Chapter 1: Chapter 0001 Rescue
“Quick, the blood!”
“Why hasn’t the blood arrived yet?”
It was past midnight, as G City’s People Hospital’s operating room was brightly lit, filled with urgent, hoarse shouts.
Several more bags of blood were hung on the IV stand, a bunch of empty bags piled on the side table next to it, the remains of the blood vaguely visible.
The blood was flowing swiftly through several transparent tubes into the patient’s body.
Blood transfusion– It had become the only lifeline for the one on the operating table.
“It’s no good, can’t find the blood vessels, the gauze! Continue stuffing, talk to the family, the chances of rescue are slim, they must be prepared mentally.” Director Wu had been digging in the pelvic cavity for a long time, unable to find the damaged blood vessels, he could only stuff the cavity with gauze. Sweat soaked his forehead as he constantly moved away from the sterile area, letting the patrolling nurse wipe his sweat.
Young doctor Yang Ping was helping to suture in the operating room, after several nights of continuous surgeries, he was exhausted and his vision was starting to blur.
Suddenly, a warm current forcibly poured from the top of Yang Ping’s head, this strange sensation radiating throughout his body.
The world seemed to freeze, as all people and objects stood still, the image in his field of vision frozen. Yang Ping’s body couldn’t move, but his consciousness could.
A window appeared in the upper right corner of his vision.
A series of subtitles, accompanied by a mechanical female voice–
“Binding has begun!”
“Binding process, smooth!”
“Binding, successful!”
“Testing–”
In an instant, everything around him vanished, and he found himself in a strange place.
There was an operating table in front of him, the patient on it had already been laid out, and a few mechanical arms like octopus tentacles were moving around it.
How did I get here? Who’s suturing on that operating table?
“Hello! Is anyone there? Where am I?” Yang Ping called out.
The space was eerily silent, with no one answering his questions.
Yang Ping cleared his thoughts and slowly approached the operating table. From the exposed surgical field and the patient on the table, he determined that this patient was the same one he had just been trying to save?
“Would you like to start a simulated surgery?” a few words appeared on the screen.
Could this be a simulation for rescuing the patient? Thinking that, Yang Ping moved the cursor using his consciousness and chose yes.
The screen instantly started a countdown, five minutes to go.
Yang Ping began the surgery, the mechanical arm served as his assistant. Indeed, this was the same patient from the stabbing incident.
The pelvic cavity was stuffed with gauze, and blood was still pouring out incessantly.
He began to attempt to find the blood vessels, but no matter how hard he tried, he couldn’t find them.
When the five-minute timer ended, the patient’s respiration and heartbeat stopped.
Yang Ping felt disheartened and a bit lost.
He got his bearings, extended the incision, and opened the abdominal cavity completely.
Because the heart had already stopped beating, there was no more bleeding inside. He thoroughly cleared the accumulated blood with a suction device, which enabled him to look for the ruptured blood vessel more easily.
He searched back and forth inside, found the common iliac artery, this common iliac artery didn’t have an apparent internal-external iliac artery sprouting from it, instead, it had a single trunk extending downward, continuously branching off either from the main trunk or the branches but none of them were damaged.
Yang Ping was puzzled, thinking from left to right, could it be a variation in vascular anatomy?
Following this train of thought, he found the upstream abdominal aorta, and traced it downwards, he discovered a finger-thick branch of the abdominal aorta, hiding in the back, about ten centimeters above the branch he had found earlier. When he traced it back, he finally found the ruptured area.
It turned out to be a variant external iliac artery, not branching from the common iliac artery, but directly originating from the aorta. The origin point was extremely high and hidden at the back. This type of variation is something that a doctor may never encounter in their entire career.
Dealing with such a variant blood vessel, let alone in an emergency situation flooded with blood, making it hard to approach.
Even given ample time, it would be very hard to find, no wonder Director Wu had spent so long searching and couldn’t find it.
Repeat the simulation?
Yang Ping clicked yes.
Indeed, the patient on the operating table was scattered like fragments of light and then reappeared, returning to the moment when he first entered the system. The countdown also started anew.
Yang Ping immediately located the bleeding vessel. This time, knowing the exact location of the vessel, he directly searched for the iliac artery variant, clamping both ends with a vascular clamp, ligating the veins, and slowly suturing the artery.
Because ligating the veins doesn’t have a significant impact, but if the artery is ligated, it would cause necrosis of the corresponding lower limb, so the veins can be ligated, but the arteries can only be sutured.
This time, the entire process took half an hour to complete.
The patient did not survive, and the system deemed it unsatisfactory.
Again!
So it continued, he wasn’t sure how many times he practiced, possibly several hundred times.
Finally, he was able to complete the surgery within three minutes, and the system finally deemed it satisfactory.
Immediately, the surroundings disappeared and Yang Ping found himself back in the real operating room.
At this point, the freeze frame released, everything was back to normal.
The External Iliac Artery is ruptured! Not only that, it was a variant unseen before.
This type of bleeding was like a geyser, if not for the continuous blood transfusion, this patient would have checked out long ago.
“The blood pressure is dropping, I can’t measure it. Increase the speed of the blood transfusion, fast! Dopamine–” The situation was changing at rapid speed, the anesthesiologist shouted, his hand never stopping as he pulled out drugs from the nearby drug box, uncapped the vial, loaded the syringe and pushed the medicine into the intravenous line.
According to the previous simulation, the rescue time window was at most five minutes. A life was on the verge of disappearing.
“Director, it’s a ruptured variant External Iliac Artery, this artery originates high in the back of the abdominal aorta, I’ve seen this kind of variation before!” Yang Ping softly told Director Wu.
How do you know?
You’ve seen it? You’ve only been working for a few years.
If only we had vascular imaging. But in this emergency situation, if we were to do an imaging scan, the patient wouldn’t make it.
Director Wu stuffed in a gauze, giving Yang Ping a glare.
He had his own considerations. Given the current blood pressure, the only choice was to pad with gauze. It was a gamble.
If he removed the gauze to make room for the blood vessels, it would be like re-opening a bleeding faucet. It was almost certain that the patient would die instantly.
“Director, trust me——”
Time was of the essence, Yang Ping was anxious, he asked again.
He was reluctant to see a life fading before his eyes, he knew he had just five minutes, but nobody else knew.
Director Wu said impatiently, “Enough, hook it.”
“Proceed with the padding!” Director Wu commanded.
“The blood pressure is not going up, the dopamine is useless!” the anesthetist was very tense.
Director Wu’s throat was dry, his heart pounding like a drum. If something happened to this patient, there was no way to explain it.
Perhaps in a critical moment, clutching at straws, Director Wu glanced at Yang Ping and nodded.
Yang Ping immediately started. He had already spent two minutes, with only three minutes left. No time to waste.
“Scalpel! Hemostat! Vascular clamp! Open three suction devices!”
The instrument nurse, the patrolling nurse, and the anesthetist all seemed stunned at first, but after a short moment, they immediately cooperated.
Little Five and Yang Ping made a good team. Upon seeing Yang Ping’s actions, after a moment’s hesitation, he immediately started to assist Yang Ping.
Yang Ping kept his cool, bending his head, the scalpel extended along the original incision.
He has been trained countless times in this process, it has almost become muscle memory.
“Keep the pressure on, give blood! Get the suction tubes ready, remove all the tips, direct suction.
“Suction! Vascular clamp!”
When the gauze that was stopping the bleeding was completely removed, the blood sprang forth, flowing swift and red along the three suction tubes.
With utmost efficiency, Yang Ping immediately located the broken blood vessels in the sea of blood. Without even looking, he reached in with his left hand and grabbed the near end of the vessel between his thumb and index finger, and immediately clamped it with a vascular clamp using his right hand.
Then using the same method, he clamped the other end of the vessel.
“Hemostat!”
He temporarily clamped the accompanying vein of the external iliac artery.
The blood was stopped, and under suction, the blood in the pelvis started to decrease slowly. It was as if the tide was receding, until the clamped vessel was exposed.
“6-0, vascular suture needle thread!” The instrument nurse efficiently handed it over. Yang Ping’s scissors started to trim the ends of the blood vessels rapidly.
After trimming, he put down the scissors, took the needle and thread, and started the vascular anastomosis. Each stitch was precise, the distance appropriate, akin to a precise machine operating, fast and without error.
Extreme speed! The vessel was anastomosed in mere seconds.
“Thread, ligate!”
The hemostat with the thread was placed into the palm of Yang Ping’s overturned hand. He tied off the accompanying vein and the smaller blood vessels nearby.
Rinsing, suctioning, the operative field was immediately clean. He placed a negative pressure drain, stratified sutures, closed the wound, all in one go.
He finished the last stitch.
“The blood pressure is back up.” The anesthetist breathed a sigh of relief. All people looked at Yang Ping, a sense of respect arose spontaneously.
“Brother, awesome!” Little Five secretly gave a thumbs-up.
At this moment, the captions and female voice appeared again: “Dingdong! The system and the host match perfectly!”
Yang Ping was certain that only he could hear this voice and only he could see these captions.
Good heavens, what the hell was happening?
At this moment, Yang Ping felt like a deflated ball, extremely tired.
Everything felt like a dream!
The anesthetist was sitting against the wall on the floor, drinking a bottle of glucose.
In a corner, a nurse was making a call: “Baby, are you still awake? Is dad home yet, or is he still working late?”
The clock on the wall displayed: 00:49.
“Director, we are done here——” said Yang Ping.
Only then did he realize, he had somehow completed the surgery all by himself, leaving the director aside. There was no choice but to proceed this way with just three minutes left, otherwise, the patient’s life would have been lost.
Director Wu was still astonished, he hadn’t snapped back to the reality yet, he said, “Hmm, good, as long as the patient was saved.”
In this kind of hemorrhagic shock caused by traumas, as long as the bleeding is stopped and the blood transfusion can keep up, the situation can usually be stabilized.
They pushed the bed, and sent the patient to the Intensive Care Unit–ICU.
Yang Ping, Little Five, the anesthetist, and the nurse together pushed the stretcher to the ICU, reported the details to the doctor on duty.
Once everything was finished, Little Five returned to the Orthopedics on-call room.
Today was Little Five’s turn for duty, Yang Ping was only called over to help with the emergency surgery.
Not wanting to waste time, Yang Ping rode his little electric scooter back to his rented room in the urban village.
It was already past two o’clock in the morning, he quickly took a shower, and lay on the bed, intending to have a good sleep.
But today’s events were too bizarre, the thought of it made it impossible for Yang Ping to sleep.
He pinched himself hard.
It hurt. He was not dreaming.