CONTENT WARNING:
The following chapter contains descriptions of violence, blood, death, and intense psychological distress. It also includes themes of emotional and physical abuse, trauma, and mental health struggles.
Reader discretion is advised.
Volume 1: Rise
Pregnancy
Ectopic pregnancy in a twelve-year-old child
Gu Yanzhi, who spent a night in the ER observation room, jumped out of bed lively the next day. Before leaving, Lu Qingshi instructed her: “Change the medicine every three days, don’t let the wound touch water, and if you feel uncomfortable, come to the hospital promptly.”
The other party blinked and put her sleeves on properly: “Do I still need to go to the hospital? I can just find you directly.”
“…” Lu Qingshi was speechless, after a while reluctantly nodded her head in agreement.
Gu Yanzhi left cheerfully, and after a while, Lu Qingshi also prepared to pack up and go home, as she was on vacation today and didn’t want to waste time in the hospital. Besides, there was a big pile of messy odds and ends at home that needed tidying up.
During the noon break, Yu Gui went to eat rice noodles at a roadside stall opposite the hospital. Not far away, a middle-aged woman was scolding the little girl beside her loudly: “You wretched money-losing thing, today you have a headache, tomorrow it’s stomach pain, pretending to be sick when you’re not. I think you’re the one who’s crazy! Hurry up and finish eating and go to school!”
“Hey, your mixed sauce noodles are here!” the shopkeeper brought the noodles to the table.
The woman wore a washed-out old jacket, her dry, frizzy hair tied casually at the back with a rubber cord. As she spoke, she gave most of her bowl of noodles to her daughter.
The little girl’s face looked somewhat pale, wearing a dirty school uniform, and her cloth shoes on her feet were somewhat yellowed from washing. She didn’t eat, just stared at the bowl: “Mom… I really feel uncomfortable… I…”
She hesitated to speak, and the middle-aged woman slapped her: “You money-losing thing, where does your mother have money to get you treated? Endure it even if you’re uncomfortable!”
That loud slap made the little girl cry, and Yu Gui stood up to pay the bill: “Boss, how much?”
She took out a ten-yuan note from her pocket and handed it over. When she received the change and was about to turn to leave, she suddenly heard the crisp sound of plates and bowls.
She turned her head to look, and the little girl had knocked over the noodles, spilling them on the ground.
“You dead girl, still pretending to be dead for your mother! Get up for me!” The middle-aged woman kicked her, kicked twice with no movement and panicked.
“Qiao’er? Qiao’er? Don’t scare mom, Qiao’er…” The middle-aged woman squatted down, desperately shaking the little girl’s shoulders: “Somebody, is there any kind-hearted person to help call an ambulance!”
Yu Gui tightly held the change in her hand and remembered what Lu Qingshi had said to her: “I hope you, before obtaining the practicing doctor qualification certificate, do not declare yourself as a doctor outside, as it will harm many people.”
The surrounding diners saw something happen and scattered in haste, while the boss chased after them: “Hey don’t run! You haven’t paid yet!”
Seeing the little girl barely breathing, with sweat on her forehead, Yu Gui still rushed over in one stride, picking her up: “I am a doctor, follow me!”
She tried the first time but didn’t manage to pick the girl up, then took a deep breath, squatted down, and signaled the girl’s mother to put her onto her back. When the heavy weight pressed on her, her calves trembled, but she still barely stood up, gritted her teeth, and ran towards the hospital opposite the road, sprinting into the emergency center at full speed.
“Good… good person sister… get… get a stretcher… quick… hurry!”
Hao Renjie, napping at the triage desk, was startled by her shout, his soul almost flew away, and he sprang up instantly. When he saw who it was, he immediately exclaimed “damn,” and pushed the stretcher beside the triage desk to assist her, almost bumping into Lu Qingshi, who had just come out of the office.
The little girl was placed on the stretcher, and Yu Gui was out of breath, feeling as if her whole body had fallen apart: “I… I was eating rice noodles across the road… met them…”
She pointed to the anxious girl’s mother nearby: “Sud… suddenly she just fainted…”
Hao Renjie quickly took her blood pressure: “Don’t say these useless things, tell me the symptoms and what to do!”
Yu Gui picked up the inspection light to shine on her pupil: “Uh… she reacts to light… coma index E2 V2 M31… good… good person sister… first open an intravenous line for fluid infusion…”
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Seeing her hesitant appearance, Hao Renjie rolled his eyes: “If you can’t handle it, call your Teacher Lu over.”
“Lu… Teacher Lu is resting today…” Yu Gui said stiffly.
“Move aside,” Lu Qingshi squeezed over as soon as she finished speaking: “Push her into the emergency room first and then talk.”
As soon as they pushed her into the emergency room, the monitoring machine started alarming.
“Sister Lu, her blood pressure isn’t coming up, 40-60.”
Lu Qingshi put on a stethoscope, pressing one end on the little girl’s abdomen: “Open another intravenous line, and bring over a bedside ultrasound.”
She didn’t bother to put on a white coat, only had time to wear gloves, and when the nurse pushed over the FAST, she swiftly pressed it on the little girl’s belly, sliding it back and forth.
“Administer dopamine 10 mg with 5% glucose diluted for intravenous infusion.”
Yu Gui quickly prepared the medication as instructed and hung it up, but seeing the little girl still not improving, with blood oxygen hovering around 50, she felt uneasy.
“Teacher Lu… what… what’s happening?”
“Call OB-GYN Doctor Qin for a consultation, emergency surgery, and tell her to hurry.”
Lu Qingshi slid the ultrasound from the abdomen to the pelvis, revealing a large area with no echo, with the entire uterus soaked in bloody fluid.
“Hao Renjie, contact the operating room and the anesthesiologist, tell them to open the green channel2; we’ll need it soon. Also, write a request to apply for a blood transfusion, prepare 1000ml of red cells first.”
“Okay!”
Everyone responded in unison, busy running around. After Yu Gui finished the call with OB-GYN, she immediately came to help push the stretcher.
Lu Qingshi glanced at her: “You go give the critical condition notice to the patient’s family.”
“Ah? Me?” Yu Gui had never done this kind of thing before and felt uneasy seeing the little girl’s very dangerous situation, especially since that middle-aged woman didn’t seem easy to talk to.
“You would only add chaos on the operating table, better to stay and do something useful.”
Lu Qingshi said as she entered the elevator, leaving Yu Gui standing there feeling somewhat disappointed.
Actually… she really wanted to be on the operating table too.
When Qin Xuan came in after scrubbing her hands, Lu Qingshi was already preparing for surgery.
“So annoying, it’s always like this, and today isn’t even my on-call day; I was hoping to get off early.”
“Enough with the nonsense, hemorrhagic shock, just did an urgent blood HCG test, check the results yourself.”
The nurse handed the test sheet to her, and Qin Xuan glanced at it: “My goodness, some people over thirty are still single, yet this teenage child has an ectopic pregnancy3; Director Lu should learn from her.”
Lu Qingshi felt like she should take a suture needle and sew her mouth shut.
Though she talks poorly, when it comes to surgery, Qin Xuan is still very meticulous and rigorous.
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“Surgical knife”
“Monopolar electrosurgical knife”
“Forceps”
“Suction”
The two were not working together for the first time, having a certain tacit understanding. Qin Xuan was the main surgeon, and Lu Qingshi was the first assistant. After opening the pelvic cavity, blood immediately gushed out; the fallopian tube had already been ruptured by the developing embryo.
“Tissue scissors”
Lu Qingshi frowned and held the vascular clamp on the tissue scissors that had not yet been inserted.
“What are you doing?”
“Can’t you see? The damage is so severe, this side’s fallopian tube must be cut.” Qin Xuan moved her wrist, and Lu Qingshi gripped tighter.
“She is only twelve years old”
Cutting off one side of the fallopian tube will greatly reduce future pregnancy opportunities.
“Isn’t saving her life the most urgent task?” Qin Xuan was also anxious.
Lu Qingshi looked at her, not backing down: “Living without quality is worse than dying.”
In the operating room, tensions flared momentarily, with sparks flying.
Qin Xuan was the first to concede: “Fine, fine, I’ll do it, let go.”
Only then did Lu Qingshi release her, turning a simple unilateral salpingectomy4 into a salpingostomy with postoperative repair.5
As she placed the removed gestational sac6 into the tray, Qin Xuan sighed with relief: “I’m telling you, don’t call me for consultation next time; whenever you call me for consultation, nothing good happens.”
Lu Qingshi continued suturing, without raising her head: “It wasn’t me who called, it was Yu Gui.”
“…” Qin Xuan angrily picked up a hemostatic clamp to hit her.
Meanwhile, Yu Gui, as Chen Qiao’er’s initial attending doctor, explained to Qiao’er’s mother. In the large conference room, she intentionally dismissed unrelated people, leaving only the director of medical services. With such a big commotion, Director Liu’s nose is incredibly sharp, more worried that Yu Gui wouldn’t handle it well and disgrace the hospital, so he stayed to maintain the order.
“This… the reason Qiao’er suddenly went into shock is due to excessive bleeding… Our senior doctors are already rescuing her, rest assured… Does this child have any overly close male classmates at school? Or…”
Before she could finish, Qiao’er’s mother suddenly stood up, slamming the table loudly: “What do you mean by this, doctor! How old is Qiao’er! She is a good student with excellent character and academics at school, how could she have a boyfriend! Be honest and tell me what illness Qiao’er has, don’t think you’re great just because you saved our Qiao’er! I’ve seen many doctors like you who pretend to be righteous but are just out to scam money!”
Spit was almost hitting her face, and Yu Gui was scolded terribly, shrinking her neck, not daring to speak.
The director of medical services immediately intervened: “Qiao’er’s mother, calm down, calm down, let’s sit down and talk.”
He personally fetched a cup of warm water and handed it to her, then sat down and said: “Please don’t be angry, Dr. Yu is also very concerned about saving lives. How long has Qiao’er been experiencing such stomach pain and discomfort?”
Seeing his sincere attitude and the leader personally serving tea, Qiao’er’s mother calmed down considerably, holding the disposable cup and thinking for a while: “It’s been more than two months, I always thought this child was being lazy and didn’t want to go to school, who knew… sigh!”
The director of medical services took a thermos to refill her hot water: “That’s it, as a mother, when the child is unwell, you should bring her to the hospital as soon as possible. Delaying until now almost cost her life, thankfully Dr. Yu was there to quickly send her to the emergency room.”
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Qiao’er’s mother was shocked: “This… Don’t just criticize me… Quickly tell me what illness my child has!”
The director of medical services took a sip of tea: “The situation is quite serious, the child is in a life-threatening ectopic pregnancy, she’s still in the operating room.”
Qiao’er’s mother suddenly blacked out, collapsing onto the chair, her hands shaking like Parkinson’s.7
“What? What did you say?”
The director of medical services repeated: “The child is experiencing an ectopic pregnancy, also commonly known as a tubal pregnancy.”
“F*ck!” As soon as he finished speaking, a scalding cup of water splashed onto his face. Qiao’er’s mother rushed up, tearing at his clothes, shouting and cursing: “Tubal pregnancy your mom’s x, can you diagnose or not! Can you diagnose or not! A twelve-year-old child, you tell me ectopic pregnancy, pregnant your mother’s head!”
The rural woman cursed, mixing dialect with Mandarin, the scene was quite humorous, but Yu Gui couldn’t laugh, also rushed up to pull the two apart.
“Isn’t the child’s safety more important now?! Instead of fighting with the doctor here, it’s better to go to the operating room to see the child!”
Qiao’er’s mother slid off Director Liu, collapsing to the ground, crying and wailing: “My Qiao’er! What can be done! Our family is so unlucky! Your dad ran away with a shameless woman! And you… you are so disappointing! I… I also…”
She cursed while her chest heaved violently, as if unable to breathe. Yu Gui hurriedly helped her up to sit down.
Footnotes
- Coma index E2 V2 M3: Refers to the Glasgow Coma Scale (GCS) score, which is used to assess a person’s level of consciousness after a head injury. It indicates Eye response (E2), Verbal response (V2), and Motor response (M3), with lower scores representing more severe impairment.
- Green channel: Refers to a priority or expedited pathway in medical settings, designed to streamline urgent care processes such as emergency surgeries or critical treatments, minimizing delays for patients in critical condition. It ensures quick access to necessary medical resources and personnel.
- Ectopic pregnancy: Cccurs when a fertilized egg implants and grows outside the main cavity of the uterus, most commonly in a fallopian tube. This condition can be life-threatening for the mother if not treated promptly, as it can cause severe bleeding.
- Unilateral salpingectomy: A surgical procedure that involves the removal of one of the fallopian tubes, often due to conditions like ectopic pregnancy or infection, which can reduce future chances of pregnancy.
- Salpingostomy with postoperative repair: A surgical procedure where an opening is created in the fallopian tube to remove an ectopic pregnancy, followed by repairing the tube to preserve its function.
- Gestational sac: A structure that surrounds the developing embryo in early pregnancy, visible on an ultrasound, and is often the first sign of early pregnancy within the uterus.
- Parkinson’s disease: A progressive neurological disorder that primarily affects movement, causing symptoms such as tremors, stiffness, and difficulty with balance and coordination. It results from the degeneration of dopamine-producing neurons in the brain.
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