top student at medical school

"Jiehan, does Master have anyone in this academy who is conveniently located to come out?"

At 7:15 p.m., Fang Ziye squatted in the stairwell and called Jie Han: "Or you can just call the chief resident of obstetrics. Bed 13 here has a problem with the diagnosis."

Jie Han is currently the chief resident of trauma surgery, so he knows the phone number of the current chief resident of obstetrics.

The previous chief resident of obstetrics, Fang Ziye, had long since stepped down.

"No, senior brother, weren't you in the obstetrics department with your wife? What else did you do?" Jie Han was a little confused as he was curled up in the resident's bed, having neither performed emergency surgery nor held an emergency consultation.

Wasn't Fang Ziye a family member working in the obstetrics department? How come he asked me to notify the obstetrics resident that there was a problem with the diagnosis?
"I don't have time to explain that much to you. The patient in bed 13 just had abdominal pain and said his stomach was tightening. His family's voice woke me up."

“But the pregnant woman’s problem is probably not just her water breaking; it’s likely some other related acute abdominal condition… I’m not in a position to get involved right now!” Fang Ziye said quickly.

If Fang Ziye weren't a family member, he would have rushed straight to the doctor's office as soon as he saw it.

However, that's not the case. Fang Ziye is also a doctor and the head of a ward. He really dislikes people in the field who pretend to know everything and talk nonsense.

If the person accompanying him were a patient's family member, Fang Ziye might instinctively experience other emotions as well.

Putting himself in others' shoes, Fang Ziye hoped to handle the matter in a slightly more tactful way.

This patient's situation looks a bit tricky. If we don't prepare in advance, the expectant mother might get into the delivery room or operating room and just focus on giving birth, which could cause a lot of trouble.

Of course, Fang Ziye didn't actually touch the patient; he only observed the other person's micro-expressions through visual examination, so he couldn't be completely certain...

In this situation, it would be more appropriate to have Jie Han inform the chief resident.

"Okay, senior, I need to find the phone."

"Notify them immediately." Jie Han, sensing that Fang Ziye wasn't joking, immediately hung up the phone.

After hanging up the phone, Fang Ziye breathed a long sigh of relief, wondering what symptoms the woman might be experiencing with acute abdominal pain.
Could it be that there is a uterine rupture or severe bleeding right now?

How should we deal with any emergencies that might occur later?

After Fang Ziye re-entered the ward through the fire escape, the on-duty doctor and the on-duty associate professor rushed out. After a quick fetal heart rate monitoring, the slightly older-looking doctor loudly announced, "The fetal heart rate is not good, there are signs of distress, and the baby cannot enter the delivery room."

"Hurry up and sign the papers, you're about to go into the operating room..."

Unlike other specialties, obstetrics may involve women giving birth at any time, so it is essential to have associate senior physicians on duty in the ward to prepare for surgeries.

The resident physician had prepared the necessary materials for the interview well in advance; these materials were kept in the medical record book and could be used at any time.

"Who is the father? Come over and sign the papers right away. I won't go into the usual risks, but the fetus is in distress right now. We'll try our best to save it, but there's still a very small chance of a stillbirth!"

"Of course, the chances are very small. We will do our best to treat the baby. If the baby's condition is not good, the baby may need to stay in an incubator after birth..."

"Sign here..." she directed the child's father to sign the papers in a flurry, while watching the nurse and the on-duty teacher push the bed out of the examination room.

Just then, a slightly younger doctor rushed over. She quickly put on a mask and whispered something in the older doctor's ear.

"Was it Professor Fang Ziye who said that? The Professor Fang Ziye who lives in the single bed 3 in our department?" The older doctor's tone was slightly sharp.

"Yes! Director Du."

"The orthopedic resident said that Professor Fang was woken up, so he came over to take a look, but he didn't go into the ward, since it's not convenient, so there's some suspicion about that," said Lan Fangfang, the obstetrics resident, speaking quickly.

"Professor Fang's suggestion is something we should carefully consider, isn't it?"

Du Qin hesitated for only a few seconds before quickly saying, "Immediately request an emergency consultation with the ultrasound department and call the second-line general surgery team for an emergency consultation."

"Call the on-call staff and have them communicate directly by phone. Get him into the operating room immediately."

"Liu Luolin, quickly print out a critical illness notice and the specific disease classification!"

Fang Ziye has become quite famous in surgery in recent years, so much so that Du Qin doesn't dare to take his advice lightly.

Of course, after giving the order, Du Qin looked around for a while, but did not find Fang Ziye.

Du Qin sighed softly and said, "I heard that when Professor Fang was still in this campus, he could even catch a live thief. If he were on stage, he could save the day."

"It's a pity that Professor Fang's current status makes things inconvenient."

Fang Ziye is a normal person, and he has the right to become a family member.

Men are also entitled to paternity leave, which is a statutory holiday during which they can take a full day off.

It was clearly inappropriate for Luo Tingzhu to immediately call Fang Ziye to participate in the diagnosis and emergency treatment of Weiming, whose child had just been born.

Fang Ziye himself probably didn't want to get involved, and it was with this in mind that Fang Ziye didn't personally call Director Li, the head of the obstetrics department.

"Professor Fang must have gone to rest. Teacher Du, let's go into the operating room first, and we can call Director Li later depending on the situation," Lan Fangfang replied quickly after finishing the call and reporting.

……

When Fang Ziye returned to the private room, Luo Tingzhu and Fang Xiyan were fast asleep, while the postpartum nanny was preparing the milk.

She is a very professional postpartum nanny. She knows that newborns don't know when they are hungry and need to be fed at fixed times. She also knows to wake the baby up to drink milk even if he is not awake.

Seeing Fang Ziye enter, the nanny, Sister Chang, said softly with a smile, "Professor Fang, are you too nervous and can't sleep?"

"No, I was just asleep when the noise outside woke me up."

"The soundproofing in the old hospital area is still not good enough," Fang Ziye shook his head.

Fang Ziye was nervous when Luo Tingzhu underwent a cesarean section, but things have stabilized now. Luo Tingzhu hasn't needed any IV fluids after the surgery and can be discharged after three days of rest.

Fang Ziye was naturally not nervous.

"The soundproofing and environment at the new hospital are better than here. The obstetrics department also has a ward at the new hospital, but Director Li hasn't gone there yet."

"Many people in the obstetrics department come here specifically to see Director Li Jiafu."

“It’s common for there to be noise at night, so Director Li often says, ‘Don’t stay in the hospital. You can’t rest as well at home as you would at the hospital. On the contrary, patients and their families don’t want to be discharged,’” Sister Chang said with a smile.

Sister Chang is forty years old this year and has two children, but the younger one is already in junior high school. She is a local of Han City and has many years of experience as a postpartum nanny. She was recommended to Fang Ziye by Brother Qin Geluo.

"Okay, Sister Chang, unless there's anything special, you should get some rest too." "I'll take a nap a little longer. I don't think I'll be able to sleep well tonight," Fang Ziye said.

Sister Chang said, "Professor Fang, you can sleep peacefully. I'll keep an eye on Xiyan, he'll be fine and won't disturb you."

"I'll change her diaper again later... Newborns like her need their diapers changed more frequently."

Chang Jie thought Fang Ziye meant that he would be disturbed by the children.

Fang Ziye remained silent and lay down on the cot.

Sure enough, less than half an hour later, Fang Ziye's phone rang, and it was Professor Deng Haibo from the Department of Vascular Surgery.

What can we do? We have no choice but to accept it.

"Professor Deng." As soon as Fang Ziye answered the call, Deng Haibo's voice preemptively entered his ears: "Fang Ziye, the complicated situation you were monitoring has arisen."

"Major uterine bleeding!"

Fang Ziye said, "There must be other reasons, right? If this woman's condition were normal, she wouldn't need to come to Director Li's office."

Director Li Jiafu is a renowned obstetrician in Hubei Province. Apart from close acquaintances like Fang Ziye, ordinary pregnant women are not admitted to the hospital to give birth.

Those who come to him all have difficult and complicated illnesses.

There's a documentary called "The Gate of Life," which was filmed in the obstetrics ward of Zhongnan Hospital. It's not about the real person, but about the person themselves, and it's the kind of documentary that follows people around at any time.

"Congratulations, you guessed right again. But there's no reward, only punishment. Your vacation will be temporarily requisitioned."

“Fang Ziye, after all, we encountered him, after all, you saw through him, after all, you are still here in this hospital area, after all, it is a human life…” Deng Haibo’s voice was very deep.

“Professor Deng, I have already set off…” Fang Ziye said.

"Thank you. If you come down, there's a 60% chance she'll survive... Everyone, cheer up, Professor Fang will be here soon..." Deng Haibo quickly hung up the phone.

Sister Chang stared in disbelief as Fang Ziye quietly closed the door, her gaze shifting as she thought to herself that this Professor Fang was quite different from the other professors in the hospital.

I was called to the new hospital campus for surgery this afternoon, and now I'm being called to the operating room for surgery again. He seems very busy, as if there are some surgeries that only he can handle.
Sister Chang is just a 'maternity nurse' who lives at home. Because of her good reputation, she is often booked, so even though Fang Ziye is very famous, she is not in her circle of acquaintances.

……

When Fang Ziye entered the operating room, Li Jiafu, the director of obstetrics, and Deng Haibo, the director of vascular surgery, were "fighting" inside the abdominal cavity, their instruments clanging and clattering, looking somewhat flustered.

Another associate chief physician in general surgery said with a hint of resentment, "What happened? It's really strange. How could her blood vessels be so fragile? They would rupture with the slightest movement. Her intestines are also swollen and fragile..."

"Sterile surgical gowns, size 7.5 gloves," Fang Ziye ordered as soon as he entered.

Now that he's in the operating room, Fang Ziye is no longer a family member, so there's no need to be polite.

"Professor Fang, you've arrived..." Deng Haibo no longer simply called Fang Ziye "Ziye," but rather used the more informal form of address.

Fang Ziye is now a very mature professor and director, so even if you call him Director Fang respectfully, it's not an overstatement.

As Fang Ziye dressed, he approached the operating table: "Did you still not stop the bleeding even after puncturing the uterine artery and iliac artery?"

There are many treatment options for postpartum hemorrhage, but artery ligation to stop the bleeding is one of the more effective surgical procedures for preserving fertility.

The baby is fine and has already gone out to meet the family, but the mother is still bleeding even after her artery was ligated.

“There must be a blood vessel mutation!” Deng Haibo’s tone was exasperated.

"She encountered all sorts of rare situations; carrying this child must have been incredibly difficult for her..."

The uterine artery is the main source of blood supply to the uterus, followed by the internal iliac artery, whose origin is clamped.

If neither of these methods works, then further exploration or removal of the uterus may be necessary.

“Size 7.5 gloves.” The circulating nurse opened the gloves on the sterile table, her tone becoming low and serious, with no hint of a joke.

The anesthesiologist was making a phone call to request blood, and was also having his students prepare oxytocin and other common perinatal hemostatic drugs.

After Fang Ziye quickly took over, Deng Haibo immediately relinquished his position as chief surgeon.

Fang Ziye glanced at it briefly, then exclaimed in astonishment, "Why is this patient's abdominal arterial system so disordered?"

Normally, the anatomical structure of arteries in a healthy person is traceable.

For example, the abdominal aorta branches into the left and right common iliac arteries, and then the common iliac arteries branch into the internal and external iliac arteries, which in turn branch into tree-like structures...

This patient is quite unusual; the blood vessels did branch out, but then they fused together again, which is an extremely rare type of vascular variation.

Her uterine artery is a uterine artery, but it is also a ureteral artery. Moreover, the ureteral artery and other branches also have an "opening" in the uterus!
"The patient had a pre-existing coagulation disorder with occasional spotting. We initially thought it was an endocrine-related coagulation disorder, but it turned out to be an anatomical coagulation disorder."

"Her circulatory system is too complex, so the pressure on her blood circulation was very severe during pregnancy, which caused edema in many internal organs."

"When the amniotic sac ruptures, the blood pressure changes drastically, and the local blood vessels immediately rupture..." Director Du of the obstetrics department gave a professional analysis, explaining the general situation to Fang Ziye.

"Hmm, it's alright! If the blood circulation is complicated, we can just prick them one by one."

"There are only so many blood vessels..." Fang Ziye said slowly.

Just as Director Li and Associate Chief Physician Du of the Obstetrics Department were about to say something, Fang Ziye's movements were incredibly fast. Somehow, Fang Ziye's hand had already probed multiple 'branches' of the uterus and the openings of unconventional arteries, and he had clamped them with great precision.

The speed was ridiculously fast. Saying it would stab one artery per second would be an exaggeration, but severing an 'unnamed' artery in three or four seconds would be a conservative estimate.

Fang Ziye's treatment approach had no "skills" whatsoever; it was simply the most straightforward and violent method of severing the blood vessels.

Of course, the dexterity of those hands, the precision of the hemostasis operation, and the speed of the blood vessel exploration were as simple as going home, slipping on your slippers, and drinking water.

After about a minute, Fang Ziye laughed: "Now it should be almost done."

Fang Ziye was not only assessing the prognosis of his own operation, but also had time to help the general surgery department make a blood supply 'speculation': "Teacher, you should pay attention to the inferior mesenteric artery. According to the blood flow trajectory at this bleeding point, the inferior mesenteric artery should be ruptured."

"Professor Li, how about we hold off on removing the uterus for now? Let me see if we can preserve it through precise suturing and repair?" Fang Ziye didn't dare to make a decision on his own and still sought Professor Li Jiafu's opinion. (End of Chapter)