Chapter 33: 33 – ACS Unit

After being in the ACS for a few months, Li Yun had a good understanding of everyone in the department. Chief Lim along with the new attendings, Doctor Zuo and Doctor Mei, took the morning first shift. Chief Gao and Doctor Hao took the afternoon second shift, and everyone rotated for the 3rd and weekend shifts.

Chief Lim and Gao handled the complex surgeries while teaching the twenty-plus residents. It was not an easy task, the first-year residents barely knew anything and the third-year residents could only handle the four most basic surgeries. For everything else, they still had to consult with the senior doctors. The residents were also divided into three shifts, which were rotated on a weekly basis.

During the first shift, it was usual to see appendectomy, cholecystectomy, colectomy, and hernia repair. These were the type of surgeries residents must learn and will learn throughout their residency. For most surgeries, Doctor Zuo and Mei were the lead surgeons, taking a third-year resident as an assistant and whoever arrived first to the scene as 2nd assistant. From the theater, Chief Lim supervised the surgery while explaining the procedures to the residents.

The 2nd shifts were also similar to the morning shift, but twice as busy, and with more trauma and burn patients. Chief Guo specialized in trauma and burn care while Doctor Hao was a cardiovascular surgeon.

With the schedule managed efficiently, the majority of the residents in ACS were able to gather surgical experiences. Even the first-year residents were given opportunities, who often rushed into the ER at the sound of their pager beeping. The second and third-floor year residents chuckled when they watched the first-year residents fight for an opportunity to perform surgery. They knew from the previous experiences that there will always be patients coming into the ER.

An Luchang and Mi Xuan were usually the first to arrive for the first shift. The doctors liked them as second assistance as they both seemed to have an encyclopedic knowledge of many surgeries. It was like having Seri and Alixa in the room.

Li Yun read a lot, but his recall ability was much slower in comparison. If his memory palace of medical knowledge was located on a floor below, their medical knowledge was stored in front of them. There was no way he could compete. Nevertheless, Li Yun was learning quickly how to navigate the ER by watching Chief Gao.

One late evening, the EMT rushed a patient in with multiple knife wounds. The accompanying nurses and doctors all held their stomachs tightly, pretending they hadn't seen a part of the patient's intestine partially exposed near the knife wound. It was not easy for anyone to deal with, even Chief Resident Han would step aside and call for Chief Gao. In the meanwhile, Li Yun was already stabilizing the patient.

The sound of a heart monitoring device constantly beeping as the patient went into cardiac arrest was enough to send everyone on edge. Nurses and doctors screamed over each other for attention and to mask the fear that they might not save the patient. Everyone knew that person had 30 seconds left to live.

Li Yun called the nurse to push the defibrillator as he performed CPR. Chief Gao arrived at the scene a moment later, and watched as Li Yun continued to resuscitate the patient. The machine gave out an eerie sound of death, but Chief Gao threw down a surgeon cap and took over with the defibrillators.

"Clear!" Chief Gao called out.

Everyone backed away. The electric shock from the metal plates flowed through the patient, but no response.

"Clear!" Chief Gao called out again.

Another round of shockwave flowed through, shaking the lifeless body, but still no response. After the third time, the heart machine bottomed out with a resolute and continuous beep.

Chief Gao announced the time of death and walked back to his office, an audible click from his door echoed in the ER. It was not easy after that. A simple loss of life was enough to drain the morale of the entire department. Even Li Yun was shaken and took a short break to reset.

There was a strange quiet atmosphere in the room. It wasn't the complete silence like the void in space, but the type of silence that amplified small sounds and whispers. Small chatter of the nurses discussing the patients' charts and tapping sound of an impatient patient could be heard, making everyone more annoyed than usual. Everyone continued to work as though nothing had happened, but they subconsciously whispered and lowered their voice.

"Why is everyone whispering!?" Chief Gao rushed out of the room. "Prepare the gurney, we have a patient coming in!"

The silence broke, and the ER erupted into another cycle of chaos.

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Chief Gao prepared new gloves and rushed out. As he passed by the waiting room, he noticed that it was unusually calm. He looked ahead, and saw two ambulances and cursed.

"Why didn't the second ambulance call ahead!?" Chief Gao cried out.

"They had communication issues," responded Nurse Yuen. "I've already contacted Doctor Hao to handle it."

Chief Gao nodded and saw Li Yun nearby.

"Little Li, you assist Doctor Hao," Chief Gao directed.

Li Yun transferred the second patient onto the gurney and pushed it into the ER for the senior doctor to inspect the patient. The man had fallen from the third floor while cleaning the windows. A tree had slightly broken the fall, but he was unconscious. The senior doctor ordered the CT scans after a quick physical.

At that moment, the patient reacted violently and coughed up blood. He had regained consciousness, but was coughing uncontrollably.

"He's going to choke on his own blood!" Doctor Hao cried out from across the room. He immediately rushed toward the patient.

Just as he was approaching, Li Yun held the patient's face toward the floor and slammed his hand repeatedly on the back. After five strong blows, the man coughed up another pool of blood onto the linoleum floor. Doctor Hao immediately cut away the shirt and exposed as much of the patient as possible to see any possible signs of injury.

"No visible signs of head injury, but a lot of bruising and potential internal bleeding. We're going to need lots of blood transfusions. We better operate on him quickly," Doctor Hao directed the nurse to prepare the room, and then looked at Li Yun. "Ever done an open surgery?"

Li Yun tilted his head ambiguously as he studied Doctor Hao for a moment.

Doctor Hao was the first person Doctor Zhang hired who wasn't in the military. He specialized in cardiovascular surgery in a rural hospital in the south. He had a funny accent and had strong tobacco and musky smell. Most nurses stayed as far away from him as possible. However, the man was a very skilled surgeon. If there was a person Li Yun wanted to see in action, it was Doctor Hao.

"So, you ready to operate?" Doctor Hao asked.

Li Yun nodded in response to Doctor's Hao question.

"All right, let's operate!"

Li Yun scrubbed in as assistance while Mi Xuan scrubbed in as third as she was the first to arrive. In most instances, they would wait for someone more experienced to assist, but Doctor Hao decided to bring Li Yun along. Why? Because Li Yun lacked hesitations in his eyes.

During surgery, Doctor Hao opened up the abdomen, removed the excess blood, and checked for the source of the bleeding. There were multiple organs affected, and Doctor Hao quickly sewed up one, while Li Yun used the suction and arterial forceps to control the bleeding. Doctor Hao typically had to instruct the residents what to do, but Li Yun simply knew the best way to assist the surgery.

"Damn, this kid is good," Doctor Hao thought.

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