr. Wan that I have a patient with a cerebral hemorrhage who needs urgent treatment."
Seeing the young nurse hesitate, Yan Feifan urged her sharply, "What are you waiting for? Go, now!"
The young nurse scurried out in a panic.
Just then, a voice suddenly rang out in Yan Feifanâs mind. "Not bad. You finally noticed the patientâs abnormality and made the correct diagnosis."
"But, Yan Feifan, why arenât you doing anything yet?"
Yan Feifan turned his head to look at Yiyi, who had appeared to his right dressed as a doctor, and said coldly, "Iâve already sent the nurse to report it."
Yiyi walked over to the man, who was now frozen like a statue, and studied him. "You know full well that in his condition, you must lower his intracranial pressure as quickly as possible."
"Otherwise, once the pressure gets too high, it will be difficult for blood to enter the brain. That will quickly lead to hypoxic damage to the brain cells, and subsequently, brain death."
"When every second counts, you just send a nurse to make a report while you do nothing yourself?"
Yan Feifan struggled, trying to defend himself. "Iâm just a resident. With attending physicians around, Iâm not qualified to perform this level of emergency procedure."
Yiyi shot Yan Feifan a contemptuous look. "So, to you, a personâs health and life are less important than hospital regulations?"
Yan Feifan fell silent, not knowing how to argue his case.
Yiyi pointed at the man, whose pained expression was now frozen in place, and said slowly, "Let me tell you the possible consequences of this delay of a few dozen seconds!"
"Loss of vision in one eye or hearing in one ear?"
"Numbness and impaired mobility on one side of his body?"
"Hemiplegia?"
"Paralyzed in bed, or perhaps a vegetative state?"
"Brain death, or even just... death?"
Then, Yiyiâs tone suddenly turned mocking. "Let me take another guess, Yan Feifan. The reason you wonât act probably isnât because youâre afraid of violating hospital rules. Itâs just because..."
"Youâre scared, arenât you?"
"Youâre afraid your skills arenât good enough. Youâre afraid of failure, arenât you?"
Yiyi said tauntingly, "After all, even if youâve simulated this thousands, or tens of thousands of times in the world of your consciousness, it was just a simulation. You could always try again if you failed."
"But in the real world, youâre facing a living, breathing person."
"A man of flesh and blood who can talk and breathe wonât give you a second chance."
"So, youâre cowering. Youâre backing down."
Yiyi gave him another look of disdain. "Yan Feifan, if you donât have the guts, then just give control of the body to me."
"Are you just going to stand by and watch a life be permanently damaged, or even lost, because of your cowardice and incompetence?"
Spurred on by Yiyiâs relentless provocation, Yan Feifanâs gaze gradually hardened with resolve.
He turned and looked Yiyi straight in the eye, his voice low and firm. "After practicing tens of thousands of times in the world of my consciousness, I absolutely will not fail."
"Yiyi, if you think youâre taking control of my body, you can dream on."
As he spoke those words, the world around Yan Feifan returned to its normal flow of time.
He grabbed a Puncture Needle from a compartmentalized box full of medical instruments and tore open the sterile packaging.
The dazed man vaguely saw Yan Feifan approaching with a needle that looked ten to twenty centimeters long. A jolt of fear brought some clarity back to his eyes.
"Doc... tor..."
Hearing the manâs slurred speech, Yan Feifan quickly explained, "Your intracranial pressure is too high. I need to lower it urgently to buy time for further treatment."
"Iâm going to perform a puncture through your right nasal cavity to drain some cerebrospinal fluid."
He then added reassuringly, "Donât be afraid. Itâll only hurt for a second!"
With that, Yan Feifan inserted the long needle into the manâs right nostril.
Finding the right position and trusting his feel for it, Yan Feifan took a deep breath, braced the back of the manâs head with his left hand, and with his right hand, pushed forcefully...
With a soft SQUISH of the needle piercing flesh, more than half of the needle in Yan Feifanâs hand disappeared into the manâs nasal cavity.
If this puncture went too deep, or if the angle was wrong, it would cause irreversible brain damage.
But the moment Yan Feifanâs hand stopped, he knew one thing with absolute certainty.
Heâd succeeded!
At that moment, Yan Feifan felt an unprecedented sense of relief, as if an invisible shackle had fallen away from him.
The instant he detached the syringe from the back of the Puncture Needle, a reddish, bloody fluid shot out from the needleâs hub.
The fluid sprayed all over the front of Yan Feifanâs sterile gown.
Just then, the sound of hurried footsteps approached from the distance.
The curtain to the cubicle was thrown open, and the young nurse ran in.
She saw the front of Yan Feifanâs gown soaked with bloody fluid and froze, stunned. It took a sharp glare from Yan Feifan to snap her out of it.
"Mr. Wan said that all the attending physicians and above are busy resuscitating patients and canât get away right now."
"Mr. Wan said he authorizes you to perform the emergency procedure."
"Mr. Wan also said you should proceed with confidence and that if anything goes wrong, heâll take full responsibility."
The nurse, catching her breath, added, "I also paged the neurosurgeon."
Yan Feifan nodded and gave another order. "Get a gurney over here..."
Another five minutes passed before an associate chief physician, who had rushed over from Neurosurgery, arrived with a team and took the man away...
After changing into a fresh sterile gown, gloves, and mask, Yan Feifan went back to treating the wounded.
After treating the injuries of five more patients, the young nurse led in a beautiful, impeccably dressed woman in her early twenties.
Yan Feifan removed the gauze from her left brow bone, revealing nothing more than a six-centimeter-long laceration.
He couldnât help but glance at the young nurse.
âThis wound is so small and shallow, a nurse could have handled it directly. Isnât having me treat it overkill?â
The young nurse quickly and timidly explained, "Mr. Yan, Mrs. Xv brought her over."
"Mrs. Xv said there arenât any more patients with injuries suitable for you at the moment."
"This ladyâs wound is on her face, and among all the residents in the emergency department right now, your suturing technique is the best."
"So..."
Yan Feifan waved a hand, indicating that he understood.
As he began to clean the young womanâs wound, he heard her ask through the pain, her voice filled with worry, "Doctor, will it leave a scar?"
Yan Feifan said calmly, "Itâs impossible for there to be no scar at all. However, as long as you donât have a keloid-prone skin type..."
He continued with great confidence, "After it heals, no one will be able to see it unless theyâre looking for it up close."
The young woman let out a small "oh" and, fighting through the pain and fear, remained perfectly still, allowing Yan Feifan to work.
Once the wound was cleaned, Yan Feifan selected the finest 4-0 suture to close the womanâs wound.
Surgical suture diameters come in several standard sizes, such as 6-0, 5-0, 4-0, 3-0, 2-0, 0, 1, and 2.
The more zeroes, the finer the sutureâs diameter.
Among these, the 6-0 and 5-0 sizes are also known as cosmetic sutures.
Sutures of this gauge are most commonly used in plastic surgery.
During facial cosmetic procedures, these sutures are typically made of absorbable material and used for intradermal stitches.
When a highly skilled plastic surgeon sutures a cosmetic wound, the scar will be extremely small after it heals.
To the naked eye, it would be virtually unnoticeable.
However, in a place like the emergency department, facial wounds are usually closed with 0 or 1 gauge sutures.
Yan Feifanâs deliberate choice of a 4-0 suture was already a considerable courtesy to Mrs. Xv...
After finishing with the young womanâs wound, Yan Feifan stepped out of the treatment room and saw that the emergency hall had been transformed into a massive trauma center.
A total of four teams were working to save their respective patients.
A dozen or so interns and residents stood by, observing.
Seeing that no more patients were being brought in, Yan Feifan knew that this wave of the emergency was over...
He walked out of the emergency hall and saw Yan Ziruo hurrying toward him.
Yan Feifan shielded his eyes and looked up at the bright sky, dotted with white clouds.
"Sis, Iâm fine."
"And besides, I beat that annoying Yiyi again..."
Yan Ziruo asked in confusion, "Feifan, whoâs Yiyi?"