godfather of surgery

Chapter 1350 Showing Off One's Skills
The phone rang at 2:17 p.m.

Former hospital director Li Changgeng sat in his new office in a chair that still smelled of plastic packaging, squinting as he examined the newly hung "Guandu Hospital Development Plan Map" on the wall. Sunlight streamed obliquely through the floor-to-ceiling windows, gilding his gray hair with a pale gold hue. Outside, the outpatient hall was not crowded with patients; Li Min was examining a child having an asthma attack in consultation room number three.

The phone rang urgently.

The old dean reached out and took it. On the other end was the voice of Zhou Daping, the village secretary of Chalu Village, hoarse and trembling, as if something was choking him:

"Dean Li! Something's happened! Three kilometers west of the fork in the road, a farm vehicle overturned into a ditch. There were seven or eight people on board, all of them injured, some of them look like they're about to die! We're on our way to your place, we'll be there in ten minutes, at most ten minutes!"

The old dean's temple throbbed suddenly.

"How many people? How badly injured?"

"I don't know either, there's blood everywhere..." Zhou Daping's voice was drowned out by the cries in the background, broken and intermittent, "Dean Li, you must save them, they're all from our village, all from the same village..."

The phone hangs up.

The former hospital director stood before the development plan, microphone in hand, barely having had a chance to examine it closely. The new hospital's inauguration ceremony had been less than two weeks prior; the brand-new Class 100 laminar flow operating room hadn't even been officially put into use yet, and the mobile CT scanner donated by Cheng Liquan was still being tested. He had dreamed countless times of this hospital finally coming into use, but never of it happening on an afternoon like this, in this way.

He activated the emergency broadcast system for the entire hospital.

"All on-duty medical staff, assemble immediately in the emergency room lobby. I repeat, all on-duty medical staff, assemble immediately in the emergency room lobby."

Three seconds of silence, followed by footsteps.

When Li Min rushed out of consultation room number three, he was still clutching the stethoscope he hadn't had time to put down. He saw Dr. Zhang jogging down the corridor, Head Nurse Wang running from the direction of the obstetrics and gynecology department, and Sister Liu from the pharmacy just grabbing a first-aid kit.

No one asked why, and no one said, "This is not my responsibility."

All twenty-odd people from Guandu Hospital gathered.

The former hospital director stood in the center of the emergency room lobby, his voice frail and aged:
"A car overturned at the intersection, several seriously injured, will arrive in ten minutes. Head Nurse Liu, prepare emergency supplies and set up four resuscitation units. Dr. Zhang, you are in charge of triage for minor injuries. Xiao Wang, notify the operating room to prepare, and have all equipment perform self-checks."

He paused, his gaze falling on Li Min.

"Dr. Li, you are in charge of assessing serious injuries. You have a lot of experience and can stop the bleeding if you can. If not, you can only send the patient to the county."

Li Min nodded, and the stethoscope was already back in the pocket of his white coat.

"Is there a spare autologous blood transfusion machine in the operating room?" he asked.

The old director was taken aback. The old "operating room" at Guandu Health Center, which could only perform wound cleaning and suturing, certainly didn't have such a thing. But he immediately realized that Li Min was asking about the new hospital.

“Yes!” he said. “The engineers from Chairman Cheng’s side just finished debugging last week.”

"But...but...nobody knows how to use it!" the old dean said with difficulty.

“I can, it’s very simple, I can teach the nurses on the spot,” Li Min said calmly. His training at Sanbo Hospital was very comprehensive.

After saying that, Li Min turned and walked towards the entrance of the emergency room.

A screeching sound of brakes came from outside the door.

The first van carrying the wounded arrived.

The car door opened, and the stench of blood and cries of agony poured out like water bursting from a dam.

Zhou Daping was the first to jump out of the car, his face showing a fear Li Min had never seen before. This village secretary, in his fifties, had served as a cadre in Chalu Village for twenty years, mediating fights, dealing with wildfires and landslides, and hadn't even panicked when the flood washed away the road that year. At this moment, his hands were trembling, and his trouser legs were stained with dark red blood.

"Dean Li, Dean Li..." His voice sounded like it was being squeezed out of his throat.

Li Min didn't look at him; his gaze had already passed over Zhou Daping's shoulder and landed on the wounded in the carriage.

The first person carried off was a young man named Zhao Qiulin, who looked to be in his early twenties. His left thigh was severely twisted and deformed, with white bone fragments piercing through his skin and trouser fabric, exposed to the air. He was still groaning, but not loudly, as if he had exhausted all his strength.

"Early stage of hemorrhagic shock." Li Min spoke quickly. "Open fracture of the left femur, active massive bleeding. Apply tourniquet, establish dual intravenous access, rapidly infuse 500 ml of lactated Ringer's solution, draw blood for crossmatching, stabilize blood pressure, and prepare for surgery."

The two nurses practically ran to pick him up.

The second wounded was a middle-aged woman named Chen Dongxiu, who was being carried by several villagers on a door panel. She didn't groan or shout; she just stared blankly at the ceiling with her eyes open.

Li Min placed his hand on her abdomen, pressing it only once.

"Closed abdominal injury, highly suspected liver and spleen rupture, massive intra-abdominal bleeding. Shock. Send this person directly to the operating room. Immediately notify the blood bank and prepare all blood of the same type. Apply tourniquet to Zhao Qiulin to stop the bleeding and record the time of hemostasis."

His voice was completely still as he spoke and acted, as if he were simply reporting on today's weather.

The third, the fourth, the fifth. Head and facial injuries, left upper arm fracture, multiple soft tissue contusions and lacerations—these could wait. Li Min was like a precise triage instrument; wherever his fingers passed, he assessed the injury, its priority, and the treatment plan without the slightest hesitation.

Zhou Daping stood behind him, watching him issue orders almost without thinking, watching the bloodied and mangled wounded being systematically triaged, treated, and transferred. He suddenly had a strange illusion.

This wasn't the Dr. Li he knew who had worked at the Guandu Health Center for ten years. That Dr. Li was gentle, calm, and meticulous; he would spend twenty minutes asking questions during a consultation and never prescribed more than three medications. That Dr. Li had never spoken in this tone before, like a general commanding a battle.

Yet this was clearly Dr. Li. It was still that tanned face, still those hands with their long, sculpted knuckles from years of wielding a scalpel. Only now, those hands were steadily cradling lives hanging precariously on the edge of a cliff, without the slightest tremor.

He suddenly realized that Li Min had not panicked at all since entering the hospital. He was like a precision instrument with a pre-programmed sequence, starting to operate at full speed the moment the injured arrived, without any hesitation or unnecessary movements.

What exactly did he experience in the provincial capital that year?
The sixth injured person to be carried off the vehicle was Xu Dehou, a man in his fifties who was the driver. His arrival brought a brief moment of silence to the entire emergency room.

It was a body with almost no visible injuries, but its face was as pale as paper, and its chest was rising and falling in a strange way. Instead of the even expansion and contraction during normal breathing, the right side of its chest wall would abnormally collapse with each breath.

"Flare chest!" Li Min's first reaction was to squat down and gently press his hand on the collapsed chest wall. "Multiple rib fractures, abnormal breathing. Lung contusion, tension pneumothorax is highly likely."

His hands didn't stop; he had already taken the stethoscope from the nurse.

“Breath sounds are absent on the right side, and the trachea is deviated to the left.” He put down the stethoscope. “Tension pneumothorax. Decompress immediately, then perform closed chest drainage.”

The nurse stood by, somewhat at a loss.

"Give me a large-bore needle! Then immediately prepare a closed chest drainage kit."

The new hospital is equipped with closed chest drainage kits.

The nurse immediately handed over a thick needle. Li Min's fingers groped around in the intercostal space for a second before the needle was inserted diagonally.

A gust of air carrying fine blood foam spurted from the needle's tip. The man's breathing almost instantly calmed down, and his pale lips regained a faint hue.

"Tension pneumothorax resolved!" Li Min stood up. "But the chest trauma is severe; damage to the heart or major blood vessels cannot be ruled out. Give me the closed chest drainage kit! I'll perform closed chest drainage immediately, prepare the ventilator, and notify the operating room. Observe this patient while preparing for surgery, and be ready to perform thoracotomy at any time." Ventilator? Nobody knows how to use a ventilator.

Although the new hospital is fully equipped, staff training has not kept up, and the first batch of trainees sent out for training have not yet returned.

Seeing everyone's expressions, Li Min knew what was going on: "Don't worry, you guys get ready, I'll take care of it."

With his words, everyone felt relieved.

He spoke in a very ordinary tone, and while he was speaking, he had already completed closed chest drainage. His quick judgment and decisive action were astonishing.

The old hospital director stood two meters away, shocked. When he heard that Li Min wanted to have open-chest surgery, he immediately came up and said, "Little Li, you want to have open-chest surgery? We'll only do what we can here. Those with serious injuries should be sent to the county!"

To the county?

Li Min was taken aback, then immediately said, "There's no time, and there's no need to send him. I'll do the surgery!"

"Little Li..."

This is open-chest surgery! It's open-chest surgery! The county can't handle it; they have to send it to a prefecture-level hospital, and some may even have to be sent to the province.

During Li Min's training at Sanbo, Yang Ping set a goal for him in surgical procedures: "to become proficient in a batch, master a batch, and gain experience with a batch." "Being proficient in a batch" included almost all emergency life-saving surgeries that might be encountered in township hospitals.

These things are no big deal to him.

Li Min didn't have time to explain to the old dean.

Unexpectedly, even more seriously injured people were yet to come.

The seventh wounded soldier was the last to be carried out of the carriage. Zhou Daping personally cradled his head, his voice completely trembling:
"Dr. Li, this is Zhou Fusheng, Zhou Fusheng! He was driving just now, and when the car overturned, the steering wheel hit his chest, and he passed out immediately. He hasn't woken up yet..."

Li Min squatted down.

The man, in his fifties, had a pale, ashen face and cyanotic lips. His carotid pulse was weak, like a candle flame about to go out. There was a palm-sized subcutaneous bruise shaped like a steering wheel in the middle of his sternum.

“Pre-traumatic cardiac arrest.” Li Min’s fingers rested on his carotid artery. “High suspicion of cardiac tamponade, bedside ultrasound.”

The portable ultrasound machine was wheeled over, and the doctor performing the ultrasound was a little flustered. She was no match for this situation, but Li Min comforted her, "I'll do it!"

Li Min took the probe, applied coupling gel to his chest wall, and then lowered the probe.

On the screen, the outline of the heart was tightly bound by a dark, liquid-like area, like a bird being clenched in a fist.

"Massive pericardial effusion, right ventricular collapse due to compression." Li Min's voice remained calm. "Pericardial puncture and drainage, immediately!"

The nurse handed over the pericardiocentesis kit. Li Min put on sterile gloves, disinfected, draped the area, and inserted the puncture needle into the angle between the xiphoid process and the left costal arch, slowly advancing the needle tip.

Everyone held their breath.

Dark red blood slowly flowed from the needle tip, like turning on some hidden valve. The almost straight line on the electrocardiogram monitor began to show weak, fragmented fluctuations.

Zhou Fusheng's eyelashes trembled slightly.

“Hemorrhagic pericardial effusion indicates myocardial or coronary artery damage.” Li Min stared at the monitor. “Drainage is effective, but it’s a temporary measure. He needs emergency surgery.”

He paused.

"Open chest surgery, heart repair."

The emergency room lobby fell silent again.

Open-chest surgery, heart repair?

When Li Min uttered these words, it was as casual as "taking blood pressure." But everyone present knew the weight of those words. This was not a surgery that a township health center should perform, nor was it a surgery that a county hospital could perform. This was a forbidden zone that only a cardiothoracic surgeon from a top-tier hospital in the provincial capital would dare to touch.

Zhou Daping looked at Li Min, then at the old dean, his lips moving as if he wanted to say something, but he didn't know what to say.

The old dean was at a loss for what to do.

Li Min didn't look at Zhou Daping; his gaze was fixed on the still fragile electrocardiogram curve on the monitor.

“If we send them to the county hospital now, they will all die on the way within an hour and a half, with no chance of survival.” He summarized the current condition of the wounded in the simplest terms, “especially him, his blood pressure can’t wait, and the pericardial drainage can’t be maintained for that long.”

"All actions are subject to my command!" Li Min calmly ordered.

The old dean stepped forward.

How confident are you?

Li Min did not answer immediately. He looked at Zhou Fusheng's ashen face and then at his own hands.

“Seventy percent!” he said.

The old dean remained silent for three seconds.

"Enough!" he said. "Do it!"

"Listen up, everyone! Don't be afraid, don't panic, just follow my instructions and lend me a hand!"

"Zhou Fusheng should be taken to the operating room immediately for surgery! Blood should be drawn and tests completed as he is being transported."

"Chen Dongxiu should also be sent to the operating room immediately and prepared for surgery. The two surgeries will be performed in parallel. I will do them. While I am working on Zhou Fusheng, you disinfect and drape Chen Dongxiu. Be quick. I will come over as soon as I finish over there."

"Xu Dehou has just undergone closed chest drainage, which has temporarily relieved the pressure on his heart. He is being observed while awaiting surgery."

"Zhao Qiulin, take over from Xu Dehou. Pay attention to when he applies the tourniquet. Notify me in an hour and a half."

"The other injured are currently under observation in the emergency room!"

After speaking, Li Min began assigning tasks to specific individuals.

After making the arrangements, he and the former hospital director rushed to the operating room.

The operating room lights came on.

P.S.: I'm slowly wrapping it up now, but it won't be over too quickly. Later on, there will be some ensemble scenes, giving each character their own ending, because everyone should have their own life. This book has been written on and off for five years because my main job has kept me from updating consistently. Thank you all for your continued support!