Emergency Department, outside the operating room.
Deputy Director Jiang Ming had just finished a laparoscopic appendectomy. The patient had gangrenous appendicitis. He used the conventional three-port laparoscopic technique: one main operating port, one auxiliary port, and one observation port.
He used cosmetic sutures for the incisions. The overall result was good, but it would still leave scars.
Recently, Jiang Ming had been working on a research project: how to achieve a nearly scarless laparoscopic appendectomy.
According to his plan, this cosmetic appendectomy technique had enormous potential and market value. It was also the project he was banking on to get promoted to Chief Physician.
However, his progress had not been very smooth lately.
’How can I minimize the trauma while ensuring safety?’
As Jiang Ming was pondering this, his phone suddenly buzzed. He took it out and saw it was a message from his older cousin, Jiang Feng, who worked at Fenglin Hospital, affiliated with Xuanshang University in Xianglin City.
"Little Ming, I have good news for you. A few days ago, I spoke with Director Cai from Fan City Satellite TV. He’s preparing a show called *Path to Health* and will be inviting doctors from Fan City to be guests. This is a great opportunity."
"Aren’t you researching acute abdominal conditions? An appendectomy is a great entry point. Make some time to prepare now. Get some materials ready for me, and I’ll put in a good word for you."
"Appendicitis is a very common illness, so it has natural promotional and educational value. If you seize this opportunity, you’ll have a good chance of becoming the youngest Chief Physician at Fan City First Hospital. Although I don’t think too highly of City First Hospital as a platform, it’s still a decent stepping stone."
Coming from a family of doctors, many of their relatives were in the medical field. Jiang Feng and Jiang Ming had grown up together, so Jiang Feng always thought of his younger cousin whenever a good opportunity arose.
Looking at Jiang Feng’s message, Jiang Ming thought about it. It really was a good opportunity.
"Got it, Brother Feng."
"If you call me ’Little Ming’ one more time, I’m blocking you."
Jiang Ming had an almost physiological aversion to the nickname. Growing up, he’d had to endure endless jokes and gags about "Little Ming," and he was sick and tired of it.
"Okay, Little Ming. Tell me what ideas you have. I’ll help you vet them."
Jiang Ming sighed. He was truly helpless when it came to Jiang Feng.
"I’m currently researching a new surgical technique for a cosmetic appendectomy. If I can pull it off, I think going on this show would be the perfect boost."
Jiang Feng replied a moment later:
"Little Ming, I think that’s a great idea. A cosmetic appendectomy has a lot of market potential and value for widespread adoption. I suggest you collaborate with doctors from the Cosmetic Surgery department, or maybe select some junior doctors in the hospital who are gifted at suturing to be members of your research group. You can train them up."
"Okay."
Jiang Ming began to consider it. That was indeed one possible direction.
"By the way, you have a Dr. Wu in your emergency department who’s incredible. When it comes to tendon repair, I have to admit he’s better than me. Next time I visit your hospital, I’ll have to pay him a visit."
Reading Jiang Feng’s sudden message, Jiang Ming was a bit baffled. In the emergency department’s surgical group, besides Huo Yun, he was the strongest. Where did this person who could surpass his cousin in tendon repair come from?
’He must have remembered wrong,’ Jiang Ming thought, and didn’t pay it any more mind.
Jiang Ming started planning his cosmetic appendectomy surgical technique.
’If I’m going to build a team... I heard Qin Donglai has a trainee with very solid fundamentals. He was even selected for a spot in a provincial case competition. When I get a chance, I’ll check him out. If his skills are really good, I could ask Director Huo for him.’
After all, Jiang Ming was a Deputy Chief Physician. For him to ask Huo Yun for a junior doctor would be an honor for that trainee.
The people under him were, at minimum, senior residents, and there was no shortage of attending physicians assisting him.
...
...
After Wu Ting’s debut appendectomy, no new patients came in over the next few days. He was mainly responsible for the few patients from his own surgery.
Qin Donglai also hadn’t found any suitable new patients for him to practice on these past few days.
Another night, another ordinary night shift.
The calm before the storm!
Just as Wu Ting and Luo Ming were making their rounds, a sense of impending doom suddenly fell over the entire emergency department.
The 120 Emergency Center contacted the emergency department. A terrifying explosion had occurred at an old chemical plant in Yu State, Fan City, due to faulty equipment.
Moreover, the timing of the chemical plant’s explosion was a huge coincidence—it happened just as a team from Fan City TV Station was filming a documentary there.
The scene was a complete wreck. A lighting technician, a prop master, a host, and several other staff members from the TV station were all caught in the blast. There was no exact number of total casualties yet, but the situation was extremely grim.
The emergency department’s Director Huo was in the middle of a major eight-hour surgery. After being informed of the situation, he prepared to rush to the emergency department to command and coordinate as soon as he was finished.
Before Director Huo came out, the several Deputy Chief Physicians of the emergency department had all rushed to the scene at once, simultaneously notifying all medical staff to be prepared.
All on-call attending physicians were also called back in.
Key physicians from related departments—Anesthesiology, General Surgery, Burn Surgery, Orthopedics, and Internal Medicine—were all pulled over as long as they were available.
This chemical plant explosion had caused a fire and chemical poisoning. The situation was extremely complex.
According to City First Hospital’s standards, an incident that caused burns to more than 20 people at once was classified as a mass burn casualty response.
Since the burn incident occurred some distance from City First Hospital, this kind of massively destructive accident could easily lead to respiratory tract burns, with a constant risk of asphyxiation. Some patients had combined burns and shock.
After receiving the notification, all departments at the City Hospital began to coordinate and cooperate closely.
This was, of course, the first time Wu Ting had ever encountered such a scene. It was impossible not to be nervous.
Even Luo Ming was experiencing this for the first time.
Fortunately, as the best comprehensive hospital in Fan City, City First Hospital was battle-tested.
An emergency rescue leadership team was immediately established. Vice President Tang Long was appointed commander, with Burn Department Director Wei Guoqiang and Emergency Department Director Huo Yun serving as deputy leaders. The team members included directors from various divisions and relevant multidisciplinary departments, with overall coordination handled by the Medical Administration Department, Nursing Department, and logistics staff.
Ambulances were dispatched, and rescue helicopters were contacted.
City First Hospital deployed its newly purchased high-end ambulances, equipped with various life-saving devices. In coordination with aerial rescue, the Fan City 120 system, which had helicopter transport capabilities, ensured timely, stable, and rapid transfers.
Ensuring patient safety during transport, commanding and guiding the on-site doctors, and mobilizing all treatment efforts upon arrival at City First Hospital’s Emergency and Burn departments—all these tasks were set in motion with great urgency.
In particular, the Emergency Department and Burn Surgery, as the backbone of this response, required every single one of their medical personnel to play a part.
Anesthesiology for sedation and analgesia, the emergency department for tracheal intubation, critical care medicine for dying patients, neurosurgery, pulmonology, cardiology—it was destined to be a tense and stimulating rescue effort involving multiple departments and numerous personnel.
With so many Chief Physicians, Deputy Chief Physicians, and attending physicians present, residents like Luo Ming were considered out of their depth, to say nothing of trainees like Wu Ting and the others.
While Director Huo, Director Wei, the hospital president, and others commanded from the central command post, Jiang Ming, as the Deputy Director of the Emergency Department’s surgical group, became the temporary group leader.
This was also Jiang Ming’s first time facing such a major rescue operation. Following Director Huo’s instructions, he held a notebook filled with bullet points and began to mobilize the emergency surgical group.
At the same time, Qian Minghua, the Deputy Chief Physician of the emergency internal medicine group, was also mobilizing his team.
Qin Donglai, Luo Ming, Wu Ting, Cheng Feng, and the others all listened to Deputy Director Jiang Ming’s instructions.
"Everyone, our surgical group will be coordinating with Burn Surgery on treatment. As soon as the patients are admitted, they will be triaged immediately. The general classification is as follows: critically ill patients will be properly placed in priority wards. In particular, patients with deep burns covering over 30% of their body will be handled by me and the senior attending physicians, in coordination with the burn specialists..."
"Patients with small to medium-sized burns covering less than 30% of their body will be placed in general wards, primarily handled by attending physicians and senior residents..."
"The remaining junior residents, trainees, and interns will assist with debridement, suturing, and other tasks within their capabilities. They will be assigned by their respective supervising doctors..."
"Everyone must ensure the three key elements are in place: doctor, nurse, and patient. Remember to use a gentle tone to comfort the patients, alleviate their fear, and gain their cooperation for treatment..."
"For patients with associated respiratory tract injuries, provide early, low-flow oxygen to maintain an open airway. If there are indications for a tracheotomy, perform it as soon as possible to prevent respiratory obstruction and life-threatening situations..."
Soon, Jiang Ming finished briefing the emergency surgical group. However, he felt a knot of uncertainty about this mass burn casualty response. He didn’t know if the emergency department’s doctors could handle it.
Especially for procedures like tracheotomies, burn escharotomies, and fluid resuscitation for patients in severe burn shock... there weren’t many senior physicians who had mastered these techniques. He couldn’t count on some of the junior attending physicians and residents.
On top of that, Director Huo had just completed a major surgery that lasted over eight hours. Jiang Ming waited anxiously for the first batch of injured to arrive.
Meanwhile, Qin Donglai led Luo Ming, Wu Ting, and Cheng Feng as one of the teams responsible for managing burn patients in the general wards.