28: Chapter 28 The First Person to Die
It was exactly 5:00 PM.
The Emergency Department hallway was already overflowing.
It wasn't just the Yellow Zone; the Green Zone was also full. They had even pushed chairs together in the waiting area to let patients with minor injuries lie down while waiting for treatment.
In the Red Zone, Director Li Sen was working with the heads of the Department of Thoracic Surgery and the Neurosurgery Department to treat the most critically injured patients.
The news Lu Chen heard was that they had already performed three emergency surgeries in the Red Zone, and the operations were still ongoing.
On the Yellow Zone side, over thirty patients with moderate injuries had been admitted so far.
Lu Chen, Zhao Yaqin, and Zhou Ze hadn't stopped for a single moment.
Zhou Ze was treating a patient with rib fractures complicated by hemothorax. He had contacted the Department of Thoracic Surgery for a consultation and was performing a Puncture for drainage while waiting.
He was very proficient at this; with over a decade of experience in the Emergency Department, such procedures were routine for him.
Lu Chen glanced over, said nothing, and turned back to his own patient.
This was the nineteenth patient he had taken over today, a teenager around seventeen or eighteen years old.
The boy hadn't made a sound when he was wheeled in; his face was deathly pale, and his eyes were half-closed.
Lu Chen walked over and immediately activated the Eye of Truth.
"Eye of Truth scan complete"
"Patient information: Male, approx. 17 years old"
"Chief complaint: Car accident trauma, persistent lethargy after impact. Family reports brief loss of consciousness followed by recovery, but mental state remains poor"
"Eye of Truth diagnosis: Epidural hematoma, right temporal region, hematoma volume approx. 35ml, mild midline shift, increased intracranial pressure"
"Danger level: Extremely high"
"Current symptoms: Altered consciousness, GCS score 9, right pupil slightly larger than the left, elevated blood pressure, slowed heart rate (early Cushing's triad)"
"Recommendation: Immediate emergency consultation with the Department of Neurosurgery, urgent cranial CT, prepare for emergency Craniotomy, control intracranial pressure, intravenous push of mannitol"
"Warning: Extremely high risk of cerebral herniation, very short time window. Delaying surgery will cause irreversible damage. Please treat immediately!"
After reading the results, Lu Chen's heart sank abruptly.
An epidural hematoma, and at 35 milliliters with midline shift, it already showed early signs of Cushing's triad.
This child was on the verge of cerebral herniation.
He turned and shouted.
"Teacher Zhao!"
Zhao Yaqin looked up from another bed.
"What is it?"
"This child is highly suspected of having an epidural hematoma. His pupils are starting to become unequal. We need to call the Neurosurgery Department immediately, push mannitol, and get an urgent CT right now!"
Zhao Yaqin walked over quickly and leaned down to look at the boy's eyes.
The right pupil was indeed a circle larger than the left, and the reflex was sluggish.
"Call the direct line to the Neurosurgery Department!"
Zhao Yaqin shouted to the Nurse, then turned back to look at Lu Chen.
"You prescribe the mannitol, 250ml, rapid drip. You go get the CT order, and I'll go call them."
"Okay!"
The two split up, not wasting a single second.
Lu Chen filled out the order and ran to the Nurse Station to urge them on.
"This CT is top priority. Can you contact the Radiology Department and open a green channel for me?"
The on-duty Nurse immediately picked up the phone.
Over in the Radiology Department, they were already working overtime scanning patients due to today's accident.
But upon hearing it was a teenager suspected of an epidural hematoma with unequal pupils, they immediately provided a green channel.
The boy was wheeled off for the CT, with Lu Chen following to monitor him the entire time.
The CT results came out in less than ten minutes.
The moment the results appeared, even the radiologist reading the films fell silent for two seconds.
Right temporal epidural hematoma, hematoma volume 38ml, midline shift 6mm.
The radiologist looked at the scan, their voice sounding a bit dry.
"This must be operated on immediately."
"I know, the Neurosurgery Department is already on their way," Lu Chen replied.
When the boy was wheeled back to the Emergency Department, the head of the Neurosurgery Department, Liu Ming, was already standing there waiting.
He looked at the CT scan, glanced at the boy, and then turned to look at Lu Chen.
"You discovered this?"
"Yes."
"What was the extent of the symptoms when you found him?"
"GCS was around 9, the right pupil was starting to dilate, blood pressure and heart rate were already drifting, and Cushing's triad had just emerged."
Liu Ming fell silent for a second, then said one thing.
"You discovered it quite early. If it had been half an hour later, this child might not have been able to withstand the surgery."
After saying that, he turned to arrange the surgery.
Lu Chen stood there, watching the boy being wheeled toward the Operating Room.
The boy's mother followed beside them, crying so hard she couldn't speak.
She could only nod continuously, clutching a phone case that was already soaked through.
Lu Chen said nothing.
He turned and walked back to the Yellow Zone.
The next patient was waiting.
...
5:40 PM.
Bad news arrived.
A long alarm sound came from the Red Zone; everyone who heard that sound knew what it meant.
The heartbeat had stopped.
Lu Chen was in the middle of applying a splint to a patient with a wrist fracture.
When he heard that sound, the movement of his hands paused for a moment.
Then he heard voices coming from the direction of the Red Zone.
It wasn't shouting, but that kind of restrained, short, commanding voice.
"Keep compressing!"
"Give another dose of epinephrine!"
"Prepare for defibrillation!"
Then came the heavy, low hum of the defibrillator discharging.
Then silence.
Then the alarm sound again.
Lu Chen finished fixing the wrist, turned to say two words to Head Nurse Fang Ying, and then walked quickly toward the Red Zone.
Zhao Yaqin didn't stop him; she herself was also walking toward that side.
The doors of the Red Zone were open. Lu Chen stopped at the entrance, not entering, just watching inside.
It was a man in his forties, a passenger from the bus.
By the time he was dragged out of the accident, he was already in cardiac arrest.
Emergency personnel had started CPR on the bus and performed it for over twenty minutes before bringing him in.
Now, Director Li Sen and the doctors in the Red Zone were still trying to resuscitate him, but the line on the ECG monitor was flat—flat, straight, and silent.
Defibrillation had been performed three times.
Four doses of epinephrine had been pushed.
Director Li Sen stood beside the Hospital bed, looking at the ECG monitor, not moving.
Two minutes of silence.
Then Director Li Sen spoke, his voice flat, but every word carried weight.
"Thank you all for your hard work. Stop now. Record the time of death as 17:42."
The sounds of resuscitation in the Red Zone stopped.
The alarm sounds of the equipment were turned off.
The entire Red Zone was as quiet as another world.
Lu Chen stood at the doorway, looking at the face that had stopped breathing, saying nothing.
He grew up in an Orphanage and had seen all kinds of life and death since he was young; it wasn't that he hadn't seen dead people before.
But this was his first time in a Hospital seeing a person pass away right in front of a group of doctors who had given their all.
That feeling was strange.
It wasn't a sense of powerlessness, nor was it frustration; it was more like something very concrete and heavy pressing on his chest.
He stood at the door for about ten seconds, then turned and left.
There were still patients waiting in the hallway.
That man in his forties was gone; there was no way around it.
But the people in the hallway who were still alive could still be saved.
He returned to the Yellow Zone, said nothing, and continued seeing patients.
...
6:30 PM.
In the Yellow Zone hallway, family members were crowded together.
With such a large number of car accident casualties, the family members arrived even faster than the patients.
Many people received the call and rushed over without saying a word.
Some didn't even know which Hospital their family members were at, running to several places before finding this one.
The sound of crying traveled from one end of the hallway to the other, intermittent and never stopping.
When Lu Chen passed through the hallway, a woman in her fifties or sixties suddenly grabbed his white coat.
"Doctor! Doctor!"
"Where is my son? My son's name is Chen Ye, forty-two years old, he was on that bus. Where is he?"
Lu Chen stopped.
"Ma'am, please calm down. Tell me, when was he brought in?"
"I don't know, I don't know. I got a call saying there was an accident, and I just ran over. Is my son okay? Is he alright?"
"Please come with me to the Nurse Station, and we'll check the registration records."
Lu Chen led the woman to Head Nurse Fang Ying.
Head Nurse Fang Ying checked the patient registration, flipped through two pages, and found Chen Ye's name.
"He's under observation in the Red Zone and is out of danger."
"He has a fracture. Surgery hasn't been performed yet, waiting for an opening in the Operating Room."
When the woman heard the words "out of danger," she burst into tears on the spot.
It wasn't crying out of sadness, but the kind of wailing after a total breakdown, crying out all the fear that had been building up for months.
"Thank you, thank you, thank you, Doctor..."
Lu Chen said nothing more and gently unclasped her hand from his white coat.
He let Head Nurse Fang Ying guide her to the waiting area, then continued walking forward.
How many times had he said "It's okay" or "Don't worry" today? He couldn't even remember himself.
Some were truly okay, some were still uncertain, and some were said to help people steady themselves so they wouldn't faint right there in the hallway.
This is the Emergency Department; in the face of life and death, you have to help the living stand firm first.