CHAPTER 484: 484 COUGHED MY LUNGS OUT

Of the six fledglings, two and a half were already secured. It was only a matter of time before Xu Yino caved. That left Huang Bo, Miao Rui, and Li Hao still to be won over. It’s a heavy task and a long road. Anyway, Liu Banxia, stepping out of his office, would eye these three whenever he was free.

The trio felt unnerved being targeted by Liu, the Great Devil. Nothing good ever came from his attention.

Especially Li Hao, whose performance in the operating room today hadn’t been up to par. Among the six interns who went in, Qing Kewa aside, the other three had all received praise.

Ma Zhiguo, the intern from Orthopedics, was personally mentored by Wu Mingyu, and his skills were solid. Liang Xiaolin not only performed surgeries cleanly and efficiently but also handled emergencies well.

Su Wenhao had even taken the lead in a partial kidney resection surgery and was now ahead of all the general surgery interns. Miao Rui was even rewarded with chicken drumsticks today. Although he looked grumpy, he was actually quite happy inside.

And what about my situation? Li Hao thought. If measured by the standards of a normal intern, it’s actually not that bad. But since everyone is with Liu, the Great Devil, and I faltered, that means a poor rating. Whether I stay at the Second Hospital’s Emergency Center in the future is one thing, but I definitely don’t want to be the worst performer among all the interns.

Gathering his courage, he sneaked another glance at Liu Banxia. Meeting Liu Banxia’s smiling eyes, he chickened out.

Forget it, I’d better take over the debridement work and temporarily escape the Great Devil’s intimidating gaze.

"What’s wrong with Li Hao?" Shi Lei asked curiously.

"HEH HEH, nothing much, just putting a little pressure on him," Liu Banxia said. "Xu Yino, Liu Yiqing, and Su Wenhao have all decided to stay at the hospital. The other three of you need to work harder too. I can’t do it all by myself."

"No need. You can handle it all by yourself. In their hearts, you’re the primary mentor, so just keep leading them. Keep up the good work," Shi Lei said with a straight face.

Liu Banxia gave him a helpless look. Shi Lei had learned to be mischievous too.

However, it had to be said that morale in the Emergency Center was quite high these days. They had emerged from the gloom of the previous day. If everyone continued to work with such high spirits, things would go smoothly.

The afternoon was relatively quiet. Aside from some minor issues, there was no need to even go to the operating room.

This could be considered a perk of the Spring Festival. Even though illnesses don’t pick and choose their timing, people tended to be more cautious during this period. They would do their best to avoid catching colds and prefer to stay cooped up at home with their families.

"Dr. Liu, a patient with dyspnea is being brought in now!" the dispatch nurse called out just as the shift change was happening and it was time for dinner.

"Okay, where’s Li Hao? Li Hao, come and take this patient," Liu Banxia called out with a smile.

Li Hao, who was reading a book nearby, felt a wave of helplessness but put on his gloves and mask to prepare for the patient.

"Patient has dyspnea and chest pain. Blood pressure 70/110, heart rate 110. Receiving oxygen in the ambulance," the paramedic reported as they wheeled the patient in.

"Take him to Resuscitation Room One!" Li Hao said quickly.

Hearing about the chest pain, he didn’t dare be negligent. He was worried the patient might have a cardiac issue.

"One, two, three, transfer! Connect the monitor. I’ll auscultate," Li Hao said hastily after they moved the patient to the bed.

"Blood oxygen 92 percent," Zhou Qian reported quickly after connecting the monitor.

Li Hao, auscultating, frowned. "No breath sounds in the right lung. Get a stat portable X-ray! Everyone, clear the way!"

After everyone quickly moved aside, they placed the cassette and took the X-ray.

"Notify cardiothoracic surgery! Pneumothorax. I’m inserting a chest tube," Li Hao said decisively, looking at the image on the display.

Liu Banxia, watching, nodded. That’s what makes a competent emergency physician. Do what needs to be done; if it benefits the patient, you do it yourself.

In the past, if a chest tube insertion was needed in the Emergency Department, it would have been a rare event. But for the current Emergency Center, it was now routine.

Take these interns, for example: each had performed dozens of non-invasive airway intubations and, conservatively, at least five chest tube drainages.

Pneumothorax and hemothorax were common occurrences after accidents. Although these procedures weren’t always extremely urgent, early treatment benefited the patient.

"Blood oxygen is rising!" Zhou Qian reported quickly once Li Hao finished inserting the tube.

"What’s the patient’s condition?" Liang Xiaolin hurried over.

"Pneumothorax. There seemed to be some bleeding when I inserted the chest tube for drainage. Should we get a chest CT after drawing blood?" Li Hao asked.

After auscultating, Liang Xiaolin nodded. "It might be ruptured alveoli. I don’t see any signs of trauma. How did this happen?"

"Let’s wait a moment. The patient just caught his breath. His blood oxygen was 92 percent on arrival," Li Hao said.

The patient removed his oxygen mask and said with some effort, "Cough... cough..."

"Do you have any history of hypertension, heart disease, or diabetes?" Liang Xiaolin asked.

The patient shook his head.

"We’ll take you for a CT scan shortly to confirm the condition of your lungs. However, I suspect a ruptured alveolus, which would require surgery," Liang Xiaolin said.

The patient nodded.

This was considered patient consent, acceptable in emergency cases without family present.

"It’s really something, being doctors. If you told an ordinary person that someone coughed so hard they ruptured a lung, probably no one would believe it," Liu Banxia said after the patient was wheeled away.

"I remember there was another case, a patient who sneezed, right? And ended up with a pneumothorax, also from a ruptured lung?" Shi Lei asked.

Liu Banxia nodded. "Yes, there was such a case. I think it was a group who had been drinking and came to our Emergency Department for IV fluids. There was some dispute over compensation that dragged on for several days."

"A sneeze can easily cause a pneumothorax, so that must have been a hell of a cough to rupture a lung. His temperature is normal, so he probably doesn’t have a cold or fever."

"The X-ray of the left lung looked fine, but the right side was obscured because of the rupture. Surgical exploration should reveal more; there might be some inflammation."

"This looks like it could be bronchial. He’ll need a bronchoscopy. Why are you all looking at me like that? Am I wrong?"

Shi Lei shook his head and stepped aside.

"Chao, are you trying to sneak off too?" Liu Banxia quickly called out, seeing Wang Chao about to leave.

"Why wouldn’t I leave? Should I stay here just to be annoyed by you?" Wang Chao said resentfully.

"I already feel like I’m working incredibly hard. But look at you! You’re already so skilled, why do you still push yourself so much? Give us a break, will you?"

"My goodness, you sound like such a complainer. What on earth did I do?" Liu Banxia said helplessly.

"I was just thinking about how pitiful that guy is, coughing until his lung ruptured. And you? You’re already deep into diagnosing his condition. It’s impossible to keep up!" Wang Chao shook his head after speaking.

Liu Banxia scratched his scalp. "Well, it might just be an occupational hazard. I don’t know how I jumped to that conclusion. Aren’t you guys curious too?"

「DING! Task Assigned: Patient with a Cough-Ruptured Lung

Open Task: Patient admitted to hospital due to dyspnea and chest pain. Examination reveals the patient’s lung ruptured from coughing. The host has developed a strong interest in this case; further diagnosis is required. Rewards will be issued based on diagnostic results.」

Looking at the newly issued task, Liu Banxia couldn’t help but chuckle. He hadn’t expected his curiosity to actually trigger a task.

Truthfully, he was genuinely intrigued by this case. Although not extremely rare—such cases had occurred before—it was statistically quite uncommon.

If people could easily cough up a pneumothorax or rupture a lung, hospitals might as well open specialized pneumothorax clinics.

However, the necessary cardiac markers still needed to be checked for this patient. Better safe than sorry. If chest pain from the lung masked cardiac pain, and a heart problem was overlooked, it would be a medical incident.

"Teacher Liu, you’re working so hard. Shouldn’t you reward us with some chicken drumsticks?" Xu Yino sidled up to him.

"You think so?" Liu Banxia asked with an amused smile.

"HEH HEH, it’s been a long time since we’ve had your reward drumsticks, Teacher Liu," Xu Yino said.

"We’ll see how you all perform... Hmm, let’s use this patient. Go investigate what exactly happened," Liu Banxia said, a hint of resignation in his voice.

"Really, Teacher Liu?" Xu Yino pressed.

"Absolutely. No kidding. The reward goes to whoever figures it out. Actually, I need to look into it myself too," Liu Banxia said.

The moment he finished speaking, the six fledglings dashed off after the patient, eager to get firsthand information.

"See? A single reward from you can have such an effect. It just shows how highly they regard you," Shi Lei said, approaching him again.

"Boss, I’ve realized something. You definitely have the makings of a mother hen," Liu Banxia said, giving him a thumbs-up.

"You think I care if you tease me? I’m immune by now," Shi Lei said, stretching lazily.

"As long as they all stay and mature quickly, you can say whatever you want. With them around, I’ll have an easier time in the future. I don’t have many ambitions; just steadily advancing to Chief Physician will be enough for me."

"You should be up for Associate Chief Physician this year, right?" Liu Banxia asked.

Shi Lei shook his head. "It’s hard to say. Even with some advantages in the Emergency Center, getting promoted isn’t easy. We’ll see. If not, I’ll try again next year."

"Boss, I support you, both mentally and physically," Liu Banxia said earnestly.

"Get lost. You should also find some time to study. If you fail your attending physician exam... Tsk tsk, that would be quite amusing," Shi Lei retorted.

"Definitely. I study whenever I have spare time. There’s still a long way to go, so it should be enough," Liu Banxia nodded.

This was indeed something I need to focus on, as it overlaps with my term as Chief Resident. But it should be fine. After all, I have real skills now.