Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
“We’re doctors from Yun Hua Hospital,” Doctor Zhou introduced himself in order to ease the patient’s discomfort.
“There’s still one who is injured. He’s over there, and he’s a teenage boy.” A policeman applied pressure on his wound with one hand while he laboriously pointed at one spot with his other hand.
“I’ll go over there to look for him,” Doctor Zhou offered.
Ling Ran nodded as he looked at the policeman’s wound. Then, he spoke to Boss Shao, who came over. “Bring me a bottle of high-density alcohol.”
“I have iodophor,” Boss Shao replied calmly as he returned to the shop. He took out a first aid kit and a large bottle of iodophor from below the cashier counter.
Ling Ran glanced at Boss Shao in surprise.
Ordinary people would normally not be able to finish using a thousand milliliters of iodophor on their own. Of course, Boss Shao probably bought it based on experience. If he regularly used large amounts of iodophor, buying more in one go would naturally be cheaper.
The sound of people shouting in the surroundings, the heat brought about by the crowd who came to look at the scene, and the chaotic thoughts that flooded his mind; everything was blocked out the moment Ling Ran opened up the first aid kit.
For Ling Ran, who had been an intern in the Emergency Department for so long, a normal laceration from a knife was not much of a problem. Back when he was performing debridement and suturing, he had also come across the same sort of lacerations. However, the wound right before his eyes seemed a little deeper…
Nonetheless, Ling Ran did not let his guard down.
After staying in the Emergency Department for two weeks, a person’s understanding of accidents would change in its basis. A patient in good shape could suddenly fall into critical condition while a patient who seemed to be dying could become healthy enough to greet you in the corridor a few days later…
Ling Ran was unable to see the wound in the policeman’s abdomen. He could only observe and make assumptions while he asked for a pair of scissors.
After he had the scissors sterilized, Ling Ran removed the policeman’s uniform neatly and quickly. Then, he poured a large amount of iodophor on the surface of the wound. Boss Shao observed Ling Ran as the young doctor poured the bottle of iodophor, the former’s cheeks began to twitch.
Ling Ran had poured a third of the entire bottle of iodophor in one go before he reluctantly stopped.
His action was just like this popular remark in the advertising industry, “We know that half of the money we spent is wasted, but we don’t know which half it is.”
Doctors were also the same, especially doctors from the Emergency Department. It was inevitable that a lot of consumables would be wasted. But who would really know which part was wasted? If a doctor could do a large-scale experiment or carry out a qualitative and quantitative study on the relationship between the amount of iodophor and infection involved in thousands or more people over ten to twenty years, it might be possible for them to publish a good article or thesis…
It did not take long for the iodophor to clean away the blood stains. Soon after, a large amount of fresh blood washed away the iodophor until its color faded away. The face of the brave policeman just now was currently pale, but it was unknown if it was due to fear or loss of too much blood.
“Everything’s fine.” Ling Ran was reminded of the patient who woke up from a cardiopulmonary resuscitation (CPR) earlier in the day. He said, “Your injury isn’t serious.”
“It’s not serious?” The policeman’s voice was a little hoarse.
“Yes, you’ll definitely not die.” Ling Ran sounded absolutely sure. While he spoke, he passed the iodophor to Boss Shao and signaled for him to pour the iodophor to wash his own hands.
‘…Die?!’ The policeman thought to himself.
It was most probably due to his adrenaline rush gradually fading, but the policeman finally started to slowly feel pain assault his senses. He gritted his teeth and said, “If I don’t die this time, I’ll definitely arrest the bastard who stabbed me with my own hands. What an idiot. He doesn’t even know how to cut down a man.”
Ling Ran stretched out one of his hands and applied pressure around the policeman’s wound.
Ling Ran could have imitated the shows on TV and used cloth, preferably clean gauze, to apply tight pressure on the patient’s wound to stop the bleeding.
However, that was not the best way. That was only deemed the most suitable way to handle emergency cases for ordinary people who had never gone through medical training.
Putting aside the fact that it was extremely difficult to control internal bleeding, and that internal bleeding was equally fatal to other serious wounds, the action of applying pressure on the wound itself could also cause a second injury. The wounded could only pray for good luck and hope that the pressure applied would miss their vital points.
However, Ling Ran had many more choices.
He first applied his Physical Examination Skill to examine the patient’s abdomen before he judged the case accordingly in his heart.
Ling Ran carried on with rinsing his hands to prevent any infections that would happen when he performed barehanded bleeding control. It would not be a wrong move to pour more iodophor out in a small alley where street food was sold.
Boss Shao watched the fresh blood gushing out relentlessly from the policeman. He was anxious, yet he had no choice but to persuade himself that this was necessary. In the meantime, he spoke to the policeman lying down on the ground, “Doctor Ling is Doctor Zhou’s colleague. Doctor Zhou’s from the Emergency Department. Doctor Ling, you’re also from the Emergency Department, right?”
Ling Ran nodded and said, “Yes.”
“You see, I’m right. Doctor Ling’s a doctor from the Emergency Department so there won’t be a problem. We have no reason to worry. When we arrive at Yun Hua Hospital, you’ll be taken care of by Doctor Ling and Doctor Zhou anyway. You’ve saved the ambulance some time to come and get you. You’re safer now.”
“I want to go to Yun Hua Hospital.” Being reminded, the policeman quickly spoke and repeated, “Yun Hua Hospital.”
He knew that Yun Hua’s ambulances operated on the principle of proximity and gave consideration to reasonable demands of the patients. However, there was also a high possibility that he would be sent to a nearby district hospital despite his request, and he might not be able to recover well if he received treatment there.
“We’re going to Yun Hua Hospital. We’re definitely going to Yun Hua Hospital,” Boss Shao held on to the policeman’s hand and said, “Doctor Ling, the one who is inspecting your wound, and Doctor Zhou, the one who went ahead, are doctors from Yun Hua Hospital. You can rest assured…”
The policeman’s ability to think was obviously affected by the fact that he had lost too much blood. He watched Ling Ran’s movements as he spoke to Boss Shao, “He really is just inspecting my wound, argh… Argh!!”
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However, just as the policeman relaxed the muscles in his abdomen, Ling Ran suddenly plunged two of his fingers into the wound.
At the same time, Boss Shao screamed, “What in the world?! That grip of yours is insane! Let go now! Hurry up and let go! You’re going to squash him!”
Ling Ran breathed a small sigh of relief.
The environment within the abdominal cavity was relatively complicated. The important organs such as the liver, gallbladder, pancreas, and lungs shared similar levels of protection. The only other important organ that has a different level of protection was the muscles, which had a layer of skin to protect it. Determining whether a person would die from a stab from a knife would mainly rely on the position of the knife in the body and the condition available to perform emergency treatment on the wounded.
Of course, the easiest organ to be injured was the spleen. It was also the main issue that Ling Ran was currently facing.
Ling Ran used his finger to press on the pedicle of the spleen with appropriate strength. He immediately stopped the spleen from massive bleeding, and he did so with bizarre ease.
Truth be told, the same process would have been applied even if the patient was being treated on the operation table.
The reason was because by the time they entered the operating theater, the abdominal cavity would have been fully filled with blood caused by internal bleeding. It would be very dangerous to directly clip the spleen with hemostatic forceps. The surgeon would accidentally kill the patient if they clipped the wrong part because they could not see clearly. So, they had to first wait for the assistant to perform aspiration and suck away the blood to clear up the surgical field before they could use the hemostatic forceps. And if the surgeon wanted to suck away all the blood, the surgeon needed to use his or her hand to seize the spleen.
Therefore, barehanded bleeding control was also considered to be a basic surgical procedure in abdominal surgery. If grading was applied, it would be deemed as Novice Level Barehanded Bleeding Control.
“How should I address you?” After Ling Ran found that there were no more problems, he began the standard procedure.
The policeman felt dizzy, scared, and uncomfortable all at once as he said, “Zang Zhao.”
“Zhan Zhao[1]? The fourth-ranking arms-bearing royal guard?” Ling Ran looked at the policeman’s age. He felt that he did not seem as if he was born during the time when “Justice Bao” became famously known across the entire country. So Ling Ran said, “I’ll help you do a physical examination on your head.”
“Zang… It’s Zang, Z-A-N-G…”
“Hmm…” Ling Ran squeezed the pedicle of the fourth-ranking arms-bearing royal guard’s spleen with one hand while he sank into deep thought, ‘I remember that this man fell limply to the ground with his hands covering his stomach. I don’t recall him hitting his head…’
The voices of the crowd discussing among themselves got much louder. The Perfect Level Barehanded Bleeding Control was working perfectly. Even people without the slightest medical knowledge would have been able to tell just by looking that the bleeding on the policeman’s abdomen gradually slowed down until it almost stopped.
“Boss Shao, Doctor Ling! Boss Shao, Doctor Ling!” a man shouted as he ran over to their side.
“What’s the matter?” Boss Shao made the crowd of onlookers part to two sides.
“Doctor Zhou… Doctor Zhou said you have a first aid kit. He wants you to take it over to him, or-or send Doctor Ling over there.” The man wore a scarf around his neck. He was panting. It was obvious that he was also an owner of a inn nearby.
“Why would Doctor Zhou want a first aid kit? What does he want Doctor Ling to do?” Ling Ran’s fingertips were steady and still, not moving in the slightest. Even though Ling Ran referred to himself in the third person, it came completely naturally.
“He said that he can’t stop the bleeding… He needs to, uhm… open the stomach. He also said I could get Doctor Ling over there to stop the bleeding.” The man who came over could not think of the term ‘laparotomy’ in that particular moment.
Ling Ran pondered over this for two seconds and said, “We’ll go over there. Boss Shao, do you have a cart that can carry people? Please send us over there.”
The “us” Ling Ran mentioned was Zang Zhao and himself.
Ling Ran guessed that Doctor Zhou was unable to locate the bleeding point, and he wanted Ling Ran to assist him. It was either this or that he wanted to perform an exploratory laparotomy to detect the problem and solve it.
Whenever they encountered patients with abdominal injuries, the first thing that crossed the minds of legitimate surgeons would definitely be, ‘Should I perform an exploratory laparotomy right now?’
The advantages of performing an exploratory laparotomy were countless. It was the most intuitive step.
Upon opening up the abdominal cavity, one just needed to patch up any holes and stitch up any broken parts. It was simple and straightforward, and it brought about good effects. The number of sequelae were obviously not few as well, but it was nothing compared to losing a life.
If they were in a complete different environment, perhaps Doctor Zhou would have used a kitchen knife to perform a laparotomy without question.
He had been an attending physician in the Emergency Department for more than a decade. Although he was a little lazy, his skills and experiences were still up to standard. He had encountered many cases involving abdominal open wounds.
It was just that the hygiene of the small, street food alley was truly awful. There was a shortage of medication for disinfection. Even the alcohol available could be fake. It could be an act of great risk to forcefully perform a laparotomy.
The most important thing was, Doctor Zhou knew about Ling Ran’s capability in performing barehanded bleeding control, and he was also capable of doing it very well. Hence, why should he choose to perform a laparotomy on the spot?
In less than half a minute, Boss Shao pulled out a two-wheeled flatbed cart which was used to move vegetables.
A few people from the crowd came to assist as they moved the policeman onto the flatbed cart. Then, they allowed Ling Ran to get on the cart as well. After that, those people pushed the cart together by exerting strength together, swiftly guiding Ling Ran and Zang Zhao to the main street of this entire area selling street food
The flatbed cart trembled. Ling Ran adjusted his hands accordingly as he steadily controlled the amount of blood flowing out from Zang Zhao.
The onlookers pushed the flatbed cart, and Boss Shao followed suit.
Meanwhile, more and more onlookers began to follow the flatbed cart as well.
An increasing number of passersby held their phones up as they recorded video footages from all angles in hopes of adding a colorful touch to their desolated friend circle.
Translation Notes:
1. Zhan Zhao: A fictional character in the Chinese wuxia classic The Seven Heroes and Five Gallants. Nicknamed the “Southern Hero”, he is a righteous knight-errant with incredible martial arts skills, often helping Prefect Bao Zheng uphold justice. Emperor Renzong of Song made him a 4th rank royal guard and gave him the title “Royal Cat” for his swift movements.
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