CHAPTER 185: DECISION CONCERNING LIFE AND DEATH

Seeing Liu Banxia move to the side to think, Qiu Mingyuan wisely didn’t disturb him, instead heading over to Liang Xiaolin and Qing Kewa to inquire about the situation.

Even when new patients arrived, Wei Yuan handled them. He knew Liu Banxia’s attention was focused on the patient upstairs and had temporarily drifted.

After more than half an hour, Liu Banxia’s phone rang again.

"Brother Wu, are the scans ready?" Liu Banxia asked after answering the phone.

"The X-ray and MRI are both done. They only show a distal radius fracture in the left arm, which is nearly fixed after repositioning. There are no issues with his head or spine," Wu Bo replied.

"No fracture in the spine?" Liu Banxia asked in surprise.

"No, none. The X-ray and MRI didn’t show any. Moreover, there’s a new development—he’s now losing sensation in both arms, but his circulation is normal," Wu Bo added.

"Thank you, Brother Wu," Liu Banxia said gratefully.

This was a kind gesture; knowing he was waiting anxiously, Wu Bo had informed him before the official scan results were even out.

After some contemplation, Liu Banxia dialed Xiao Zhaoqiu at the Neurosurgery Department.

"Hello?" Xiao Zhaoqiu’s voice came over the line after a few rings.

"Director Xiao, hello, this is Liu Banxia from the Emergency Department. We have a patient here who has manifested symptoms of progressive paralysis after a drunk driving accident," Liu Banxia reported hastily. "Recent X-rays and MRI scans show everything is normal, aside from a fractured radial bone in his left arm. If you have time, I hope you can come in person. This patient is also connected to a hit-and-run victim currently in our ICU."

After hanging up, Liu Banxia waited anxiously. He wasn’t sure if Director Xiao had time or would be able to come in person.

"Alright, I’ll be at the Emergency Department shortly." After ten agonizing seconds, Director Xiao finally responded and then hung up.

Liu Banxia pumped his fist, a wave of relief washing over him.

"Banxia, you’re awesome for managing to call Director Xiao directly," Wei Yuan said, giving him a thumbs-up.

Liu Banxia gave a bitter smile. "I was really out of options; I had to bite the bullet and call him. I’m just so worried about the patient upstairs. Even though we can treat him now, it’s only limited treatment."

Wei Yuan patted him on the shoulder, empathizing with his situation and knowing that words of comfort were of little use.

"Brother Liu, uh, I think I’ll... head back first," Qiu Mingyuan stammered.

Liu Banxia stared blankly for a moment, then laughed. "Such a scaredy-cat. But it’s your decision; I won’t interfere."

"Heh heh, even if I had more guts, it wouldn’t help. I’ll just take the long way around," Qiu Mingyuan said before quickly slipping out the main entrance of the Emergency Department.

"What was that all about?" Wei Yuan asked curiously.

"It’s complicated. Help me figure out how to explain the patient’s condition to Director Xiao when he arrives. If I leave anything out, you need to fill me in," Liu Banxia said.

"You explained it very clearly over the phone just now. What else could there be to add?" Wei Yuan responded with a wry smile.

At that moment, the nurse and a police officer brought the patient back to the Emergency Department. The patient’s mother stood to the side, crying silently.

"Was it both arms that lost sensation earlier?" Liu Banxia asked one of the nurses.

"No, initially it was just both hands," the nurse replied.

Liu Banxia frowned, then took a probe, disinfected it, and proceeded to perform a pinprick test on Wang Yu’s body. Now, Wang Yu couldn’t even feel the needle on his abdomen.

"I’ll reset the fractured arm first. An expert will be here soon." After saying this, Liu Banxia promptly attended to Wang Yu’s left arm.

Before Wang Yu’s mother could ask about his condition, Liu Banxia had already reset the fracture.

"Stabilize it with a splint for now. I’ll check the situation," Director Xiao’s voice said from behind Liu Banxia, just as he finished.

"Director Xiao, the patient’s paralysis has now spread to his arms and abdomen, and it’s progressing upwards very rapidly," Liu Banxia hurriedly reported.

Wei Yuan, who was standing beside them, turned the monitor to show Director Xiao the X-ray and MRI images that had just been transmitted.

Director Xiao frowned, took a probe just as Liu Banxia had done earlier, and examined Wang Yu.

"Book an operating room and notify our department to send someone over. It’s likely a hemorrhagic embolism in the spine. The condition is progressing too fast and must be treated immediately," Director Xiao instructed.

"The nerve compression might not be due to a traumatic fracture. It could also be from changes within the spinal canal. The most plausible diagnosis is a gradually forming blood clot. We need to perform exploratory surgery, checking section by section. Otherwise, he could genuinely become paraplegic."

Ding! Daily Mission Completed (4/20)

Paralyzed Legs Mission: Complete. Reward: 10 Experience Points, 100 Diagnostic Skill Proficiency.

Liu Banxia was taken aback for a moment, then quickly nodded. He arranged for Wang Yu to be sent to the operating room and carefully explained the surgical risks to Wang Yu’s mother.

At this point, Wang Yu’s mother had no other thoughts; her only wish was for her son to be cured.

"Sigh, I’m truly impressed. Director Xiao is really something else. Why didn’t I think of that earlier?" Liu Banxia said with great emotion after the consent form was signed.

"Us? We have too little experience to compare with Director Xiao. But the surgery is very risky; it’s a race against time," Wei Yuan remarked.

Liu Banxia nodded in agreement. If the clot was too large, the ensuing pressure could lead to permanent nerve damage.

He was truly convinced now, especially considering the reward from the mission. When had he ever received 10 experience points for an open-ended mission like this? The diagnostic skill points were probably because Director Xiao explained the reasoning, allowing him to learn something new.

A spinal injury doesn’t always present as an external fracture; it can also involve an internal clot. It’s just that because of the car accident, everyone naturally assumed an external fracture was the cause.

Huh?

Realizing this, Liu Banxia, who had been sitting, suddenly stood up.

Ding! Mission Issued: Patient with Respiratory Distress

Open-ended Mission: Due to the host’s concern for the patient with respiratory distress, it is believed that it might be caused by other factors. Mission reward will be based on the diagnostic result.

"What’s wrong?" Liang Xiaolin was startled.

She felt that this day had been extremely thrilling.

"Doctor Liang, do you think the ICU patient’s left upper lobe collapse might not be from trauma, but from a pre-existing condition?" Liu Banxia asked, his eyes shining.

"Um... this... this... Dr. Wei, what do you think?" Liang Xiaolin asked, uncertain, turning to Dr. Wei.

Upon hearing this, Wei Yuan also knitted his brows. "Although it’s possible, the odds are slim, right? After all, we all saw the pulmonary contusion on the X-ray."

"There’s always a chance, no matter how small. Brother Wei, please keep an eye on things here while I check his diagnostic records," Liu Banxia said before rushing to the computer.

"Is Dr. Liu always like this?" Wei Yuan asked curiously.

"Um... pretty much," Liang Xiaolin replied after some thought.

"Last time, with the arterial aneurysm patient, he just muttered to himself in the ward for ages and then suddenly figured it out."

"Dr. Wei, do you really think it could be caused by the patient’s own illness? If so, can we still save him?"

"That’s hard to say. Even if his assumption is correct, it all depends on the actual condition. The patient’s blood oxygen level is too low now. If we could restore some of his respiratory function and raise the oxygen level, there’s a chance he might pull through without any issues," Wei Yuan mused.

"But that’s just wishful thinking; we can’t be sure. Besides, the patient’s blood oxygen has already dropped significantly. He’s in danger."

Liang Xiaolin’s expression fell. That was indeed the situation. Liu Banxia wasn’t an internal medicine specialist; no matter how smart he was, he might not be able to figure this out. And they were running out of time.

But to her surprise, Liu Banxia wasn’t at the computer for even five minutes before he jumped up and sprinted towards the green channel, moving incredibly fast.

"Ah! Why did he just run off?" Liang Xiaolin exclaimed in surprise.

"He probably thought of something. I’ll keep an eye on things here; you and Qing Kewa can follow him," Wei Yuan suggested with a smile.

Liang Xiaolin and Qing Kewa were long-legged and quite fast themselves, but they still couldn’t catch up to Liu Banxia. He was running for dear life.

Even though Liu Banxia’s stamina had been enhanced, such an intense sprint was still a significant strain on his body. By the time he reached the ICU entrance, all he could do was lean against the wall, gasping for air.

"Dr. Liu, we were just about to call you. We’re planning to use antibiotics. The patient’s blood oxygen has dropped to 80. If it continues to decrease, it will inevitably cause irreversible brain hypoxia," said Xu Guosheng, emerging from the ICU.

"Doctor Xu, wait—" Liu Banxia panted, struggling to catch his breath. "HUFF... HUFF... Don’t use antibiotics yet. I... I just looked at the bronchoscopy findings. The patient is comatose, and we’re maintaining respiration via intubation. In a coma, the chest wall should be relaxed, but I noticed his airway is consistently constricted. That’s not right. It’s completely wrong! I believe his respiratory distress isn’t due to trauma but a pre-existing condition, perhaps an asthma-like expiratory distress disorder. What do you think? Should we take a gamble?"

Listening to Liu Banxia, Xu Guosheng stopped in his tracks, frowning deeply.

What Liu Banxia said was plausible, but it was a risky choice. The medication to alleviate asthma involves corticosteroids. If it was indeed asthma, these drugs would work immediately.

But what if they were wrong? Using steroids instead of antibiotics could accelerate the spread of infection, potentially causing myopathy, and ultimately hasten the patient’s death.

This was not an easy decision to make.