Chapter 404 - 262: Report
But Xu Chen worked without a single complaint, desperate to prove himself.
Because this was Jiang He’s team.
As long as he was here, there was still hope he could relearn how to revere life and return to the operating table.
"Xu Chen."
"Here!"
"The patient in bed three with the post-op biliary fistula—has the drainage volume from the tube decreased today?"
Xu Chen reported loudly, "Reporting, Boss! It has. This morning’s total drainage was less than fifteen milliliters. The color has changed from pale yellow to clear, with no signs of active bleeding."
Jiang He nodded. "Mm, if the volume is still the same tomorrow morning, tell the ward nurse we can consider removing the tube."
"Yes, sir!"
"What was the overall situation with the patients on the floor last night?"
Jiang He turned his head to look at Attending Physician Liang Shaojun, who was sitting across from him.
Liang Shaojun was in his early thirties, with a calm and capable demeanor.
He opened the handoff report and began.
"Boss, our team was responsible for sixteen patients last night. Things were stable overall, with no emergency resuscitations. The main case to report is in bed seven: a patient with acute pancreatitis admitted due to binge eating and drinking. His vitals were stable on admission. However, yesterday we ran his data through the SAP prediction model, and the system’s score crossed the critical illness threshold."
"After seeing the alert, we immediately placed him under close observation. We increased the frequency of his C-reactive protein and serum calcium checks and proactively started him on a somatostatin infusion pump. Sure enough, at two in the morning, the patient developed shortness of breath and fluctuating blood pressure—a clear trend toward a severe case. But because we intervened early, we got his condition under control before it could worsen. His vital signs are currently stable."
Liang Shaojun paused, looked up, and said with sincere admiration, "Boss, this SAP model you developed is exceptionally effective."
After listening, Jiang He smiled. "As long as it’s useful. A model, no matter how good, is just a tool. In the end, it all comes down to your team’s execution. The early intervention was very timely. I’ll credit you for that."
The man before him, Liang Shaojun, was actually an old acquaintance from his past life.
Jiang He had personally gone to the HR department to pick the members of this medical team.
The people on this team:
Liang Shaojun, Song Yiming, Shi Hao, and the others... Jiang He knew them all in his previous life.
He didn’t just know them.
In his past life, they had all been his seniors.
Especially Liang Shaojun.
He had been Jiang He’s direct supervising teacher back then.
𝚏𝕣𝐞𝗲𝐰𝕖𝐛𝐧𝕠𝕧𝚎𝚕.𝐜𝚘𝗺
Liang Shaojun was notoriously strict. If Jiang He made a mistake, he would get an absolute earful.
But for all his strictness, Liang Shaojun was a very good person in private.
He would often take Jiang He out for good food nearby and share practical tips about working in the hospital.
They were all good, dedicated doctors.
It was precisely because he knew their character that Jiang He had recruited them all.
It’s just that...
Now, their roles were completely reversed.
His strict teacher and senior from his past life had become his subordinate in this one.
The supervising teacher who used to treat him to street food stalls now sat respectfully across from him, calling him "Boss" with every other word.
’The feeling is a little surreal.’
Jiang He pulled his thoughts back to the present and said:
"Old Liang, keep a close watch on bed seven. Arrange for a follow-up abdominal CT today to check the absorption of the peripancreatic fluid. Also, New Year’s Day is almost here. Let’s try not to keep too many patients in the department. For those who can be discharged and meet the criteria, get the paperwork done quickly so their families can enjoy the holiday with peace of mind."
"Understood." Liang Shaojun nodded and took notes.
Jiang He stood up. "Alright, let’s go do rounds. I have a meeting to attend."
"Take care, Boss."
Everyone stood up to see him off.
「That morning, in Conference Room 3 of the Affiliated Hospital No. 1’s administrative building.」
It was a closed-door internal meeting.
The bigwigs had all arrived.
Zhang Sui, Dean Chen, Yang Xu, Liu Jianbang—everyone was there.
Jiang He brought up the PowerPoint he had prepared.
On it was written:
"Clinical Deduction and Practice for Severe ARDS Complicated by North-South Syndrome under a V-A-V ECMO Configuration."
He said, "Dean, Directors, I’ve already explained the pathological mechanism of the disease itself. Severe ’white lung’ causes the patient’s own pulmonary circulation to fail, which is the root cause of North-South Syndrome. I won’t go into detail on that again."
"Today, my main focus is to explain how I was able to deduce a plan to modify the circuit in just a few minutes."
The bigwigs below instantly dropped their smiles.
Yes, this was the question they were most concerned about.
’How did you dare?’
"Please look at this paper on the screen. It’s a cutting-edge discussion from this year’s *AIC*. The article proposes a hypothesis: in cases of severe hemodynamic instability, is it possible to alter the blood delivery path of the extracorporeal circuit via an artificial shunt?"
"At the time, by the bedside, the patient’s right-hand blood oxygen had dropped below 65%. The first thing I ruled out was increasing the overall speed of the ECMO pump. Under the existing circuit configuration, simply increasing the flow would not only fail to reverse the mixing of blood in the aortic arch, but it could also cause the vascular endothelium to tear from the shear stress."
The deans and directors below were furiously taking notes, not even looking up.
They seemed a hundred times more focused than when they were students.
Jiang He continued, "Since increasing the overall flow was not an option, the only choice was to provide localized oxygenation. But how? I quickly thought of the formula for resistance in a parallel circuit."
"The internal jugular vein is a low-pressure system; the femoral artery is a high-pressure system. If we cut an opening in the original V-A circuit and connect it to the internal jugular vein, the blood will inevitably follow the path of least resistance."
"Therefore, the oxygenated blood would rush into the right atrium, then be pumped through the right ventricle into the lungs, achieving a physical bypass. It would ultimately be ejected into the aortic arch, saving the hypoxic brain."
Liu Jianbang, upon hearing this, raised his hand politely to ask a question. "But if you do that, the vast majority of the blood would short-circuit and flow into the venous side. The blood supply to the lower body would plummet. How could you be sure at that moment that it wouldn’t cause a total collapse of systemic blood pressure and ischemic necrosis of the organs?"