The Enhanced Doctor-Chapter 378: High fever during surgery

(Thanks to my good friend for the generous donation.)

Last night’s hypothyroidism patient would undoubtedly leave a significant mark on Liu Banxia’s medical career. Such is the life of a doctor. Sometimes, the right things one does are soon forgotten, but if a mistake occurs, it will be remembered for a lifetime.

Doctors cannot afford to make mistakes, as a patient’s life is at stake. 𝐟𝚛𝕖𝚎𝕨𝗲𝐛𝚗𝐨𝐯𝐞𝕝.𝐜𝗼𝗺

Today, Liu Banxia had nothing much on his schedule during the day; there were currently no surgeries planned. Whether he could peacefully spend a day in the hospital would depend on fate.

"Liang Xiaolin, how are the surgeries you’ve been assisting with recently?" Liu Banxia asked.

"Tiring. There’s one more today. I have to go to orthopedics for an internship tomorrow. I really shouldn’t be trying to juggle so many things," Liang Xiaolin said.

"In our department, Qing Kewa is perhaps the only one who doesn’t need to stretch herself thin. Everyone else is indispensable," Liu Banxia said.

"It’s not a big deal, you don’t need to set such high standards for yourself. Just being able to handle simple fractures is enough. At the very least, the requirement for you is one tier lower than for Xu Yino and her group. This is all in preparation for handling large influxes of trauma patients in the future."

"Teacher Liu, aren’t you angry at all about what those people are saying online?" Xu Yino came over and asked.

"You, ah, you’re certainly enthusiastic when it comes to chasing gossip," Liu Banxia looked at her helplessly.

"I think we should make a switch and send you to intern with Wang Chao. You two could gather all the Second Hospital’s grapevine news. That should be interesting."

"You called?" Wang Chao, who had just returned from breakfast, asked casually.

"Nothing much, you just have to treat us to chicken drumsticks for lunch," Liu Banxia said seriously.

"Why do I have to treat everyone? I didn’t do anything," Wang Chao grumbled, looking troubled.

"Xu Yino plans to become your apprentice. She wants you to teach her one of your unique skills," Liu Banxia continued teasing, keeping a poker face.

"Little Xu, don’t worry. Just tell me which of my skills you admire. For President Liu’s sake... What are you all looking at?" Wang Chao stopped mid-sentence.

"Banxia is just teasing you. He wants you to teach Doctor Xu how to research grapevine news," Zhou Li said, joining in the laughter.

Wang Chao shot Liu Banxia a resentful look. "I’ve made poor choices in friends, and President Liu has led me astray, ruining my best years!"

"Oh my, that gave me goosebumps. However, here’s a reminder: is your belly getting bigger? You need to start exercising," Liu Banxia said as he patted Wang Chao’s stomach.

"Ah... President Liu, I’ve been wondering why my belly keeps growing when my work every day is so tiring," Wang Chao said with a grimace.

"Teacher Wang, don’t worry about your belly for now. Teacher Liu is being slandered online. Shouldn’t we think about how to fight back? We can’t just let them spout nonsense," Xu Yino said.

"That depends on what Teacher Liu himself thinks, doesn’t it? If he doesn’t care, there’s no point in you all fretting about it," Wang Chao said, laughing.

"Actually, Teacher Liu is like that—sometimes he can be quite petty, and at other times very magnanimous. You’d have better luck trying to persuade Qiaoqiao than him."

Liu Banxia looked at him helplessly. "You really can’t keep quiet, can you? Do you have to stir up trouble?"

"That’s precisely it! On a small scale, this is slanderous reporting targeting you personally. On a larger scale, it’s defamation of our entire profession. Who can tolerate it?" Wang Chao said righteously.

"You just have too much free time. If I scheduled three consecutive surgeries for you, you wouldn’t have so many thoughts," Liu Banxia said.

"Hehe, I’m just sticking up for you, aren’t I?" Wang Chao said, laughing.

He was actually worried that Liu Banxia would schedule three consecutive surgeries for him. He wouldn’t dare protest and could only endure it silently.

"You all don’t need to worry about it. I’ll think about it later. Letting them fabricate stories like this definitely isn’t acceptable," Liu Banxia said.

"Cheer up, everyone. The number of patients with the flu or alcohol intoxication has increased significantly recently. Be careful; we can’t afford any slip-ups."

The interns all chuckled and agreed.

This could be considered a unique morning meeting for the Emergency Center. Since patient information was updated in real-time, things weren’t too complicated. Besides, Liu Banxia intentionally reduced the time taken during handovers to ensure everyone got adequate rest.

He was truly worried that these interns would eventually become exhausted. Even though he had told them they could choose their own paths, he hoped they would remain in the Emergency Center of the Second Hospital.

By now, they were well-trained. Handpicked by Chen Zhenxing and having undergone extensive training, they would be capable of working independently once they graduated.

After giving these instructions, Liu Banxia returned to his office to review the files of patients due for discharge today. As the number of incoming patients increased, a lot of time was spent on paperwork each day.

It was only because he had been consistently performing intensive training and taking on many surgeries in the past few months that he could juggle his workload and maintain his surgical skills. Otherwise, his performance in one area would inevitably affect the other.

As for the media reports, he could only brush them off for now. He couldn’t truly control what those people said. If he responded or explained, it would only fuel them further.

"President Liu, you’re needed in surgery! Two sisters were injured in an electric bike accident. The older sister’s CT scan shows a liver laceration, and the younger one has a perforated bowel. Dr. Wei has already taken the younger one to the operating room," Wang Chao ran in while Liu Banxia was busy.

"Alright, you can assist me on this one and gain some experience with this type of case. How large is the tear?" Liu Banxia asked.

"It should be about 1.5 centimeters," Wang Chao said.

"They ran a red light at the intersection. A car in the first lane saw them, but a car in the second lane hit them directly. People are so reckless these days; waiting just a few more seconds could have prevented this."

"I see you’re developing quite the social conscience. That’s admirable," Liu Banxia said with a smile.

"That’s not enough. Can you explain more during the surgery today?" Wang Chao asked.

"If it’s not too severe, I’ll let you handle the liver suturing," Liu Banxia said.

Wang Chao nodded eagerly.

In the Emergency Center, the first choice for liver surgery was Zhou Shuwen, followed by Liu Banxia, and then Shi Lei. If all three of them were busy, they would have to request help from the hospital’s general surgery department.

If surgeons competent in such operations from that department were also busy, the priority was to save the patient, so whoever was available would take the case. But this was only a last resort; the patient’s well-being always came first.

Actual surgical practice opportunities weren’t plentiful. Getting a chance with Zhou Shuwen was nearly impossible, so most aspiring surgeons set their sights on Liu Banxia for guidance.

Upon reaching the operating room, the anesthesiologist for today was still Li Liwei.

"I thought it was Old Wang. After reviewing the scan results, the blood loss isn’t too significant," Liu Banxia said.

"The other patient seems to have some spleen damage, so Wang Lei went to that OR," Li Liwei said.

"The patient’s vital signs are very good. With your speed, today’s lunch won’t be delayed. Everyone will be able to relax a lot too. Good luck."

Liu Banxia smiled and nodded. Being able to eat and rest normally in the hospital was already a comfort.

There was a slight twist, however: Liu Banxia would be supervising, and the primary surgeon would be Wang Chao. So the pace of the surgery was still undetermined; it depended on Wang Chao’s skills.

Once the abdominal cavity was opened, the laceration was visible to everyone.

"Chao, how should we handle this? It’s about two centimeters long. It looks like the liver capsule tore a bit more after the CT scan, but fortunately, the depth isn’t too great," Liu Banxia said.

"We’ll use a pedicled omental flap repair. You can’t stump me with this one," Wang Chao said confidently.

"Wow, Wang Chao, congrats! After the procedure, aren’t you going to treat us to lunch?" Li Liwei joked.

Wang Chao nodded. "No wonder President Liu told me I’d be treating everyone to chicken drumsticks this morning. It must be fate. If it were any deeper, I wouldn’t have been able to handle it. I definitely have to treat everyone to chicken drumsticks. Let’s irrigate."

He was feeling very confident now; this surgery would be no problem. He could add liver suturing to his surgical experience; hands-on practice was always more profound than simulations.

BEEP, BEEP, BEEP...

To everyone’s surprise, just as they began irrigating, the monitor beside them started blaring alarms.

"Not good! Tachycardia, high end-tidal carbon dioxide, and rising body temperature!" Li Liwei shouted.

"Use ice packs to help cool her down!" Liu Banxia also became tense.

"Damn, malignant hyperthermia! Her body temperature is already 42 degrees Celsius! Get the cooling blanket, ice packs, and set the air conditioning to the lowest! Quickly administer Dantrolene to prevent organ failure!" Li Liwei suddenly yelled.

This startled everyone. Malignant hyperthermia can lead to a cascade of complications like acidosis, hypoxemia, hyperkalemia, arrhythmias, and organ failure, ultimately resulting in the patient’s death.

No one stood idle; everyone scrambled to bring the patient’s temperature under control.

"The anesthetic I used was sevoflurane," Li Liwei said with a bitter smile.

"Don’t dwell on that now. Cooling her down is the priority," Liu Banxia said, nodding.

Malignant hyperthermia usually doesn’t show any symptoms, but it can be induced by exposure to volatile anesthetics or muscle relaxants during general anesthesia.

"Wang Chao, go to the next operating room and notify them to be wary of malignant hyperthermia! This condition is hereditary!" Liu Banxia, who was helping to cover the patient with a cooling blanket, suddenly realized.

Wang Chao was taken aback, then turned and ran in that direction.

They had only been focusing on treating the patient and had forgotten that this is an inherited disease. Today’s injured were two sisters; if one had already developed malignant hyperthermia, the other was in grave danger too.

Both of their surgeries required general anesthesia, so if there was any sign of danger, the procedure on the other sister would need to be halted immediately, the anesthetic changed, and preventative measures implemented.

Suturing this patient’s liver was secondary now. The absolute priority was to lower her body temperature. If her life couldn’t be saved, what was the point of anything else?