CHAPTER 186: 186. THIS TIME IT’S NOT A GUESS, RIGHT?

"Dr. Xu, please discuss with them. We can’t wait any longer. If oxygen starvation causes brain damage, even if the patient survives, they’ll be in agony," Liu Banxia urged anxiously, seeing Xu Guosheng still hesitating.

"Alright, let’s take a gamble. If there’s a problem, I’ll shoulder the blame with you." Saying this, Xu Guosheng walked into the ICU.

Liu Banxia slumped to the ground. This is the only chance, he thought, even though I’m not fully confident.

The bronchoscopy had revealed the only abnormality. Even the slightest relief could buy the patient more time, he reasoned.

Qing Kewa and Liang Xiaolin arrived then, looking quite calm as they had taken the elevator. They spotted Liu Banxia slouched against the wall.

The sight startled them. The patient’s condition must have worsened, they thought. Otherwise, Liu Banxia wouldn’t look so dispirited.

"Don’t overthink it. We’ve done our best," Liang Xiaolin consoled, crouching beside Liu Banxia.

"Dr. Liu, I’ll treat you to a chicken leg tonight," Qing Kewa encouraged.

She knew about the "chicken leg" inside joke circulating in the Second Affiliated Hospital, though she wasn’t entirely sure of its origin. Still, Liu Banxia must like chicken legs, so that should work, she figured.

"The results aren’t out yet. I’m just tired from running up the stairs," Liu Banxia replied helplessly.

Liang Xiaolin stared at him, startled, then shot him a glare.

"Dr. Liu, it worked! We used methylprednisolone, and the blood oxygen level has increased!" Xu Guosheng burst out of the ICU, his face beaming with a triumphant grin.

Ding! Daily Task Completed (5/20)

Respiratory Distress Patient Task Completed. Gained 100 experience points, 200 diagnostic skill proficiency points.

This task has been rated: Perfect. Gained 500 experience points, 500 diagnostic skill proficiency points, and 10 Glory Points.

Liu Banxia beamed. "Not bad! The gamble paid off. We don’t have to worry about the patient’s family suing us now. HA HA HA..."

"You’re really something, kid! Let’s grab a drink when you have time," Xu Guosheng said, giving Liu Banxia a thumbs-up.

"I’ll have to pass on the drinks for now. Could someone help me up? I ran too hard just now; I think I pulled a muscle," Liu Banxia said, looking pitiful.

Liang Xiaolin glared at him again. Before she could move, Qing Kewa had already reached out and started palpating Liu Banxia’s leg.

"Qing Kewa, what are you doing?" Liu Banxia asked curiously.

"I’m checking the injury. After a muscle strain, the muscle will swell. It needs ice and bandaging," Qing Kewa replied matter-of-factly.

"It’s not that serious. I just haven’t exercised in a while, and I pushed myself too hard running. It feels like my biceps femoris. It’s nothing major; some topical spray should do the trick," Liu Banxia said.

"Alright, I’ll leave Dr. Liu in your care. I’m going back to check on the patient. I’ll contact you once the patient wakes up. You really saved a life today." With that, Xu Guosheng ducked back into the ICU.

Most patients admitted to the ICU are struggling on the brink of life and death. If today’s patient had been treated with antibiotics according to the established protocol, without a doubt, it would have been disastrous. At best, it would have resulted in hypoxic brain damage. At worst, the patient would have died. Neither outcome would technically be considered a failed treatment.

Look at the doctors he’s training, Xu Guosheng mused, a touch envious. They’re so concerned; they even followed him here.

"Actually, I can walk slowly on my own now. You don’t need to support me like this," Liu Banxia said helplessly, looking at the two young women flanking him, each holding an arm.

"No, a muscle strain can become very serious. You could develop compartment syndrome, rhabdomyolysis, or even kidney failure," Qing Kewa stated gravely.

Liang Xiaolin couldn’t help but laugh. The patient was saved, Qing Kewa was fussing over Liu Banxia, and Liu Banxia himself looked troubled. She found the whole situation quite amusing. She conveniently forgot that she was also an accomplice on his other side. Their unusual trio certainly drew stares as they passed by.

Liu Banxia informed Wei Yuan of the good news. Then, leading his two juniors, he headed straight for the operating room.

Today’s patients were all complex cases. Now that the patient with respiratory distress was stable, Liu Banxia wanted to see what was happening with the hit-and-run driver.

When they arrived, Liu Banxia was surprised. My goodness! This surgery is being done in the teaching operating room,

he thought. Several doctors were already in the observation room, so the arrival of their conspicuous trio didn’t attract much notice.

"This patient was admitted after a car accident and presented with rapidly progressing paralysis," Xiao Zhaoqiu explained. "X-rays and an MRI showed no signs of spinal fractures, leading us to suspect a spinal hematoma.

"Due to the rapid progression of the symptoms, we didn’t have time for more detailed examinations and had to proceed with surgical exploration. You may encounter similar situations in your future medical careers. These hematomas bear a strong resemblance to cerebral hematomas and can also present with a delay.

"Of course, we are proceeding without definitive surgical indications in this instance. What I want to emphasize is that while treating patients, we must be mindful of mitigating risks, but we also need the courage to take necessary ones. The patient is now anesthetized. Let’s begin the incision."

Outside, Liu Banxia and the others watched Xiao Zhaoqiu operate with intense focus. This was the spine; utmost care was essential throughout the entire procedure.

Surgical exploration. Four simple words, yet the actual procedure was fraught with uncertainty.

With the aid of imaging, doctors could usually pinpoint the lesion’s location. Alternatively, clear symptoms might guide them to a probable diagnosis.

This time was different. It was an exploration of a significant segment of the spine. They would have to open it level by level, meticulously searching from top to bottom. How long would such a surgery take? That, too, was uncertain.

If they were lucky, they might find the hematoma’s location in minutes. If not, they could explore extensively and still find nothing.

This was an exploration within the spinal canal. The hematoma wasn’t necessarily large; the slightest oversight could mean missing it. If the hematoma were large, the patient wouldn’t exhibit progressive paralysis but would likely be immediately paraplegic.

Xiao Zhaoqiu’s luck wasn’t very good today. He had already been exploring for two hours and still hadn’t found the bleeding point below the third thoracic vertebra.

Just then, the monitor’s alarm blared.

"Blood pressure 180/105, pulse 50. Pushing antihypertensives now!" the anesthesiologist reported urgently.

"What happened?" Liang Xiaolin asked.

"It’s likely due to neurological compromise, causing unstable blood pressure and pulse," Liu Banxia said. "This is dangerous. If we can’t find the hematoma soon, it could cause irreversible damage, or..."

Even though he trailed off, Liang Xiaolin knew it meant the patient might not make it off the operating table.

Liu Banxia and the others watching from outside were incredibly tense; one could only imagine the immense pressure Xiao Zhaoqiu felt while operating.

Yet, despite operating for so long, Xiao Zhaoqiu’s hands remained steady, his demeanor calm.

Liu Banxia watched with deep envy. If I were in his place, I’d find it hard to maintain such composure, he thought. Even with enhanced concentration, this is just too intense.

As Xiao Zhaoqiu began to re-examine the cervical spine, Liu Banxia frowned, meticulously recalling the images from the surgical exploration he had just witnessed.

After a moment of thought, Liu Banxia pressed the intercom button. "Director Xiao, could you re-examine the third thoracic vertebra? Just now, when you were exploring there, I thought the color of the blood at one point looked a bit off."

His abrupt statement startled everyone, both in the operating room and among the observers outside.

To put it mildly, he was showing concern for the patient. On a grander scale, however, he was essentially guiding Xiao Zhaoqiu, a renowned chief of neurosurgery, during an operation. Whether this was a minor suggestion or a major overstep depended entirely on how Xiao Zhaoqiu and others perceived it.

Liu Banxia immediately felt a pang of regret. That was really too rash, he thought. He had been so engrossed in his thoughts that he’d overlooked the context and situation. Once the idea formed, his instinct was to voice it as a reminder.

Xiao Zhaoqiu looked up at him. "Liu Banxia, are you sure?"

"Director Xiao, when you were examining the third thoracic vertebra, it coincided with the patient’s blood pressure and heart rate fluctuations," Liu Banxia explained honestly. "I recall the blood at one spot there appearing slightly darker. Perhaps that’s the location of the hematoma."

He could now hear the murmurs of the doctors around him. But having come this far, he had to see it through. I really need to be more circumspect in the future, he mentally chided himself.

"Re-examine the third thoracic vertebra," Xiao Zhaoqiu instructed.

Liang Xiaolin tensed up. What if there’s still nothing at the third thoracic vertebra? she worried. The consequences would be far worse than mere embarrassment.

Liu Banxia was even more nervous than she was. As Xiao Zhaoqiu’s re-examination dragged on, he began to seriously doubt his own memory. Did I misremember? Did I see it wrong?

"Found it! Inferior to the third thoracic vertebra. Suction!" Xiao Zhaoqiu suddenly exclaimed, his voice filled with excitement.

Ding! Daily Task Completed (6/20)

Treatment Task Completed. Gained 30 experience points, 30 diagnostic skill proficiency points.

If hearing about the improvement in the ICU patient’s breathing had brought Liu Banxia immense relief, this moment made him feel like a deflated balloon; he almost collapsed to the floor.

The tension had been unbearable, even more so than when he was performing surgery himself. His nerves had been stretched taut, and now, finally, they completely unwound.

"Patient’s blood pressure, heart rate, and oxygen saturation are back to normal," the anesthesiologist reported promptly after the hematoma was aspirated.

Xiao Zhaoqiu looked up. "Liu Banxia, wait for me at the entrance to the OR."

Liu Banxia was bewildered. Oh no, it looks like I’m still going to get an earful for this big mouth of mine, he thought.

Liang Xiaolin, however, glanced at him in surprise, completely puzzled. Is he actually going to be criticized for this? He shouldn’t be, right?