13: Chapter 13 The distance between life and death is sometimes that short.
The patient's condition continued to deteriorate.
The waveforms on the ECG monitor became increasingly chaotic, and the frequency of ventricular premature beats was rising.
"Prepare for defibrillation!" Zhou Ze shouted.
At that exact moment, the monitor emitted a piercing, continuous beep.
The waveform suddenly turned into coarse fibrillation.
ventricular fibrillation.
"Defibrillate! 200 Joules!"
The Nurse placed the electrode pads while Lu Chen had already applied the conductive gel.
Holding the electrode pads with both hands, Zhou Ze pressed the discharge button.
The patient's body jerked.
Everyone looked at the monitor.
The waveform was still chaotic.
"It didn't convert, try again! 360 Joules!"
The second defibrillation.
The patient's body jerked again.
The waveform on the monitor flickered a few times, then slowly shifted into a sinus rhythm.
"It converted!"
The Nurse shouted.
Everyone breathed a sigh of relief.
But they could only breathe half a sigh.
Because the thrombus was still blocking the coronary artery, and the myocardium was still undergoing necrosis.
If interventional surgery wasn't performed as soon as possible to remove the thrombus and clear the vessel, this person could go back into ventricular fibrillation at any time—and next time, they might not be brought back.
"What did the Cardiology Department say?"
"The Catheterization Laboratory is already preparing; they can take him in five minutes!"
"Push him over, fast!"
The patient was pushed onto a gurney, and a crowd of people rushed toward the Catheterization Laboratory.
The woman chased after them, sobbing breathlessly.
"Hubby! Hubby, don't scare me!"
Lu Chen also ran along for a while, helping to push the gurney.
Once they reached the doors of the Catheterization Laboratory, the patient was taken inside.
The rest was left to the Cardiology Department's intervention team.
Lu Chen stood outside the Catheterization Laboratory, panting slightly.
The effect of the 'enemy of yama' title had played a crucial role just now.
If the title hadn't slowed the decline of vital signs by 50%, that patient might have been completely gone during those dozens of seconds spent waiting for defibrillation.
A difference of dozens of seconds.
The distance between life and death is sometimes that short.
...
After the doors to the Catheterization Laboratory closed, the hallway fell silent.
Zhou Ze stood by the wall, leaning his whole body against it, his face ashen.
He didn't say a word.
Zhao Yaqin walked over to him, offering neither comfort nor blame.
At this point, words were useless.
The key was that the person was currently in surgery; whether they could be saved was still up in the air.
About five minutes passed.
Zhou Ze finally spoke.
"That intern told me half an hour ago."
Zhao Yaqin gave a soft "mm."
"Every point he made was correct: hyperlipidemia, cold sweats, nausea, neck discomfort, and the early false-negative ECG for an inferior wall myocardial infarction."
"He didn't get a single word wrong."
Zhao Yaqin didn't respond.
Zhou Ze gave a bitter smile.
"I've worked in the Emergency Department for fifteen years, only to be slapped in the face by an intern who's been here for five days."
"Believe it or not, if word of today gets out, the entire Emergency Department will laugh at me."
Only then did Zhao Yaqin speak.
"Old Zhou, no one is going to laugh at you."
"The atypical presentation of an inferior wall MI is indeed very easy to miss."
"False-negative ECG results are documented in textbooks; such cases appear in major Hospitals across the country every year."
"But you were wrong on one point."
Zhou Ze: "What?"
"You shouldn't have rejected that kid's suggestion."
"Even if you didn't agree with his diagnosis, his suggestion to check Myocardial Enzyme Spectrum and Troponin was reasonable in itself."
"It's just one vial of blood and fifteen minutes for the results."
"If you had agreed to the test then, the results would have shown elevated Troponin, and we could have started the rescue half an hour early. The patient wouldn't have collapsed at the pharmacy entrance."
Zhou Ze's mouth twitched, but he couldn't find the words.
Because he couldn't refute a single word Zhao Yaqin said.
He was indeed wrong.
It wasn't a lack of diagnostic ability, but rather that his ego was too heavy.
When an intern questioned his diagnosis, his subconscious treated it as a provocation rather than a well-intentioned reminder.
His focus shifted from 'is there really something wrong with the patient' to 'my authority is being challenged by a green kid.'
That was the most fatal mistake.
Zhou Ze closed his eyes.
After a long while, he opened them and took a deep breath.
"What's that intern's name?"
“Lu Chen.”
"Have him come see me."
...
Ten minutes later.
Lu Chen was called by Zhao Yaqin to the hallway outside the Catheterization Laboratory.
Zhou Ze was standing there waiting for him.
The two stood face to face.
The hallway was quiet, save for the distant beeping of medical equipment.
Zhou Ze looked at Lu Chen with a complex expression.
A forty-six-year-old Associate Chief Physician looking at a twenty-four-year-old intern—his eyes held embarrassment, admiration, and an indescribable mix of emotions.
"Little Lu."
"Doctor Zhou."
Zhou Ze opened his mouth, then closed it again.
He thought for several seconds before speaking again.
"What you told me earlier—the chest tightness, cold sweats, nausea, neck discomfort, the history of hyperlipidemia, and the possibility of an early false-negative ECG."
"You were completely right. My judgment was flawed."
When he said this, Zhou Ze's voice was very soft.
But in the quiet hallway, every word was crystal clear.
An Associate Chief Physician with fifteen years in the Emergency Department was admitting to an intern's face that his judgment had been wrong.
This required no small amount of courage.
Lu Chen showed no sign of smugness.
"Doctor Zhou, I didn't have conclusive evidence at the time either. I just felt some details weren't quite right, which is why I brought it up."
"If there had been even a slight abnormality on the ECG, you definitely would have seen it."
"It's just that this ECG happened to hit the false-negative window; you can't be blamed for that."
Hearing this, the corner of Zhou Ze's mouth quirked bitterly.
This kid wasn't just technically skilled; he was also very tactful.
He gave him a way out without making it seem intentional.
"Alright, don't try to save face for me. A mistake is a mistake; I know what happened."
Zhou Ze patted him on the shoulder.
"That life today—it's because you sounded the alarm early. Even though I didn't listen at the time, at least you gave me a mental heads-up."
"When he collapsed, my first reaction was an MI rather than something else, which bought us time for the rescue."
"And the family member—you told her to get extra tests. Although she didn't insist in the end, she at least didn't leave the Hospital and was still waiting at the pharmacy."
"If she had already taken him away, I wouldn't even dare imagine the consequences."
Lu Chen said, "It was because he hadn't gotten his medicine yet, so they were moving slowly."
Zhou Ze continued.
"In any case, what happened today is my responsibility. I will report it truthfully to Director Li, and I'll take whatever disciplinary action comes."
"As for you."
Zhou Ze glanced at him.
"You've got real potential for an intern."
After saying that, he turned to leave.
He walked a few steps, then stopped and looked back at Lu Chen.
"By the way, how did you know about the hyperlipidemia? I didn't catch that during my consultation."
Lu Chen: "I asked the family privately afterward."
Zhou Ze was silent for a moment.
"In other words, after I finished the consultation, you went and did a follow-up consultation of your own?"
"I suppose so."
Zhou Ze shook his head and turned away, this time without looking back.